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Well, good morning, everybody. Today is Tuesday, January 27th, and let's call this meeting to order. If I could please have a clerk call the roll.

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Supervisor Abhay Koga.

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Here. Supervisor Yoon. Here. Supervisor Ellen Burke.

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I'm here. Vice President Arrennance is absent. President Lee.

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Good morning, President. Good morning. You have a quorum.

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Thank you, Ronda. Would you please go ahead and give the interpretation the announcement, please?

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Yes, I'd like to our interpreters to translate the following into Spanish and then Vietnamese.

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If you are in chambers and requires Spanish or Vietnamese translation,

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translation devices are available at the back of chambers.

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The clerk can assist you with setup.

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Translation is also available in Zoom using the interpretation button.

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Additionally, as a gentle reminder for those public commenters,

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staff and those of us on the day is please speak clearly and at a measured pace directly into the microphone to ensure accurate translation.

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Thank you, Ronda.

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So next moving to next is our touch of allegiance and may I please have supervisor Abikoga.

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Lead us in a touchable allegiance this morning, please.

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Thank you, please join me in rise to view our evil.

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I pledge allegiance to the flag of the United States of America and to the Republic for which it stands.

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One nation under God, individual with liberty and justice for all.

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Thank you.

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Thank you.

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And now I'll go ahead and pass it over to supervisor Elamberg to introduce just mornings

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and the kids today.

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Good morning, everyone.

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To begin today's meeting, I am honored to welcome Albert Wright to offer an invocation.

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Albert is a San Jose resident, a United States Navy veteran, and a accomplished engineer

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whose career spans decades at the forefront of semi-conductor manufacturing nanotechnology

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in advanced microscopy.

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He's the CEO and founder of Infinite Potential,

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and previously worked with industry leaders,

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including Hattachi, High Tech Knowledgeies, and Land Research,

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where he served as a senior master engineering technician

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and inventor supporting critical technologies

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used in integrated circuit manufacturing.

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Equally central to Albert's Life is his commitment

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to service and mentorship.

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He's a member of the 100 Black Men of Silicon Valley

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It serves as co-chair of mentoring where he dedicates his time to guiding African-American and Latino students

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in STEM education at Bernal Intermediate and Santa Clara and Santa Teresa High School here in San Jose.

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Through that work, he helps young people see pathways into careers that may not have otherwise imagined.

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Albert's life reflects a deep balance of technical experience, public service, and community leadership.

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And yet, none of these reasons were the driving force behind my inviting him to offer an

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invocation this morning.

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I met Albert at a recent SVLG convening, and the reason I introduced myself is that slung

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over his shoulder was a very long ram's horn that I recognized as the traditional instrument

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that is blown in synagogues around the globe on the Jewish New Year.

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I cycled up and asked him about his horn, and to my surprise he referred to it by its

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Hebrew name, a shofar. In my tradition, the loud blasts serve as a literal and figurative

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wake-up call to return to faith to good works and to community. In the moment, I knew I

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wanted Albert to blow the shofar at a board meeting at the beginning of our new year,

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and

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Please join me in welcoming Albert Wright to our chambers.

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The podium has a built-in microphone.

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Thank you.

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Good morning, Supervisors, Ellen Burke, and distinguished supervisors and our community from

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around the San Francisco Bay area.

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As supervisor, Ellen Berg mentioned, the show far or Ram's horn is used in Jewish celebrations.

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This particular show far is the African Kudu Antelopeard,

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you know, we'd be left to the left horn, I bet.

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And I proudly carry this around the nation, I call it my American Express, because literally

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it changes atmospheres and frequencies and mirrors.

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Like the United States military doing World War II involved the youth, the help of the

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to speak a language that could not be understood by the Japanese forces.

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So, the sounding of the show far is too an unconventional weapon of warfare.

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But it's a blessing. It's a blessing.

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One of my favorite movies,

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long ago,

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It was, who was, it's the bestest alone's first blood, where he was proposed to find the community law enforcement agency.

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You know, it wasn't his fault, and he declared, it wasn't my war, they true for blood.

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I love that line.

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And so as we have, as we, the people of the Santa Clara Valley, here in these hollow chambers

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of Silicon Valley, we have the opportunity to set a directive for our leadership for

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this coming 2026 year, and this is a very important year.

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I don't know if you guys are excited, but I am super excited.

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And I'm also the Vice President of the Silicon Valley,

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and that's favor of honor, which we're standing on business

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and opportunities for our members in the community

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to receive opportunities to make money, OK?

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And so with that, and everything that's going on in this

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in the nation and around the world the eyes of the world.

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I'm going to be looking back and I'm just excited about that because as I give the

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evocation and then sound the show far, I want you to receive the sound of the show far with

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great joy. There are four distinct sounds of the show far. The first sound is called

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It means it's a call to bring the congregation together.

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The second sound is called Severine.

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It's a call to broken this and repeat it.

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The third sound is called to Rua, a call to spiritual warfare.

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And the final sound is to hear Gordola.

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It's a long last, a reminder of the coming of Lord and saved with Jesus Christ to return at the final drop of God.

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So, with that, I want to read the invocation, bless our leaders, and call them to remember that this call to service is for the community of Santa Clara County.

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But we know that as California goes, thus goes the nation and the world, is really important to understand to prophetically, that in this nine o'clock hour, this is the third hour of prayer, and that's the hour of the anointing, simultaneously across our great nation on the east coast, it is the sixth hour of prayer, noon, and that's the hour of vision.

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So, my prayer for our leadership is that God would annoy your vision, that God would annoy

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your vision for we the people of Santa Clara County, and that that vision will align with

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his plans and his purposes for this valley of hearts delight.

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Let's pray.

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To El El Yon, the most high God, a prayer of invocation, directive for the governing body of

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Santa Clara County Board of Supervisors, Santa Clara,

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Holy Clarity, Santa Clara, Holy Clarity,

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Open the heavens Lord and open the earth.

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We welcome you King of Glory into the chambers of this hollowed hall for the earth is the

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Lord's and all is fullness, the sea and all day that dwells in, but you have chosen to give

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it to the kingdom of men in whom you are well pleased and we thank you Lord.

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Lord, at this Cairo's moment in time, on a day like no other day, humbly and boldly, we invoke

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you Holy Father, that you grant to our leaders this board of distinguished supervisors,

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that you would grant to them a spirit of wisdom and revelation in the knowledge of you,

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that the eyes of their understanding would be enlightened, flooded with light, for God you

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are light.

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Lord, we thank you that today we invoke you for your anointing vision as we stand proxy for our leaders, families, communities, and the multitude of cities in the need of reformation in this great nation.

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Lord, as your children and your creation, the Ecclesiah, that you have planted in this valley of

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heart to the light, we, this SEC Board of Supervisors, as a ruling body of governance in the

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great state of California, Bula, you claim it for yourself, make our invocation to our father

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in heaven, for your spirit of wisdom, revelation in the knowledge of who you are, and in

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insight into the hopes and inheritance for which you have called each of the supervisors.

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Lord, this is a vital time in our nation's history. As all the eyes will be on this land,

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the Bay Area from around this earth you've created for us. And as it has been said,

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so we say, as Go California so goes the nation. From these hollow halls we invoke you for Holy

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clarity. As you have granted and anointed this board of supervisors, the authority and future

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forward vision for this region. That vision, that future forward vision, that will shine

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like a bright light around the globe, Lord. Help our 2026 board of supervisors to come into

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divine alignment with your purpose. As the scissors are made, for many are the plans in a man's

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But it is your purpose that will stand, as the show for ourselves, speak Lord, for your servants are listening.

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Isaiah 2026 declares, verse 1, in that day shall this song be sung in the land of Judah.

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We have a strong city.

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Salvation will appoint for walls and bull walks.

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Lord, open the gates that the righteous nation which keep of your truth may enter in.

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Lord, you will keep them in perfect peace, whose mind is stayed on you, because we trust in you.

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Trust in you the Lord forever.

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For the Lord, Jehovah is everlasting strength.

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And so, Lord, as we...

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As I in this invocation, we again declare Lord God, open the heavens and open the earth.

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For Lord, you have been our dwelling place in all generations before the mountains were brought forth,

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or ever you had formed the earth and the world, even from everlasting, you are God, Olam Elb.

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The days of our lives are 70 years and if by reason of strength they are 80 years yet their boasts is only labor and sorrow

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For the soon cut off and we fly away who knows the power of your anger for as the fear of you so is your wrath

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So teach us

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The number our days

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That we may gain a heart of wisdom. Oh satisfy us early with your mercy

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that we may rejoice and be glad all our days.

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Return, O Lord, how long and have compassion

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on your service, these leaders.

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Make us glad according to the days in which

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you have afflicted us, the years in which we have seen evil.

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Let your work appear to your servants, these leaders,

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and your glory to their children,

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and let the beauty of the Lord our God,

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be upon us, and establish the works of our hands for us.

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Yes, established the works of our hands.

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Lord God, we thank you.

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And Lord, as you instructed in your children

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to design the silver trumpet,

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the silver trumpet was made by the hand of man.

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But the show far was made by the hand of God.

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The breath of man goes into the show far,

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but the voice of God comes out of it.

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Thank

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you so much.

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I appreciate your starting or meeting today. Thank you. And I assume everyone is wide awake now.

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Yes, now that we all wickened by that last horn. Let's move to our next item the agenda, which is the German in the Naut and Memoriam.

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item number four. The first item in the German is an honor and memory of the Nielo

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cells Boac.

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So, I would like to take a moment to honor memory of the Nielo

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cells Boac, the beloved husband of our dear colleague and community leader, Thelma Boac,

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whom I have to honor to have met two decades ago, and proud to call great loyal friend

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for all these years. The Nielo, known to many simply as Dan, is not someone who sought public

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recognition, but his impact on community was deeply felt through the life of service he shared with

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Alma.

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The film was many years of public service and education and civic leadership, then was her

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steady source of encouragement, strength and support.

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Behind every dedicated public servant is often a partner who makes sacrifices, office guidance

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and provides a quiet reassurance to continue serving others, then embody that role of grace

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and humility.

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As I'm waving support, allow Thelma to fully dedicate yourself as not only a teacher, but

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principal to thousands of students, families, and the broader community, should serve

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so faithfully.

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Today we recognize not only Dan's memory, but also the powerful example partnership,

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love, and shared commitment to service that Dan and Thelma has represented together.

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The journey reminds us that public service is really a solo effort, it is sustained by family

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by love and by those who stand behind us every step of the way.

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On behalf of the Board of Surveys and the entire community, we extend a heartfelt condolences

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to Thelma and her family and we are on the dance life and legacy and the many lives

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touched through this quiet but profound support.

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Surveys, I hope you have a comment to me.

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All right, and on that, I would just like to ask of being honored to invite Mrs. Thama,

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a boy to come up and see a few words, so we flagged Dan's life and share your thoughts

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and hearts.

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Thank you.

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Thank you.

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Thank you.

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And good morning.

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Good morning.

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Thank you very much to Supervisor Rodoli and to the members of the Board of Santa Clara County.

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Board of Supervisors for remembering my husband and dad before your adjourning.

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Knowing that his dedication to supporting local community efforts was recognized by this

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honorable and esteemed body, which is our county.

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It means the world to me and to my family, especially during this very difficult time.

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So, with a grateful heart to all of you, thank you from the bottom of my heart for your

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kindness and your compassion.

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Thank you so much.

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Thank you, Thoma.

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Okay, and then we do a second agreement today, and I'm going to defer this one to

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Vice-as-Almbrick Young for the next adjournment.

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Please.

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Thank you.

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It is my solemn and sad honor to adjourn today's meeting

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in recognition of San Jose resident,

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advocate, and beloved friend, Roma Dawson,

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who's more than 40 years of service

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have left an indelible mark on our community.

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Roma dedicated her career to public service,

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education, and community building.

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She earned her bachelor's degree in psychology

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from the University of California Berkeley and pursue graduate studies at the University of Texas at El Paso.

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Early in her career, she taught GED courses to U.S. Army soldiers stationed in Germany.

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Roma was then drawn to local government through leadership training with the Coro Foundation.

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She went on to play a formative role in San Jose Civic Life.

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She was part of the Corps staff for Tom McKenaries first campaign for mayor of San Jose

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and later served on his City Hall staff.

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Roma's career included trusted leadership roles across City Hall and beyond.

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She served as Chief of Staff to Council Member Charlotte Powers, Assistant Campaign Manager

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for Susan Hammers, Mayoral Campaign, and as a core staff member of Zolafgren's first

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campaign for election to the Santa Clara County Board of Supervisors.

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She later worked in then Congresswoman Lovgren's district office, assisting residents with

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complex immigration matters during times of uncertainty and need.

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She continued her service at City Hall as a council assistant and senior council assistant

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to council members Cindy Chavez and Sam Lachardo, including during council member Lachardo's successful campaign for the mayor's seat.

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In each role, Romo is recognized for her knowledge, steady leadership, and deep respect for the communities she served.

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Beyond government, Roma made lasting contributions to San Jose's cultural and civic institutions.

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She served in leadership and advisory roles with the San Jose Parks Foundation,

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the San Jose Stage Company, the San Jose Convention and Visitors Bureau, the San Jose Arts Commission,

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and the Housing and Community Development Commission.

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She also held a longstanding leadership association with tapestry and talent,

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including serving as its president, helping to elevate the arts

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as a vital part of San Jose's community life.

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Roma's legacy is one of dedication, integrity, and quiet impact.

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Through decades of service, she helped shaped policies, campaigns, institutions, and cultural spaces that continue to benefit residents today.

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At first met Roma in the 1990s, who are a mutual admiration of the mayor, Susan Hammer. She was so smart, and warm, and fun to talk to.

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I was new to San Jose, and she quickly gave me the lay of the political landscape, and we remain connected over decades through various campaigns, organizations, and shared interests.

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I will miss her company and her always fascinating stories, fascinating aside, when she shared stories that were invariably total news to me, even though I thought I was in the know. She taught me a lot and lived a life-worth emulating.

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Romas Sunshine is here in Chambers and her husband Daniel has joined us on Zoom.

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We're also honored to be joined by some of Romas dear friends.

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After Supervisor Young offers some remembrances of her own,

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Alan Bite Kathy Sutherland and Carol Watts both close friends of Roma to come up and share some more about her.

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Supervisor Young.

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Thank you, Supervisor.

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Alan Bite.

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Excuse me.

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Today, we adjourn a memory of Roma Dawson, and thank you, Supervisor Elambury, for leading the charge for a woman who's impacted us felt by many.

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Roma spent her life doing what she believed in, making it our county stronger, fair, and more thoughtful.

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She served as a policy analyst from multiple elected officials.

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And what's particularly novel is the list of whose offices and administrations she worked for.

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Tom McEnnery, so a lawfgrin.

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Sunni Chavez, Sam LaCardo.

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This is because Roma was just not known

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for her knowledge, skills, and expertise,

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but also her integrity.

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Her energy, dedication, and skill

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made her trusted across political lines

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and for people to seek her counsel during challenging moments.

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Deeply committed to civic engagement,

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she was a lifelong time board member

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at the League of Women Voters of San Jose in San Eclera.

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She served on the board directors of the League of Women Voters

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of the Bay Area, including us co-present from 2022 to 2025.

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In addition, she gave her time and leadership to many local commissions, just as Supervisor

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Elmerberg had listed, including two terms in San Jose City Arts Commission.

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I first met Roma during the 2016 Measure A Affordable Housing Bond Measure Campaign.

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It was the first campaign I ever ran, but it was not hers.

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And she made sure we were on the path towards victory, because the stakes were so high.

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And I felt that in every conversation, every moment of engagement with Roma, the stakes were too high to fail, and she never let us fail, and she didn't.

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Over the years, we cost past again to the League of Women Voters and later during my own first in my life campaign as supervisor, where Roma often reached out to let me know the website wasn't working, a page was glitching, or there was a typo on the fourth paragraph of the eighth page of my document.

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Remo is always a trusted friend advisor who always made sure that you knew she was watching

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not for you, but not just because of who you were. She was watching out for you as her

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commitment to watch out for this county. Roma believes behind a loving family, her sunshine,

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her husband Daniel, a legacy of service, fairness, and leadership in the community of friends

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who could say that they were made better by Roma's friendship and engagement. May her memory be

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blessing to us all in inspiration during these challenging and troubling times when steadfast leadership

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defined by integrity is needed now more than ever. Thank you. Thank you. Kathy and Carol.

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Thank you supervisors for this great honor for Roma. She was a true friend to everybody in Santa Clara Valley.

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I'd like to introduce her son Sean and her husband Daniel and her son Scott are also listening

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I have comments from Supervisor Chavez, Roma worked for Cindy when she was at City Hall and so I'd like to read those.

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Roma Dawson was a woman who believed in the values of all voices being heard, all cameras being welcomed, Roma worked hard to ensure that everyone registered to vote and had the tool they needed to make their voices heard in free and fair elections.

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She was dogged in her pursuit of equity and she worked hard to make sure no one was left behind.

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Roma worked through many organizations and candidates to make sure women were represented in important debates

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and in elected and appointed leadership positions.

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When she believes strongly in an idea, she worked hard to make it so.

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She was a champion for housing for all the environment, access to health care and reproductive health care.

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She left no stone unturned when fighting for our rights.

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Roma was a type of friend who could see when those around her needed to be hugged and encouraged without a word being spoken.

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She loved others deeply, and for those of us blessed to call her a friend we are better for knowing her.

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To her family, she loved each of you fiercely.

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She was always your champion.

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I am deeply grateful to you for sharing the amazing Roma Dawson with all of us.

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I am deeply sorry for your loss.

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And then my comments, if you ever spent more than 15 minutes with Roma Dawson, you would

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quickly find out the three things she loved and cared deeply about and she could speak fast.

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So she let you know.

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The first thing was her family, first the men, Daniel, Sean, and Scott, and then quickly and just as deeply as Parama, Scott's wife and her family.

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Every conversation brought up a chance for Roma.

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Second was San Jose. Romo was the all-time cheerleader. She loved this city and she knew every department, and it seemed like every person. No matter where you were, when you were with Roma, you always ran into a friend. And finally, good governance and leaders. If you had a project or a question, Roma was there in a flash. Leading by example, with values and the belief that we can always do better.

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She will be greatly missed by me and everyone who you are.

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Thank you.

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My name is Carol Watts, and I'm the chair of the Leaks Women Voters of Santa Clara County and

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Vice President of Women Voters of Santa Clara.

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Roma was one of the most active members in the League of Women Voters.

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She served as the current co-president of the League of Women Voters of the Bay Area.

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was a legislative analyst for LWV California's housing and homelessness to committee.

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She was also active in projects of the five leagues in Santa Clara County.

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She was on our board of directors in San Jose Santa Clara, Charter Housing and Homeless

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Committee, was an active member of membership action climate change and she was just working

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on a new project that was going to help us all learn more about the possibility of democracy

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to dollars in our local government.

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She joined the League in 2013 after all the years that you just heard about, which are just

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amazing, and we were so lucky that she brought her experience and her positive energy

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to the many levels of the League of Women Voters.

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She loves to do a deep dive on complex policy issues and develop programs showcasing the challenges

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and potential solutions of issues.

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She was proud of San Jose, passionate about the environment, the arts, and the league.

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She leaves behind a legacy of positive impact on the league, the community, and those who

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knew her, especially her beloved family.

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She's greatly missed by all of us, rest in peace, Roma.

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Thank you, All.

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And may ram us.

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Memory, be fair, passing.

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As I said mentioned earlier, many public officials of many also help us with sizes and

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Rona is absolutely one of those true examples of serving so many really influential and

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powerful leaders of our community.

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Just look at her name, even as of last year, she was serving as a commissioner in San Jose

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and was complaining about why mobile home companies could just raise their rent illegally.

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This is the type of work she does every single day, whether she's an office or helping others.

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So I just want to say thank you so much for all your amazing work and you're definitely going to be so dearly.

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Thank you very

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much.

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Okay, the next moving on we actually have the commendations of pronations, which is item 5.

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And now now we're also going to turn back to sort of as a young for the first proclamation about the national children's dental health month.

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So as you?

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Thank you.

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Good morning, everyone.

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I'm going to switch gears a little bit in our program here.

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The members of the Public Health Department are joining me today because today we are

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proclaiming February as national children's dental health month, raising awareness about the

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importance of oral health for children, families, and Santa Clara County.

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The American Dental Association of Zers February as national children's dental health month,

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What the goal promoting the importance of good or a hygiene and raise awareness about preventing

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childhood tooth decay, a common but preventable chronic disease.

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Cravidies remain the most common preventable chronic disease amongst children, and poor or a

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health can contribute to mystical, difficulty, concentrating, and long-term health challenges.

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In fact, chronic, like tooth decay, cavities is one of the top leading causes of chronic absenteeism,

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In the effects children of color and communities, immigrant communities, and low-income communities disproportionately more than other communities.

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Children with poor oral dental health or lack of access to dental care are four times more likely to have chronic absenteeism in school,

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leading to lifelong learning challenges.

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So this is an important issue and as a mom of an eight-year-old who loves to brush her teeth or social claims.

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What I would love to tell other young parents is that the most important thing is for them to find

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to find a oral health exciting to know that's part of their complete health, and that's what we focus on

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at a younger age, right?

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That this is a normal thing, that's what we want to lean into, and this is all tied to your wellness and the healthiest

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of you, so that you could be the best version of you.

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But I'm going to turn it over to the experts to tell you much more concrete information about this and why it's so important.

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I have with me Dr. Rudman, or a public health officer, and along with her is Samaya.

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Angelica Brandy, Janki Suma, Lucy, the team that makes sure that every child, every youth in

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Santa Clara County has access to dental hygiene and oral care and health education for their parents.

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So I think you ladies for all your hard work, and let's hear it for Dr. Rudman.

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Thank you so much, Supervisor Young.

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Thank you, President Lee, and Board of Supervisors for this important recognition of February

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as national children's dental health month, and despite being the doctor on the day as

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supervisor young, nailed it exactly with respect to the, you know, always have a spot

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in the public health department should you need one. I exactly why it is so important to

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think beyond just the cosmetic components of dental care, that our dental care, and especially

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the dental care dental health of our children is reflected in the rest of their health and their

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ability to thrive for their young lives. It is a major impact on school, success on school,

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attendance, and it affects every part of someone's body from your heart health to your brain health

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to your learning and your mental health. And so that's why the public health department,

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our partners at Santa Clara Valley healthcare and dental care providers all over the county

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find this message of national children's dental health month to be so important. In the public

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health department, a key thing we do is look at the data from across the county to understand

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who's impacted by different health problems and therefore what solutions do our community members

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most need their government to be focusing on? You will see released in the next couple of months

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and updated oral health needs assessment update that unfortunately reflects that even in

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a county like this one where we devote significant efforts to making sure our youth have

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access to oral health care. We still see significant inequities in preventive dental care service.

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We see families face significant barriers to care. And so by promoting oral health today,

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promoting oral health literacy, strengthening our community partners, and focusing on prevention.

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Santa Clara County can achieve the equitable access to health care, especially oral health care,

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that we know our youth needs and that folks of all ages need.

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In our public health department in particular, we're excited for a couple of new ventures

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over the coming months.

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Some of which partner exactly with the agencies we know most closely serve our communities

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in need.

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We're working with our WIC program, our women infants and children nutrition program, to educate

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parents and caregivers about oral health, we're working with school district nurses, partnering

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for a poster campaign in schools, we're working with Evergreen to enhance through social

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media and prove messaging around importance of oral health and we're working with our home

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visitation nurses to integrate oral health messaging in all of our services that bring

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health into new families' homes. So with that, I'll offer an additional thank you to our

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who in addition to brushing your own teeth and like I do with my kido fighting to get them to

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brush theirs and maybe even floss.

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Thank you for everyone's efforts to help bring this important issue to the forefront and

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keep our kids healthy and safe.

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Thank you.

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Thank you.

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All right.

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We also, in the coming months, you're going to be hearing about from the county promotions about

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the happy teeth dental event.

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It's a really cool because what it does is that we provide free dental screenings and community

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for families, no appointments, necessary, no charges, whatsoever, and with new, new local rules

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and laws, children entering teak and kindergarten needs to have their teak examination,

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their dental health examination, and the happy teak that Sullivan also provides for that

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no cost appearance to make sure there are no disruptions to the show's education.

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Thank you, ladies, for this incredible lift and making sure that this important issue is on

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everyone's forefront. All right, we're going to turn it back to take a photo, so sorry.

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I'm going to invite my members of the board to join me, my fellow moms, for sure you have your own data stories of brushing teeth and flossing every night.

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Yes, and I have to mention that I've learned something very interesting, but did my Navy physical was that when I checked the boxes as I floss every day, my life expectancy could extend by two years.

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Think about that. Flossing daily would save lives.

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Just think about it.

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Thank you.

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Thank you.

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Thank you.

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Thank you.

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Thank you.

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Thank you.

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Supervisor Reynas is not with us today, but she is also a member of the Human Trapping Commission,

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which I serve as chair alongside coach here's district attorney Jeff Rosen and chair

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Bob Johnson.

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And I am pleased to join me.

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Members of the Human Trapping Commission.

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Today, we also have members of our human trafficking task force.

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You?

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You also have the San Jose Airport.

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Okay.

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Good morning.

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I want to, first up, I want to acknowledge and think the members of our coalition here with us today to proclaim human trafficking prevention month.

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And as Sharon Denella, Pearl of Flores,

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Ruth Silver-Talb, she was here, but she had to leave

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Lieutenant Kimana Josh Singleton, Sergeant Casey, Jessica Jenkins, Julie Jarrett, and of

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course, my co-chair here, Jeff Rosen.

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Human trafficking happens in our neighborhoods, along our quarters, and two people who

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deserve safety, dignity, and care.

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California is one of the largest sites of human trafficking in the country, but we are combating that.

438
00:57:53,140 --> 00:57:54,740
We're going to change that narrative and outcome.

439
00:57:55,320 --> 00:58:00,060
Trafficking takes many forms including sex trafficking, labor trafficking, and domestic servitude.

440
00:58:00,600 --> 00:58:05,260
And behind every horrible statistic is a real person, a child, a neighbor, a family member.

441
00:58:05,820 --> 00:58:08,980
These individuals and the communities they touch are forever impacted.

442
00:58:09,640 --> 00:58:12,400
In Santa Clara County, we take human trafficking personally.

443
00:58:12,900 --> 00:58:15,920
By proclaiming January as human trafficking prevention month,

444
00:58:15,920 --> 00:58:18,140
We were saying clearly the prevention matters,

445
00:58:18,860 --> 00:58:22,260
survivors matter, and our county will continue to show up

446
00:58:22,260 --> 00:58:25,920
an coordinated fashion that centers trauma in clients' first.

447
00:58:26,440 --> 00:58:29,080
As we prepare to host major sporting events this year,

448
00:58:29,220 --> 00:58:32,980
including the Super Bowl and Bayes March Madness and the FIFA World Cup,

449
00:58:33,420 --> 00:58:35,760
we know that large events can increase vulnerability

450
00:58:35,760 --> 00:58:40,820
and ultimately human trafficking because economics drives exploitation.

451
00:58:40,820 --> 00:58:47,220
That's why our county has joined the safety for the Bay Campaign, a multi-lingual public

452
00:58:47,220 --> 00:58:53,020
awareness campaign across Santa Clara, Alameda, Solana counties and total expands across

453
00:58:53,020 --> 00:58:58,240
the nine Bay Area counties to ensure that there is a resource for survivors and for those

454
00:58:58,240 --> 00:59:01,240
who spot something, see something, say something.

455
00:59:01,900 --> 00:59:06,100
This effort is about prevention, about sharing resources and about making people know that

456
00:59:06,100 --> 00:59:08,120
they are not alone and that help is available.

457
00:59:08,120 --> 00:59:12,620
This is what communities centered public safety looks like, and not this time I'd like to invite

458
00:59:12,620 --> 00:59:16,580
my co-chair District Attorney Jeff Rosen to share some words.

459
00:59:19,150 --> 00:59:23,430
Thank you, supervisor. In the run up to the Super Bowl in the people world cup and March

460
00:59:23,430 --> 00:59:28,790
madness, I want to assure the community that the Santa Clara County Human Trafficking Task Force

461
00:59:28,790 --> 00:59:36,470
is ready for the influx of visitors, which may include traffickers. We run the largest anti-human

462
00:59:36,470 --> 00:59:38,890
trafficking task force in the Bay Area.

463
00:59:39,630 --> 00:59:42,930
We have two prosecutors, more than five law enforcement officers,

464
00:59:43,450 --> 00:59:45,410
full time as a part of this task force,

465
00:59:45,710 --> 00:59:48,310
along with our partners in the community community solutions,

466
00:59:48,770 --> 00:59:51,890
the YWCA, and the entire South Bay Coalition

467
00:59:51,890 --> 00:59:53,090
against human trafficking.

468
00:59:53,650 --> 00:59:57,490
In the lead up to these large sporting events that are coming here

469
00:59:57,490 --> 00:59:59,970
to our area, there are more than 50 person out.

470
01:00:00,000 --> 01:00:09,800
All that have been deployed to disrupt trafficking efforts. In the last couple of years, we've had

471
01:00:09,800 --> 01:00:16,300
enormous successes in rescuing victims of human trafficking and bringing perpetrators to justice.

472
01:00:16,800 --> 01:00:21,960
Just a few months ago, we launched a large operation and closed more than 10 operational

473
01:00:21,960 --> 01:00:25,780
brothels and saved more than 40 commercial sex workers.

474
01:00:28,220 --> 01:00:28,960
Thank you.

475
01:00:29,640 --> 01:00:30,800
Thank you.

476
01:00:31,720 --> 01:00:35,800
And those efforts are a result of the strong collaboration between law enforcement

477
01:00:35,800 --> 01:00:40,080
and the community-based organizations which help trafficking survivors.

478
01:00:40,580 --> 01:00:46,660
So a supervisor, young said, if you see something, say something, and then we will do something.

479
01:00:46,960 --> 01:00:50,560
Something good that will help victims and prosecute perpetrators.

480
01:00:50,560 --> 01:00:51,980
Thank you.

481
01:00:56,200 --> 01:01:01,860
Now, Senate Clara County is known as a national leader on this front against human trapping

482
01:01:01,860 --> 01:01:02,600
in prevention.

483
01:01:03,000 --> 01:01:07,660
And that's only possible because of the unique collaboration we have across all partners

484
01:01:07,660 --> 01:01:08,460
and communities.

485
01:01:09,800 --> 01:01:14,420
So at the time I'd like to invite, Sharon Denella, the director of the South Bay Coalition

486
01:01:14,420 --> 01:01:16,840
to end human trafficking to say a few words.

487
01:01:19,440 --> 01:01:25,840
Thank you, Supervisor Yong and D.A. Rose and in Santa Clara County we've seen work happening

488
01:01:25,840 --> 01:01:32,260
since 2003, even though 2010 is when National Human Trafficking Prevention Month started.

489
01:01:32,840 --> 01:01:37,080
But we've been working behind the scenes to build capacity in Santa Clara County to identify

490
01:01:37,080 --> 01:01:38,440
and respond to human trafficking.

491
01:01:39,200 --> 01:01:43,780
Our county's protocols and funding priorities reflect best practices and leadership in the

492
01:01:43,780 --> 01:01:44,740
fight against trafficking.

493
01:01:45,440 --> 01:01:50,460
We've seen the Board of Supervisors really take a stand against human trafficking and supporting

494
01:01:50,460 --> 01:01:51,080
survivors.

495
01:01:51,580 --> 01:01:53,680
The Human Trafficking Commission is a one of a kind.

496
01:01:53,680 --> 01:01:57,220
We have seen survivors from every part of the world here.

497
01:01:57,600 --> 01:02:01,680
We have seen all forms of trafficking, sex trafficking on mine and in the streets.

498
01:02:02,120 --> 01:02:07,120
We've seen labor trafficking and salons in restaurants, construction sites and in the fields.

499
01:02:07,680 --> 01:02:12,520
We have street vendors who have been exploited, domestic servitude, and debt bondage has happened.

500
01:02:13,140 --> 01:02:17,840
And we've seen trafficking cases that intersect with domestic violence and sexual assault.

501
01:02:18,420 --> 01:02:21,600
What we know is that economic drives exploitation.

502
01:02:21,600 --> 01:02:25,800
And so with three major sporting events happening and beginning in just a few short weeks,

503
01:02:25,960 --> 01:02:30,240
we need to bolster our efforts to be able to create a safe community where help is available

504
01:02:30,240 --> 01:02:32,580
for community members and visitors alike.

505
01:02:33,360 --> 01:02:37,860
San Jose, Maneta International Airport has recently implemented a robust training for all

506
01:02:37,860 --> 01:02:39,780
badge staff through Freedom Insight.

507
01:02:40,180 --> 01:02:43,900
That means all badge staff are going to be able to identify and respond to human trafficking.

508
01:02:45,080 --> 01:02:48,840
And as mentioned, we launched a website safety for the Bay.org.

509
01:02:48,840 --> 01:02:54,260
This is a resource navigator for anybody feeling unsafe, and it's not just for human trafficking.

510
01:02:54,520 --> 01:02:56,620
It's for any way that somebody might feel unsafe.

511
01:02:57,060 --> 01:03:00,700
That might be domestic violence, sexual assault, housing insecurity.

512
01:03:01,340 --> 01:03:04,740
Increasingly, we know that immigration protections are a major concern.

513
01:03:05,140 --> 01:03:07,520
There may be hate crimes or other types of violence.

514
01:03:07,860 --> 01:03:11,020
This website is to help navigate people to the help that they need,

515
01:03:11,440 --> 01:03:16,200
whether that's a confidential advocate, an attorney, or if they want to report something to the law enforcement.

516
01:03:16,200 --> 01:03:19,620
So, we encourage you to check out the site in the coming months.

517
01:03:19,940 --> 01:03:23,720
This site will be translated to make it accessible to all of our community members.

518
01:03:24,160 --> 01:03:29,560
And that's through the partnership with this Board of Supervisors, our county and really across the region.

519
01:03:29,840 --> 01:03:34,500
We invite you to join us in combating human trafficking and promoting a safer community.

520
01:03:35,020 --> 01:03:35,580
Thank you.

521
01:03:39,280 --> 01:03:39,440
Thank you.

522
01:03:40,060 --> 01:03:47,540
Safety for the Bay.org and for as a number four, safety for the Bay.org, a resource navigator,

523
01:03:47,540 --> 01:03:54,400
service navigator information source by developed by trusted messengers, and really developed by

524
01:03:54,400 --> 01:03:59,420
it's very common formed in development with the survivors from trafficking informing us

525
01:03:59,420 --> 01:04:02,920
what would have been helpful to them during their time of need. Okay, and I also want to give

526
01:04:02,920 --> 01:04:07,420
a shout out, there's so many partners as part of this effort over the years, from our health care providers

527
01:04:07,420 --> 01:04:11,780
to our labor movement, to our office support of housing making sure that emergency shelters are

528
01:04:11,780 --> 01:04:16,000
available for those who need it most. So we're on part of this together, and I want to thank

529
01:04:16,000 --> 01:04:20,080
My colleagues on the board, and also our administration for being champions of this issue.

530
01:04:20,360 --> 01:04:24,600
And I'm going to invite everybody join me on the day as to join me down here for a photo to

531
01:04:24,600 --> 01:04:27,980
proclaim January as human trafficking prevention month.

532
01:04:28,180 --> 01:04:30,340
And remember, safety for thevay.org.

533
01:04:30,760 --> 01:04:31,220
Thank you.

534
01:05:59,270 --> 01:05:59,790
So

535
01:06:26,100 --> 01:06:30,660
before we move to the public comments today, I would like to share a personal story.

536
01:06:30,660 --> 01:06:36,540
So, this Sunday, over breakfast, I actually asked my daughters, a very simple question, I thought,

537
01:06:37,080 --> 01:06:38,440
who was pretty and good?

538
01:06:39,300 --> 01:06:40,960
Well, their answer was very immediate and innocent.

539
01:06:41,220 --> 01:06:42,440
And says, oh, that's me.

540
01:06:43,420 --> 01:06:44,980
So, I had to explain.

541
01:06:45,700 --> 01:06:48,020
Pretty and good were not adjectives.

542
01:06:48,620 --> 01:06:49,620
They were people.

543
01:06:50,360 --> 01:06:52,940
Extraordinary names we should never forget.

544
01:06:53,780 --> 01:06:57,480
Alex, pretty, and Renee, good were 237-year-old American citizens,

545
01:06:57,480 --> 01:07:02,100
who were gunned down by ICE agents and brought daylight in Minneapolis two weeks apart.

546
01:07:02,600 --> 01:07:06,660
Both were horrifically labelled as, quote, domestic terrorists and quote.

547
01:07:07,440 --> 01:07:10,140
But the truth tells a very different story.

548
01:07:11,160 --> 01:07:16,120
Act Freddy was an ICU nurse who spent his days saving the lives of our veterans at the VA hospital.

549
01:07:16,700 --> 01:07:20,800
René Nicole Good was a loving mother, deeply cherished by her family and friends.

550
01:07:21,460 --> 01:07:26,540
And thanks to brave bystanders who recorded these killing from multiple angles on their cell phones,

551
01:07:26,540 --> 01:07:34,900
The truth is now visible to the world, directly contradicting what DHS officials initially claimed or attempted to conceal.

552
01:07:35,820 --> 01:07:46,220
I will not go free by frame today, but I urge you to watch our videos yourselves, but I'd must warn you, what you will see is cruel, horrific, and profoundly un-American.

553
01:07:46,220 --> 01:07:50,040
and these were not isolated incidents.

554
01:07:50,660 --> 01:07:54,000
An in-bit Minneapolis, a 57-year-old citizen

555
01:07:54,000 --> 01:07:56,240
was dragged out of his home wearing only boxes

556
01:07:56,240 --> 01:07:57,820
and crock and freezing temperatures

557
01:07:57,820 --> 01:08:00,660
after ICE agents ignored to citizenship documents

558
01:08:00,660 --> 01:08:02,160
right inside the house.

559
01:08:02,640 --> 01:08:04,140
A US Army veteran was detained

560
01:08:04,140 --> 01:08:06,380
and interrogated for eight hours.

561
01:08:07,380 --> 01:08:10,580
A five-year-old child was taken by ICE agents

562
01:08:10,580 --> 01:08:13,420
and flown to detention facility in Texas.

563
01:08:13,420 --> 01:08:22,580
No woman was arrested and publicly photographed, her image later manipulated using AI to make her look hysterical, and many, many more.

564
01:08:24,260 --> 01:08:32,600
These acts were so egregious that even Republican senators publicly condemned them, even President Trump himself acknowledged these tragedies.

565
01:08:32,600 --> 01:08:38,840
And so yesterday, he removed the Minneapolis-Iscanander, Mr. Bavino, and bar-dicture secretary,

566
01:08:39,000 --> 01:08:40,740
Nome, from visiting the city.

567
01:08:41,760 --> 01:08:44,400
As civil vote will be coming soon to our county,

568
01:08:45,080 --> 01:08:47,060
I sorry said that they will be here.

569
01:08:47,760 --> 01:08:50,080
So let me be absolutely clear.

570
01:08:50,940 --> 01:08:52,700
No one is above the law.

571
01:08:53,400 --> 01:08:58,320
There is no such thing as absolute immunity, and there is no license to kill.

572
01:08:58,320 --> 01:09:04,520
If anyone comes into our county mask, spreading terror, breaking laws, offending our

573
01:09:04,520 --> 01:09:09,520
residents, they will be arrested by our sheriff deputies and police officers and be held

574
01:09:09,520 --> 01:09:14,560
accountable on the full force of our federal and state law before our courts and judges.

575
01:09:19,680 --> 01:09:24,000
And when you hear the term domestic terrorists, I ask you to think about this.

576
01:09:24,300 --> 01:09:29,460
Who are the aggressive mask gunmen stopping cars, breaking down doors, abducting our neighbors,

577
01:09:29,460 --> 01:09:34,940
Covering up crimes, spreading lies, and terrorizing communities across American cities.

578
01:09:36,100 --> 01:09:40,320
As I told my daughters, remember Alex Pretty and Renee Good.

579
01:09:40,800 --> 01:09:46,320
These were brave Americans who stood up for the most vulnerable among us,

580
01:09:46,560 --> 01:09:51,960
and who exercised the constitutional rights to protect our freedom and rule of law.

581
01:09:51,960 --> 01:10:01,540
honor their sacrifice, tell their stories, teach them to our next generation and do not allow

582
01:10:01,540 --> 01:10:06,740
lies, politics, or internet memes to erase their courage and sacrifice.

583
01:10:08,000 --> 01:10:13,820
And we must demand a full and independent investigation to their tragedies so that those

584
01:10:13,820 --> 01:10:17,580
responsible must be prosecuted and held accountable.

585
01:10:19,180 --> 01:10:25,020
These are tragedies that's happening not only in Minneapolis, but across our country.

586
01:10:25,840 --> 01:10:29,020
So I'm going to ask our clerk around to please go ahead and display the slide.

587
01:10:32,680 --> 01:10:36,680
We have heard repeated falses about individuals being killed by ICE agents.

588
01:10:37,220 --> 01:10:43,000
I mentioned Alex Freddie, I mentioned René Nicole Good, Keith Porter, but there are also many, many others.

589
01:10:43,640 --> 01:10:48,980
And so today I want to take a moment to acknowledge the lives we know that happened last.

590
01:10:49,660 --> 01:10:54,460
Behind me on the screen are the names of more than 40 people that have died in an ice

591
01:10:54,460 --> 01:11:01,940
cavity, custody, or were killed by ice agents since 2025, and I ask that we all take

592
01:11:01,940 --> 01:11:03,820
a moment of silence to honor these victims

593
01:11:28,560 --> 01:11:31,140
and may them rest in peace and rest in power.

594
01:11:31,360 --> 01:11:33,100
Thank you.

595
01:11:33,240 --> 01:11:34,080
Thank you very much, everybody.

596
01:11:39,270 --> 01:11:44,030
Next, we move to our public comments, Pirate, which is an item reserved for members of

597
01:11:44,030 --> 01:11:49,210
like to address the board on items not on this agenda, any public wish to speak on the agenda

598
01:11:49,210 --> 01:11:53,670
should speak at this time. And please fill out the speaker card and return it to our clerk.

599
01:11:54,070 --> 01:11:58,790
We will call up the 30 names now, then the remainder names when they'll be called at the end of

600
01:11:58,790 --> 01:12:03,670
the agenda. In person speakers will be called first followed by Zoom speakers and no further requests

601
01:12:03,670 --> 01:12:08,710
to speak a big step that under the continued public comment. The reminder for public on the Zoom,

602
01:12:08,930 --> 01:12:13,190
as soon as the first public speaker in the chamber starts speaking, no more speakers will be taken.

603
01:12:13,190 --> 01:12:22,310
And during public comments, that's when we want to really respect everybody's comment and do not allow applause on booth at that time.

604
01:12:22,670 --> 01:12:27,210
But you can also show your support by simply raising your hands and shaking quietly.

605
01:12:27,950 --> 01:12:32,270
Thank you for your cooperation to keep our meeting moving orderly.

606
01:12:32,730 --> 01:12:34,790
Ronda, how many speakers we have this morning?

607
01:12:35,670 --> 01:12:40,950
I currently have 14 speakers in chambers and four on Zoom.

608
01:12:44,470 --> 01:12:49,570
All right. So let's do one minute each. Thank you.

609
01:12:50,890 --> 01:13:00,890
All right. We're going to go ahead and close the cues. And I'm going to call the first set of speakers up. You may speak in any order.

610
01:13:00,890 --> 01:13:15,490
Sabrina Fernandez, Patricia Mora, Veronica Saldiver, Natasha Walker, Alberta Cortez, Adam Cole,

611
01:13:16,370 --> 01:13:21,110
Zebb Velvman, and Carlton's show Alan.

612
01:13:22,530 --> 01:13:23,170
Go ahead.

613
01:13:27,710 --> 01:13:29,850
Yes, we could hear you, but we'll see.

614
01:13:30,530 --> 01:13:30,650
Perfect.

615
01:13:32,150 --> 01:13:32,410
Welcome.

616
01:13:33,810 --> 01:13:43,550
I'm here because I'm worried about our salary as much as I can to be able to see it in a moment.

617
01:13:44,570 --> 01:13:50,230
It's a situation that is very complicated, very difficult, economy, every time it's more difficult.

618
01:13:51,030 --> 01:13:52,690
And it's not necessary for a moment.

619
01:13:53,910 --> 01:13:58,110
We have come to many times, I hope this occasion, if you don't listen,

620
01:13:58,110 --> 01:14:00,270
We need your support.

621
01:14:00,650 --> 01:14:01,710
The union is for you.

622
01:14:02,310 --> 01:14:03,990
We want you to support us.

623
01:14:04,710 --> 01:14:06,230
Thank you.

624
01:14:06,270 --> 01:14:07,110
Thank you.

625
01:14:08,050 --> 01:14:10,170
And our translator?

626
01:14:10,810 --> 01:14:11,570
Are you ready to translate?

627
01:14:13,900 --> 01:14:14,460
Yes.

628
01:14:16,040 --> 01:14:19,360
I'm here because I am very concerned because of our salary.

629
01:14:20,540 --> 01:14:23,460
The scalekeepers at home.

630
01:14:25,460 --> 01:14:26,540
We have a friendly break.

631
01:14:26,820 --> 01:14:27,580
It's very difficult.

632
01:14:34,120 --> 01:14:44,900
We want your support, we are here once again, because we want to be here, the union is for you, but we want you to be for the union. Thank you.

633
01:14:51,360 --> 01:14:58,080
Good morning. My name is Veronica Sadivar. I have a kid with autism and severe asthma. I work in tech.

634
01:14:58,080 --> 01:14:59,960
and I'm a single one with three kids in golf.

635
01:15:00,000 --> 01:15:07,880
Service to be able to, for me to be able to work and contribute to society. I'm a poll in the negotiations,

636
01:15:07,880 --> 01:15:13,980
and how the current is trading these providers. We're not giving them livable wages and the opportunity

637
01:15:13,980 --> 01:15:21,800
to try. You are denying them the American dream that you are leaving behind that podium. So please do something

638
01:15:21,800 --> 01:15:23,940
with the power we gave you. Thank you.

639
01:15:30,340 --> 01:15:40,040
When I think about the speech that the president just gave, I can't, but think of what Paul said would happen before a Christ comes back.

640
01:15:40,640 --> 01:15:44,100
He said the restrainer, which is government, will be taken away.

641
01:15:44,920 --> 01:15:47,000
It's like everybody here is an anarchist.

642
01:15:47,320 --> 01:15:49,680
You're all, you're all talk, you know, Jeff Rosen.

643
01:15:50,080 --> 01:15:54,180
I think about that guy who calls in for four years saying his kids are being molested.

644
01:15:54,360 --> 01:15:55,480
And I think he's Jeff lying.

645
01:15:56,060 --> 01:15:58,680
They're all just, he's all talk about Obama and Clinton.

646
01:15:58,700 --> 01:16:00,840
We're stronger than Trump on illegal aliens.

647
01:16:00,840 --> 01:16:06,100
You know, but they're all talk and now they're going against the nation against, but it's happening.

648
01:16:06,200 --> 01:16:08,400
This is what Paul said would happen before he comes.

649
01:16:08,840 --> 01:16:11,260
The Christians in Thessalonica were deceived.

650
01:16:11,700 --> 01:16:17,040
They're quit their jobs. They're just looking up, I guess, and Paul said, hey, Jesus is not coming back yet.

651
01:16:17,100 --> 01:16:22,840
It's not time. The restrainer, which is government, will be taken out of the way.

652
01:16:23,020 --> 01:16:28,700
And then Christ will return when evil is abounding and it certainly is abounding.

653
01:16:28,700 --> 01:16:30,480
She'd be ashamed of yourself.

654
01:16:30,540 --> 01:16:32,040
I've been trying to save America.

655
01:16:41,880 --> 01:16:43,060
My name is Patricia Mora.

656
01:16:44,060 --> 01:16:49,260
I'm a provider of the YHNCC, I'm a year-old.

657
01:16:49,280 --> 01:16:50,340
My sister Maria.

658
01:16:50,940 --> 01:16:52,980
She has a very special need.

659
01:16:53,740 --> 01:16:55,760
She's a part of her mother's mother.

660
01:16:56,740 --> 01:16:58,240
She can't eat anything.

661
01:16:59,400 --> 01:17:00,600
She can't eat it.

662
01:17:00,600 --> 01:17:01,020
She can't eat it.

663
01:17:01,460 --> 01:17:02,140
I'm here.

664
01:17:03,920 --> 01:17:05,880
She's a lot of love.

665
01:17:05,880 --> 01:17:08,080
There is a lot of need.

666
01:17:09,400 --> 01:17:11,160
And not only us, but also us.

667
01:17:11,280 --> 01:17:12,820
We need a good salary.

668
01:17:14,200 --> 01:17:15,460
We are here for the union.

669
01:17:16,680 --> 01:17:18,940
And we want to fight, and we have to listen,

670
01:17:21,120 --> 01:17:24,940
to support us with our salary.

671
01:17:25,320 --> 01:17:31,060
We need the best help, because we are in a place where everything is more expensive than ours.

672
01:17:32,240 --> 01:17:36,320
My family and I need their support.

673
01:17:36,320 --> 01:17:41,800
and mejores coberturas médicas.

674
01:17:42,960 --> 01:17:46,980
Estamos negociando por un año y necesitamos.

675
01:18:11,240 --> 01:18:22,400
change flow. And yet here I am here in front of you. I'm doing this in the next vlog. We are in a very urgent need.

676
01:18:22,980 --> 01:18:32,340
We care givers need a better salary and we are here for the union. We want to be here. We want to be supported and we want to have a better salary.

677
01:18:32,920 --> 01:18:41,000
Also, we know that living here is even more expensive than living anywhere else.

678
01:18:41,480 --> 01:18:47,680
My family and I need support, we need better health coverage, and we have been here for

679
01:18:47,680 --> 01:18:48,360
a year negotiating.

680
01:18:49,580 --> 01:18:50,420
Thank you.

681
01:18:58,810 --> 01:18:59,470
Good morning, Board.

682
01:18:59,650 --> 01:19:01,230
This is Adam Cole with Seema.

683
01:19:01,470 --> 01:19:06,150
Seema and RNPA shared a brief memo with the Board regarding the layoff notices that our

684
01:19:06,150 --> 01:19:08,130
members received earlier this month.

685
01:19:08,130 --> 01:19:21,230
This is the third budget cuts cycle in a row, we're seeing a standing here saying the process didn't go right this time, but thankfully these are relatively small cuts compared to what we know is coming now is the time to get the process right.

686
01:19:21,990 --> 01:19:37,950
Unfortunately those large cuts are now right around the corner and rather than having a dialed in efficient employee family process for notifying folks that their positions have been cut we have seen new different and worse ways that our members are being notified their positions are cut.

687
01:19:37,950 --> 01:19:42,650
We have several asks and suggestions in the memo that we shared and we're looking for the board's

688
01:19:42,650 --> 01:19:46,890
leadership to make sure that this process gets a dialed in before the large cuts that we all know

689
01:19:46,890 --> 01:19:47,390
are coming.

690
01:19:47,810 --> 01:19:48,550
Thank you for your support.

691
01:19:57,210 --> 01:19:57,970
Morning board members.

692
01:19:58,150 --> 01:20:04,130
My name is Carlton Sean Allen Jr., I am a senior trainer and staff developer in the office

693
01:20:04,130 --> 01:20:07,090
of Wellness and Experience at SCVH and a senior member.

694
01:20:07,910 --> 01:20:13,090
Today I'm here to speak about all my colleagues that are moving through this transition

695
01:20:13,090 --> 01:20:18,110
and what uncertainty and concern over the past weeks, managers and staff have been notified

696
01:20:18,110 --> 01:20:24,250
their positions may be eliminated and have been directed to seek information through

697
01:20:24,250 --> 01:20:25,170
union channels.

698
01:20:25,670 --> 01:20:31,690
At the same time, key details needed to understand the next steps, such as position lists and

699
01:20:31,690 --> 01:20:35,530
you're already information and available vacancies have not been fully shared.

700
01:20:36,990 --> 01:20:42,350
This has left many employees in a space without clear answers or knowing what comes

701
01:20:42,350 --> 01:20:51,010
When people are told, these things, this is not wellness, and this is not from a trauma-informed perspective.

702
01:20:51,970 --> 01:20:57,050
We can do better, and we need to do better for our staff and our members of our community.

703
01:20:57,350 --> 01:20:58,870
From a trauma-informed perspective.

704
01:20:59,530 --> 01:21:00,210
Thank you.

705
01:21:07,130 --> 01:21:07,970
Good morning, Board.

706
01:21:08,190 --> 01:21:09,270
Does that film in with Seema?

707
01:21:10,250 --> 01:21:11,730
I want to emphasize this.

708
01:21:12,010 --> 01:21:18,010
If someone tells you that the layoff process is complicated and difficult to get right,

709
01:21:18,010 --> 01:21:20,090
Please, don't believe it.

710
01:21:20,470 --> 01:21:23,150
It's serious, yes, but not that difficult.

711
01:21:23,470 --> 01:21:26,470
And the county has done this smoothly for decades past.

712
01:21:27,210 --> 01:21:29,750
The county can do so again with a simple rule.

713
01:21:30,430 --> 01:21:33,150
Followed seniority, engage with your unions

714
01:21:33,150 --> 01:21:36,390
and ask before you make changes to the process.

715
01:21:37,470 --> 01:21:40,590
Don't decide behind closed doors and implement without notice.

716
01:21:41,050 --> 01:21:43,010
Notice matters and seniority matters.

717
01:21:43,310 --> 01:21:45,830
Get it right, and employees will be less upset

718
01:21:45,830 --> 01:21:48,230
in a terrible time of wayops.

719
01:21:48,670 --> 01:21:54,190
SEMA and R&DA understand the budget deficit and the wrenching decisions that will have to be made ahead.

720
01:21:55,710 --> 01:22:04,610
We would rather be partnering with the county and maintaining our services as well as increasing revenue rather than fighting about process and violations.

721
01:22:05,490 --> 01:22:06,570
Thank you for your kind of attention.

722
01:22:08,900 --> 01:22:13,940
I'm Nicola Hadden call forward the rest of the in person public speakers.

723
01:22:14,760 --> 01:22:26,400
Alberto Cortez, Solia Copeland, Alan Kamara, Robin Rittas, Andrew Jean, and Maria Durant.

724
01:22:28,740 --> 01:22:29,080
Go ahead.

725
01:22:32,670 --> 01:22:35,970
Hello, good morning, Board of Supervisors. My name is Natasha Walker.

726
01:22:36,410 --> 01:22:37,890
I'm with SCIU 2015.

727
01:22:37,890 --> 01:22:43,690
I am a critical care provider for my daughter who is 23 years old.

728
01:22:44,330 --> 01:22:50,810
This she says at home pretty much full time now, and I am here asking as a public

729
01:22:50,810 --> 01:22:56,030
servant of this county myself, and on the advisory board for IHSS, I'm asking our county

730
01:22:56,030 --> 01:23:01,750
CEO to be a beacon of light by showing the nation how to put those with disabilities and

731
01:23:01,750 --> 01:23:06,710
families and the state's master plan for aging first. This critical

732
01:23:06,710 --> 01:23:10,890
safety program is a backbone of the county health system. The money paid to

733
01:23:10,890 --> 01:23:15,810
critical care providers goes directly back into the local economy. It is

734
01:23:15,810 --> 01:23:19,210
difficult for us to find providers and it's going to become more difficult

735
01:23:19,210 --> 01:23:26,650
with your current wage offer. As it is, we sent you the board sent you a

736
01:23:26,650 --> 01:23:31,250
recommendation letter in September and we have not heard back from you yet and it

737
01:23:31,250 --> 01:23:33,130
as a solution in there, as well.

738
01:23:33,250 --> 01:23:34,330
We'd appreciate your input.

739
01:23:34,910 --> 01:23:35,090
Thank you.

740
01:23:42,380 --> 01:23:43,620
My name is Maria Durand.

741
01:23:43,960 --> 01:23:46,380
So this is an element of my apologies for keeping

742
01:23:46,380 --> 01:23:49,840
on your office regarding harassment and stocking.

743
01:23:49,920 --> 01:23:51,260
I was a previous county employee.

744
01:23:51,860 --> 01:23:55,240
I'm going to stocking her harassment, previous departments.

745
01:23:55,520 --> 01:23:58,120
They have labor meat, mental, and I'm not.

746
01:23:58,320 --> 01:24:00,960
Sounded they have a few specific multiple cases.

747
01:24:01,320 --> 01:24:02,620
I have 25 cases.

748
01:24:03,380 --> 01:24:05,020
Three sexual assaults.

749
01:24:05,020 --> 01:24:06,560
One such a group by law enforcement.

750
01:24:06,560 --> 01:24:12,380
And to also to that my apologies for keeping you on email, I need your help with this case.

751
01:24:13,320 --> 01:24:16,900
My granddaughter has been placed in danger, her father was killed along forcement.

752
01:24:17,660 --> 01:24:20,300
So, I don't know how County has considered her as an assessment by CC.

753
01:24:20,740 --> 01:24:22,320
I'll let her systems next when they haven't watched.

754
01:24:22,620 --> 01:24:24,640
I need her help. My apologies, keep calling you.

755
01:24:25,020 --> 01:24:26,180
My name is Marianne Durand.

756
01:24:27,420 --> 01:24:30,720
1059 Park Avenue. She's blocked my address.

757
01:24:31,600 --> 01:24:33,260
But the considered her as for has not stopped.

758
01:24:34,900 --> 01:24:38,240
Do I desire a deforestaff member of parties?

759
01:24:38,800 --> 01:24:40,120
No, no, don't apologize.

760
01:24:40,940 --> 01:24:41,480
Thank you.

761
01:24:44,860 --> 01:24:49,400
If you can hang on for a minute, I will have someone from my office come down and connect with you.

762
01:24:52,800 --> 01:24:53,740
Good morning, Board of Supervisors.

763
01:24:53,900 --> 01:24:57,340
My name is Alan Kamar from R&PA.

764
01:24:57,560 --> 01:25:01,080
To this supervisor, we want to come and talk to you and ask for your commitment.

765
01:25:02,020 --> 01:25:05,660
All label organization within the county has a layoff language.

766
01:25:05,660 --> 01:25:10,500
And that layoff language tells you how the county can walk with the unions.

767
01:25:11,260 --> 01:25:17,080
So if there is a layoff, like my seamer partners just stated, you can follow those rules.

768
01:25:17,700 --> 01:25:22,040
Today, as the 27, we still have not received our seniority at least.

769
01:25:22,720 --> 01:25:27,760
Meanwhile, all our members have been notified that some of them may lose their position.

770
01:25:27,760 --> 01:25:36,140
In five section five of RMB contract as a layoff language, in five point one is stated that the

771
01:25:36,140 --> 01:25:42,920
county will provide senior release to the union before any layoff that's announced.

772
01:25:43,580 --> 01:25:46,480
While we're passed out today, the 27th will still have us receive it.

773
01:25:46,720 --> 01:25:48,040
And encourage you please.

774
01:25:48,860 --> 01:25:50,340
We want to walk with you.

775
01:25:50,600 --> 01:25:51,000
Please.

776
01:25:51,880 --> 01:25:52,360
Thank you.

777
01:25:58,510 --> 01:25:59,010
Good morning.

778
01:25:59,490 --> 01:26:00,470
My name is Andrew Tian.

779
01:26:00,470 --> 01:26:04,630
I am Assistant Nurse Manager at BMCIDOT,

780
01:26:04,750 --> 01:26:06,470
acute psychiatric services.

781
01:26:06,870 --> 01:26:10,170
I'm here to represent RNPA, all my nurses,

782
01:26:10,430 --> 01:26:12,250
and all my assistant nurse managers.

783
01:26:13,450 --> 01:26:17,210
I just want to say that it's recommended

784
01:26:17,210 --> 01:26:19,950
to have 50 best per 100,000 people

785
01:26:19,950 --> 01:26:24,050
and we have 2 million population in Santa Clara County,

786
01:26:24,310 --> 01:26:27,330
and we have 48 acute psychiatric beds.

787
01:26:27,330 --> 01:26:30,610
And here are the people who take care of them.

788
01:26:30,890 --> 01:26:33,370
As a system nurse managers, we are on the floor.

789
01:26:33,430 --> 01:26:38,150
We're part of a core staffing where there are nine out of 10 days

790
01:26:38,150 --> 01:26:40,870
on the floor taking care of our patients.

791
01:26:41,350 --> 01:26:43,770
The most acute population in our county.

792
01:26:44,890 --> 01:26:48,350
And I understand the situation that I tested it by the dollar.

793
01:26:49,310 --> 01:26:53,010
I'm here to say that we are the best bang for your buck.

794
01:26:53,430 --> 01:26:54,750
We take care of the patients.

795
01:26:54,750 --> 01:27:02,510
on the way also to take care of all the administrative services at the U.N., thank you very much.

796
01:27:09,060 --> 01:27:19,880
I've been with the county for 47 years. I am an assistant nurse manager and I really

797
01:27:19,880 --> 01:27:27,880
want the board to understand the assistant nurse managers supposedly or told with work cut

798
01:27:27,880 --> 01:27:31,940
because to bring us into compliance with the other units in the hospital.

799
01:27:33,420 --> 01:27:36,340
These cuts were tried once before.

800
01:27:37,280 --> 01:27:40,960
I don't remember the air, but they were cut once before.

801
01:27:41,720 --> 01:27:48,220
Quickly they realized that we are on the floor and that we need to be replaced.

802
01:27:48,540 --> 01:27:52,980
And we became non-compliant with the staffing ratios.

803
01:27:52,980 --> 01:28:02,420
state came involved. It became an issue. We met with the county. There were many meetings.

804
01:28:03,180 --> 01:28:10,980
I was part of that team. These positions were replaced within months because they realized

805
01:28:10,980 --> 01:28:17,480
there was no cost saving. Nothing has been done to look at the impact of these cuts.

806
01:28:17,480 --> 01:28:17,620
Thank

807
01:28:22,320 --> 01:28:24,060
you.

808
01:28:28,580 --> 01:28:29,980
Who do I give this to?

809
01:28:45,270 --> 01:28:47,870
Ron, do we have any more in person's figure?

810
01:28:48,170 --> 01:28:49,410
Or do we go to Zoom now?

811
01:28:50,490 --> 01:28:54,990
So I did have two in person's figures that did not speak.

812
01:28:55,610 --> 01:28:59,090
Soliat, Copeland, and Alberta Cortez.

813
01:29:00,750 --> 01:29:05,450
And since I do not see them coming forward, let's move on to our Zoom speakers.

814
01:29:06,190 --> 01:29:08,830
Our first Zoom speaker is Ronald Owen.

815
01:29:08,830 --> 01:29:09,530
One

816
01:29:14,550 --> 01:29:16,050
of the most dream that we target lubrication

817
01:29:16,050 --> 01:29:18,290
option is the California Department of Public Health.

818
01:29:18,750 --> 01:29:20,350
I'm a black man who loves all humanity.

819
01:29:21,070 --> 01:29:23,190
I would just start to learn what how many of us are sitting

820
01:29:23,190 --> 01:29:24,770
on table 14, 2022.

821
01:29:25,310 --> 01:29:27,490
We know these vaccines are by killing people of color, blacks,

822
01:29:27,930 --> 01:29:29,790
Latinos, indigenous people at about two times

823
01:29:29,790 --> 01:29:30,770
the rate of white Americans.

824
01:29:31,430 --> 01:29:33,970
I've informed this board that the vaccines are killing people

825
01:29:33,970 --> 01:29:36,770
in writing under the July 29th, 24th.

826
01:29:36,770 --> 01:29:39,370
And the person on November 5, 2024.

827
01:29:39,730 --> 01:29:42,050
And writing, again, on December 10, 2024,

828
01:29:42,050 --> 01:29:49,250
And now, today, I've informed COVID-19 vaccines are killing people to all California's border survivors.

829
01:29:49,830 --> 01:29:52,550
I've prepared it to 51 border survivors, thus far.

830
01:29:52,950 --> 01:29:56,810
Senator Public Health Department is still promoting administering.

831
01:30:00,000 --> 01:30:13,200
1, 0, 2, 5, mandate for you to preserve and protect the public health. I urge this board to put this matter in the agenda. And at least, notify your citizens that the vaccines are not safe and are not affected.

832
01:30:16,090 --> 01:30:19,850
Thank you. Our next speaker is Julia Dree.

833
01:30:26,290 --> 01:30:29,430
Yeah, Julie Dree calling in for the third time for view County California.

834
01:30:29,430 --> 01:30:31,890
a 20-year resident of Sunnyvale, California.

835
01:30:32,650 --> 01:30:36,890
I want to tell you, President Lee, that five years ago today, your public health department

836
01:30:36,890 --> 01:30:44,090
injected my mother with the no toxic poison, Moderna, lot number 029L20A with the first

837
01:30:44,090 --> 01:30:46,890
of four deadly shots that killed her.

838
01:30:47,130 --> 01:30:50,650
She lived in Sunnyvale and she worked hard for Silicon Valley.

839
01:30:51,210 --> 01:30:55,530
You people need to look up her marriage report 2431-153.

840
01:30:55,810 --> 01:30:58,950
There are 89 people dead from that one toxic lot alone.

841
01:30:58,950 --> 01:31:01,530
I have come here before you three times.

842
01:31:02,030 --> 01:31:05,010
She was the best friend of Carmen and Larry Stone.

843
01:31:09,320 --> 01:31:11,460
She worked for Sunnyville Community Services.

844
01:31:12,020 --> 01:31:13,660
She was the Silicon Valley Icon,

845
01:31:13,740 --> 01:31:15,080
its Technetics, and some Mexican.

846
01:31:15,720 --> 01:31:19,820
She made rainbow dresses for me and my friends

847
01:31:19,820 --> 01:31:21,420
and Sunnyville rainbow girls.

848
01:31:21,740 --> 01:31:23,520
She made the Sunnyville Metro Bay owners

849
01:31:23,520 --> 01:31:24,760
and the Sunnyville Little League.

850
01:31:25,200 --> 01:31:25,760
She demands.

851
01:31:29,100 --> 01:31:31,280
Thank you, our next speaker is, parent.

852
01:31:33,180 --> 01:31:34,580
Yes, a little more than you all.

853
01:31:34,580 --> 01:31:41,740
Jeff Rosen just said that if you see something, say something and we'll do something good.

854
01:31:41,760 --> 01:31:44,480
Those words are the exact words about sex trafficking.

855
01:31:45,080 --> 01:31:46,280
It's a complete lie.

856
01:31:46,460 --> 01:31:53,660
I told Jeff Rosen personally, that my ex-wife was letting him make my son, beginning when he was 13.

857
01:31:54,040 --> 01:31:55,700
It was unnecessary basing with the children.

858
01:31:56,720 --> 01:32:01,220
There was sexual contact between children and all this led to abrupt,

859
01:32:01,220 --> 01:32:04,940
and severe personality changes for my kids.

860
01:32:06,120 --> 01:32:08,380
And his response to doing something good

861
01:32:08,380 --> 01:32:11,300
was to file charges against me to conceal the abuse

862
01:32:12,200 --> 01:32:17,800
because his political supporter is involved in all of this.

863
01:32:18,500 --> 01:32:20,820
I've both brought this information online.

864
01:32:21,040 --> 01:32:23,320
If you want to see it, the Google's DA,

865
01:32:23,580 --> 01:32:26,400
Jeff Rose, and Sex Graphicking Edition, all those types

866
01:32:26,400 --> 01:32:28,660
of the other top-greens also see what I'm talking about.

867
01:32:28,880 --> 01:32:30,260
Jeff Rose, and it's not telling the truth.

868
01:32:30,260 --> 01:32:32,000
Thank you so much for your time.

869
01:32:35,520 --> 01:32:37,460
Thank you, our next speaker is Gosmer.

870
01:32:43,210 --> 01:32:45,210
Business pay a lot of money.

871
01:32:45,550 --> 01:32:46,070
Good morning.

872
01:32:46,730 --> 01:32:48,130
Well, if that's in the can,

873
01:32:48,290 --> 01:32:50,970
where you're counting sons at the hospital

874
01:32:51,970 --> 01:32:56,370
is letting out un-house people with no place to go.

875
01:32:57,410 --> 01:33:00,310
Regional, one of the un-house employees

876
01:33:00,310 --> 01:33:02,690
has been the regional pre-time.

877
01:33:03,350 --> 01:33:06,110
She had the money, she lived in her car,

878
01:33:06,110 --> 01:33:09,830
with her husband and regional team letting her out.

879
01:33:09,970 --> 01:33:12,650
Now, I don't understand why there's no place

880
01:33:12,650 --> 01:33:15,850
that regional, or corner, or billion things

881
01:33:15,850 --> 01:33:19,270
can maybe house somebody that has no place.

882
01:33:19,730 --> 01:33:21,330
Oconer is the worst.

883
01:33:21,530 --> 01:33:23,670
They have brought out so many announced people

884
01:33:23,670 --> 01:33:25,070
with no place to go.

885
01:33:25,370 --> 01:33:28,050
Some of them aren't even well, and they still are them out.

886
01:33:28,430 --> 01:33:31,390
This woman's yesterday should not have been messed up

887
01:33:31,390 --> 01:33:34,090
or kicked out, but regional did.

888
01:33:34,090 --> 01:33:43,410
I talked to the case manager, all we don't do that, we don't have the money, we don't find the money, this is not acceptable, thank you.

889
01:33:45,300 --> 01:33:47,260
And that concludes our public speakers.

890
01:33:50,910 --> 01:33:52,110
Thank you very much, Rhonda.

891
01:33:52,870 --> 01:34:00,490
Okay, and then we move to the next item of the agenda, which is the consent calendar and changes to the Board of Surveys of Gender this morning.

892
01:34:01,050 --> 01:34:05,050
And Rhonda, would you please read the various update to our consent calendar?

893
01:34:06,520 --> 01:34:12,720
We have a request from administration to hold item 29 to February 10th, 2026.

894
01:34:13,280 --> 01:34:19,880
Item 29 is to approve retroactive second amendment to agreement with Board of Trustees of

895
01:34:19,880 --> 01:34:26,580
Leland Stamford Junior University relating to providing cardiovascular and thoracic surgery

896
01:34:26,580 --> 01:34:41,220
physician services, increasing the maximum contract amount by $6,777,849 from $6,611,134

897
01:34:41,220 --> 01:34:53,520
to $12,688,983 and extending the agreement for a 36-month period through February 28, 2020.

898
01:34:54,660 --> 01:35:13,960
Request from supervisor Jung to remove item 56 from the consent calendar item 56 is to consider recommendations relating to the surveillance use policy for the automated license plate readers for the city of Saratoga City of Cupertino and the town of Los Altos Hills.

899
01:35:13,960 --> 01:35:21,500
There's a request from administration to hold item 57 to date, and certain item 57 is to

900
01:35:21,500 --> 01:35:27,420
prove second amendment to agreement with Santa Clara Valley Transportation Authority, relating

901
01:35:27,420 --> 01:35:33,000
to providing supplemental law enforcement services, amending the scope of services and

902
01:35:33,000 --> 01:35:39,220
cost recovery in and amount equal to the county's cost of providing services with no change

903
01:35:39,220 --> 01:35:40,620
to the term of the agreement.

904
01:35:41,520 --> 01:35:47,300
Correction, the item number 59C, the item should reflect that it is jointly submitted with

905
01:35:47,300 --> 01:35:54,720
President Lee, item number 59C is adopted commendation for use star productions on the

906
01:35:54,720 --> 01:36:01,500
occasion of the 11th anniversary of a Holy Tent San Jose Lunar New Year Tent Festival,

907
01:36:01,820 --> 01:36:09,340
San Jose 2026 for celebrating and preserving Vietnamese heritage and culture around us Lee.

908
01:36:09,340 --> 01:36:18,820
request from administration to hold item number 61 to February 10th, 2026 approved request for

909
01:36:18,820 --> 01:36:26,620
preparation modification number 101 for $1 million increasing estimated revenue and

910
01:36:26,620 --> 01:36:33,380
expenditure appropriations in the consumer and environmental protection agency budget relating

911
01:36:33,380 --> 01:36:40,040
to eradication of glassy-winged sharpshooter and pierces disease control.

912
01:36:40,760 --> 01:36:43,260
And this concludes our consent calendar update.

913
01:36:44,220 --> 01:36:45,280
Thank you very much, Ronda.

914
01:36:46,180 --> 01:36:49,540
Do any more of the changes that took my call that gets?

915
01:36:50,700 --> 01:36:55,280
I don't have changes, but comments on a few items.

916
01:36:56,220 --> 01:37:03,080
First item 28, during last year's budget discussions, it was deeply invokedly concerned about

917
01:37:03,080 --> 01:37:08,840
potential contraction of family housing services after learning that the state had not yet

918
01:37:08,840 --> 01:37:14,160
allocated funding to the bringing family's home program. This program specifically aims to

919
01:37:14,160 --> 01:37:20,260
reduce homelessness among families that are connected to the child welfare system. And it's

920
01:37:20,260 --> 01:37:25,400
critical of course to ensure that children's most basic needs are met to improve stability

921
01:37:25,400 --> 01:37:31,980
in a system where a child's safety is of the utmost concern. I was relieved to see that the state

922
01:37:31,980 --> 01:37:34,840
has renewed funding through 2020-8,

923
01:37:35,180 --> 01:37:38,480
and allocated just over $3 million to our county.

924
01:37:39,000 --> 01:37:40,980
This funding will provide rapid rehousing

925
01:37:40,980 --> 01:37:45,180
and stabilization services to 145 families.

926
01:37:45,960 --> 01:37:49,400
I want to express my appreciation to SSA leadership,

927
01:37:49,960 --> 01:37:53,200
especially DFCS director Wendy Canier-Roush

928
01:37:53,200 --> 01:37:56,660
for your advocacy alongside other child welfare directors

929
01:37:56,660 --> 01:37:59,300
in the state to sustain this program.

930
01:37:59,960 --> 01:38:00,640
Good work.

931
01:38:00,640 --> 01:38:07,260
items 45 and 46. Again, not pulling either from consent, but just want to make some general

932
01:38:07,260 --> 01:38:13,160
statements about the importance of each. The county's poet laureate program has been

933
01:38:13,160 --> 01:38:18,540
in effect for 18 years and serves as a testament to this county's commitment to elevating

934
01:38:18,540 --> 01:38:23,220
the arts as part of the public good and ensuring our communities are seen and celebrated.

935
01:38:24,080 --> 01:38:29,140
At our last board meeting, current poet laureate, Yosima Reyes, reminded us of the importance

936
01:38:29,140 --> 01:38:34,620
of community showing up for one another and this is what every one of us at the county does

937
01:38:34,620 --> 01:38:39,820
every day. From the board to executive administration to line staff and health care workers,

938
01:38:40,440 --> 01:38:45,440
we meet people where they are and try to make things better in their lives. I want to express

939
01:38:45,440 --> 01:38:51,720
appreciation to SV creates our partner in this work and all the poets including the youth

940
01:38:51,720 --> 01:38:58,180
poet laureates who have held this post in the past. Secondly, I want to uplift the work of our

941
01:38:58,180 --> 01:39:03,440
libraries, including the update in item 46, to better meet the needs of our communities

942
01:39:03,440 --> 01:39:10,400
efficiently and effectively in this time of financial uncertainty. I serve on the Joint

943
01:39:10,400 --> 01:39:14,780
Powers Board for our libraries and witness the passion of people working to serve our

944
01:39:14,780 --> 01:39:21,840
communities at every meeting. These days, as Supervisor Lee noted, maybe dark in many ways,

945
01:39:22,200 --> 01:39:25,940
but libraries continue to be a beacon for the best parts of community.

946
01:39:26,680 --> 01:39:34,280
I am 56 consistent with my prior votes, I will be abstaining on this, and with that I'm happy to move approval of the consent calendar.

947
01:39:36,040 --> 01:39:37,280
Okay, I have a motion to have a second.

948
01:39:38,740 --> 01:39:45,600
I mean, it was hoping for quick clarification and I'm happy a second, but the yellow sheet looks different.

949
01:39:46,440 --> 01:39:51,300
It had item 60s as a being pulled, but is that no longer being pulled?

950
01:39:51,480 --> 01:39:53,260
That's correct yet, that's no longer being pulled.

951
01:39:53,260 --> 01:39:56,180
Is it 61 that we are adding?

952
01:40:01,560 --> 01:40:06,560
I believe it's 56 that was pulled on to regular off of consent.

953
01:40:06,580 --> 01:40:07,300
Okay, great.

954
01:40:07,300 --> 01:40:07,740
Thank you.

955
01:40:07,760 --> 01:40:11,200
I'll just try to follow along with this and it didn't match.

956
01:40:11,800 --> 01:40:13,240
So, with that, yes, I'll second the lesson.

957
01:40:13,560 --> 01:40:13,760
Thank you.

958
01:40:14,340 --> 01:40:14,880
Motion second.

959
01:40:15,380 --> 01:40:19,680
Let's see if we have any speaker on the consent item agenda.

960
01:40:21,020 --> 01:40:26,680
I currently have one speaker in chambers and no speakers on Zoom.

961
01:40:26,680 --> 01:40:28,800
Let's do two minutes, go ahead.

962
01:40:30,200 --> 01:40:38,660
All right, with that, we are closing out the Zoom queue and our in-chamber speaker is Mary Ying.

963
01:40:42,520 --> 01:40:48,860
And for the consent item agenda, please state the consent item number to identify which item you're speaking on.

964
01:40:48,940 --> 01:40:50,260
Thank you so much for saying.

965
01:40:54,640 --> 01:40:57,200
Good morning, here for number 58,

966
01:40:57,200 --> 01:41:03,560
probation department. I'm speaking on behalf of Terrell Pena. My name is Mary Ang. I'm

967
01:41:03,560 --> 01:41:09,680
a board member of Opportunities for Change. And he could not be here. Our lived experience

968
01:41:09,680 --> 01:41:15,160
CEO is the single father, Seoul custody of a three-year-old. He brought her home from the

969
01:41:15,160 --> 01:41:23,260
day she was born. So they had a preschedule appointment that couldn't be changed. So we want

970
01:41:23,260 --> 01:41:30,120
really affirmed the amazing impact the CEO program has had on several of our clients.

971
01:41:30,760 --> 01:41:33,220
I wanted to highlight two of them, theodore and Vernon.

972
01:41:33,880 --> 01:41:39,280
So Teddy, he came straight out of county jail to work and to stay with us.

973
01:41:39,580 --> 01:41:46,660
And we discovered that he had this incredible untapped subrosa computer nerd skill set.

974
01:41:47,160 --> 01:41:50,200
He'd never been able to work in the computer industry.

975
01:41:50,200 --> 01:41:57,260
On the second day he went to the CEO program and what that did for him was power building.

976
01:41:58,060 --> 01:42:02,760
He was able to immediately make money, get skills training on his resume, he enrolled

977
01:42:02,760 --> 01:42:09,100
in college as a result of the CEO, counselor, urging him on, he really enjoyed working with

978
01:42:09,100 --> 01:42:09,980
that case worker.

979
01:42:10,420 --> 01:42:16,660
So I really want to let you know that we feel the daily impact of your support for this program.

980
01:42:16,660 --> 01:42:26,480
As far as Vernon is concerned, he spent 28 years in a California prison, same thing, the first day of freedom he came and stayed with us.

981
01:42:26,800 --> 01:42:30,420
I point to him as an example of wealth with pride.

982
01:42:31,640 --> 01:42:40,860
So many of our clients have tremendous skill sets and they earn their living wealth without pride.

983
01:42:41,440 --> 01:42:45,680
Wealth earned on the backs of hurting people and communities.

984
01:42:46,780 --> 01:42:49,180
We have an effective program to turn that around.

985
01:42:49,540 --> 01:42:51,000
I want to thank you for this program.

986
01:42:51,540 --> 01:42:56,800
The only negative is you have to be an active probation or parole to use it.

987
01:42:56,900 --> 01:42:57,320
Thank you.

988
01:42:57,960 --> 01:42:58,920
Thank you.

989
01:42:59,740 --> 01:43:01,440
And this concludes our public speakers.

990
01:43:01,880 --> 01:43:04,420
Okay, go ahead and let's call it the rule.

991
01:43:04,680 --> 01:43:05,160
Call the vote.

992
01:43:07,370 --> 01:43:08,290
Supervisor Avacoga?

993
01:43:08,950 --> 01:43:09,130
Aye.

994
01:43:09,610 --> 01:43:10,170
Supervisor UM?

995
01:43:10,890 --> 01:43:11,110
Yes.

996
01:43:11,110 --> 01:43:18,730
supervisor Ellenberg? Yes. Presently. I as well. Motion carries for the zero. And that was

997
01:43:18,730 --> 01:43:25,210
on motion of supervisor Ellenberg, seconded by supervisor Avigalga. Great. Thank you very much

998
01:43:25,210 --> 01:43:30,770
Ronda. And moving to item number eight, setting the time, sir, in no early 1930, that's

999
01:43:30,770 --> 01:43:36,710
strongly, it's not the problem. Item eight is reporting, reclaning to Senator Clara Valley

1000
01:43:36,710 --> 01:43:42,730
health care. This is only an information item, and no action is actually needed today.

1001
01:43:43,110 --> 01:43:50,090
And we do have our staff here presenting including our CEO here, Hufflepuff's system,

1002
01:43:50,730 --> 01:43:51,630
Paul Lorenz.

1003
01:43:51,910 --> 01:43:52,270
Go ahead.

1004
01:43:55,890 --> 01:43:59,950
Thank you, President Lee, members of the board, Paul Lorenz, CEO for Santa Clara Valley

1005
01:43:59,950 --> 01:44:04,990
Health Care. I do have members of our leadership team here, which I'd like for them to

1006
01:44:04,990 --> 01:44:07,370
introduce themselves, and then we'll move on with the presentation.

1007
01:44:07,370 --> 01:44:08,390
Good

1008
01:44:11,520 --> 01:44:14,660
morning, I'm Rino Sharma, I'm the CFO for the Health System.

1009
01:44:15,940 --> 01:44:19,600
Good morning, Fongwen, Chief Medical Officer for the Health System.

1010
01:44:20,140 --> 01:44:21,060
But it was your mic on?

1011
01:44:22,040 --> 01:44:23,160
Yes, can you hear me?

1012
01:44:23,360 --> 01:44:24,900
A little bit better now, thank you.

1013
01:44:25,920 --> 01:44:28,500
Fongwen, Chief Medical Officer, thank you.

1014
01:44:30,340 --> 01:44:33,800
Brian McBeth, Chief Quality Officer, Interim Hospital Executive

1015
01:44:33,800 --> 01:44:36,240
at Santa Clara Valley Medical Center.

1016
01:44:37,640 --> 01:44:38,140
Hi, good morning.

1017
01:44:38,140 --> 01:44:41,820
Felicia Tornebany, I'm the physician executive at O'Connor Hospital.

1018
01:44:42,820 --> 01:44:45,600
Cliff Wang, I'm the Associate Chief Medical Officer for the Health System.

1019
01:44:47,260 --> 01:44:53,480
Again, thank you members of the Board for the opportunity to talk about not only the implications

1020
01:44:53,480 --> 01:44:57,380
related to HR-1, but also state change, it's put-

1021
01:45:00,000 --> 01:45:05,340
Clearly, what we are facing as a health care system was in this market in Santa Clara County.

1022
01:45:06,080 --> 01:45:11,920
I think it's really important that we have this opportunity to engage with the board to fully understand

1023
01:45:11,920 --> 01:45:20,000
the implications that we are dealing with. As you can note, we will be providing a brief overview of the health system.

1024
01:45:20,000 --> 01:45:28,640
attention on some of our key challenges and opportunities, we'll be looking at some operating

1025
01:45:28,640 --> 01:45:35,620
statistics relative to the health system and relative to the market in general. We will

1026
01:45:35,620 --> 01:45:42,140
be touching on the federal and state budget challenges as a result of HR1 in the state and

1027
01:45:42,140 --> 01:45:47,400
then getting into what we were doing to mitigate those challenges relative to our mid-year budget

1028
01:45:47,400 --> 01:45:56,000
and also going into fiscal year 2627 as you well know we are working with county executive,

1029
01:45:56,340 --> 01:46:03,820
not only in the major budget which would be presented but also looking at 2627 budget recommendations.

1030
01:46:05,120 --> 01:46:08,760
And then we can get into the Q&A which I really want to get to as quickly as possible.

1031
01:46:08,940 --> 01:46:14,140
So what I'm going to do is try to go through these slides as quickly as possible but touch on the key points.

1032
01:46:20,190 --> 01:46:31,470
So before I touch on this slide, I do want to just give some background information and once again emphasize how unique your public health care system is in Santa Clara County.

1033
01:46:32,770 --> 01:46:37,350
As you well know, we serve one and four residents in the County of Santa Clara.

1034
01:46:39,230 --> 01:46:42,690
We serve close to 60 to 70% of the Medicaid population.

1035
01:46:42,690 --> 01:46:50,390
And thus, the implications of HR1 disproportionately affects your healthcare system more so than

1036
01:46:50,390 --> 01:46:55,970
any other healthcare system in the county of Santa Clara and what touch on that in upcoming

1037
01:46:55,970 --> 01:46:56,550
slides.

1038
01:46:57,270 --> 01:47:03,470
But what's also really important to understand is that just like any other healthcare system,

1039
01:47:03,670 --> 01:47:09,990
your healthcare system is dealing with significant cost increases, structural cost increases

1040
01:47:09,990 --> 01:47:17,950
that require us to either generate more revenue or to find other ways to cut cost in order

1041
01:47:17,950 --> 01:47:20,610
to bring value-based health care to our community.

1042
01:47:22,860 --> 01:47:29,380
In this market, many of you understand that because we serve a preponderance of individuals

1043
01:47:29,380 --> 01:47:34,800
on Medicaid, we are also seeing a shift in the market relative to the Medicare population.

1044
01:47:35,580 --> 01:47:40,340
Your health system, which I've shown in future slides, has grown significantly in serving

1045
01:47:40,340 --> 01:47:43,340
the Medicare population at the same time

1046
01:47:43,340 --> 01:47:46,020
we're seeing our population age.

1047
01:47:46,720 --> 01:47:47,900
And so we have the health care system

1048
01:47:47,900 --> 01:47:50,000
have to adapt to that.

1049
01:47:51,100 --> 01:47:54,040
And all of us know what Medicare reimburses

1050
01:47:54,040 --> 01:47:57,000
health care providers today is the challenge.

1051
01:47:57,860 --> 01:47:59,940
And therefore, what you were seeing at the shift

1052
01:48:00,560 --> 01:48:03,640
from other providers to your public health care system,

1053
01:48:03,640 --> 01:48:04,780
safety and that system.

1054
01:48:05,500 --> 01:48:07,120
So the reliance on your health care system

1055
01:48:07,120 --> 01:48:08,520
is going to continue to grow,

1056
01:48:08,520 --> 01:48:15,080
not only because the implications related to HR one-around Medicaid, but also because of other

1057
01:48:15,080 --> 01:48:19,360
individuals that are going to have to depend on your health care system for care, just

1058
01:48:19,360 --> 01:48:26,220
not the Medicare population, but as you well know, the subsidies related to cover California

1059
01:48:27,980 --> 01:48:35,780
are no longer in place. And so we are already seeing individuals drop coverage. And these are

1060
01:48:35,780 --> 01:48:40,080
individuals up to 400% of FPL up to 500% of FPL.

1061
01:48:40,720 --> 01:48:48,740
So we are seeing an evolving market, but also seeing changes in the pair adequacy of reimbursement

1062
01:48:48,740 --> 01:48:50,000
in healthcare in general.

1063
01:48:51,320 --> 01:48:56,340
As a safety net system, your board is also aware that we are fully committed to equitable

1064
01:48:56,340 --> 01:48:58,000
access to healthcare.

1065
01:48:58,320 --> 01:49:03,860
That is our mission, that is our purpose, and thus what we are seeing is not only a shift

1066
01:49:03,860 --> 01:49:10,000
of individual reliant on our health care system in general because of payer reimbursement

1067
01:49:10,000 --> 01:49:10,640
challenges.

1068
01:49:11,420 --> 01:49:16,480
But we're also seeing a shift of individuals that disproportionately are those communities

1069
01:49:16,480 --> 01:49:17,280
of color.

1070
01:49:18,940 --> 01:49:24,500
And it is up to us to figure out how we balance access to care in these fiscal challenges

1071
01:49:24,500 --> 01:49:30,360
to ensure that everyone in our community has access to health care that they're able to maintain

1072
01:49:30,360 --> 01:49:32,000
basic health care services.

1073
01:49:33,000 --> 01:49:39,640
And as a healthcare system, your board is very much aware that when we were running one hospital,

1074
01:49:39,780 --> 01:49:46,900
Valley Medical Center was overwhelmed. In other words, we did not have the physical capacity in 2019 to

1075
01:49:46,900 --> 01:49:54,880
care for all the needs of our community. Your board was insightful and made the bold decision to acquire

1076
01:49:54,880 --> 01:50:01,040
two hospitals to further expand the healthcare system so that we would have the physical capacity to

1077
01:50:01,040 --> 01:50:06,640
over the growing needs of our community, and that it was also the case when we acquired

1078
01:50:06,640 --> 01:50:15,120
regional medical center central to a major population that depends and needs access to

1079
01:50:15,120 --> 01:50:17,160
healthcare services in our community.

1080
01:50:18,520 --> 01:50:24,040
We have evolved into a healthcare system that just normally serves as a safety net, but

1081
01:50:24,040 --> 01:50:30,800
is the backbone of healthcare in this county because the fact is that individuals, whether

1082
01:50:30,800 --> 01:50:38,180
You have coverage or not, are disproportionately affected by their ability to actually seek

1083
01:50:38,180 --> 01:50:38,980
access to care.

1084
01:50:39,140 --> 01:50:43,760
You can have coverage, but that doesn't necessarily mean that you have access to health care.

1085
01:50:44,420 --> 01:50:48,960
And that is why this public health care system is so critical, because we provide that

1086
01:50:48,960 --> 01:50:51,280
access irrespective of your coverage.

1087
01:50:55,920 --> 01:51:02,980
So one of the areas that I consistently get asked about is, why do we, as a health care

1088
01:51:02,980 --> 01:51:06,820
system continue to invest in this system.

1089
01:51:08,220 --> 01:51:13,140
And the reality is that what we're typically focused on is what

1090
01:51:13,140 --> 01:51:14,460
is in front of us.

1091
01:51:14,920 --> 01:51:19,340
So we are confronted with HR1 implications, financial challenges

1092
01:51:19,340 --> 01:51:21,460
that are unprecedented.

1093
01:51:22,580 --> 01:51:25,480
But the reality is that, normally, do we have to deal with that,

1094
01:51:25,660 --> 01:51:28,820
but we have to think about what our future looks like

1095
01:51:28,820 --> 01:51:32,400
and how we can strategically manage the situation

1096
01:51:32,400 --> 01:51:38,720
in front of us, but be prepared to make sure that we are a viable system in two years from now,

1097
01:51:38,980 --> 01:51:43,600
three years or five years from now, because we are a public system that is not going to go away,

1098
01:51:43,680 --> 01:51:49,980
and we have to find ways to balance the financial needs and the healthcare needs of our community.

1099
01:51:52,680 --> 01:51:57,680
We are a comprehensive and integrated system unlike any other public healthcare system in the state,

1100
01:51:58,440 --> 01:52:01,200
and we have the opportunity to leverage that.

1101
01:52:01,200 --> 01:52:05,380
to actually grow the system and bring value based health care to our community.

1102
01:52:06,800 --> 01:52:09,540
We have a strong market presence, as you all know,

1103
01:52:10,360 --> 01:52:14,640
that was one of the reasons why the community supported us around measure A

1104
01:52:14,640 --> 01:52:18,120
because they understand the value of what we bring to the community.

1105
01:52:20,300 --> 01:52:26,880
We actually have very prestigious and nationally recognized service lines

1106
01:52:26,880 --> 01:52:31,120
beyond the fact that we are considered to safety net.

1107
01:52:31,120 --> 01:52:38,080
people actually seek out care in our system because of the outcomes that we have relative to their health care.

1108
01:52:39,320 --> 01:52:44,880
So it's really important to understand that a safety net system, your investments in this system has

1109
01:52:44,880 --> 01:52:51,640
allowed us to actually leverage the system to actually compete in the marketplace for individuals

1110
01:52:51,640 --> 01:52:58,300
that want quality health care. And you see that knowledge in terms of individuals that have to access

1111
01:52:58,300 --> 01:53:03,300
care and a system around trauma care, but you see that in our rehabilitation center, you

1112
01:53:03,300 --> 01:53:08,960
also will see that in many other service lines such as oncology, pediatric and women's

1113
01:53:08,960 --> 01:53:09,560
health care.

1114
01:53:11,300 --> 01:53:16,000
We have the opportunity to leverage this system to deal with the fiscal challenges that we

1115
01:53:16,000 --> 01:53:20,780
have going forward and we have the capacity to do so.

1116
01:53:22,870 --> 01:53:27,770
Next slide, as your board is well aware, we have a wide array of essential services.

1117
01:53:27,770 --> 01:53:37,090
I've mentioned a few, it's important to understand that as such we serve the broader community.

1118
01:53:39,810 --> 01:53:47,330
We're not only a safety net system but individuals, as I said, rely on us for emergency room care, trauma care, et cetera.

1119
01:53:48,330 --> 01:53:53,350
The next slide, this slide here highlights some of those important points.

1120
01:53:53,350 --> 01:53:57,490
one and four sunny Clark County residents, as I mentioned, access

1121
01:53:57,490 --> 01:54:02,050
care in our system, and because of regional medical center, that number continues to grow.

1122
01:54:04,820 --> 01:54:10,500
We provide nearly half of all emergency room visits in this county through our four hospitals.

1123
01:54:13,240 --> 01:54:16,300
We operate two of the three trauma centers at Valley Medical Center.

1124
01:54:16,480 --> 01:54:18,080
You have an adult level one.

1125
01:54:18,460 --> 01:54:22,640
You have a level two pediatric trauma center, and now we have regional medical centers.

1126
01:54:22,640 --> 01:54:28,560
Those two trauma centers provide 75% to 80% of the trauma care in this county.

1127
01:54:30,730 --> 01:54:38,930
Every 11 minutes, a 911 call in Santa Clara County results in a patient's being transported to one of your four hospitals.

1128
01:54:41,170 --> 01:54:48,650
And as note that we are the largest medical provider, but we are also the largest Medicare provider for residents living in Santa Clara County.

1129
01:54:49,290 --> 01:54:54,810
And I've mentioned, of course, a rehab center and burn center receiving national recognition

1130
01:54:54,810 --> 01:54:57,310
because of the quality of care that we provide.

1131
01:54:58,650 --> 01:55:06,190
The next slide, as a public system, unlike any other hospital system, we provide other

1132
01:55:06,190 --> 01:55:09,930
essential public health and community health programs.

1133
01:55:11,090 --> 01:55:16,970
Some of these programs are listed here, as you well know, they range from a child advocacy

1134
01:55:16,970 --> 01:55:23,470
Center, our safe programs, which are other sexual assault forensic programs, our homeless

1135
01:55:23,470 --> 01:55:28,550
health care programs, we provide gender affirming care,

1136
01:55:31,560 --> 01:55:34,280
and we provide care to individuals

1137
01:55:36,280 --> 01:55:41,520
that in the community typically would go to a public health department for caring treatment

1138
01:55:41,520 --> 01:55:47,240
ranging from sexual transmitting diseases to immunizations. These are services provided

1139
01:55:47,240 --> 01:55:49,360
within your public health care system.

1140
01:55:50,160 --> 01:55:54,680
And these services are valued at close to $180 million dollars.

1141
01:55:54,800 --> 01:55:59,180
That is where your county investment goes beyond just providing health care.

1142
01:55:59,580 --> 01:56:06,900
We provide community health care services that are essential to our entire county resident community.

1143
01:56:08,640 --> 01:56:15,260
Your board in 2023 knows that we consolidate it and we merge custody health services as

1144
01:56:15,260 --> 01:56:17,780
being part of Santa Clara Valley Health Care.

1145
01:56:18,460 --> 01:56:21,140
That allows us to leverage the clinical expertise,

1146
01:56:22,440 --> 01:56:25,400
manage patient care between the custody health center

1147
01:56:25,400 --> 01:56:27,820
and our specialty clinics, as well as our

1148
01:56:27,820 --> 01:56:31,820
inpatient acute psychiatric unit, and our acute inpatient unit.

1149
01:56:33,640 --> 01:56:36,740
If you note the statistics in terms of the gel population,

1150
01:56:38,780 --> 01:56:41,700
the average daily census there is around 27-50,

1151
01:56:41,700 --> 01:56:47,860
and approximately 30 to 35% of that population has a serious and mental illness.

1152
01:56:48,940 --> 01:56:54,160
That is one of the reasons why it's so important that we have this close relationship

1153
01:56:54,700 --> 01:57:00,180
and that integration into Santa Clara Valley healthcare was so critical moving forward.

1154
01:57:02,040 --> 01:57:08,060
It also brings about some financial security, relative to services provided at custody health services.

1155
01:57:08,880 --> 01:57:14,140
We are committed to make sure that we continue to support custody health services financially

1156
01:57:14,140 --> 01:57:19,020
through the enterprise fund to ensure that we can manage through the consent decree and

1157
01:57:19,020 --> 01:57:22,100
the significant challenges that we have in that setting.

1158
01:57:25,120 --> 01:57:29,920
The next slide, I think you're very much aware of that we provide services all the way from the

1159
01:57:29,920 --> 01:57:35,100
North County to the South County and everything in between all the way across to Melpetus.

1160
01:57:35,100 --> 01:57:42,000
both primary care and acute hospital care services as well as specialty services.

1161
01:57:44,620 --> 01:57:53,040
The next chart map heat map shows, in this county, 400 percent of FPL, what's important

1162
01:57:53,040 --> 01:58:01,940
to note about 400 percent of FPL, a family of four was an income of $128,000 falls into

1163
01:58:01,940 --> 01:58:02,820
this category,

1164
01:58:05,760 --> 01:58:08,060
62,600 for an individual.

1165
01:58:08,960 --> 01:58:14,220
And as you would note, via this map chart of this heat map,

1166
01:58:14,780 --> 01:58:18,460
that our facilities are central to those populations.

1167
01:58:19,420 --> 01:58:22,620
It's central, obviously, with regional medical center,

1168
01:58:22,860 --> 01:58:27,180
but as you would note, to St. Louis Regional Hospital

1169
01:58:27,180 --> 01:58:28,240
in the South County.

1170
01:58:31,280 --> 01:58:33,580
In that population of 400% of P.L.

1171
01:58:33,580 --> 01:58:39,700
include those that are on Metacow, but also individual that are on covered California and

1172
01:58:39,700 --> 01:58:40,240
Metacow.

1173
01:58:44,710 --> 01:58:51,130
The next chart is the Metacow enrollment, and you can also see from this chart, it's a subset

1174
01:58:51,130 --> 01:58:57,290
of the 400%, but the important thing to note here is that your health system provides care

1175
01:58:57,290 --> 01:59:02,130
to over 60 to 70% of the Metacow population.

1176
01:59:02,130 --> 01:59:09,270
And regional medical center is central to that population, with in a five-mile radius of

1177
01:59:09,270 --> 01:59:14,950
regional medical center close to 50% of the medical eligible's live in that vicinity.

1178
01:59:20,480 --> 01:59:25,600
The next chart provides for some patient demographics around age and ethnicity.

1179
01:59:26,820 --> 01:59:32,540
You will note that under race and ethnicity that close to 50% of the population served by

1180
01:59:32,540 --> 01:59:40,460
health system are of Hispanic or Latino ethnic background. What's also important to note

1181
01:59:40,460 --> 01:59:47,600
is the age demographics where we've seen a shift into 65 plus and older being served by your

1182
01:59:47,600 --> 01:59:55,040
health care system. It is now 18 percent of our patient population which is actually the highest

1183
01:59:55,040 --> 01:59:59,820
percentage of all patient age segments that we serve.

1184
02:00:00,000 --> 02:00:06,820
That's a healthcare system. It's evenly distributed, as you would note, in terms of age groupings.

1185
02:00:11,820 --> 02:00:16,780
The paramax, this chart of substance that I've shared was the board in the past, and there's two

1186
02:00:16,780 --> 02:00:26,040
notable bits of information here that you should focus on. One is the transition of the

1187
02:00:26,040 --> 02:00:34,840
implementation of ACA, where the number of uninsured dropped from 20% down to about 3% in

1188
02:00:34,840 --> 02:00:41,000
your healthcare system. What we were most concerned about is that being reversed due to HR1.

1189
02:00:42,040 --> 02:00:47,400
The other important note about this chart is the increase in the Medicare population growing from

1190
02:00:47,400 --> 02:00:55,200
16% to 37%. And that is due to the fact that the hospital care that we provide at O'Connor

1191
02:00:55,200 --> 02:01:03,580
St. Louise and now regional medical center have a high population of medical recipients, excuse me, Medicare recipients.

1192
02:01:07,330 --> 02:01:14,850
This next chart actually provides a little bit more in-depth perspective of how Santa Clara Valley health care compares to other hospitals.

1193
02:01:14,850 --> 02:01:25,490
Our PMX is represented by 84% of medical and Medicare, government sponsored coverage compared

1194
02:01:25,490 --> 02:01:26,290
to other hospitals.

1195
02:01:26,290 --> 02:01:34,150
You can see that Valley Medical Center is by far the largest medical provider at 46% compared

1196
02:01:34,150 --> 02:01:36,110
to the next closest, which is Stanford.

1197
02:01:40,100 --> 02:01:46,760
The next chart provides for a little bit of information for your board about each of the

1198
02:01:46,760 --> 02:01:52,740
And you can see, O'Connor Hospital and Regional Medical Center, as well as Saint Louise,

1199
02:01:52,940 --> 02:01:58,320
having a very high percentage of Medicare, which was one of the reasons, as I've noted,

1200
02:01:58,480 --> 02:02:00,840
that we've seen increase in our Medicare patient population.

1201
02:02:01,580 --> 02:02:05,940
It has to do with accessibility to hospital inpatient beds.

1202
02:02:06,720 --> 02:02:13,620
So geographically, your healthcare system is located in essential communities throughout Santa Clara County.

1203
02:02:17,460 --> 02:02:30,980
Operational volume, 800 acute patient days are provided through your four hospitals, representing

1204
02:02:30,980 --> 02:02:34,520
over 300,000 patient days annually.

1205
02:02:38,280 --> 02:02:47,860
750 emergency room rooms on average per day, sometimes at number per day exceeds 800 in

1206
02:02:47,860 --> 02:02:54,700
emergency rooms in the four hospitals. While we provide 4,226% of the birth in the county,

1207
02:02:55,300 --> 02:03:04,000
we provide 80% of the medical birth in Santa Clara County and that number continues to grow.

1208
02:03:07,520 --> 02:03:16,570
The next chart, moving on, Santa Clara Valla Healthcare represents 38% of the licensed acute hospital

1209
02:03:16,570 --> 02:03:24,030
care beds and provides for close to 34% of the hospital patient days in Santa Clara County.

1210
02:03:25,410 --> 02:03:26,050
Of all hospitals.

1211
02:03:26,290 --> 02:03:32,350
We are the largest provider of health care, acute hospital patient days, emergency room

1212
02:03:32,350 --> 02:03:34,910
visits in the county of Santa Clara.

1213
02:03:40,530 --> 02:03:45,750
The next chart, which has to do with arm C, and I wanted to call this chart out specifically.

1214
02:03:45,750 --> 02:03:51,210
As you well know, when we acquired regional medical center, we had done some projections.

1215
02:03:52,370 --> 02:03:59,390
Those projections are represented by the dotted line, which showed that by the 11th or 12th months,

1216
02:04:00,390 --> 02:04:05,170
we would approach 179 in terms of our hospital daily census.

1217
02:04:06,970 --> 02:04:14,250
We have far exceeded that as you would note, in the months of December,

1218
02:04:14,250 --> 02:04:18,030
we were at an average daily census of 199.

1219
02:04:19,550 --> 02:04:22,590
In January, we were actually at a census now

1220
02:04:22,590 --> 02:04:25,130
of an ADC of 210.

1221
02:04:26,130 --> 02:04:28,530
On some days, the census at Regional Medical Center

1222
02:04:28,530 --> 02:04:33,250
reaches a high of 218 on a given day.

1223
02:04:35,200 --> 02:04:36,940
Far beyond what we had anticipated.

1224
02:04:37,340 --> 02:04:40,140
This has translated into the next chart

1225
02:04:40,140 --> 02:04:43,280
into a much more favorable financial performance.

1226
02:04:44,260 --> 02:04:50,360
This is year-to-day through November where you can see that our revenues due to our patient volumes

1227
02:04:50,940 --> 02:04:53,660
are favorable by close to $30 million.

1228
02:04:54,020 --> 02:04:57,860
This is halfway through the year, actually five months through the year.

1229
02:04:58,960 --> 02:05:04,840
Our expenses obviously have gone up, but at the same time the variance in terms of net income

1230
02:05:04,840 --> 02:05:08,380
has been favorable by close to $17.5 million.

1231
02:05:09,460 --> 02:05:12,380
This is through the first five months of the current year.

1232
02:05:12,380 --> 02:05:17,620
That is actually contributing to our ability to address some of the budget challenges that

1233
02:05:17,620 --> 02:05:22,700
we're confronted with related to HR1 and also the state impacts.

1234
02:05:25,580 --> 02:05:31,460
The next chart, I do want to emphasize a couple things here is that as you well know,

1235
02:05:31,660 --> 02:05:37,820
your board has invested in a new facility for acute psychiatric services for both the adult

1236
02:05:37,820 --> 02:05:41,220
population but also children in adolescence.

1237
02:05:41,220 --> 02:05:46,240
And for children in adolescence, it's the first time that your health care system is going

1238
02:05:46,240 --> 02:05:53,400
to be able to serve families in Santa Clara County, keep children, in our community, close

1239
02:05:53,400 --> 02:05:59,180
to home so that we can have the best outcome and best experience given these difficult

1240
02:05:59,180 --> 02:06:02,060
times for our families that we have to care for.

1241
02:06:03,640 --> 02:06:09,420
And people would say, what is the difference between investing in a facility like this

1242
02:06:09,420 --> 02:06:11,880
why you're having such financial challenges.

1243
02:06:12,480 --> 02:06:14,540
Two things that you should walk away with,

1244
02:06:15,440 --> 02:06:17,720
and I think your board clearly understands this.

1245
02:06:17,880 --> 02:06:21,100
This is a one time capital investment that your board has made

1246
02:06:21,100 --> 02:06:24,860
for the long-term future in the state ability

1247
02:06:24,860 --> 02:06:28,180
of critical healthcare services for our residents.

1248
02:06:29,080 --> 02:06:32,460
So this is not something that we are looking at short-term,

1249
02:06:32,500 --> 02:06:36,200
but we are looking at future of healthcare for our residents.

1250
02:06:36,880 --> 02:06:43,620
And at top of it, the financial mix relative to serving children and adolescents along with

1251
02:06:43,620 --> 02:06:50,280
adult population will put us in a much better and favorable financial situation given the

1252
02:06:50,280 --> 02:06:55,840
pair of mix and reimbursements that we expect under this new model in this new facility.

1253
02:06:56,980 --> 02:07:01,340
Staff will be able to care for our patients in a much more safer manner.

1254
02:07:01,340 --> 02:07:13,780
It's really important for our staff to have such state-of-the-art facilities but clearly it's a clear benefit for our patient population in terms of their health and well-being.

1255
02:07:16,530 --> 02:07:27,110
Moving on to the next slide, your board is also invested in a new facility at near the campus of the medical center on Bascom.

1256
02:07:28,210 --> 02:07:38,990
This new facility really allows us to maintain the level and the quality of care and the standard of care that people would otherwise expect from any health care system.

1257
02:07:39,970 --> 02:07:52,150
This facility will have approximately 215 treatment rooms, 215 treatment rooms, providing urgent care service for both our adult and pediatric population.

1258
02:07:52,150 --> 02:08:01,970
But also providing primary care and internal medicine, women's health care and pediatric care in general.

1259
02:08:05,020 --> 02:08:11,540
And as you board well and know, it is very important as our health care system evolves.

1260
02:08:12,160 --> 02:08:23,960
That we focus on preventative health care and manage individual health care so that individuals do not end up in our emergency room in our hospital with chronic conditions that could have been managed.

1261
02:08:25,790 --> 02:08:30,970
This slide provides for the overall impact of HR1.

1262
02:08:31,890 --> 02:08:34,690
I think you're bored and understand that nationally,

1263
02:08:35,830 --> 02:08:40,010
it's a one trillion dollar impact on Medicaid,

1264
02:08:40,930 --> 02:08:42,050
in Santa Clara County.

1265
02:08:43,110 --> 02:08:45,810
It's about one billion dollars.

1266
02:08:47,810 --> 02:08:51,870
But what people should walk away from this is

1267
02:08:51,870 --> 02:08:58,510
that millions of individuals will lose healthcare coverage and their ability to access care will

1268
02:08:58,510 --> 02:09:01,090
be tremendously impacted.

1269
02:09:03,130 --> 02:09:09,150
This is not about what's in front of us, but we also know in healthcare if individuals

1270
02:09:09,150 --> 02:09:17,470
do not have access to healthcare today, it presents long-term costs to health systems that

1271
02:09:17,470 --> 02:09:21,570
trying to provide for basic healthcare needs in essential healthcare services.

1272
02:09:24,110 --> 02:09:35,630
The next slide provides for a detail summary over the course of the next several years of the impacts of HR1.

1273
02:09:36,110 --> 02:09:39,990
We already, in the current year, have faced some challenges.

1274
02:09:40,770 --> 02:09:46,210
I'll provide a chart that was shown that we're looking at 200 million dollars for the current fiscal year.

1275
02:09:46,990 --> 02:09:53,470
But this chart kind of lays out with some of those implications are and I want to touch on a few of these.

1276
02:09:54,930 --> 02:10:04,110
The first one took place in July of 2025 when the federal government put a limit, a cap on directive payments.

1277
02:10:04,770 --> 02:10:13,490
And your board is well aware that we receive directive payments as a supplemental to Medicare reimbursement.

1278
02:10:13,490 --> 02:10:21,150
because base medical fee for service reimbursement is so low that there's no system that can sustain services,

1279
02:10:21,650 --> 02:10:25,410
particularly a system that disproportionately serving the medical population.

1280
02:10:26,210 --> 02:10:29,510
So we rely heavily on those direct repayments.

1281
02:10:29,750 --> 02:10:32,450
We receive close to three quarters of billion dollars,

1282
02:10:32,650 --> 02:10:39,730
$750 million dollars via these direct repayments for which we put up a match.

1283
02:10:42,640 --> 02:10:49,600
When we acquired regional medical center, we acquired regional medical center prior to this taken effect.

1284
02:10:50,040 --> 02:11:00,300
We were counting on close to $67 million in direct payments to offset the cost of the care that we're providing that regional medical center.

1285
02:11:01,460 --> 02:11:05,840
That was the first major blow to the health system, financially.

1286
02:11:06,920 --> 02:11:13,960
Subsequent to that, because its cap, we do not receive a cost of living adjustment, a 3%

1287
02:11:13,960 --> 02:11:21,460
cost of living adjustment to the direct repayments, because its cap, 3% of $750 million,

1288
02:11:24,000 --> 02:11:34,280
is close to $234 million. So all of these, as you can see, as the provisions are implemented,

1289
02:11:34,280 --> 02:11:43,240
it slowly create a financial stressor on the system that simply is not sustainable unless we

1290
02:11:43,240 --> 02:11:45,940
make some really difficult decisions.

1291
02:11:47,400 --> 02:11:52,160
One of the most important things to note about this chart is the implementation of the

1292
02:11:52,160 --> 02:11:53,580
six-month readie termination.

1293
02:11:54,140 --> 02:11:59,600
So those individuals that are currently on medical are going to have to go through a readie termination

1294
02:11:59,600 --> 02:12:00,840
every six months.

1295
02:12:00,840 --> 02:12:12,220
And then on top of it, in 2028, individuals are going to have to make co-pays of no more than 35 dollars a month.

1296
02:12:12,380 --> 02:12:13,440
That's per individual.

1297
02:12:14,160 --> 02:12:20,880
So a family of four, multiply that by by 35 dollars, and that's what a family four would have to pay.

1298
02:12:21,760 --> 02:12:29,440
We fully expect, because a number of these different provisions that individuals are going to start to fall off enrollment into Metacow.

1299
02:12:29,440 --> 02:12:33,980
And we'll talk about the importance of making sure that we do everything possible to keep

1300
02:12:33,980 --> 02:12:35,680
individuals enrolled in Metacal.

1301
02:12:39,160 --> 02:12:47,020
The next chart talks about what we refer to as the state-only program, which is unsatisfactory

1302
02:12:47,020 --> 02:12:53,400
immigration status of those currently enrolled in the state-only Metacal program.

1303
02:12:54,460 --> 02:12:59,440
In Santa Clara County, there are 72,000 individuals enrolled in this program.

1304
02:12:59,440 --> 02:13:08,260
We already seen a decline in individuals in the second of our patient population,

1305
02:13:10,930 --> 02:13:16,790
which is one of the contributing factors to our 200 million dollar projected loss.

1306
02:13:17,430 --> 02:13:23,090
This is something the state has chosen to do on top of the impacts of HR1.

1307
02:13:23,350 --> 02:13:28,050
So not only do we have federal implications, but we have state implications as a result of this.

1308
02:13:29,490 --> 02:13:37,370
I want to point out that in July of 2026, not only does your health system through our primary

1309
02:13:37,370 --> 02:13:44,210
care clinics, our federally qualified health centers, not only will we be impacted, but also

1310
02:13:44,210 --> 02:13:46,810
the community health centers in the county.

1311
02:13:47,690 --> 02:13:53,970
So Gardner Health, Oki, all the community health centers that are federally qualified will

1312
02:13:53,970 --> 02:14:01,110
lose what they call as a prospective payment to round out their reimbursement to serve this

1313
02:14:01,110 --> 02:14:02,070
patient population.

1314
02:14:02,890 --> 02:14:11,430
That has been taken away in some situations, community health centers estimate a loss of

1315
02:14:11,430 --> 02:14:16,570
cost of 60 to 70 percent of their patient revenue per encounter.

1316
02:14:17,690 --> 02:14:22,830
So this is quite significant not just for our health system but also for our community health

1317
02:14:22,830 --> 02:14:28,850
or ship clinics. And I would say to you that the challenge that we face is that keep in mind,

1318
02:14:29,010 --> 02:14:37,070
people are accessing care via their medical homes. They will lose that opportunity unless we come

1319
02:14:37,070 --> 02:14:41,750
up with some alternative strategy. And we want to make sure that individuals maintain access

1320
02:14:41,750 --> 02:14:42,810
to primary care.

1321
02:14:46,560 --> 02:14:50,480
And we will talk about some of our strategies there. Then on top of it, they will also

1322
02:14:50,480 --> 02:14:57,380
the state will be implementing the $30 per month premium for individuals in this population.

1323
02:14:58,460 --> 02:14:59,980
We expect that the enrollment...

1324
02:15:00,000 --> 02:15:10,440
We have individuals to drop up to no less than 50% drop in enrollment because of these changes.

1325
02:15:15,220 --> 02:15:18,200
So, what are we doing to try to mitigate some of these challenges?

1326
02:15:19,820 --> 02:15:25,780
And this is something that our county executive James William is spoken to and your board is very much aware of.

1327
02:15:25,820 --> 02:15:29,860
Obviously, we have to manage our cost, find ways to increase our revenue.

1328
02:15:29,860 --> 02:15:59,480
I will say on that point that because your system is a comprehensive integrated system, and we provide services ranging from primary care to specialty to hospital-based services, we have the ability to focus on service lines that are able to generate revenue, provide more care and access to lower our cost per unit of service.

1329
02:15:59,860 --> 02:16:03,780
and increase our revenue per patient day and per visit.

1330
02:16:05,260 --> 02:16:11,340
So our primary focus is to figure out how we maintain access and continue to grow the

1331
02:16:11,340 --> 02:16:17,000
system in a value-based way to ensure that we can deal with these financial challenges.

1332
02:16:17,880 --> 02:16:25,260
We are not going to be able to cut ourselves, make reductions to the tune of $200 million

1333
02:16:25,260 --> 02:16:30,760
or in the subsequent years, $160 million or even $300 million.

1334
02:16:31,060 --> 02:16:35,260
We have to find ways to generate revenue to continue to provide access

1335
02:16:35,840 --> 02:16:39,480
into marine value-based care to our community at a lower cost.

1336
02:16:41,200 --> 02:16:45,700
The second strategy that your board is very much aware

1337
02:16:45,700 --> 02:16:50,000
is that we are looking to the state to support public hospitals.

1338
02:16:50,760 --> 02:16:56,300
As you well know, public hospitals make up 6% of the hospitals in the state of California,

1339
02:16:57,720 --> 02:17:05,200
but we provide for 30% of the Medicaid visits and services, so just think about that

1340
02:17:05,200 --> 02:17:05,460
ratio.

1341
02:17:05,660 --> 02:17:13,140
6% of the hospitals are public hospitals, but yet we provide 30% of the Medicaid services

1342
02:17:13,140 --> 02:17:14,640
in the state of California.

1343
02:17:15,440 --> 02:17:21,300
In Santa Clara County it's a much higher percentage, we're at 60 to 70 percent, but you

1344
02:17:21,300 --> 02:17:26,680
can see what the value of public hospitals are and this is a state program and we believe

1345
02:17:26,680 --> 02:17:29,280
the state should be stepping up to support public hospitals.

1346
02:17:30,680 --> 02:17:37,860
We provide for over 50 percent of the trauma and burn care centers in the state of California

1347
02:17:37,860 --> 02:17:44,600
And we train 50% of the physicians in the state of California as public systems.

1348
02:17:46,120 --> 02:17:53,120
So we do look to the state for that support and we are working with our delegation and

1349
02:17:53,120 --> 02:17:57,540
others to ensure that they understand the importance of supporting public hospitals.

1350
02:17:58,360 --> 02:18:08,060
Then, of course, measure A was a big, big lift, and it really does reflect the community's

1351
02:18:08,060 --> 02:18:14,920
support of your public system, and they do understand that we are just not a safety net

1352
02:18:14,920 --> 02:18:23,340
system for those that are uninsured or unmedicated, we are a safety net system for every resident

1353
02:18:23,900 --> 02:18:25,360
of this community,

1354
02:18:27,500 --> 02:18:30,760
something that I, you know, I have to say that everyone was in the health

1355
02:18:30,760 --> 02:18:37,120
system, and I know it was in the county is very proud of, and it would not have come

1356
02:18:37,120 --> 02:18:44,560
about unless we have a system that people respect and understand in terms of what value we bring

1357
02:18:44,560 --> 02:18:45,720
to the community.

1358
02:18:48,360 --> 02:18:52,500
And I do have to acknowledge our workforce for that, our doctors and our nurses

1359
02:18:52,500 --> 02:18:55,600
that work day in a day out to provide that love of care.

1360
02:18:57,420 --> 02:19:00,620
I've mentioned the next slide, please, that we're looking

1361
02:19:01,580 --> 02:19:04,360
with all the provisions of HR1 implement,

1362
02:19:04,380 --> 02:19:07,360
implement it close to $1 billion in last revenue.

1363
02:19:09,080 --> 02:19:14,360
What we're looking at is $200 million for the current year,

1364
02:19:14,640 --> 02:19:17,020
that we will be presenting to your board at mid-year.

1365
02:19:17,420 --> 02:19:18,500
That is our target.

1366
02:19:18,500 --> 02:19:30,340
We're estimated $160 million for FY2627, that is after Measure A of $300 million and then

1367
02:19:30,340 --> 02:19:39,100
in 2027 and 28, when most of the provisions of HR1 are fully implemented, we are looking

1368
02:19:39,100 --> 02:19:46,340
at a much more difficult, hill to climb relative to loss to revenue related to Medicaid.

1369
02:19:46,340 --> 02:19:52,460
that is in twenty seven twenty eight. And so we're trying to get ahead of that curve and

1370
02:19:52,460 --> 02:19:54,860
trying to mitigate this as much as possible.

1371
02:19:56,500 --> 02:20:03,620
Those are make one comment. That chart assumes no money from our state-related strategies.

1372
02:20:03,680 --> 02:20:05,400
I just wanted to clarify that.

1373
02:20:08,130 --> 02:20:16,990
And that chart also reflects that we are not looking for any additional general fund contribution.

1374
02:20:18,370 --> 02:20:24,450
going forward. So we're trying to manage within the current general fund contribution along with

1375
02:20:24,450 --> 02:20:28,810
dealing with all of these other revenue losses to your health system.

1376
02:20:30,840 --> 02:20:31,820
The next slide I'm not

1377
02:20:31,820 --> 02:20:36,400
going to spend too much time on this but this gives you a breakdown of the $200 million in the

1378
02:20:36,400 --> 02:20:42,780
lost revenue as you would note the $67 million in lost direct repayments that was prior to

1379
02:20:42,780 --> 02:20:46,440
to the acquisition required regional medical center,

1380
02:20:46,740 --> 02:20:50,760
then HR1 came online, that alone was $67 million.

1381
02:20:52,420 --> 02:20:55,280
And then, of course, you see the other items,

1382
02:20:56,700 --> 02:20:59,820
including lost fee for service revenue

1383
02:20:59,820 --> 02:21:04,320
and impact of the federal government decision

1384
02:21:04,320 --> 02:21:06,400
around the MCOTACs.

1385
02:21:09,170 --> 02:21:12,230
So our strategy says, I'm sorry,

1386
02:21:12,330 --> 02:21:14,910
will you just say that sentence again, not the MCOTACs?

1387
02:21:14,910 --> 02:21:22,690
So when the federal government implemented changes due to directed payments and the ability

1388
02:21:22,690 --> 02:21:31,110
of counties in the state to put up the match, to draw down additional federal dollars,

1389
02:21:32,750 --> 02:21:42,550
they cap that and also created a situation where the expected increases the state was

1390
02:21:42,550 --> 02:21:46,170
an implement for medical fee for service reimbursement.

1391
02:21:46,410 --> 02:21:48,190
That was all lost in that.

1392
02:21:48,590 --> 02:21:51,190
The state has to now review the program,

1393
02:21:51,210 --> 02:21:55,370
determine how best to leverage what they can relative

1394
02:21:55,370 --> 02:21:56,430
to federal revenue.

1395
02:21:57,510 --> 02:22:01,140
So more to come on that from the state.

1396
02:22:03,960 --> 02:22:05,520
The other thing I would mention, supervisor

1397
02:22:05,520 --> 02:22:09,000
Ellen Burgess, that there was a specific allocation

1398
02:22:09,000 --> 02:22:12,820
in there outside of the fee for service,

1399
02:22:12,820 --> 02:22:20,520
where we would, as a public system, expect to receive about $15 million directly, which

1400
02:22:20,520 --> 02:22:22,440
is also lost because of that.

1401
02:22:27,020 --> 02:22:32,520
So the budget mitigation strategy, as I mentioned, we are looking to improve the revenue

1402
02:22:32,520 --> 02:22:36,000
picture via our revenue cycle.

1403
02:22:36,140 --> 02:22:41,540
I'll share some numbers with you, but we've made some marked improvement around our revenue

1404
02:22:41,540 --> 02:22:42,000
cycle.

1405
02:22:43,940 --> 02:22:53,500
We are also focused on making sure that our contracted pair rates are more in line with

1406
02:22:53,500 --> 02:22:59,260
the market, whether it has to do with medical, Medicare, or commercial.

1407
02:22:59,600 --> 02:23:04,400
We're really focused on making sure that our contracts reflect what we should be receiving

1408
02:23:05,240 --> 02:23:06,780
in this marketplace.

1409
02:23:08,160 --> 02:23:10,080
And then, of course,

1410
02:23:12,720 --> 02:23:16,620
you will hear a little bit more about our payer strategies, but again,

1411
02:23:16,760 --> 02:23:20,720
one of our strategies to make sure that it's many individuals that qualify for some

1412
02:23:20,720 --> 02:23:24,740
government program coverage, that they remain enrolled.

1413
02:23:25,300 --> 02:23:30,720
If they do not remain enrolled, that becomes an un-reimbursed cost to your healthcare system,

1414
02:23:31,800 --> 02:23:36,080
thus further exacerbating our financial situation in shortfalls.

1415
02:23:37,390 --> 02:23:42,130
As I mentioned, we're focused on operational efficiencies and cost savings.

1416
02:23:44,210 --> 02:23:48,890
Let me give you this perspective, which is on the next slide, which is important to understand.

1417
02:23:52,050 --> 02:23:57,670
Of the $200 million that we're coming to your board in terms of solutions,

1418
02:23:59,690 --> 02:24:04,870
we have $40 million in revenue improvement that we've identified,

1419
02:24:04,870 --> 02:24:12,340
close to $90 million in an operation of efficiencies and cost savings, that operation of

1420
02:24:12,870 --> 02:24:20,410
efficiency is reflected in terms of revenue, as opposed to more so cost reductions.

1421
02:24:22,050 --> 02:24:31,950
If we're able to improve the efficiency of our hospital patient flow, meaning discharge

1422
02:24:31,950 --> 02:24:40,110
of patients to free a bed for other patients where we can actually get reimbursement, that makes

1423
02:24:40,110 --> 02:24:48,090
the difference. So patient flow and hospital efficiency is a key factor in that revenue as well

1424
02:24:48,090 --> 02:24:53,670
as well as outpatient visits. So what we are trying to do is become a lot more efficient in

1425
02:24:53,670 --> 02:25:01,370
the way we manage our schedules and see patients. The more patients we see, the better for the patient

1426
02:25:01,370 --> 02:25:08,130
in terms of access, but we are also able to generate revenues to further mitigate some of these

1427
02:25:08,130 --> 02:25:09,290
financial losses.

1428
02:25:11,150 --> 02:25:16,870
And then we are looking at service line restructuring and consolidations in terms of annoying

1429
02:25:16,870 --> 02:25:23,030
efficiency, but also allowing us to utilize high-cost resources and much more effective manner.

1430
02:25:26,700 --> 02:25:31,320
I'm not going to go through the next slide in much detail, but these are some of the areas

1431
02:25:31,320 --> 02:25:41,380
focus around revenue cycle, ranging from charge capture to coding and documentation to regular claims

1432
02:25:41,380 --> 02:25:50,340
denial audits and review, but also having much more favorable contracts in terms of our reimbursement

1433
02:25:50,340 --> 02:26:00,180
for various payers. The next few slides are an example of some of the improvements that we've seen.

1434
02:26:01,880 --> 02:26:07,180
I'm going to touch on these and I'll let the note speak if there's something more to cover,

1435
02:26:07,340 --> 02:26:15,860
but the short of it is that in epic, we're utilizing a tool called Revenue Guardian to identify

1436
02:26:15,860 --> 02:26:22,960
opportunities where comparative markers would suggest that we should have a higher revenue reimbursement

1437
02:26:22,960 --> 02:26:23,460
base.

1438
02:26:24,540 --> 02:26:31,400
And so you can see just in this chart, in this short period of time, there's been a 29% improvement

1439
02:26:31,400 --> 02:26:36,080
in our facility charge reimbursement or charge capture.

1440
02:26:37,840 --> 02:26:42,840
And then also you see that on the next chart on the professional fee.

1441
02:26:43,360 --> 02:26:49,960
And I do have to give a lot of credit to our physicians and staff on this because they're

1442
02:26:49,960 --> 02:26:57,760
one that are working with us to make sure that our documentation and coding is optimal

1443
02:26:57,760 --> 02:27:01,420
in order for us to get the higher base of reimbursement.

1444
02:27:02,920 --> 02:27:08,880
And so you can see, if we're able to have a much more optimal charge capture that

1445
02:27:08,880 --> 02:27:14,240
are net revenue is going to be much better as a system, and this is contributing greatly

1446
02:27:14,240 --> 02:27:18,840
to our ability to deal with some of these financial challenges that we have.

1447
02:27:18,840 --> 02:27:21,880
We are also adopting, next slide,

1448
02:27:24,110 --> 02:27:46,510
AI in a much more aggressive manner, meaning that we're not going to compromise our ability to maintain privacy or maintain the data in a responsible manner, because that will be our primary focus.

1449
02:27:46,510 --> 02:27:54,730
but our ability to bring this type of technology will improve efficiency, will allow us to improve

1450
02:27:54,730 --> 02:28:03,850
productivity and performance in our system, and this is also allowed us to implement this

1451
02:28:03,850 --> 02:28:09,030
technology not just in terms of revenue cycle, but clearly in clinical setting.

1452
02:28:14,670 --> 02:28:15,190
These charts

1453
02:28:15,190 --> 02:28:21,710
provide for a little bit more detail relative to some of the areas that we're looking

1454
02:28:21,710 --> 02:28:30,490
to adopt AI. Either very similar to what other health systems are adopting and will improve

1455
02:28:30,490 --> 02:28:36,750
our ability to not only generate revenue but also provide for better care for our patients.

1456
02:28:38,210 --> 02:28:45,150
The next slide touches on our market payer strategies. Let me just say this about market

1457
02:28:45,150 --> 02:28:53,870
air strategies. We know about the major pairs being medical, Medicare, or commercial. What you should

1458
02:28:53,870 --> 02:29:00,430
also understand that with each of these categories you have different insurance companies or

1459
02:29:00,430 --> 02:29:08,350
different pairs, right? So in medical, as you well know, we have a situation where we have

1460
02:29:08,350 --> 02:29:14,090
some of the cross, we have family health plan, we have our own health care plan, but we also

1461
02:29:14,090 --> 02:29:23,610
have IPAs that take risk and pay us, so it's a very complicated scheme relative to each of

1462
02:29:23,610 --> 02:29:27,790
these payers and it's really important that we understand that and have strategies to address

1463
02:29:27,790 --> 02:29:28,270
it.

1464
02:29:28,630 --> 02:29:34,710
In medical, James has talked about and you're very familiar with our strategy to move to a single

1465
02:29:34,710 --> 02:29:41,810
plan model where we can maximize reimbursement, but also manage or cost much more effectively

1466
02:29:42,430 --> 02:29:44,030
in utilization of services.

1467
02:29:45,470 --> 02:29:49,930
That's one example, but in each of these areas, whether it's Medicare or commercial,

1468
02:29:50,630 --> 02:29:58,590
we have to take the same level of interest in terms of what's going on around us and relative

1469
02:29:58,590 --> 02:29:59,650
to what's going on.

1470
02:30:00,000 --> 02:30:05,680
Within our own system, in terms of the level of a pair of adequacy.

1471
02:30:08,950 --> 02:30:13,610
The uninsured and uninsured, the primary care

1472
02:30:13,610 --> 02:30:23,470
access program that your board is familiar with, we are looking to revise that program given the impacts

1473
02:30:23,470 --> 02:30:30,990
of HR1 in the expected increase of individuals that will be uninsured. So we are looking at putting

1474
02:30:30,990 --> 02:30:38,550
other program that is much more robust and addresses those implications. I will tell you that

1475
02:30:38,550 --> 02:30:47,110
some of our estimates suggest that we are at 3% unsure that number can easily go up to

1476
02:30:48,210 --> 02:30:57,450
10% 15% within the next year or two, which is part of the reasons that you see such a large number

1477
02:30:57,450 --> 02:30:59,290
in terms of lost medical revenue.

1478
02:31:00,510 --> 02:31:06,290
It all has to do with individuals that are not enrolling in coverage or have the ability to

1479
02:31:06,290 --> 02:31:06,930
have coverage.

1480
02:31:11,510 --> 02:31:17,230
Operation efficiencies, I won't spend much time on this slide other than to once again stress

1481
02:31:17,230 --> 02:31:26,230
that we as a healthcare system have the ability to generate revenues through our ability

1482
02:31:26,230 --> 02:31:30,890
to be much more efficient and cost effective in terms of how we deliver care.

1483
02:31:30,890 --> 02:31:34,190
And so we are heavily focused on that.

1484
02:31:37,490 --> 02:31:46,570
The next slide, what we attempted to do in our mid-year proposal was to come up with

1485
02:31:46,570 --> 02:31:50,090
$200 million, as I mentioned, was to

1486
02:31:52,330 --> 02:31:57,530
try to mitigate the $200 million without impacting services.

1487
02:31:59,330 --> 02:32:04,210
To a large degree, you know, we have done that much through the revenue initiatives.

1488
02:32:04,210 --> 02:32:12,550
We also, we're trying to figure out strategies in which we can better utilize our most valuable resource, which is our staffing.

1489
02:32:16,620 --> 02:32:24,260
We are going to be recommending 218 positions to be deleted from our budget.

1490
02:32:24,960 --> 02:32:32,500
I don't say layoffs, because many of these individuals of the field positions,

1491
02:32:32,500 --> 02:32:34,400
which represents around

1492
02:32:38,500 --> 02:32:43,200
44, 47 positions.

1493
02:32:44,000 --> 02:32:49,640
These individuals will have an opportunity to move into a vacant position in another program or service.

1494
02:32:51,740 --> 02:33:00,960
So the other item that you will note on the slide is that we are reallocating 86.6FTEs to activate the new behavioral civilian.

1495
02:33:00,960 --> 02:33:17,720
So what we are trying to do, instead of adding costs, what we are trying to do is to reallocate staff in those resources to areas in which we have a need and are able to generate revenue to cover the costs of the program.

1496
02:33:21,430 --> 02:33:33,070
The reason that the number in terms of field positions relative to the total is where

1497
02:33:33,070 --> 02:33:38,370
it's at today is because over the past nine months we were very careful not to

1498
02:33:38,370 --> 02:33:44,050
fill positions in anticipation of these budget challenges.

1499
02:33:46,070 --> 02:33:49,890
So that is why we're able to give up more vacant positions in field positions in

1500
02:33:49,890 --> 02:33:51,730
to meet our budget obligation.

1501
02:33:58,230 --> 02:34:04,350
The next slide in terms of service line restriction consolidation, this gives you some perspective

1502
02:34:05,370 --> 02:34:11,670
of both administrative, realignment that's going on within the healthcare system, but also

1503
02:34:12,310 --> 02:34:13,710
clinical service lines.

1504
02:34:17,240 --> 02:34:26,240
And of course, range from women's healthcare to cardiac care in other specialties.

1505
02:34:28,160 --> 02:34:38,740
I wanted Dr. Cliff Wang to talk about cardiac care as an example of why and this is so important for your health system to embrace.

1506
02:34:39,320 --> 02:34:39,900
Thanks Paul.

1507
02:34:40,600 --> 02:34:48,080
The natural progression of any major health system is to really, with multiple hospitals, it's developed clinical service lines.

1508
02:34:48,960 --> 02:34:55,760
We created that cardiac care service line to really integrate and consolidate health care across our system.

1509
02:34:55,760 --> 02:35:00,380
There are really three drivers that you think about in terms of why you want to do that.

1510
02:35:00,520 --> 02:35:02,300
The first is really quality and safety.

1511
02:35:03,300 --> 02:35:10,040
For you to be really good at doing complex cardiac procedures, such as thoracic, organic

1512
02:35:10,040 --> 02:35:18,460
dissection or advanced coronary bypass surgeries or pulse frequency ablations for cardiac

1513
02:35:18,460 --> 02:35:23,300
arrhythmias, you really have to concentrate certain services in various locations.

1514
02:35:23,300 --> 02:35:25,340
you can't have them across the whole system.

1515
02:35:25,800 --> 02:35:29,720
I'm going to allow us for more standardization of your protocols to be able to have enough

1516
02:35:29,720 --> 02:35:32,680
on-call coverage for those types of procedures.

1517
02:35:33,480 --> 02:35:38,240
The second is really resource use in staff wisely.

1518
02:35:39,020 --> 02:35:44,880
We know that many of these types of procedures require very specialized training, so you

1519
02:35:44,880 --> 02:35:51,660
want to be able to sort of strategize where you put those staff in personnel as well as equipment.

1520
02:35:51,660 --> 02:35:59,280
As an example, we have ECMO at the MC, and that allows us to do very high risk cardiac procedures that can save patients lives.

1521
02:36:00,360 --> 02:36:06,300
So you can't do that everywhere. You have to be really strategic about where you place that equipment, it's very expensive, et cetera.

1522
02:36:07,180 --> 02:36:15,720
The third is actually just, you know, financial and regulatory stewardship in order for us to really do well at any of these endeavors.

1523
02:36:15,720 --> 02:36:22,080
is we have to be very effective both from a patient standpoint and in terms of looking at our

1524
02:36:22,080 --> 02:36:22,660
cost.

1525
02:36:23,080 --> 02:36:31,060
So by organizing your care in a very integrated way, we think that this is how you can maintain

1526
02:36:31,060 --> 02:36:36,440
national standards, improve your quality, and then also improve your throughput and efficiency.

1527
02:36:37,340 --> 02:36:43,620
Our hope is that whenever you start your journey in our system with a heart problem, you will

1528
02:36:43,620 --> 02:36:49,340
get the best cardiac care using all of the available resources in our system and that's why

1529
02:36:49,340 --> 02:36:52,440
we organize the system in a way that is much more effective.

1530
02:36:54,700 --> 02:36:59,960
Thank you, Dr. Wang, and so that's just an example of why we focus on a service line strategy

1531
02:36:59,960 --> 02:37:06,080
in such a large health system that we have, so we're leveraging our assets.

1532
02:37:07,000 --> 02:37:11,720
The next item I want to talk to Tornabini to talk about because it's been a lot of conversation

1533
02:37:11,720 --> 02:37:17,160
within our workforce about this topic of service to the aging population.

1534
02:37:18,180 --> 02:37:18,920
Thank you.

1535
02:37:19,260 --> 02:37:26,700
As part of the growing national recognition of the importance of optimizing care for older adults,

1536
02:37:27,200 --> 02:37:29,780
we are pursuing becoming age-friendly.

1537
02:37:30,300 --> 02:37:34,620
Specifically, we are starting that program at OConnor Hospital.

1538
02:37:34,620 --> 02:37:43,700
There are different programs that health systems can put into place in order to achieve that age-friendly designation.

1539
02:37:46,990 --> 02:37:54,390
But it's important to understand that these programs not only meet the requirements of being age-friendly,

1540
02:37:54,550 --> 02:38:00,690
but they also form the clinical basis for care transformation for older adults.

1541
02:38:00,690 --> 02:38:08,050
We have applied at O'Connor Hospital to become an age-friendly hospital.

1542
02:38:09,270 --> 02:38:17,710
We heard last Friday that the IHI had accepted our application and we are now an age-friendly

1543
02:38:17,710 --> 02:38:19,570
health system participant.

1544
02:38:21,010 --> 02:38:27,330
We will be working on implementing a new framework of care for older adults that's based

1545
02:38:27,330 --> 02:38:30,990
on four clinical pillars, what matters,

1546
02:38:31,770 --> 02:38:35,230
mentation, mobility, and medications.

1547
02:38:36,270 --> 02:38:38,930
We will be starting that in the perioperative area

1548
02:38:38,930 --> 02:38:41,690
and then spreading that across other units

1549
02:38:41,690 --> 02:38:42,630
in the hospital.

1550
02:38:43,790 --> 02:38:48,190
Our goal is to improve the outcomes for our patients

1551
02:38:48,190 --> 02:38:51,710
by reducing the incidence of delirium,

1552
02:38:52,610 --> 02:38:56,030
falls, readmission, readmissions,

1553
02:38:56,030 --> 02:39:03,530
functional decline and polypharmacy of our older patients. In a future phase, we will also

1554
02:39:03,530 --> 02:39:12,870
be looking to transform our geriatric care in our outpatient environment. So in implementing this,

1555
02:39:13,230 --> 02:39:19,230
we hope to set up the system to not only improve the care that we're providing our older adults,

1556
02:39:19,230 --> 02:39:23,790
but also improve the value that we're providing our community.

1557
02:39:27,660 --> 02:39:28,680
Thank you, Dr. Hornebini.

1558
02:39:28,940 --> 02:39:33,620
So it gives you some insight in terms of some of the planning that's going on with our health,

1559
02:39:33,620 --> 02:39:36,040
within our health care system looking toward the future.

1560
02:39:37,480 --> 02:39:39,720
And this does provide a basis for sustainability,

1561
02:39:40,580 --> 02:39:42,580
in terms of not on providing access to care,

1562
02:39:43,060 --> 02:39:47,640
but also from a financial perspective in having a place to the market.

1563
02:39:49,020 --> 02:40:00,080
The next slide I do want to share with your board that we did ask staff to give input relative to budget ideas.

1564
02:40:01,140 --> 02:40:08,140
We received over 600 responses from our workforce in a matter of 60 days.

1565
02:40:09,200 --> 02:40:13,900
These ideas fall into one of these eight categories that are before you.

1566
02:40:13,900 --> 02:40:20,420
And as you would note, many of the malign with many of the items that I have presented today

1567
02:40:20,420 --> 02:40:24,920
around cost control in efficiency.

1568
02:40:27,240 --> 02:40:32,040
So I'm very, very pleased to share with you that there's been a level of staffing engagement

1569
02:40:32,040 --> 02:40:34,740
that has been very productive and fruitful.

1570
02:40:35,980 --> 02:40:40,520
We are adopting many of them in moving forward with those suggestions.

1571
02:40:40,520 --> 02:40:41,720
The

1572
02:40:44,060 --> 02:40:51,880
next slide, I just want to summarize that we have coming to your board at me, you're

1573
02:40:51,880 --> 02:41:02,720
about 200 million. The goal for that 200 million is to reflect on going reduction or

1574
02:41:02,720 --> 02:41:11,480
improvement in our bottom line. That's ongoing because it's cumulative. As you well know, we

1575
02:41:11,480 --> 02:41:18,460
200 million dollars this year next year another 160 million dollars and another 280 million

1576
02:41:18,460 --> 02:41:25,180
dollars. So we have to find ways to make sure that we lower the cost or find ways to generate

1577
02:41:25,180 --> 02:41:33,780
ongoing revenue to deal with those losses. Regional medical center has noted contributed to our

1578
02:41:33,780 --> 02:41:39,440
ability to meet these targets, and we'll continue to.

1579
02:41:39,980 --> 02:41:43,440
There are 13% of over the budget census today,

1580
02:41:44,040 --> 02:41:46,340
and we fully expect that that will continue.

1581
02:41:48,460 --> 02:41:50,740
So we are providing not only access to care,

1582
02:41:51,060 --> 02:41:54,400
but we are finding a financial solution going forward,

1583
02:41:55,200 --> 02:41:56,640
so that we can sustain the system.

1584
02:41:58,460 --> 02:42:01,920
And then, of course, revenue cycle improvements

1585
02:42:01,920 --> 02:42:03,960
and pair of strategies.

1586
02:42:05,080 --> 02:42:09,700
We've seen a 7.5% gross year over year in our revenue.

1587
02:42:12,180 --> 02:42:13,680
That's about $104 million.

1588
02:42:15,040 --> 02:42:19,420
So these are efforts that we're going to continue to focus on going forward.

1589
02:42:20,220 --> 02:42:23,720
And then an example that I've given here is primary care,

1590
02:42:24,140 --> 02:42:29,680
where year over year there's been an increase in efficiency of 10%

1591
02:42:29,680 --> 02:42:31,820
in terms of seeing more patients.

1592
02:42:32,520 --> 02:42:35,240
So, now, again, are we providing more access to care,

1593
02:42:36,040 --> 02:42:38,480
but this will allow us to generate the revenue

1594
02:42:38,480 --> 02:42:42,760
to further offset the lost revenues in other areas.

1595
02:42:43,780 --> 02:42:45,160
So, this is where we're focused.

1596
02:42:45,600 --> 02:42:47,200
We are going to do everything possible

1597
02:42:47,200 --> 02:42:53,080
to minimize impact to staff, minimize the impact to services.

1598
02:42:54,100 --> 02:42:56,320
And this is our strategy going forward.

1599
02:42:57,060 --> 02:42:58,640
And, you know, because you have such a robust

1600
02:42:58,640 --> 02:43:04,180
and integrated healthcare system, and we're able to leverage those assets.

1601
02:43:05,660 --> 02:43:07,440
I think we do have a pass forward.

1602
02:43:11,150 --> 02:43:14,770
I just want to share a couple of comments as we turn to questions.

1603
02:43:16,410 --> 02:43:25,990
I first want to express tremendous gratitude to Paul specifically and to the incredible team that he has working with him.

1604
02:43:25,990 --> 02:43:46,970
We're very fortunate to have in Paul a leader for our health system who came to the county with decades of leadership in public health and in county delivery of health care down in Southern California and he's now been at the helm here through tremendous expansion of our health care system.

1605
02:43:46,970 --> 02:43:55,290
he leads with compassion, integrity, wisdom, and I really cannot overemphasize how fortunate

1606
02:43:55,290 --> 02:44:01,530
we are in this time and with so much that has been happening at Santa Clara Valley Healthcare

1607
02:44:01,530 --> 02:44:07,870
to have Paul's leadership. And he's surrounded himself with an incredible team not just

1608
02:44:07,870 --> 02:44:13,270
the folks you see here, although each of them this is certainly true, but a much broader team

1609
02:44:13,270 --> 02:44:19,010
of leadership across our healthcare system, dedicated public servants, and that includes the

1610
02:44:19,010 --> 02:44:22,210
entirety of the workforce, working day in and out.

1611
02:44:22,750 --> 02:44:29,010
And the initiatives that you've seen highlighted here reflect a values-based focus that is

1612
02:44:29,010 --> 02:44:34,650
a focus on centering the patients that we serve, where some of the most vulnerable families

1613
02:44:34,650 --> 02:44:39,950
in our community, but also on recognition that we serve every family in our community.

1614
02:44:39,950 --> 02:44:49,490
and moving forward a litany of initiatives that seek to minimize disruption to the system,

1615
02:44:49,790 --> 02:44:55,970
maximize revenue for the system, and mitigate impacts on our workforce and most importantly

1616
02:44:55,970 --> 02:44:57,570
on the patients that we serve.

1617
02:44:58,510 --> 02:44:59,970
So I want to just extend.

1618
02:45:00,000 --> 02:45:05,720
Government is gratitude to the leadership across the system. This is coming off the heels, mind you.

1619
02:45:06,340 --> 02:45:14,140
I think context is important. This is coming off the heels of the incredible 80 day acquisition of regional medical

1620
02:45:14,140 --> 02:45:24,440
center, the pandemic, the transformations happening more broadly in the healthcare space, the 2019 acquisition of the other two hospitals.

1621
02:45:24,440 --> 02:45:31,200
These are all hugely generationally transformative changes for any healthcare system.

1622
02:45:31,720 --> 02:45:39,120
We've had all of them occur in just a matter of a handful of years, and we have to acknowledge that as well.

1623
02:45:40,320 --> 02:45:51,660
I won't go on longer than that, but I could not fail to acknowledge Paul and the broader team both here and across our healthcare system for the work that they continue to do tirelessly

1624
02:45:51,660 --> 02:45:59,060
to address the new challenge that has been foisted on us by the federal and state government.

1625
02:46:04,590 --> 02:46:10,170
Thank you James, and thank you very much, Bob. I don't see any questions or lights on my colleague.

1626
02:46:10,450 --> 02:46:13,690
I'm telling you, I want to open up a public when I get out. Yeah, let's see, how many

1627
02:46:13,690 --> 02:46:15,270
are the public electors pick on this item?

1628
02:46:18,580 --> 02:46:23,240
I currently have one speaker on Zoom, and that is all.

1629
02:46:23,480 --> 02:46:28,900
Okay, just two minutes. All right. For our speaker, are we going to close the queue?

1630
02:46:28,920 --> 02:46:31,060
are speaker on Zoom as parent?

1631
02:46:33,400 --> 02:46:34,960
Yes, thank you for the presentation.

1632
02:46:36,500 --> 02:46:38,760
While people, they have choices.

1633
02:46:40,140 --> 02:46:43,300
They can get private insurance.

1634
02:46:43,480 --> 02:46:46,020
They can go to private providers.

1635
02:46:46,160 --> 02:46:50,400
They don't have to go to our public health care system.

1636
02:46:51,300 --> 02:46:53,180
But when it comes to children being molested,

1637
02:46:55,500 --> 02:46:59,640
the county has them an awfully on seeing them,

1638
02:46:59,640 --> 02:47:05,760
specifically at the Child Advice and my children are being molested, my son is already confirmed

1639
02:47:05,760 --> 02:47:11,020
that my ex-wife was letting a man rape woman and there's a signs of sexual abuse for all

1640
02:47:11,020 --> 02:47:17,060
the other children and I can't get the county to provide screening for my children and that's

1641
02:47:18,000 --> 02:47:24,200
because my former attorney she wants the sexual abuse to get to you and it doesn't make sense

1642
02:47:24,200 --> 02:47:32,920
to meet up. One person can dictate how the county spends its money when it's a mandated

1643
02:47:32,920 --> 02:47:39,080
service that my kids get a screening. Everybody here knows that when the things that

1644
02:47:39,080 --> 02:47:45,040
I've reported that a screening is mandatory, they've never received one and they need one

1645
02:47:45,040 --> 02:47:50,200
and I can't get one and it's just a real shame that we're touting on all these great things

1646
02:47:50,200 --> 02:47:54,260
about our health care system, and I can't get a screening for my kids.

1647
02:47:54,920 --> 02:47:55,800
And it's not just me.

1648
02:47:56,000 --> 02:47:59,640
There are a lot of other parents who are complaining about these issues here at the Child

1649
02:47:59,640 --> 02:48:07,060
Advocacy Center that either they can't get a screening when they do, when there's apparent

1650
02:48:07,060 --> 02:48:11,600
child molestation, the county won't affirm it.

1651
02:48:12,020 --> 02:48:13,800
And the child molestation just continues.

1652
02:48:14,080 --> 02:48:16,160
I mean, look at what happened to violent books is kids.

1653
02:48:16,160 --> 02:48:22,060
They got molested to lower 18 and when they sued the person, after they turned 18, I mean

1654
02:48:22,060 --> 02:48:27,460
it's just as terrible that we're allowing sexual abuse to be so rampant in this county

1655
02:48:27,460 --> 02:48:34,140
for children and I've asked Paul Orens, can you facilitate a screen for my kids and he's

1656
02:48:34,140 --> 02:48:34,740
just sorry?

1657
02:48:37,550 --> 02:48:39,490
And it's concludes our public speakers.

1658
02:48:40,010 --> 02:48:40,510
Thank you.

1659
02:48:40,790 --> 02:48:47,970
Just like to read this response, which is that California law prohibits the disclosure of

1660
02:48:47,970 --> 02:48:52,710
information related to and in this case you have suspected child abuse and we are now

1661
02:48:52,710 --> 02:48:57,710
authorized by a lot to speak to specific of any particular case. The law also requires

1662
02:48:57,710 --> 02:49:01,730
child welfare departments, neatly cross report, please have a reviews to law enforcement.

1663
02:49:02,430 --> 02:49:06,310
And the public can be assured that our county takes a allegations child abuse and neglect

1664
02:49:06,310 --> 02:49:11,970
seriously and takes your appropriate action. Thank you. And now go to my colleagues. I see

1665
02:49:11,970 --> 02:49:17,250
the lights. I see you supervisor Abikuga. Thank you, President Lee. I have quite a few questions

1666
02:49:17,250 --> 02:49:21,750
so I'm happy to start and limit it to the 10 minutes that you want it.

1667
02:49:22,190 --> 02:49:25,130
Yeah, let's do 10 minutes each, just to keep it moving.

1668
02:49:25,190 --> 02:49:25,490
Great.

1669
02:49:25,490 --> 02:49:27,290
Nobody got enough of us all the time.

1670
02:49:27,290 --> 02:49:27,930
I want to talk about that.

1671
02:49:28,550 --> 02:49:35,570
But just remind that this information item today and no actual action needed to be taken.

1672
02:49:35,910 --> 02:49:36,030
Thank you.

1673
02:49:36,490 --> 02:49:36,750
Great.

1674
02:49:36,850 --> 02:49:37,530
Thank you.

1675
02:49:37,770 --> 02:49:41,510
And thank you so much to staff for bringing this forward.

1676
02:49:41,930 --> 02:49:46,250
This is really exactly the type of information that I was,

1677
02:49:46,250 --> 02:49:53,790
I've been seeking, and I also just want to say thank you to all of you, especially under the leadership of Paul.

1678
02:49:53,910 --> 02:50:06,890
This is really quite tremendous work, and I'm very excited to see the plan, the black plan, and to see it rolling out, especially at this very critical time.

1679
02:50:06,890 --> 02:50:11,590
So with that, I appreciate what you shared about improving

1680
02:50:11,590 --> 02:50:16,270
medical base rates, maximizing contract revenue, utilizing AI,

1681
02:50:16,610 --> 02:50:20,310
and I have definitely have some comments on that area

1682
02:50:20,310 --> 02:50:21,330
and some questions.

1683
02:50:22,390 --> 02:50:26,190
But I guess that's just started out with the overall plan,

1684
02:50:26,250 --> 02:50:27,650
the three-pronged plan.

1685
02:50:29,510 --> 02:50:31,470
I wasn't sure, I know it was mentioned,

1686
02:50:32,890 --> 02:50:35,450
but I guess that it has concerns about the state support

1687
02:50:35,450 --> 02:50:39,670
because it sounds like it's not necessarily going to be there as much as we expected.

1688
02:50:40,630 --> 02:50:47,790
And so was hoping you could maybe touch on that a little further as to what we really might

1689
02:50:47,790 --> 02:50:48,550
be able to fix it.

1690
02:50:48,630 --> 02:50:54,110
Yeah, I can talk more about it, but it actually might be better timed, happy talk about it now,

1691
02:50:54,130 --> 02:50:59,070
but we also have later on, we have later on the agenda, the monthly legislative report,

1692
02:51:00,090 --> 02:51:03,990
and that might actually be a better spot in on the agenda to talk about it, but we have a

1693
02:51:03,990 --> 02:51:08,570
strategies we're pursuing on the state front that I'd love to lay out in detail.

1694
02:51:08,810 --> 02:51:14,730
And I guess this is also like the backup plan if we don't get that finding from the state.

1695
02:51:15,310 --> 02:51:18,810
Yeah, so what you see on if you go for example to slide 26.

1696
02:51:20,870 --> 02:51:27,730
These are cumulative annual amounts, so they stack, but these are year over year impacts, right?

1697
02:51:27,730 --> 02:51:31,470
two hundred million ongoing, one sixty ongoing, two sixty ongoing.

1698
02:51:33,410 --> 02:51:39,510
And these numbers assume that the state does nothing.

1699
02:51:41,190 --> 02:51:47,870
So to the extent that we are successful in our state strategies that will help mitigate these impacts.

1700
02:51:49,870 --> 02:51:56,410
And if we are not successful in obtaining any assistance from the state,

1701
02:51:56,410 --> 02:52:23,690
The reality for us here at the county is we will have to make up that entire gap through a combination of local efficiency and revenue initiatives like the ones that are being brought forward at mid-year or reductions in services and programs and the end as the board is well aware the reality is as you get deeper and deeper in it becomes harder and harder to

1702
02:52:23,690 --> 02:52:30,330
out additional productivity or revenue-based options and at some point you then tip over into needing

1703
02:52:30,330 --> 02:52:36,570
to look at service closures. So we're very fortunate that nothing coming in front of the board

1704
02:52:36,570 --> 02:52:45,790
at mid-year is a service closure, but we cannot say that that will be the case in the future

1705
02:52:45,790 --> 02:52:52,770
our absent success on our state-related strategies to help bridge the gap.

1706
02:52:53,130 --> 02:52:54,570
Thank you.

1707
02:52:55,850 --> 02:53:02,910
As you look at service line consolidation, what criteria did you use to determine whether

1708
02:53:02,910 --> 02:53:06,930
service should be restructured, centralized, or discontinued?

1709
02:53:08,450 --> 02:53:11,390
How do you incorporate geographic access?

1710
02:53:13,020 --> 02:53:15,340
That is a great question.

1711
02:53:16,780 --> 02:53:26,220
The typically in healthcare and Dr. Lincoln speak to this is that you look at volume.

1712
02:53:26,720 --> 02:53:32,240
You create centers of excellence because in healthcare if you do not have the volume, you're

1713
02:53:32,240 --> 02:53:38,500
unable to maintain competencies relative to the quality in the outcome of care.

1714
02:53:38,500 --> 02:53:44,220
So it's not just staff, but health care outcomes are achieved when you have volume.

1715
02:53:44,840 --> 02:53:56,900
So part of the reason we're consolidating cardiac services is that valley is so that we have enough volume to maintain the quality and the consistency of care.

1716
02:53:58,220 --> 02:54:07,200
Because your health outcomes are better, then you are able to create what we consider to be a reputation in the community,

1717
02:54:07,200 --> 02:54:11,840
relative to health outcomes, and so you're able to then build upon that.

1718
02:54:12,460 --> 02:54:14,720
A perfect example is a rehabilitation center.

1719
02:54:15,200 --> 02:54:18,240
Yes. So we have acute rehab center at Valley Medical Center.

1720
02:54:18,960 --> 02:54:22,540
All the patients from the other hospital, whether it's regional or

1721
02:54:22,540 --> 02:54:27,500
Connor, or Satan, we've come to Valley for that rehabilitation care.

1722
02:54:28,520 --> 02:54:31,700
And it is at that center, we have the centers of excellence,

1723
02:54:31,900 --> 02:54:35,440
because of the competencies of staff and the levels care that we provide.

1724
02:54:35,440 --> 02:54:40,510
And that's no different than any other service line, whether it's oncology or women's health care.

1725
02:54:41,760 --> 02:54:44,380
I'm not sure if Dr. Wing or Dr. Foam, you want to add to that.

1726
02:54:45,020 --> 02:54:50,020
But it is focused on quality and access at the same time.

1727
02:54:50,900 --> 02:54:52,800
It's a hub and spoke model, if you will.

1728
02:54:53,340 --> 02:54:53,820
Okay, great.

1729
02:54:54,000 --> 02:55:01,500
I did want to as Dave, I had a friend whose husband had an accident and spinal surgery

1730
02:55:01,500 --> 02:55:06,160
and was transferred from his hospital to our rehab center

1731
02:55:06,160 --> 02:55:08,840
and had an incredible experience.

1732
02:55:09,660 --> 02:55:12,060
And this is just a few months ago, like in the fall

1733
02:55:12,060 --> 02:55:13,920
and apparently he's walking.

1734
02:55:14,840 --> 02:55:16,720
So just, she was just delighted.

1735
02:55:17,160 --> 02:55:19,180
And so I wanted to relay that.

1736
02:55:19,200 --> 02:55:20,520
So thank you.

1737
02:55:20,740 --> 02:55:23,420
Did you have some further comments on that?

1738
02:55:23,500 --> 02:55:25,820
I was going to ask, I was going to explain that,

1739
02:55:26,120 --> 02:55:28,700
in our process of looking at cardiac care service,

1740
02:55:28,700 --> 02:55:30,960
we did look geographically, you know,

1741
02:55:30,960 --> 02:55:32,520
where the cardiac care is,

1742
02:55:32,520 --> 02:55:35,760
we know that around the regional east side

1743
02:55:35,760 --> 02:55:38,820
is clearly the South County as well.

1744
02:55:39,140 --> 02:55:41,600
And so when I talk about cardiac care services,

1745
02:55:41,740 --> 02:55:43,720
even though we're concentrating some services,

1746
02:55:43,920 --> 02:55:46,360
particularly highly complex cardiac surgeries

1747
02:55:46,360 --> 02:55:47,960
at Valley Medical Center,

1748
02:55:48,400 --> 02:55:51,460
we are also spreading out some of our resources

1749
02:55:51,460 --> 02:55:53,600
for cardiac care, for instance,

1750
02:55:53,920 --> 02:55:56,560
when I talk about electrophysiology service,

1751
02:55:56,620 --> 02:55:58,880
if you have a heart rhythm abnormality,

1752
02:55:58,880 --> 02:56:04,040
We have that at regional medical center and we have that at O'Connor as an example because we know that's where

1753
02:56:04,040 --> 02:56:09,860
We'd like to place those kinds of procedures and stuff. So we're not concentrating everything in one place

1754
02:56:09,860 --> 02:56:16,720
But we're trying to be very strategic about where we're providing all that care and we take in the consideration of the population as part of that

1755
02:56:17,100 --> 02:56:18,220
Great. Thank you

1756
02:56:18,220 --> 02:56:21,080
And another example. I just have to add this because sometimes

1757
02:56:21,980 --> 02:56:26,240
When we speak of cardiac care at St. Louis Regional Hospital

1758
02:56:26,240 --> 02:56:32,720
If you will notice recently, we opened up a cardiac program there so that we can have studies

1759
02:56:32,720 --> 02:56:36,400
in testing done in the community so it's more accessible.

1760
02:56:37,140 --> 02:56:39,820
Once again, it's an example of the hub and spoke model.

1761
02:56:40,680 --> 02:56:40,880
Great.

1762
02:56:41,000 --> 02:56:41,840
Thank you.

1763
02:56:43,040 --> 02:56:51,940
I talked about volume and part of that goes in hand in hand with productivity and I understand

1764
02:56:51,940 --> 02:56:58,280
their primary care clinics are growing and that's really great. Can you share a little bit more

1765
02:56:58,280 --> 02:57:04,180
about what investments we could make to expand primary care access and, again, all parts

1766
02:57:04,180 --> 02:57:13,020
of the county to get to that break even productivity level? Really good question. So as you've

1767
02:57:13,020 --> 02:57:19,720
noted, primary care is a heavy focus for us as a health care system because that is where people

1768
02:57:19,720 --> 02:57:26,200
should be receiving the preventive health care, and it is also important to understand that

1769
02:57:26,200 --> 02:57:33,960
primary care is the front door into health care. The primary care system provides for the medical

1770
02:57:33,960 --> 02:57:39,880
home to help individuals navigate their care throughout the system, whether it be referrals to

1771
02:57:39,880 --> 02:57:46,280
specialties and so forth. So what we are trying to do and what we are actually doing is currently

1772
02:57:46,280 --> 02:57:51,460
evaluate in our current physical capacity at all of our sites to determine whether or not we can

1773
02:57:51,460 --> 02:57:57,960
add additional providers. So we're trying to maximize our current facilities to the full extent

1774
02:57:57,960 --> 02:58:04,060
possible. The other thing that we're doing is trying to work with our staff to change and improve

1775
02:58:04,060 --> 02:58:12,360
on the workflows so that we can actually ensure that we're using every available appointment slot.

1776
02:58:12,360 --> 02:58:19,980
Now, in other words, making sure that our no-show rate is lower with our contact in patients

1777
02:58:19,980 --> 02:58:25,760
if not, we can schedule another patient in, so we're trying to maximize our current capacity

1778
02:58:26,520 --> 02:58:32,520
and at the same time identify improvements in efficiencies relative to how we schedule

1779
02:58:32,520 --> 02:58:33,460
in make appointments.

1780
02:58:33,460 --> 02:58:41,640
And the other thing that we're doing is also looking at telehealth as an option, virtual

1781
02:58:41,640 --> 02:58:48,340
visits as well, which will allow us to not only improve access in timelyness of care,

1782
02:58:48,620 --> 02:58:52,060
but also be much more convenient for our patient population.

1783
02:58:54,760 --> 02:58:58,960
I'm looking at Dr. Wayne, because he's also helping in primary care or Dr. Fong Nguyen

1784
02:58:59,580 --> 02:59:00,860
around the physician coverage.

1785
02:59:00,860 --> 02:59:10,860
Supervisor, I can also add that recognizing how important is to invest in the future generation of primary care physicians.

1786
02:59:10,860 --> 02:59:17,860
Now we are in the process of transitioning the family medicine training program at O'Connor.

1787
02:59:17,860 --> 02:59:24,760
into the health system, so we'll become the sponsoring institution, and with that, you know,

1788
02:59:25,320 --> 02:59:32,120
with the commitment of all those residents who chose to come to a program that get trained

1789
02:59:32,120 --> 02:59:39,320
in a public sector. Hopefully that will be a conduit for future physician workforce that is dedicated

1790
02:59:39,320 --> 02:59:44,820
to our patient and our community as well, right? And then the item that Dr. Noon just referred to is

1791
02:59:44,820 --> 02:59:48,720
going to be one of the proposals as part of the mid-year, which includes actually a strategic

1792
02:59:48,720 --> 02:59:56,980
augmentation of resources to bring that program into the county and not only achieve

1793
02:59:56,980 --> 02:59:59,720
the pipeline that's been discussed, but also.

1794
03:00:01,390 --> 03:00:07,890
Thank you. I think my ten minutes to set up, if I will, hopefully, can have a second round later, but thank you.

1795
03:00:08,010 --> 03:00:26,290
Yes, what is the answer? Thank you so much. I don't think I'll need a second round. I really appreciate the presentation, Paul, and the thoughtfulness that has gone into addressing which is really an existential crisis for our county.

1796
03:00:26,290 --> 03:00:33,290
I have questions about a couple of the slides, but first, just a general, one, what is happening

1797
03:00:34,030 --> 03:00:39,110
with the disproportionate share payments that I think are part of a waiver? Are those going

1798
03:00:39,110 --> 03:00:39,710
away?

1799
03:00:40,910 --> 03:00:44,090
So, I can speak a little, I was going to give an update in the kind of executive report.

1800
03:00:44,530 --> 03:00:50,630
But there is one of the appropriations bills pending in front of the U.S. Senate.

1801
03:00:50,630 --> 03:00:59,990
Would actually kick out the current scheduled cuts to those dish payments through 2028?

1802
03:01:00,930 --> 03:01:03,430
It did pass the House of Rep.

1803
03:01:03,470 --> 03:01:05,050
Would extend until 2028?

1804
03:01:05,070 --> 03:01:07,730
It would delay the cut until 2028.

1805
03:01:09,110 --> 03:01:12,090
Right now that cut will take effect at the end of this month.

1806
03:01:13,770 --> 03:01:19,770
That bill did, this was part of the Appropriations Bill for the Federal HHS.

1807
03:01:20,330 --> 03:01:23,810
That bill did pass the House of Representatives, it's pending in the Senate.

1808
03:01:23,950 --> 03:01:29,650
The bills are all stuck in the Senate right now, because of very, very legitimate concerns

1809
03:01:29,650 --> 03:01:35,430
around the separate funding bill for the Department of Homeland Security and for ICE.

1810
03:01:36,330 --> 03:01:41,410
So it remains to be seen what will happen, the current appropriations for all those departments

1811
03:01:41,410 --> 03:01:43,250
expires at the end of this month.

1812
03:01:43,670 --> 03:01:45,790
So we could see another shutdown for those agencies

1813
03:01:45,790 --> 03:01:51,010
including HHS because the Democrats in the Senate

1814
03:01:51,010 --> 03:01:53,310
have asked for the bills to be split up and voted on

1815
03:01:53,310 --> 03:01:53,710
separately.

1816
03:01:54,530 --> 03:01:57,870
There is an agreement on the HHS bill, but so far,

1817
03:01:58,230 --> 03:02:00,610
the Senate Republicans are unwilling to split

1818
03:02:00,610 --> 03:02:02,550
the bills apart for separate votes.

1819
03:02:03,250 --> 03:02:05,730
So we will monitor that, but that's the current status.

1820
03:02:05,730 --> 03:02:06,710
Awesome.

1821
03:02:08,450 --> 03:02:09,890
Can you back to slide 23?

1822
03:02:12,810 --> 03:02:17,170
I feel like I've asked this question before, and I'm so sorry that I need an answer again.

1823
03:02:18,850 --> 03:02:26,290
But looking at the first line, the prohibition on new provider taxes for Medicaid expansion states,

1824
03:02:27,330 --> 03:02:33,550
can you explain to me perhaps again why our MCO tax falls into this category,

1825
03:02:33,550 --> 03:02:38,130
and was it perhaps because of Prop 35 did that render it a new?

1826
03:02:38,610 --> 03:02:43,690
Yes, so the changes in the MCOTX that were approved by the voters in November of 2024 had

1827
03:02:43,690 --> 03:02:48,430
not yet received federal regulatory approval before the passage of HR1.

1828
03:02:48,670 --> 03:02:50,730
And we advocated for the passage of...

1829
03:02:50,730 --> 03:02:54,110
We did, we support this board endorsed that proposition.

1830
03:02:54,690 --> 03:02:59,570
It wasn't perfect but it had augmented funding for public hospital systems.

1831
03:03:00,310 --> 03:03:02,850
That's the $15 million there was a set aside.

1832
03:03:02,850 --> 03:03:04,430
It's gone entirely.

1833
03:03:06,050 --> 03:03:10,750
The state says that they're trying to do some conversation with federal CMS.

1834
03:03:11,730 --> 03:03:15,890
I would just say I'm much more skeptical than the governor's budget is about the success

1835
03:03:15,890 --> 03:03:17,170
of that conversation.

1836
03:03:19,250 --> 03:03:22,330
The question since he did not want to prop to 35 in the first place.

1837
03:03:23,990 --> 03:03:25,550
So, we'll see what happens.

1838
03:03:26,270 --> 03:03:31,410
But there's two things that HR1 does with regard to the MCOTACS and the directed payments

1839
03:03:31,410 --> 03:03:35,270
that I think people have confused a little on the timeline, which is, we tried to show it

1840
03:03:35,270 --> 03:03:42,210
in here, immediately there was a freeze, and we got caught up in the freeze. So we have

1841
03:03:42,210 --> 03:03:50,270
impacts from the freeze. And then later, you'll see in 27 and 28, there's the ratcheting

1842
03:03:50,270 --> 03:03:59,750
down of both the MCOTACs and the directed payments, ultimately a 50% reduction in directed

1843
03:03:59,750 --> 03:04:07,390
payments. So we have two separate types of impacts that we're facing. Immediately, we've

1844
03:04:07,390 --> 03:04:14,070
been frozen out with the freeze. We're not seeing the natural growth of the program,

1845
03:04:14,230 --> 03:04:18,010
right? Because these are programs that you would normally have and if you look over the last

1846
03:04:18,010 --> 03:04:23,710
decade, they grow year over year because costs grow year over year. So with the freeze, you're

1847
03:04:23,710 --> 03:04:29,730
no longer getting the growth. That actually has a revenue impact on us. And then to

1848
03:04:29,730 --> 03:04:36,990
make things much, much worse, starting in 27, you actually see the frozen amounts getting chopped

1849
03:04:36,990 --> 03:04:37,510
down.

1850
03:04:37,630 --> 03:04:43,350
Ultimately, in the case of those directed payments that Paul mentioned, are about $750 million

1851
03:04:43,350 --> 03:04:48,130
a year in revenue to our system, ultimately seeing those payments chopped down in half.

1852
03:04:49,670 --> 03:04:53,610
So, it's a layering impact, and that's why when you see on that chart on slide, I think,

1853
03:04:53,670 --> 03:04:58,390
it was 26, those ongoing impacts stacking up over time.

1854
03:04:58,390 --> 03:05:04,870
So we've got ones immediately, some of which are due to the freeze, and then we have these other ones hitting, and that

1855
03:05:04,870 --> 03:05:12,810
that 260 million bucket that comes 2728 is largely attributable to those

1856
03:05:13,650 --> 03:05:22,950
ratcheting down of the supplemental payments, and MCOTax, while part of it is attributable to enrollment loss,

1857
03:05:22,950 --> 03:05:27,810
a big chunk of the middle orange block 160 is due to enrollment loss.

1858
03:05:28,110 --> 03:05:30,710
So there's a multitude of ways in which we're getting hit.

1859
03:05:31,010 --> 03:05:37,330
So why we're on this slide is the 300 million counted in each of those...

1860
03:05:37,330 --> 03:05:41,410
Each here, these are annual amounts, so the 200, these are ongoing.

1861
03:05:43,130 --> 03:05:49,250
So another way to think about this is this is the ongoing annual impact in 28.

1862
03:05:50,090 --> 03:05:55,610
And you see how we get from here to there year over year over year so that 200 million for this current year?

1863
03:05:56,170 --> 03:05:57,370
That's 200 million a year.

1864
03:05:58,210 --> 03:06:01,090
So we're dealing with 200 million in ongoing solutions.

1865
03:06:02,530 --> 03:06:04,370
Otherwise we have the 200 million last this year.

1866
03:06:04,670 --> 03:06:06,750
Next year the year after that the year after that.

1867
03:06:06,970 --> 03:06:07,350
Got it.

1868
03:06:08,090 --> 03:06:08,590
I think.

1869
03:06:09,250 --> 03:06:09,630
Okay.

1870
03:06:12,500 --> 03:06:13,180
Thank you.

1871
03:06:13,600 --> 03:06:17,820
I apparently might need a second round but I'll come back to.

1872
03:06:17,920 --> 03:06:18,820
I'll think about that.

1873
03:06:19,540 --> 03:06:23,300
On slide 24, the UIS population is discussed.

1874
03:06:24,560 --> 03:06:31,260
Can you say a little bit just about the refugee care, which is an incorporated here, and

1875
03:06:31,260 --> 03:06:36,820
those are folks with protected legal status that have not been impacted by the federal government,

1876
03:06:37,200 --> 03:06:41,840
but the governor's proposal does propose to cut their care as well?

1877
03:06:42,080 --> 03:06:44,280
Yes, you're going to get me worked up on this point.

1878
03:06:44,280 --> 03:06:46,940
There's about 200,000 Californians.

1879
03:06:47,180 --> 03:06:49,940
It's a relatively modest number of people.

1880
03:06:50,640 --> 03:06:55,860
But these are folks who in this federal administrations

1881
03:06:55,860 --> 03:07:01,600
infinite wisdom have been kicked off of Medicaid coverage.

1882
03:07:01,840 --> 03:07:05,460
These are refugees, folks here who are on a asylum.

1883
03:07:06,240 --> 03:07:08,080
You visa holders, TVs or holders.

1884
03:07:08,840 --> 03:07:12,860
These are verified victims of human trafficking

1885
03:07:12,860 --> 03:07:20,740
and domestic violence, all of whom are here legally, in other words, they have lawful status

1886
03:07:20,740 --> 03:07:22,800
to be in the United States.

1887
03:07:23,760 --> 03:07:29,660
The federal government has chosen to toss them off of Medicaid, and the governor's budget

1888
03:07:30,140 --> 03:07:33,360
is proposing to just roll forward and implement that.

1889
03:07:33,380 --> 03:07:40,880
In other words, not to place these individuals onto the state-only program, so they be left

1890
03:07:40,880 --> 03:07:46,960
with worse coverage than the state-only medical program.

1891
03:07:47,960 --> 03:07:51,560
So from a moral standpoint, even though the population numbers

1892
03:07:51,560 --> 03:07:54,600
are modest, the specific fiscal impact is more modest,

1893
03:07:55,380 --> 03:08:01,160
but from a moral standpoint, this is really just

1894
03:08:01,160 --> 03:08:02,540
a horrific proposal.

1895
03:08:02,920 --> 03:08:06,720
And it's quite stunning to me to see the state

1896
03:08:06,720 --> 03:08:12,360
choose to just roll forward and implement that federal policy direction.

1897
03:08:14,610 --> 03:08:14,890
Thank you.

1898
03:08:14,950 --> 03:08:17,830
I think more people need to be talking about that.

1899
03:08:19,190 --> 03:08:21,950
It's a line item of a line item.

1900
03:08:23,250 --> 03:08:24,770
And really, I think,

1901
03:08:27,130 --> 03:08:32,730
is as you said, really just a horrific proposal.

1902
03:08:32,730 --> 03:08:39,590
Let me ask about the FQHC rate strapping.

1903
03:08:40,690 --> 03:08:47,430
What are we thinking about the clinics that we currently have contracts with, especially

1904
03:08:47,430 --> 03:08:53,870
the smaller ones, is it realistic that they stay in business, losing 60% of their revenue

1905
03:08:53,870 --> 03:08:54,750
with each patient?

1906
03:08:54,750 --> 03:09:08,210
Well, it would vary by clinic, depending on how many of the state-only recipients are accessing care at their clinic site.

1907
03:09:09,050 --> 03:09:19,710
So as an example, in my conversations with one clinic, close to 12% of the patient population fall into this category.

1908
03:09:20,510 --> 03:09:29,190
So, if they're losing 60, 70% of the revenue for that time, 10% of the time, that's the impact.

1909
03:09:30,330 --> 03:09:40,410
And so, we are having conversations, supervisors, you well know around, as I mentioned, the revision, the remodeling of the PCAP program,

1910
03:09:41,690 --> 03:09:47,930
to ensure that these individuals can maintain their medical home and continue their own going care.

1911
03:09:49,090 --> 03:09:54,850
So that is one of the proposals that we'll be being back to your board, probably in October, November

1912
03:09:54,850 --> 03:09:55,530
time, right?

1913
03:09:55,710 --> 03:09:56,070
Thanks.

1914
03:09:56,390 --> 03:10:01,930
Obviously, it doesn't do us any good and harms us if the clinics aren't providing care, because

1915
03:10:01,930 --> 03:10:04,450
wherever those patients go, they'll come to the county.

1916
03:10:04,710 --> 03:10:07,130
So one way or another, we're paying for that care.

1917
03:10:07,170 --> 03:10:10,330
I do have three more questions that I'll be happy to take in the second round.

1918
03:10:10,590 --> 03:10:11,210
Thank you.

1919
03:10:13,550 --> 03:10:14,470
Yes, thank you.

1920
03:10:15,970 --> 03:10:17,470
Thank you for this presentation.

1921
03:10:17,470 --> 03:10:40,190
And I know the world has changed again and again, and continues to do so, since the time that we've requested the study session, and I also want to appreciate the staff and Paul, especially for answering so many of our questions along the way, as we continue to see more headlines and more changes affecting our healthcare policies, and other our ability to serve more constituents here.

1922
03:10:40,190 --> 03:10:46,090
So I want to acknowledge that, that it's not, you know, to the public, we may see Paul here for these major study sessions,

1923
03:10:46,290 --> 03:10:51,310
but you're always on call for all of us to help us understand exactly what's happening with our care systems.

1924
03:10:53,170 --> 03:10:56,110
James, that was very, you know, you talk about getting riled up.

1925
03:10:56,530 --> 03:11:03,590
It's very hard not to get emotional, especially since we have such a deep immigrant history here.

1926
03:11:03,590 --> 03:11:05,710
And it

1927
03:11:11,050 --> 03:11:16,530
is. I'll just say, you know, healthcare is personal but healthcare is also a statement of community values.

1928
03:11:17,790 --> 03:11:28,650
And one of the things I just want to say when you look at these numbers and you look at the chart is we have had a decades-long commitment in this community to keeping our doors open to all.

1929
03:11:30,050 --> 03:11:34,010
And we will remain absolutely steadfast in that commitment.

1930
03:11:35,830 --> 03:11:41,370
That's in part why you're seeing all of the things in front of you that you are is because

1931
03:11:41,370 --> 03:11:46,930
people are working night and day to try to ensure that we can honor that commitment in this community.

1932
03:11:47,510 --> 03:11:52,510
And so even those individuals, for example, who if the state just implements that proposal,

1933
03:11:53,290 --> 03:11:55,930
our doors will remain open to refugees.

1934
03:11:56,150 --> 03:12:02,990
Our doors will remain open to you, Visa, and TV's the holders, and we will come up with a primary

1935
03:12:02,990 --> 03:12:07,670
care access program that's modified to help address that.

1936
03:12:07,830 --> 03:12:14,970
Now that will mean impacts across our county organization, that will mean we will be doing

1937
03:12:14,970 --> 03:12:21,970
things that other counties and other systems won't who will instead turn around and close

1938
03:12:21,970 --> 03:12:36,430
some of those doors and what you see for example in us accounting for enrollment loss is not

1939
03:12:36,430 --> 03:12:41,970
just looking at the revenue loss associated with that but the reality that we expect to

1940
03:12:41,970 --> 03:12:50,210
continue to deliver services to those residents in our community. Instead of making a forecast

1941
03:12:50,210 --> 03:12:52,750
that expects to shut doors and turn people away.

1942
03:12:53,690 --> 03:13:00,050
And that is a choice that this organization has made historically and continues to make consistent

1943
03:13:00,050 --> 03:13:03,210
with the leadership of this board and the values of our county.

1944
03:13:03,570 --> 03:13:08,170
And so I want to acknowledge that because there are different policy choices.

1945
03:13:09,150 --> 03:13:13,990
We could make policy choices the way you see at the state or other places where we closed

1946
03:13:13,990 --> 03:13:18,110
doors and we record that on our books as a budget savings.

1947
03:13:19,150 --> 03:13:23,550
And we are not doing that in what we have brought forward to this board.

1948
03:13:24,310 --> 03:13:24,930
Thank you, James.

1949
03:13:39,930 --> 03:13:40,690
It's okay.

1950
03:13:42,690 --> 03:13:44,230
I'm all I'm feeling that I'm okay.

1951
03:13:44,450 --> 03:13:47,710
I'm in all my fields today, so my audience, to our audience, our public, please don't

1952
03:13:47,710 --> 03:13:48,930
be alarmed.

1953
03:13:50,990 --> 03:13:51,450
Just

1954
03:13:55,100 --> 03:13:55,840
thank you, James.

1955
03:13:55,960 --> 03:14:00,460
We're going to, I know we're going to lean into that continuously through our intergovernmental

1956
03:14:00,460 --> 03:14:07,800
relations through I mean you talk about choice this is a choice that our governor is making and the choice our federal government has made

1957
03:14:07,800 --> 03:14:14,660
But we have choices here to make to and I'm so proud that this is a board that are either the children of immigrants

1958
03:14:15,680 --> 03:14:18,460
Immigrants themselves and I'm the pro I was made by refugees

1959
03:14:18,460 --> 03:14:24,460
who relied on this counties open door policy and the Medicaid that was afforded to them in the 70s

1960
03:14:31,960 --> 03:14:36,380
these policies are inhumane, and I'm glad that we are part of the county that's going

1961
03:14:36,380 --> 03:14:43,040
to be the last dance if we have to be, to protecting the health care of everyone in our county.

1962
03:14:44,360 --> 03:14:49,420
The uninsured access program on slide 35, I wanted to like mean into that a little bit more

1963
03:14:49,420 --> 03:14:55,900
and try to understand is that, is that part of the P-CAT program is, is, is,

1964
03:14:57,320 --> 03:14:58,140
Thank you so much.

1965
03:15:00,000 --> 03:15:04,660
I didn't call a peak cap because I think it's going to be much different than it is today.

1966
03:15:06,560 --> 03:15:15,140
And what a lot of people don't appreciate is that under peak cap, we have a tremendous partnership with our community health clinics,

1967
03:15:16,940 --> 03:15:21,280
where they provide the medical home beyond just our primary care clinics.

1968
03:15:21,280 --> 03:15:30,000
But those individuals have access also to our specialty clinics, our hospital and other services.

1969
03:15:31,300 --> 03:15:37,580
So in essence, it is a coverage program that focuses on ensuring that individuals have a medical home.

1970
03:15:38,140 --> 03:15:42,100
And that is a model that we have to continue to develop.

1971
03:15:43,320 --> 03:15:47,900
It's kind of, and I've talked to James kind of an entree into universal coverage

1972
03:15:48,660 --> 03:15:54,660
because at the health care system, as a comprehensive health system, we're able to provide care

1973
03:15:54,660 --> 03:15:57,780
and a managed and a value-based way, right?

1974
03:15:57,880 --> 03:16:02,980
Making sure that people are receiving care at the right time, at the right place.

1975
03:16:05,740 --> 03:16:07,160
So that is what we're focused on.

1976
03:16:07,320 --> 03:16:11,040
And as Paul mentioned, we are working on options of rethinking.

1977
03:16:11,100 --> 03:16:12,180
We obviously have the program.

1978
03:16:12,400 --> 03:16:17,220
It's just chunk in size over the last several years for very good reasons, which is over

1979
03:16:17,220 --> 03:16:22,460
last decade, people have been able to get healthcare coverage through a medical, through

1980
03:16:22,460 --> 03:16:23,240
cover California.

1981
03:16:24,360 --> 03:16:29,380
So we will be bringing forward in the fall, as Paul mentioned, options for the boards

1982
03:16:29,380 --> 03:16:32,040
consideration on a reimagined program.

1983
03:16:32,660 --> 03:16:37,840
But I just want to say this is an example, and if you look also at, I think it was slide

1984
03:16:45,270 --> 03:16:55,570
slide seven, these are examples of services and programs that are supported by county

1985
03:16:55,570 --> 03:16:58,710
general fund, because they're not revenue backed.

1986
03:17:00,210 --> 03:17:06,510
And when we talk about the general fund investment in the health system, it's absolutely

1987
03:17:06,510 --> 03:17:12,950
pivotal to keep in the back of our minds that there are a litany of very important services

1988
03:17:12,950 --> 03:17:21,470
and programs including programs for specific populations that other county health systems, even

1989
03:17:21,470 --> 03:17:26,970
though they do incredible work, just don't provide. And we're only able to provide them because

1990
03:17:26,970 --> 03:17:33,450
of the use of local discretionary resources to do so. This is just an example of some of those

1991
03:17:33,450 --> 03:17:38,470
services and the board will be very familiar with many of these, because many of these have come

1992
03:17:38,470 --> 03:17:41,510
over the years from advocacy in these chambers.

1993
03:17:42,650 --> 03:17:44,910
And P.C.A.P.A. is a piece of that as well.

1994
03:17:45,450 --> 03:17:48,850
But those are only services that really can be supported

1995
03:17:48,850 --> 03:17:51,250
with significant general fund resources.

1996
03:17:51,250 --> 03:17:56,870
That's all part of that ongoing annual general fund

1997
03:17:56,870 --> 03:17:58,250
investment in the system.

1998
03:17:59,130 --> 03:18:01,850
And sometimes I think is forgotten about when people talk

1999
03:18:01,850 --> 03:18:04,110
about the system, just as an enterprise system.

2000
03:18:04,610 --> 03:18:06,930
It's a public health care delivery system

2001
03:18:06,930 --> 03:18:15,970
that also is delivering a whole set of services that we have directed them to provide in

2002
03:18:15,970 --> 03:18:22,070
addition to the regular work that a county health care system would otherwise do.

2003
03:18:22,630 --> 03:18:25,130
And that systems otherwise do and the rest of the state.

2004
03:18:25,670 --> 03:18:26,690
Thank you, James.

2005
03:18:27,450 --> 03:18:30,350
And I guess we'll be hearing more about it in October.

2006
03:18:30,350 --> 03:18:34,230
And it's going to be something that I personally would like to be

2007
03:18:34,230 --> 03:18:37,850
kept a price of what the redesigning of this program entails,

2008
03:18:38,830 --> 03:18:42,130
especially because of its and complete dependency on the general fund.

2009
03:18:42,550 --> 03:18:44,590
And now my time is running up on the next run.

2010
03:18:44,690 --> 03:18:49,510
I'm going to be asking about the proposed 47 FTE position

2011
03:18:49,510 --> 03:18:52,590
elimination that's going to be coming up during the mid-year discussion

2012
03:18:52,590 --> 03:18:56,610
and just really understanding what the impact to service will look like.

2013
03:18:56,710 --> 03:18:58,750
In that case where there were shifting positions,

2014
03:18:58,750 --> 03:19:08,310
what's the strategy behind that to ensure that we're not losing any quality or level of care for our residents and how we're interacting and gauging with our impact to employees.

2015
03:19:08,890 --> 03:19:09,510
Thank you.

2016
03:19:09,750 --> 03:19:11,530
Well, there's still a minute. So Paul, you have the answer.

2017
03:19:11,590 --> 03:19:12,270
Can we do that in a minute?

2018
03:19:14,370 --> 03:19:16,230
I'll say one thing on turn over to Paul.

2019
03:19:19,070 --> 03:19:28,170
So I know that there's frustration in the parts of the organization around the county hiring freeze.

2020
03:19:29,650 --> 03:19:31,230
I'm well aware of that.

2021
03:19:31,230 --> 03:19:40,950
But I want to say that this is why we have it in place, which is, it gives us the ability to help minimize impacts on staff.

2022
03:19:41,630 --> 03:19:46,670
And so we can yet again say, and we may not always be able to say this.

2023
03:19:46,850 --> 03:19:51,210
But we can yet again say that for all of the items coming in front of the board for mid-year,

2024
03:19:52,070 --> 03:19:57,590
that we have positions for every single one of our staff to move into,

2025
03:19:57,590 --> 03:20:01,330
most of those positions, the overwhelming number,

2026
03:20:02,050 --> 03:20:08,570
same classification, meaning no change in classification or pay.

2027
03:20:09,710 --> 03:20:14,950
And that is a direct result of the steps that the health system is taken,

2028
03:20:15,150 --> 03:20:17,610
but also across the rest of the county organization,

2029
03:20:18,930 --> 03:20:27,570
of maintaining and managing vacancies in a way that minimizes those

2030
03:20:27,570 --> 03:20:36,810
detail, but I do want to assure the board that for the 47 filled positions that the overwhelming

2031
03:20:36,810 --> 03:20:44,870
majority have same classification transfers and all of them have positions available in the

2032
03:20:44,870 --> 03:20:45,910
county organization.

2033
03:20:47,330 --> 03:20:50,690
But the other thing I'll just say and then I'll have Paul speak a little more and obviously

2034
03:20:50,690 --> 03:20:57,350
we'll be talking about the specific proposals at mid year at the next board meeting is that

2035
03:20:57,970 --> 03:21:10,170
Also, in this set of mid-year proposals, our no-service closures, no facility closures, again, these are things we may not always be able to say in the future.

2036
03:21:10,830 --> 03:21:14,590
The Board has seen the staggering numbers as they stack up in the out-years.

2037
03:21:15,390 --> 03:21:22,710
But we continue to be able to say that because we've worked very hard on revenue and other solutions.

2038
03:21:22,710 --> 03:21:31,110
the staff positions reflected here represent roughly about 20% of that 200 million and only

2039
03:21:31,110 --> 03:21:40,230
about 21-22% of the positions are filled impacts. So you can kind of see if you apply those

2040
03:21:40,230 --> 03:21:46,710
percentages just how hard folks have been working to try to minimize any impacts on County staff.

2041
03:21:46,710 --> 03:21:48,930
then we'll call them like you add.

2042
03:21:52,530 --> 03:21:58,110
So the way that I would describe the initiative that we're bringing forward is really a real

2043
03:21:58,110 --> 03:22:05,570
alignment of resources where they're most needed or we'll be able to ensure that we're

2044
03:22:05,570 --> 03:22:08,210
balancing the needs of patient care.

2045
03:22:08,210 --> 03:22:20,870
As an example, when we look at a particular service line, and we may feel as though that

2046
03:22:23,140 --> 03:22:30,660
the reassignment of a nurse or a program assistant or an analyst would be better served

2047
03:22:30,660 --> 03:22:39,200
in another program, what we're doing is basically cutting the position from that program and

2048
03:22:39,200 --> 03:22:42,780
and getting them a position elsewhere within the organization.

2049
03:22:45,860 --> 03:22:49,620
In a lot of respect, what we're looking at for that program

2050
03:22:49,620 --> 03:22:52,680
with a position with move from to be more efficient

2051
03:22:52,680 --> 03:22:55,920
with the resources that they do have or what they're left with.

2052
03:22:56,660 --> 03:22:58,900
And so they are going to have to look at different ways

2053
03:22:58,900 --> 03:23:02,660
of managing their priorities, making sure

2054
03:23:02,660 --> 03:23:05,140
that we continue to maintain the same level

2055
03:23:05,140 --> 03:23:07,740
of patient care and patient access.

2056
03:23:07,740 --> 03:23:13,600
So, it is a re-environment of resources, it's probably a better way of saying it.

2057
03:23:14,500 --> 03:23:19,560
There are known as layoffs because, clearly, we're cutting a position from a program.

2058
03:23:20,120 --> 03:23:26,440
But, as since James has described, we've been very careful to make sure we do not fill positions

2059
03:23:26,440 --> 03:23:29,580
for which we know there may be an in-placement.

2060
03:23:31,340 --> 03:23:35,740
So, that's what you see going on to a large degree throughout the health system.

2061
03:23:35,740 --> 03:23:45,700
I would say that there will be disagreement or are different perspectives of whether or not the

2062
03:23:45,700 --> 03:23:52,460
deletion of a position in a particular program to move that resource to another program was the right decision.

2063
03:23:53,340 --> 03:24:03,360
But that is why this is so difficult because we have to as leadership work to find the right balance and kind of thread that needle of where to put the resources

2064
03:24:03,360 --> 03:24:05,740
where we would get the most benefit.

2065
03:24:07,420 --> 03:24:10,440
A perfect example is on that slide,

2066
03:24:11,200 --> 03:24:15,820
you see the reallocation of 86.6 FTEs.

2067
03:24:16,180 --> 03:24:18,760
So these are vacant positions,

2068
03:24:19,640 --> 03:24:22,340
which we've been over the past year,

2069
03:24:22,780 --> 03:24:25,880
trying to work to identify that we can actually re-purpose

2070
03:24:25,880 --> 03:24:31,960
for the activation of the child in adolescent behavioral or civilian.

2071
03:24:31,960 --> 03:24:38,480
So, we are doing some administrative ad deletes in order to get the right classifications

2072
03:24:38,480 --> 03:24:41,060
in order to activate this new service.

2073
03:24:42,540 --> 03:24:49,840
Individuals that may have been identified to lose a position in one program will have the

2074
03:24:49,840 --> 03:24:52,860
opportunity for example to help us fill these vacancies.

2075
03:24:53,860 --> 03:24:58,620
And as you well know, we need staff to operate this new service line.

2076
03:24:58,620 --> 03:25:06,140
And it's the critical service that Nali will provide critical care to our patients, but

2077
03:25:06,140 --> 03:25:12,660
also allow us to generate revenue based on the pair mix, because the child adolescent,

2078
03:25:13,200 --> 03:25:20,560
there's a favorable pair relative to both commercial coverage, that will allow us to

2079
03:25:20,560 --> 03:25:26,060
not only sustain the service line, but also continue to do what we're here to do, which provide

2080
03:25:26,060 --> 03:25:30,820
essential services. So that's why you see, that's why I'm calling the real

2081
03:25:30,820 --> 03:25:36,100
alignment of where positions are used and allocated more. So then we're at the

2082
03:25:36,100 --> 03:25:41,480
point of layoffs. I cannot tell you because we're still working on the $160

2083
03:25:41,480 --> 03:25:47,780
million for next year where we're going to end up, whether or not it's James has

2084
03:25:47,780 --> 03:25:53,080
mentioned, we're going to have to actually potentially close service lines, which

2085
03:25:53,080 --> 03:25:55,120
Obviously, we're impacting additional positions.

2086
03:25:55,360 --> 03:25:59,020
We're trying to avoid that through these strategies that I've

2087
03:25:59,020 --> 03:25:59,920
walks through.

2088
03:26:00,700 --> 03:26:05,060
We get to 28, and we have no state support,

2089
03:26:06,440 --> 03:26:10,340
then you can see how the problem becomes much more

2090
03:26:10,340 --> 03:26:11,800
difficult to solve.

2091
03:26:14,560 --> 03:26:17,720
So we're trying every trick in the book if you want

2092
03:26:17,720 --> 03:26:20,640
to make sure that we do not impact services

2093
03:26:20,640 --> 03:26:28,360
to the full extent possible, and that we maintain our workforce to the full extent possible

2094
03:26:28,360 --> 03:26:30,280
and not have layoffs.

2095
03:26:31,060 --> 03:26:34,860
But I can't make any promises sitting here, given the magnitude of what we're looking

2096
03:26:34,860 --> 03:26:35,300
at.

2097
03:26:35,740 --> 03:26:41,680
But I will say one thing, which is, this is where Measure A is so powerful, and we have been

2098
03:26:41,680 --> 03:26:50,280
able to, because of the support of the community here, plug in to the budget that Measure

2099
03:26:50,280 --> 03:26:56,200
revenue and that is making a world of difference and we would be having a very different

2100
03:26:56,200 --> 03:27:01,620
conversation right now, but for the passage of measure A, there's no doubt in my mind we

2101
03:27:01,620 --> 03:27:06,580
would be stirring down of service line and facility impacts right now.

2102
03:27:07,860 --> 03:27:12,240
Yeah, every single measure A dollar matters in this context and it's going to continue to do so.

2103
03:27:12,460 --> 03:27:19,640
Thank you so much for the responses for your work and as a last last my last contribution to

2104
03:27:19,640 --> 03:27:22,900
the time that's been, extra time has been allocated to me.

2105
03:27:23,020 --> 03:27:29,780
Thank you for that, President, is that my office is receiving numerous responses

2106
03:27:29,780 --> 03:27:34,280
and just overwhelming support and gratitude for regional medical center.

2107
03:27:35,000 --> 03:27:39,120
A lot of our e-ciders, no regional medical center, by other names, have had experiences

2108
03:27:39,120 --> 03:27:43,740
throughout their past iterations and engaging with the hospital system there under

2109
03:27:43,740 --> 03:27:44,460
different ownership.

2110
03:27:44,920 --> 03:27:47,120
And what we've been hearing is overwhelming hands down.

2111
03:27:47,140 --> 03:27:48,580
This is the best it's ever been.

2112
03:27:48,580 --> 03:27:53,340
So thank you so much for. I want to make sure I give that shout-out and appreciation to our leadership

2113
03:27:53,340 --> 03:27:59,060
and to your staff please relay my appreciation that my residents over on the east side is feeling

2114
03:27:59,060 --> 03:28:05,300
honored. They feel seen and they feel a huge, marked difference in the care and the quality of

2115
03:28:05,300 --> 03:28:11,310
that receiving at Regional Medical Center. Thank you. Thank you. So before the second round of questions

2116
03:28:11,310 --> 03:28:16,230
I understand Paul, you actually have to go immediately after discussion to Sacramento,

2117
03:28:16,230 --> 03:28:20,990
So, the test file before the legislation on behalf of a county, to let them know, allow

2118
03:28:20,990 --> 03:28:24,170
them clear how those proposed cuts are inhumane, right?

2119
03:28:24,530 --> 03:28:25,870
So, I don't want to delay a trip.

2120
03:28:26,550 --> 03:28:31,190
So, I just want to say if you could bring this presentation also to our February HXC meeting,

2121
03:28:32,650 --> 03:28:37,790
for the budget study, so that I would like to discuss come items like AI, healthcare,

2122
03:28:38,750 --> 03:28:42,910
revenue, cycle, enhancement, some of the service line restructuring, and the market

2123
03:28:42,910 --> 03:28:47,150
to create strategies, so we could take a little deeper on, but other social components we

2124
03:28:47,150 --> 03:28:49,990
can look more on this budget process. That's okay with people.

2125
03:28:51,970 --> 03:28:57,370
Yeah, we're certainly happy to come to the February HHC. We did activate our backup plan

2126
03:28:57,370 --> 03:29:03,570
for the Sacramento Test of Moni, but we were very fortunate, and we'll talk more about this

2127
03:29:03,570 --> 03:29:08,270
under the Intergovernmental Relations Report, but to be the only county that was invited

2128
03:29:08,270 --> 03:29:12,410
to participate in the Assembly Health Committee hearing on this.

2129
03:29:13,950 --> 03:29:14,990
Thank you.

2130
03:29:15,310 --> 03:29:15,410
Thank you.

2131
03:29:15,410 --> 03:29:16,050
He should go.

2132
03:29:16,110 --> 03:29:19,150
You've got a good team here that you continue to answer questions.

2133
03:29:19,670 --> 03:29:22,070
I'd love to go, but I'm not sure I'm going to make it by 130.

2134
03:29:23,690 --> 03:29:23,750
But.

2135
03:29:23,750 --> 03:29:24,570
I'd love to go.

2136
03:29:24,770 --> 03:29:25,210
I'd love to go.

2137
03:29:25,250 --> 03:29:28,310
We activated our backup option for that.

2138
03:29:29,930 --> 03:29:31,350
We have a good backup option.

2139
03:29:31,790 --> 03:29:37,530
But to James's point, I have to say to this board that.

2140
03:29:37,530 --> 03:29:44,110
the level of interest in what's happening here in Santa Clara County by our state legislature,

2141
03:29:45,110 --> 03:29:57,430
but also from official that DHCS and others is probably at its optimal level because many of the strategies that we have.

2142
03:30:02,740 --> 03:30:04,860
Thank you.

2143
03:30:04,960 --> 03:30:06,800
Did you have that?

2144
03:30:06,800 --> 03:30:11,260
Oh no, that's all I have. So if there's things you can see for the HXC because we're here in February.

2145
03:30:11,540 --> 03:30:14,100
Since you're a HXC, we could ask those questions to us.

2146
03:30:14,140 --> 03:30:15,880
Just a couple questions for James.

2147
03:30:19,120 --> 03:30:20,000
Thank you.

2148
03:30:20,520 --> 03:30:22,200
And then I had to really,

2149
03:30:25,940 --> 03:30:31,740
I've been really watching this and, you know, really grateful to see,

2150
03:30:31,740 --> 03:30:35,800
and I appreciate that I think our way to solvency

2151
03:30:35,800 --> 03:30:37,600
is frankly expansion.

2152
03:30:38,540 --> 03:30:42,340
But in light of that, I have been concerned about,

2153
03:30:42,340 --> 03:30:46,620
there's only so much one person can do,

2154
03:30:47,160 --> 03:30:49,420
or in the leadership team.

2155
03:30:51,120 --> 03:30:57,520
So I understand that a few years ago, there was a COO position

2156
03:30:57,520 --> 03:30:59,540
that was created for the hospital system.

2157
03:30:59,540 --> 03:31:06,260
And I was wondering what the status of that position is, and the expected time for hiring,

2158
03:31:07,400 --> 03:31:14,280
and then along with that, just in general, the administrative bandwidth to look at, again,

2159
03:31:14,600 --> 03:31:21,980
how we continue to leverage revenue generation and other solutions, because I do think leadership,

2160
03:31:22,820 --> 03:31:28,720
and this is about, you know, right, the strategic thinking into the future, we do need the right

2161
03:31:28,720 --> 03:31:32,840
leadership to be able to drive this effort forward, so.

2162
03:31:33,100 --> 03:31:34,820
Now, I really appreciate the question supervisor.

2163
03:31:37,740 --> 03:31:42,920
A couple years ago, I think it was in the first budget

2164
03:31:42,920 --> 03:31:45,160
proposal, and my tenure is kind of executive.

2165
03:31:45,400 --> 03:31:48,180
We did add a COO position in recognition

2166
03:31:48,180 --> 03:31:49,480
of how the system has grown.

2167
03:31:50,320 --> 03:31:51,840
We have struggled to fill that position.

2168
03:31:51,900 --> 03:31:54,560
We've had several rounds of recruitment.

2169
03:31:54,560 --> 03:31:55,940
We are in active recruitment.

2170
03:31:56,200 --> 03:31:58,280
I think we have some interviews coming up.

2171
03:31:58,280 --> 03:32:04,920
So we're hopeful that that will be successful, but we absolutely agree that given that we're now

2172
03:32:04,920 --> 03:32:12,800
a four hospital system that we need to not just have the right people and right team and we've

2173
03:32:12,800 --> 03:32:18,140
got some excellent excellent folks, as I mentioned earlier, but that we also have the right structure

2174
03:32:18,140 --> 03:32:23,400
on size to sustain the operation and move all of these initiatives forward because, you know,

2175
03:32:23,420 --> 03:32:27,160
some of the things that we haven't gotten into, you know, all of this specific details, but when you're

2176
03:32:27,160 --> 03:32:31,900
talking about, for example, you know, negotiations that we might be having with

2177
03:32:31,900 --> 03:32:37,180
medical managed care plans, or you're talking about restructuring contract

2178
03:32:37,180 --> 03:32:41,200
relationships, or restructuring service lines, and service line delivery,

2179
03:32:41,440 --> 03:32:44,480
or many of the other initiatives that we've been focused on.

2180
03:32:44,540 --> 03:32:46,980
They all take a significant amount of bandwidth.

2181
03:32:48,480 --> 03:32:52,260
So, you know, we will continue to take a look at that.

2182
03:32:52,260 --> 03:32:59,880
And I think we also recognize that we don't want to be a Pennywise and Pound Foolish.

2183
03:33:02,080 --> 03:33:08,420
And, you know, one of the stories of what happened at Regional is HCA started cutting

2184
03:33:08,420 --> 03:33:13,320
service lines in a way that led to such a decline in census at the hospital.

2185
03:33:13,520 --> 03:33:17,240
And you need volume in order to deal with overhead, to deal with the equipment,

2186
03:33:17,240 --> 03:33:22,300
for example, the Dr. Wang mentioned, to ensure that you have staff or competent trance,

2187
03:33:22,380 --> 03:33:24,000
you can maintain a level of excellence.

2188
03:33:25,780 --> 03:33:31,220
And so being cognizant of all those pieces, that we will need to continue to make strategic

2189
03:33:31,220 --> 03:33:40,060
investments in facilities, in equipment, in staff, including bringing some of our physician

2190
03:33:40,060 --> 03:33:48,740
staff in house and that also means in the administrative infrastructure and positions that are

2191
03:33:48,740 --> 03:33:56,440
necessary to be best and most effectively positioned to fight for every penny that we deserve

2192
03:33:56,440 --> 03:34:01,540
as a system, especially when we're talking about commercial payers and managed care plans.

2193
03:34:03,040 --> 03:34:04,600
So we'll keep our eye on that.

2194
03:34:05,120 --> 03:34:09,620
We may need to bring some additional recommendations to the board as part of these strategies

2195
03:34:09,620 --> 03:34:16,120
because they are part of driving revenue and saving services and positions for the system overall.

2196
03:34:16,860 --> 03:34:22,540
Great, thank you. Yes, I think it's important to have, you know, the right positions and the right personnel

2197
03:34:22,540 --> 03:34:31,620
and in those positions, as much as, you know, it's challenging when we have to look at cuts, but sometimes we just have to shuffle things around too.

2198
03:34:31,620 --> 03:34:33,200
So I look forward to that.

2199
03:34:33,420 --> 03:34:36,860
And then the last thing is, there was a lot about AI,

2200
03:34:37,080 --> 03:34:39,300
which I'm very excited to see.

2201
03:34:39,720 --> 03:34:42,000
I don't know that as a sport, at least,

2202
03:34:42,220 --> 03:34:45,440
has had a chance to talk about AI and policy.

2203
03:34:46,960 --> 03:34:50,180
And there's been, obviously, there's a lot of concerns, too.

2204
03:34:51,460 --> 03:34:55,280
But at some point, maybe hopefully soon,

2205
03:34:55,960 --> 03:35:00,060
I would like to request that we have a steady session, perhaps,

2206
03:35:00,060 --> 03:35:04,020
on what our AI policy is and should be.

2207
03:35:04,200 --> 03:35:09,160
Sure, we have an active AI-related administrative policy that's

2208
03:35:09,160 --> 03:35:12,880
in the meeting confer process with SEMA and SCIU.

2209
03:35:13,120 --> 03:35:17,600
We have implemented, as you can see from this slide, especially

2210
03:35:17,600 --> 03:35:19,980
the health system, but even in other parts of the organization,

2211
03:35:20,240 --> 03:35:22,000
a number of AI initiatives.

2212
03:35:22,640 --> 03:35:27,380
But I agree that we haven't done as good a job as some other places

2213
03:35:27,380 --> 03:35:31,440
in talking is publicly about some of the things that we're doing in this space.

2214
03:35:32,220 --> 03:35:32,300
So.

2215
03:35:32,340 --> 03:35:32,420
Okay.

2216
03:35:32,820 --> 03:35:33,640
Thank you very much.

2217
03:35:33,680 --> 03:35:34,260
Thank you, President.

2218
03:35:35,140 --> 03:35:35,620
Thank you.

2219
03:35:35,960 --> 03:35:37,340
And this is an information item.

2220
03:35:37,500 --> 03:35:38,120
There's no motion.

2221
03:35:38,520 --> 03:35:39,220
Need a thank you Paul.

2222
03:35:39,560 --> 03:35:43,320
Have a safe trip up there and call the sheriff and my bar is helicopter.

2223
03:35:45,800 --> 03:35:47,820
All right, let's see.

2224
03:35:47,860 --> 03:35:55,720
I know it's $12.50 and we still have another item on item 9, which is the public here in environmental

2225
03:35:55,720 --> 03:35:56,460
health fees.

2226
03:35:56,460 --> 03:36:01,580
I'm going to check with my colleague. Should we try to do this because I know a lot of the speakers are here. Would like to speak.

2227
03:36:02,100 --> 03:36:06,260
So do you think we could do this before lunch or no? Well, I had additional questions.

2228
03:36:06,440 --> 03:36:10,180
Oh, I'm sorry. I thought you were done. Oh, I'm so sorry. I thought you'd say go.

2229
03:36:10,640 --> 03:36:12,380
I'd be up for the questions. I'll have a seat.

2230
03:36:12,660 --> 03:36:14,720
I'm so sorry. I'm so sorry.

2231
03:36:20,900 --> 03:36:26,860
I definitely don't need ten. I will be I will be quick, but didn't want to miss the opportunities.

2232
03:36:26,860 --> 03:36:35,520
is also wanted to not to further aggravate James around the state hitting harder than the federal

2233
03:36:35,520 --> 03:36:40,540
government but I couldn't help thinking of the irony this morning that you honored oral

2234
03:36:40,540 --> 03:36:47,700
health months and one of the governor's proposed cuts in service is eliminating dental coverage

2235
03:36:47,700 --> 03:36:55,560
for the state only medical population and that I think will almost assuredly have major medical

2236
03:36:55,560 --> 03:37:02,360
consequences that we will see in emergency rooms and for a whopping savings in the state budget

2237
03:37:02,360 --> 03:37:11,520
of $134 million out of $222 billion medical budget. So clearly we have a lot of advocacy

2238
03:37:11,520 --> 03:37:13,820
work to do.

2239
03:37:15,900 --> 03:37:20,300
What I wanted and I don't even know that it's easy to give an answer now so maybe

2240
03:37:20,300 --> 03:37:27,420
something to think about is, with all of the changes, particularly around increasing revenue,

2241
03:37:28,120 --> 03:37:28,960
that you mentioned,

2242
03:37:31,440 --> 03:37:37,060
how do we assess or how are you assessing the likelihood? Are the things

2243
03:37:37,060 --> 03:37:44,880
that you've mentioned, 100% going to happen, crazy, maybe only 5% if we're lucky, it's really

2244
03:37:44,880 --> 03:38:03,220
to have a sense with that division you have of 70 million, 90 million in the remaining of what is what you feel confident about, revenue improvements, and is cost savings does that include the FTE reductions?

2245
03:38:04,060 --> 03:38:06,960
Yes, yes. So that's in the 90 million dollars.

2246
03:38:06,960 --> 03:38:13,780
that's in both the 90s and the 70s, so there are some positions due to restructuring

2247
03:38:13,780 --> 03:38:18,900
the alignment of services and there are some positions that are deleted.

2248
03:38:19,300 --> 03:38:23,740
So that's we have pretty good control over because we're making those decisions.

2249
03:38:24,340 --> 03:38:30,320
So can I assume that the 70 and the 90 are highly likely to be successful?

2250
03:38:30,440 --> 03:38:32,660
Not all of that is position reductions.

2251
03:38:32,660 --> 03:38:37,920
the cumulative amount associated with positions is about 50 out of the two-year-old.

2252
03:38:38,360 --> 03:38:46,260
Okay, but operational efficiencies, I would still think we have some good degree of control.

2253
03:38:46,380 --> 03:38:52,580
We do, in fact, the finance team is working very hard to track each of these initiatives

2254
03:38:52,580 --> 03:38:58,660
to ensure that we actually incur the ongoing savings and improvements that we've identified

2255
03:38:58,660 --> 03:39:01,120
because these have to be on-go-way.

2256
03:39:01,120 --> 03:39:01,380
Right.

2257
03:39:02,060 --> 03:39:02,600
Going forward.

2258
03:39:03,160 --> 03:39:04,460
And the revenue improvements.

2259
03:39:04,880 --> 03:39:05,420
Yes.

2260
03:39:05,420 --> 03:39:06,080
Four million.

2261
03:39:07,500 --> 03:39:09,800
Is that a moon shot or is that easy?

2262
03:39:10,520 --> 03:39:10,800
No.

2263
03:39:11,180 --> 03:39:18,300
In fact, I would say that the 104 million total that I had mentioned earlier from year over year

2264
03:39:18,300 --> 03:39:22,440
improvement, some of that we had already budgeted or anticipated.

2265
03:39:23,660 --> 03:39:28,460
But a lot of the revenue improvements are directly tied to specific initiatives for which we

2266
03:39:28,460 --> 03:39:32,420
in track, including improvements in revenue cycle,

2267
03:39:32,680 --> 03:39:34,840
whether has to do with denial, management,

2268
03:39:35,080 --> 03:39:37,020
and improvement in charge capture.

2269
03:39:38,180 --> 03:39:40,840
I would just add, this is something

2270
03:39:40,840 --> 03:39:44,760
that we look at very closely centrally.

2271
03:39:45,480 --> 03:39:48,660
And so this is a part of the push and pull tension

2272
03:39:48,660 --> 03:39:52,600
between OBA and the health system finance.

2273
03:39:52,600 --> 03:39:54,740
I see some notes smiling, you know what I'm talking about,

2274
03:39:54,840 --> 03:39:58,420
which is we have tremendous confidence in this team,

2275
03:39:58,420 --> 03:40:06,180
deliver what they say but we also monitor it very closely and we will be continuing

2276
03:40:06,180 --> 03:40:11,760
to monitor it because the reality is if we see over months gaps opening up we're

2277
03:40:11,760 --> 03:40:16,140
going to have to take further actions to keep the budget in balance so it's something

2278
03:40:16,140 --> 03:40:21,580
that we have to monitor and have been having to monitor that's not a new thing it's

2279
03:40:21,580 --> 03:40:28,020
just a magnitude that's newer given what's happening to us from HR1 so we will be

2280
03:40:28,020 --> 03:40:31,640
continuing to track at every single month.

2281
03:40:32,480 --> 03:40:35,600
And we meet across the finance and budget teams

2282
03:40:35,600 --> 03:40:38,100
every single month to track all of that.

2283
03:40:38,620 --> 03:40:39,560
I appreciate that.

2284
03:40:39,640 --> 03:40:42,440
You feel confident about the revenue?

2285
03:40:42,440 --> 03:40:44,660
We feel confident about the revenues.

2286
03:40:45,400 --> 03:40:47,680
If you go to slide number 42,

2287
03:40:48,620 --> 03:40:52,920
because this 40 million is only out of the 200.

2288
03:40:53,160 --> 03:40:55,840
But if you go to slide number 42,

2289
03:40:55,840 --> 03:41:01,880
where the revenue cycle has shown seven and a half percent improvements, where we are seeing

2290
03:41:01,880 --> 03:41:11,340
that our per patient, visit and per patient per DM rate or per is increasing significantly.

2291
03:41:11,460 --> 03:41:15,900
That is about 104 million dollars growth in this year.

2292
03:41:16,360 --> 03:41:23,340
Those are monitored regularly and finance is actually partnering with all the departments

2293
03:41:24,820 --> 03:41:31,580
And working closely with them to monitor these things because if they fall, the chances

2294
03:41:31,580 --> 03:41:33,460
are next year would be even more difficult.

2295
03:41:34,960 --> 03:41:35,560
Thank you.

2296
03:41:35,660 --> 03:41:40,820
I appreciate the confidence I also just want to extend again, appreciation to the physicians

2297
03:41:40,820 --> 03:41:46,780
and the nurses who I know are working closely with you there, the one performing the

2298
03:41:46,780 --> 03:41:56,020
and their efficiencies and increases, obviously, without compromising care, are going to be a really significant part of our success.

2299
03:41:56,680 --> 03:41:57,860
So, sorry for the false alarm.

2300
03:41:58,140 --> 03:42:00,420
I really am finished and I appreciate all of you.

2301
03:42:00,600 --> 03:42:01,140
Go eat lunch.

2302
03:42:02,380 --> 03:42:02,460
Okay.

2303
03:42:02,760 --> 03:42:03,500
Thank you.

2304
03:42:03,980 --> 03:42:04,620
All right, thank you.

2305
03:42:04,980 --> 03:42:07,180
So, moving on, I'm just going to pull my colleagues.

2306
03:42:07,520 --> 03:42:10,500
Item number nine is regarding the environmental health fees.

2307
03:42:10,760 --> 03:42:15,040
Do you think we can break, but we should do this first before a break for lunch?

2308
03:42:15,040 --> 03:42:18,260
Or do you want a big flood first?

2309
03:42:19,140 --> 03:42:19,760
You can do it.

2310
03:42:19,780 --> 03:42:20,020
All right.

2311
03:42:20,240 --> 03:42:20,340
Let's go.

2312
03:42:21,260 --> 03:42:21,680
I don't mind.

2313
03:42:21,880 --> 03:42:23,020
Let's see if we can do this one quickly.

2314
03:42:28,310 --> 03:42:33,590
I will speak things along by beginning their presentation for them as Dr.

2315
03:42:34,070 --> 03:42:34,510
Redmond.

2316
03:42:34,990 --> 03:42:35,430
Dr. Underwood.

2317
03:42:35,610 --> 03:42:38,130
Make their way forward as public health departments.

2318
03:42:38,270 --> 03:42:39,310
Environmental health branch.

2319
03:42:39,370 --> 03:42:40,490
This is a return of the item.

2320
03:42:40,670 --> 03:42:42,750
Those in front of the board in December.

2321
03:42:43,650 --> 03:42:46,470
With the additional information requested by the board.

2322
03:42:46,470 --> 03:42:52,470
included in attachments that look at specifically the food facility and body art fees, as

2323
03:42:52,470 --> 03:43:00,170
they relate to other counties, as well as looking at impacts on smaller entities and

2324
03:43:00,170 --> 03:43:04,930
noting that there's a number of fee decreases, actually, for smaller facility kitchens.

2325
03:43:05,670 --> 03:43:09,850
The board has in front of it the specific recommendations that are being brought forward by

2326
03:43:09,850 --> 03:43:10,430
administration.

2327
03:43:11,230 --> 03:43:12,870
There was additional outreach conducted.

2328
03:43:12,870 --> 03:43:19,990
I'll see if Dr. Rotten has anything else to add to that very brief summary, but of course we're all available for questions.

2329
03:43:20,670 --> 03:43:20,890
Thank you.

2330
03:43:20,950 --> 03:43:23,330
I think Mr. Williams covered everything.

2331
03:43:23,490 --> 03:43:27,910
I hope to bring to you today as well as to introduce Dr. Underwood Director of Environmental Health.

2332
03:43:28,070 --> 03:43:34,770
And we do have our Division Director of Consumer Protection here with us for additional questions.

2333
03:43:35,050 --> 03:43:42,850
But our most important goal at your direction to the board has been over the last several months to make sure that the community had every opportunity to become aware.

2334
03:43:42,850 --> 03:43:50,770
of these proposed fee changes to engage with us through website outreach via post and email.

2335
03:43:52,290 --> 03:43:58,550
And to be absolutely certain that these fee increases not only were justified based on the complex

2336
03:43:58,550 --> 03:44:02,190
fee study we presented, but we're in line with the surrounding counties.

2337
03:44:02,470 --> 03:44:07,230
And so you'll see additional counties provided for you today in the attachment that indicates

2338
03:44:07,230 --> 03:44:11,290
that the fees that we bring you today are in line with what our neighbors are requesting

2339
03:44:11,290 --> 03:44:30,930
as well. And then finally, I think as Mr. Williams said, I do want to restate one of the most important findings was that especially for our smaller kitchen food service businesses, you will see a reduction in many of the fees that we look forward to putting into place that are in accordance with our findings from our fee study about the services required for those inspections.

2340
03:44:31,530 --> 03:44:33,670
With that we're happy to support any of your questions.

2341
03:44:33,670 --> 03:44:40,390
Dr. Rodman, I forgot to mention the good news regarding the Mikos program, so if you want

2342
03:44:40,390 --> 03:44:41,390
to just add that real quick.

2343
03:44:42,070 --> 03:44:46,950
I appreciate you leaving the good news for us, so we were very pleased to speak with the leadership

2344
03:44:46,950 --> 03:44:51,590
of the health trust after hearing from you several months ago about how important it is,

2345
03:44:51,650 --> 03:44:53,250
especially with our Mikos program.

2346
03:44:53,350 --> 03:44:56,550
Support some of our newest business arch patures in.

2347
03:45:00,000 --> 03:45:06,880
Food Services, that they are willing to both fund and operate a system that will offer fee relief

2348
03:45:08,320 --> 03:45:12,220
for low-income applicants. And so, we're working closely with Dr.

2349
03:45:12,300 --> 03:45:16,600
Iton and his team to help get that off the ground. They may be bringing in community-based organizations

2350
03:45:16,600 --> 03:45:20,840
on their end as well. And so, extremely grateful to the Health Trust for that partnership.

2351
03:45:22,260 --> 03:45:28,020
Wonderful. Thank you. We like good news for need-good news. All right. Let's see how many

2352
03:45:28,020 --> 03:45:31,900
and public would like to speak, have you run it?

2353
03:45:32,180 --> 03:45:37,460
I currently have 10 speakers in chambers and one online.

2354
03:45:38,100 --> 03:45:39,160
Okay, can we do a melody?

2355
03:45:40,440 --> 03:45:44,340
All right, we'll start with our speakers in chambers.

2356
03:45:44,760 --> 03:45:47,300
We're going to go ahead and close our cue.

2357
03:45:48,320 --> 03:45:50,740
I'll call you up and you can speak in any order.

2358
03:45:50,740 --> 03:46:02,100
Sean Dollard, Zowilder, Zeru Vasquez, Lopez, Surya Tajoba, Suitsa Del Rio.

2359
03:46:04,860 --> 03:46:08,260
And just to appreciate this as the opening of the panel here.

2360
03:46:08,860 --> 03:46:09,620
Thank you. Good afternoon.

2361
03:46:14,840 --> 03:46:17,820
I'm honored to be here today on behalf of our CEO Dr. Tony Eighton.

2362
03:46:18,820 --> 03:46:21,400
At the health trust, we fully support agenda item nine,

2363
03:46:21,520 --> 03:46:24,260
and then propose recommendations related to the Mikos program.

2364
03:46:24,820 --> 03:46:35,940
As a catalyst in collaborative force to advance health equity, the health trust is steadfast in our commitment to partner with the public health department, the county of Santa Clara, and our community partners to strengthen the local community food system.

2365
03:46:36,880 --> 03:46:39,740
The opportunity before us today is a resolute pathway to health equity.

2366
03:46:39,740 --> 03:46:45,240
Poyce to catalyze a flourishing, culturally rooted food entrepreneurship ecosystem that reduces

2367
03:46:45,240 --> 03:46:49,000
barriers to opportunity and prosperity that our neighbors justly deserve.

2368
03:46:49,960 --> 03:46:53,780
Food entrepreneurs living on lower incomes have the vision, the tenacity and the brilliance

2369
03:46:53,780 --> 03:46:57,400
to bring their business to life, yet their greatest hurdle can be the cost and regulatory

2370
03:46:57,400 --> 03:46:58,340
burden to get started.

2371
03:46:59,340 --> 03:47:03,940
Today we have a chance to remedy a challenge that disproportionately impacts our community members

2372
03:47:03,940 --> 03:47:09,320
and small business owners living with less economic power and resources than they justly deserve.

2373
03:47:09,320 --> 03:47:10,620
Thank you very much.

2374
03:47:11,600 --> 03:47:12,280
Thank you.

2375
03:47:18,620 --> 03:47:20,800
Good afternoon, my name is Surayah Jovell.

2376
03:47:22,300 --> 03:47:25,540
Dear Supervisor of the Condado Santa Clara.

2377
03:47:26,380 --> 03:47:28,560
I am a good friend from the University of Mexico.

2378
03:47:28,660 --> 03:47:32,800
In the rest of the year, I want to thank the condado

2379
03:47:32,800 --> 03:47:34,760
for everything that has happened especially

2380
03:47:34,760 --> 03:47:37,600
for being able to collect more data

2381
03:47:37,600 --> 03:47:38,920
on the micro operators.

2382
03:47:39,900 --> 03:47:43,940
I consider the resolution to modify the tasks

2383
03:47:43,940 --> 03:47:52,440
and to be more happy, that helps us a lot to continue and especially with the changes in

2384
03:47:52,440 --> 03:47:58,300
the laws and the costs, thanks for supporting the small businesses and for their

2385
03:47:58,300 --> 03:48:00,140
commitment with our community.

2386
03:48:01,220 --> 03:48:03,140
Thank you, and I translate it, please.

2387
03:48:04,000 --> 03:48:09,860
Yes, this is a honor of the rest of my friends.

2388
03:48:09,860 --> 03:48:16,100
And I just want to thank the county for collecting data about the Microsoft Providers and

2389
03:48:16,100 --> 03:48:19,740
We could change into these to be more just for everyone and help us move

2390
03:48:20,280 --> 03:48:24,080
a form work and support the support small business

2391
03:48:26,160 --> 03:48:32,040
Thank you. Please. Oh, hello. Good afternoon. This is Pervator. It's the condado. My name is Soraia Vasquez

2392
03:48:32,040 --> 03:48:34,900
And my pequeño negocio, I am a Soraia's co-fian Bakerie

2393
03:48:34,900 --> 03:48:38,600
a few months ago, we were going to the same

2394
03:48:38,600 --> 03:48:40,580
supplicating them so that they could not attend

2395
03:48:40,580 --> 03:48:43,480
to reduce the costs of food

2396
03:48:43,480 --> 03:48:45,920
that we will buy from home.

2397
03:48:46,380 --> 03:48:48,680
And fortunately, we have been listening

2398
03:48:48,680 --> 03:48:50,340
for so many reasons.

2399
03:48:51,460 --> 03:48:54,080
In my name, I am a small business

2400
03:48:54,080 --> 03:48:56,280
and the organization of Begyllusio,

2401
03:48:56,580 --> 03:48:57,880
who is attending our university

2402
03:48:57,880 --> 03:48:59,460
of the services.

2403
03:48:59,800 --> 03:49:04,880
And we can also come closer to the market

2404
03:49:04,880 --> 03:49:08,080
Thank you very much very much for supporting the community.

2405
03:49:08,800 --> 03:49:10,780
And we hope that you will not miss it.

2406
03:49:10,860 --> 03:49:13,540
We will be in some time, more adelante, in the future,

2407
03:49:14,100 --> 03:49:17,080
sharing the best of our business, in my case,

2408
03:49:17,580 --> 03:49:20,060
in my business that is called Soria Escoffian Bakerie.

2409
03:49:20,220 --> 03:49:22,620
Because there are many delicious and delicious

2410
03:49:22,620 --> 03:49:24,200
and delicious dishes that share with all of you.

2411
03:49:24,620 --> 03:49:25,420
Thank you very much.

2412
03:49:34,880 --> 03:49:47,100
I just a few months ago we asked you to reduce the costs for the permits and we want to thank you for addressing this issue and for continuing your continuous support to the community.

2413
03:49:48,000 --> 03:49:59,100
And we hope that in the future we can continue to show our success and to share with you more for products like Donuts, which are very delicious. Thank you very much.

2414
03:50:03,430 --> 03:50:10,330
Good afternoon, Supervisal is the condado. My name is Sojita Del Real. I am a part of the

2415
03:50:10,330 --> 03:50:12,590
evolution and member of the community force.

2416
03:50:14,610 --> 03:50:16,210
It is a commitment to entrepreneurs

2417
03:50:16,210 --> 03:50:22,650
small business business in the area of the San Jose, as before, we have already been here. I want

2418
03:50:22,650 --> 03:50:31,010
to thank you all for having considered the recopulation of data, the model of business

2419
03:50:31,770 --> 03:50:38,350
And I consider to modify the tasks and establish a more fair manner for everyone.

2420
03:50:39,230 --> 03:50:43,410
This means a lot for everyone and each of us,

2421
03:50:43,750 --> 03:50:51,850
because there would be a great way to obtain the permission of each one of the employees of the Panamico business.

2422
03:50:52,150 --> 03:50:56,910
Thank you for all your support and for your commitment to the small businesses.

2423
03:50:57,450 --> 03:50:57,950
Thank you.

2424
03:51:03,110 --> 03:51:10,930
I'm a member of the entrepreneurial business in the San Jose area and I just came to

2425
03:51:10,930 --> 03:51:17,850
with Deep Heart to thank you for all the because of data model for data collection

2426
03:51:17,850 --> 03:51:22,250
and how you have helped us to obtain the permits and reduce the costs.

2427
03:51:23,070 --> 03:51:26,070
And we just want to thank you again for all of your continuous support.

2428
03:51:27,710 --> 03:51:33,310
I'm going to go ahead and call forward the rest of the speakers in Chambers, Miguel Gonzalez,

2429
03:51:34,130 --> 03:51:38,050
Katherine McClillan, Michael Orlando, and Nathan.

2430
03:51:44,900 --> 03:51:50,480
My name is Zoe Wilder and I'm a body art practitioner and constituent of district 2.

2431
03:51:51,140 --> 03:51:56,180
Thank you to the board for taking the time to listen and protect small businesses in Santa Clara County.

2432
03:51:56,780 --> 03:52:01,080
We urge the board to not pass these updated fees for the body art program.

2433
03:52:01,080 --> 03:52:09,420
Body art is defined in the safe body art act as body piercing, tattooing, or application of permanent cosmetics.

2434
03:52:10,520 --> 03:52:19,800
Many of these services do include reconstruction for misectemies and cancer-related traumas, or decorative pieces that celebrate the survival of that journey.

2435
03:52:20,720 --> 03:52:23,860
While many clients do not utilize all of the body art services,

2436
03:52:24,400 --> 03:52:29,500
most Santa Clara County residents have used at least one of these services that are available to the public.

2437
03:52:29,500 --> 03:52:40,680
There are many inefficiencies and discrepancies in servicing the body art program that merit further discussion and I believe that my fellows will continue that thought.

2438
03:52:41,120 --> 03:52:41,780
Thank you.

2439
03:52:52,400 --> 03:52:56,280
My name is Michael and I'm going to continue on.

2440
03:52:56,860 --> 03:53:09,180
We've been told that there was only one worker with one email at this facility and for inspections and investigations for the entire Santa Clara county.

2441
03:53:09,180 --> 03:53:18,520
nearly every phone call made to the DEH and to update our contact information, change shop names, etc.

2442
03:53:19,440 --> 03:53:25,560
is met with someone who isn't trained to deal with any of our inquiries related to body art programming.

2443
03:53:26,320 --> 03:53:35,800
It can only send us a send us to a very full voice mailbox and tell us to call back in hopes of catching them at some further time.

2444
03:53:35,800 --> 03:53:38,700
And our shop rosters have not been updated.

2445
03:53:39,360 --> 03:53:44,040
So we're to people who are no longer working

2446
03:53:44,040 --> 03:53:47,860
at the facilities and into inactive artists.

2447
03:53:48,900 --> 03:53:50,080
And they will continue on.

2448
03:53:57,810 --> 03:53:58,150
Hello.

2449
03:53:59,030 --> 03:53:59,770
My name is Nathan.

2450
03:54:00,510 --> 03:54:02,650
And I am a tattoo artist based in Campbell, California.

2451
03:54:02,890 --> 03:54:05,150
I'm here to continue the thoughts of my colleagues.

2452
03:54:06,390 --> 03:54:08,070
The lack of roster updates leads

2453
03:54:08,070 --> 03:54:09,990
to clients not knowing who is registered

2454
03:54:09,990 --> 03:54:14,550
and who to book with potentially beating to artists losing a fair amount of money.

2455
03:54:15,530 --> 03:54:20,570
This opens up to possible lawsuits as well because clients, he clients, does not know

2456
03:54:20,570 --> 03:54:25,250
who is responsible in a personal lawsuit case or if the artist is permitted to work.

2457
03:54:25,750 --> 03:54:29,070
This holds the facility liable for employing unlicensed practitioners.

2458
03:54:29,890 --> 03:54:33,510
It will be the facility's responsibility to answer to any lawsuit.

2459
03:54:33,950 --> 03:54:37,490
Updating the roster is one service that is provided for by the county.

2460
03:54:39,070 --> 03:54:43,570
Diverting precious hours of time looking into complaints submitted without any evidence or

2461
03:54:43,570 --> 03:54:48,450
verifying who's submitted to be abused with zero repercussions on and both parties being

2462
03:54:48,450 --> 03:54:52,630
responsible for a loss of income for numerous artists who need to halt their work during this

2463
03:54:52,630 --> 03:54:59,150
inspection. Now that the body arts program is under the consumer protection division of the DEH should be

2464
03:54:59,150 --> 03:55:01,170
charging they will continue.

2465
03:55:07,500 --> 03:55:12,920
So my name is Katie McLean and I am a cosmetic doctor to artist. So the

2466
03:55:12,920 --> 03:55:18,660
EH has provided no plan as how the fees increases would increase the support in the body

2467
03:55:18,660 --> 03:55:20,220
art program as they've been promising.

2468
03:55:20,760 --> 03:55:25,080
There is no accountability, there needs to be a tangible plan provided publicly as well

2469
03:55:25,080 --> 03:55:29,620
as a schedule for the DEH to adhere to in order to demonstrate that the DEH is being held

2470
03:55:29,620 --> 03:55:32,740
accountable and efficiency and using funds appropriately.

2471
03:55:33,580 --> 03:55:37,560
Hours build for certain services are unrealistic if not intentionally skewed.

2472
03:55:37,560 --> 03:55:48,320
For example, a new practitioner application is built at 1.00 hours, yet simply renewing a permit for someone who is already in the system takes 1.03 hours.

2473
03:55:48,900 --> 03:56:03,820
New applicants have done a lot of paperwork to process and also a verification call with shop owners to confirm residency, while practicing practitioners renew their permits themselves and the DEH only mails out the permit certificates.

2474
03:56:03,820 --> 03:56:10,700
State of Clear County is on track to being one of the most if not most expensive and worse to serve as body communities.

2475
03:56:19,880 --> 03:56:20,400
Good morning.

2476
03:56:20,900 --> 03:56:25,540
My name is Omega Gonzalez and I am a body art facility owner.

2477
03:56:26,220 --> 03:56:30,480
Public comment regarding Proposition 26 and body art program fees.

2478
03:56:30,700 --> 03:56:31,180
Good morning.

2479
03:56:32,880 --> 03:56:38,980
I like to address the ongoing impacts of Proposition 26 proposed by the body art program fee increases.

2480
03:56:38,980 --> 03:56:46,540
Proposition 26 was passed approximately 15 years ago, and resulted in the removal of the scale system fee system.

2481
03:56:46,960 --> 03:56:57,200
Since then, small body art businesses have been required to pay fee similar to those paid in much larger entities, despite significant differences in revenue, staffing and operational capacity.

2482
03:56:58,320 --> 03:57:07,600
The absence of a scale fee structure disproportionately benefits large businesses while placing small studios and independent artists as an added disadvantage.

2483
03:57:07,600 --> 03:57:14,020
It removes the ability to fairly account for what businesses can reasonably afford while still maintaining cost recovery.

2484
03:57:14,540 --> 03:57:17,120
Our business has already been impacted by the county's actions.

2485
03:57:17,320 --> 03:57:20,780
Some of these artists have not yet received their health permits in a timely manner,

2486
03:57:21,060 --> 03:57:24,620
which directly restricted our ability to operate fully and generate income.

2487
03:57:25,120 --> 03:57:29,620
Proposing this fee increases under those conditions for other strengths,

2488
03:57:29,640 --> 03:57:33,580
small businesses that have already been struggling due to administrative delays beyond their control.

2489
03:57:34,120 --> 03:57:35,660
I also want to address that.

2490
03:57:38,380 --> 03:57:42,120
Thank you and our final speaker is Chase Wedgland.

2491
03:57:42,360 --> 03:57:43,600
We've asked you to unmute.

2492
03:57:49,240 --> 03:57:50,280
Hi, my name is Chase Wedgland.

2493
03:57:50,420 --> 03:57:52,380
I'm a tattoo shop owner in Campbell, California.

2494
03:57:53,580 --> 03:57:56,180
A majority of body art practitioners are registered as independent

2495
03:57:56,180 --> 03:57:58,760
contractors, not employees who receive hourly pay,

2496
03:57:58,960 --> 03:58:00,560
health benefits, paid time off, et cetera.

2497
03:58:01,100 --> 03:58:03,900
Every single dollar that the body art practitioner earns is crucial

2498
03:58:03,900 --> 03:58:04,640
to their survival.

2499
03:58:05,200 --> 03:58:08,260
Increasing body art program, these places the FD financial burden

2500
03:58:08,260 --> 03:58:11,140
on practitioner that can mean the difference of purchasing higher quality

2501
03:58:11,140 --> 03:58:15,480
applies for the adequate groceries, saving for retirement or for the living costs, etc.

2502
03:58:16,400 --> 03:58:19,340
In addition, the DEA does not mean any consideration for a large number of body

2503
03:58:19,340 --> 03:58:22,740
practitioners and facility owners who are a part of protected classes,

2504
03:58:23,260 --> 03:58:27,120
the saving by the DEA to survey its not been yet conducted to determine the

2505
03:58:27,120 --> 03:58:31,160
percentage of body art businesses owned by members of protected classes, such as

2506
03:58:31,160 --> 03:58:35,840
survey could be valuable to better understand impacts to explore potential

2507
03:58:35,840 --> 03:58:39,020
mitigation strategies including alternative funding sources.

2508
03:58:39,020 --> 03:58:43,820
As Supervisor Betty Duong mentioned in the meeting in December 9, the current society pressures

2509
03:58:43,820 --> 03:58:49,640
and economy, disproportionately impacting immigrant families and those of protected classes.

2510
03:58:51,950 --> 03:58:54,130
And this concludes our public speakers.

2511
03:58:54,850 --> 03:58:55,410
Thank you, Ronda.

2512
03:58:55,850 --> 03:58:59,270
And we'll go ahead and close the public hearing portion.

2513
03:59:00,290 --> 03:59:01,430
There's really, yes, change.

2514
03:59:02,050 --> 03:59:06,750
I just wanted to make one very, very brief comment of appreciation for our last in-person

2515
03:59:06,750 --> 03:59:12,990
speakers at something really powerful by Prop 26 that I feel like is very, very, very

2516
03:59:12,990 --> 03:59:18,610
misunderstood by the general public, which is the way in which it ties our hands, not

2517
03:59:18,610 --> 03:59:23,850
just the county, but cities and all governments, by eliminating the ability to do sliding

2518
03:59:23,850 --> 03:59:30,010
scale fees, has actually really harmed across the state. And I'm not just talking about

2519
03:59:30,010 --> 03:59:35,030
this kind of fee. I'm talking about water rates. I'm talking about all sorts of other

2520
03:59:35,030 --> 03:59:39,710
permitting structures has really harmed small businesses all over California.

2521
03:59:40,650 --> 03:59:46,150
And I say that because that's not how those measures are sold to the public when they're put on the ballot.

2522
03:59:46,970 --> 03:59:51,170
They're sold to the public as if they're going to provide relief to small businesses.

2523
03:59:51,670 --> 03:59:59,610
But in fact, they tie our hands in creating fee structures in ways that make more sense.

2524
04:00:00,000 --> 04:00:08,520
And that can allocate the costs of a regulatory program to those entities who have disproportionately higher revenue.

2525
04:00:09,300 --> 04:00:14,660
And so I just wanted to note that it's something that comes up over and over again every time we look at fees.

2526
04:00:15,180 --> 04:00:23,140
It's in the state constitution. It was added there by the voters, but they were sold one thing and the end result is something else.

2527
04:00:23,800 --> 04:00:31,240
And that happens all too often, but it has now tied our hands here at the county on every type of feet, not just these.

2528
04:00:32,880 --> 04:00:34,500
Thank you, James, so so far as young.

2529
04:00:36,160 --> 04:00:36,900
Thank you.

2530
04:00:37,060 --> 04:00:39,120
Thank you, Dr. Redmond, Dr. Underwood.

2531
04:00:39,460 --> 04:00:43,140
I know that today is a continuation of a previous hearing that we had.

2532
04:00:44,020 --> 04:00:48,780
And with the following up on their quest for information for their comparative studies,

2533
04:00:48,780 --> 04:00:52,860
as is for his request. I want to appreciate you for that. I'm encouraged by the updates

2534
04:00:52,860 --> 04:00:57,480
for some of a few questions. And also thank you for the clarification. I'll have to remember

2535
04:00:57,480 --> 04:01:02,580
to refer to the department as EHB now or the environment to the health branch moving forward.

2536
04:01:02,580 --> 04:01:10,620
That's going to have to undo a decades worth of calling you. So breaking down the EHB funding and

2537
04:01:10,620 --> 04:01:16,520
why really just wanting to understand why it took so long to take until now to update these fees.

2538
04:01:17,900 --> 04:01:21,780
The Environment Health Branch is almost fully funded by these fees, yes.

2539
04:01:22,620 --> 04:01:27,280
And can you elaborate on the departments like totality of funding sources to provide

2540
04:01:27,280 --> 04:01:28,160
further context?

2541
04:01:29,540 --> 04:01:31,960
I'll let Dr. Underwood jump in first.

2542
04:01:32,220 --> 04:01:33,700
Let's see if I can do that.

2543
04:01:34,280 --> 04:01:34,920
Good morning.

2544
04:01:35,300 --> 04:01:35,360
Good morning.

2545
04:01:35,360 --> 04:01:36,780
Supervisor Young and Board.

2546
04:01:37,640 --> 04:01:43,860
Primarily, I think it's about 94% of our budget is covered by fees and we do have small

2547
04:01:43,860 --> 04:01:51,720
member grants that make up the other 6% and then less than 1% of a couple of general funds

2548
04:01:51,720 --> 04:01:55,460
that fund our healthy nails as well as our noise ordinance.

2549
04:01:55,900 --> 04:01:58,680
Primarily it is fees that cover our costs.

2550
04:01:59,880 --> 04:02:04,500
And the report, the update report says that fees for food and body art facilities had not been

2551
04:02:04,500 --> 04:02:11,620
updated since 2013 and the department has focused on cost containment versus full cost recovery.

2552
04:02:11,620 --> 04:02:17,780
can you explain this further and why did the Department wait or what was preventing us from making

2553
04:02:17,780 --> 04:02:25,400
movements since 2013? Sure, the program was within the solid and medical waste group and within

2554
04:02:25,400 --> 04:02:33,540
that group, they also do solid waste inspections. That needed basically revamping the entire program

2555
04:02:33,540 --> 04:02:41,480
which you guys approved back in December to be in line with Prop 26 Prop 13 where the landfills

2556
04:02:41,480 --> 04:02:48,710
and the transfer stations that we were doing actually took their full cost of what it took to inspect them.

2557
04:02:49,820 --> 04:02:54,500
Because the solid waste and medical waste team had been doing the body art inspections,

2558
04:02:54,900 --> 04:02:59,580
and we hadn't really restructured the entire program and their cost.

2559
04:03:00,120 --> 04:03:03,600
We had not actually looked at the body art in time.

2560
04:03:03,740 --> 04:03:08,300
It took to do this work and restructured their cost.

2561
04:03:08,300 --> 04:03:11,080
So, we did move the body art program.

2562
04:03:11,240 --> 04:03:17,140
It is a consumer protection program into the consumer protection division a couple of years ago.

2563
04:03:17,680 --> 04:03:22,180
And with this fee study, we were able to not only look at the solid waste, but also put

2564
04:03:22,180 --> 04:03:24,700
an alignment the body art fees as well.

2565
04:03:26,200 --> 04:03:26,780
Thank you.

2566
04:03:26,980 --> 04:03:32,180
And then there are two new fees are listed at Identify as a new in the attachment for

2567
04:03:32,180 --> 04:03:33,320
a body art practitioners.

2568
04:03:34,140 --> 04:03:39,860
Can you tell me if these fees are brand brand new or if they were under a different category when

2569
04:03:39,860 --> 04:03:42,060
body art was under solid and medical waste?

2570
04:03:43,380 --> 04:03:47,520
So one of the things that we want to do is just in pointing out not only in this program,

2571
04:03:47,720 --> 04:03:52,920
but in other programs where we have annual operating costs was to take out one time cost,

2572
04:03:53,240 --> 04:03:56,820
like a new food facility, our new body art facility, our new practitioner.

2573
04:03:57,760 --> 04:04:01,780
So that's not only in this program, but we're over the last few years we've been adding

2574
04:04:01,780 --> 04:04:07,780
the application fees to these different programs so that we're pulling that time out and making sure

2575
04:04:07,780 --> 04:04:13,760
that the annual operating people are not paying for a new application. So it is brand new for the

2576
04:04:13,760 --> 04:04:18,360
body art but we have also been over the last few years with bringing it to the board. The last

2577
04:04:18,360 --> 04:04:24,220
time we bought feed changes to the board. We introduced application fees for other programs as well.

2578
04:04:24,700 --> 04:04:30,200
So prior to the introduction to application fees, we just processed applications without any fees.

2579
04:04:30,200 --> 04:04:35,400
Well, it was part of the annual operating permit, eventually, that they would be paying for.

2580
04:04:35,660 --> 04:04:42,540
So, the cost was already embedded in the annual operating permit, and now this cost has been moved out of the operating permit

2581
04:04:42,540 --> 04:04:45,360
into this application fee to rent.

2582
04:04:46,360 --> 04:04:47,760
So, I just want to make sure I'm getting this.

2583
04:04:47,760 --> 04:04:51,660
So, it's technically kneel on ordinance on paper,

2584
04:04:52,220 --> 04:04:59,220
but it's a movement of a portion of the fees from one category where it was typically charged to another separate

2585
04:04:59,220 --> 04:05:08,960
The time that was taken used to be incorporated into the annual operating fee and now it's been taken out and that time is being assigned to the application.

2586
04:05:09,680 --> 04:05:19,440
So then, hypothetically speaking that if I were to open a new body art facility, which I wouldn't because I can't draw.

2587
04:05:19,440 --> 04:05:35,840
I would pay a one-time application fee and that fee used to live in the annual operating permit.

2588
04:05:36,500 --> 04:05:40,120
So then the annual operating permit has been reduced by that amount.

2589
04:05:41,200 --> 04:05:45,860
Well again, the time has been taken out of the calculation for the annual operating permit.

2590
04:05:45,860 --> 04:05:55,680
Right, so that time's not applied there anymore, and then the fee follows it to this one time application fee versus having that being paid again and again every year.

2591
04:05:56,260 --> 04:06:05,940
It does allow us to more accurately calculate the correct time for that annual permitting process so that it helps us maintain the lowest possible allowable fee for that process.

2592
04:06:07,340 --> 04:06:09,060
Thank you. Thank you for that clarification.

2593
04:06:11,180 --> 04:06:26,180
And I noticed that the gentleman from the Health Trust just left, I wanted to give a shout out, but this presentation is recorded and broadcast right now that I'm just really encouraged by the development of the Mecos program.

2594
04:06:26,820 --> 04:06:30,980
I had a chance to support Supervisors in the Chavez on that program.

2595
04:06:30,980 --> 04:06:34,840
as her former staffer Paul Murphy was here earlier, I don't know where he is now, but helped

2596
04:06:34,840 --> 04:06:40,400
develop that with her. Really encouraged that it's been converted to transition to a permanent

2597
04:06:40,400 --> 04:06:47,520
program and that we found a way to be able to support that program through this partnership.

2598
04:06:48,920 --> 04:07:00,380
Another aspect of the health-interest partnership that not only are they taking on the cost of the

2599
04:07:00,380 --> 04:07:02,280
permits, right, which results in few deductions.

2600
04:07:02,760 --> 04:07:05,500
But they're also taking on the task of identifying

2601
04:07:05,500 --> 04:07:08,960
qualified mecos participants for that fee reduction,

2602
04:07:09,580 --> 04:07:14,480
which is something that I know that EHB is not typically

2603
04:07:14,480 --> 04:07:19,020
tasked with or has been outfitted for in terms of identifying

2604
04:07:19,610 --> 04:07:26,100
who is eligible for a lesser for reduced rates

2605
04:07:26,100 --> 04:07:41,120
And accordance with Proposition 26, because we could provide a discount of fee when you are a client of our social services benefits programs.

2606
04:07:42,120 --> 04:07:45,560
And so, did I get that right, James is leaning in? I didn't get that right.

2607
04:07:45,560 --> 04:07:55,500
Yeah, to be clear of Prop 26, the problem that it causes is we cannot increase anybody's fees to recover offsets for other folks.

2608
04:07:56,120 --> 04:08:06,780
So what we used to be able to do before Prop 26 is we could say the total cost of the food facility program is $3 million.

2609
04:08:07,640 --> 04:08:12,040
So we're going to cost our cover $3 million, but we're going to have a sliding scale and

2610
04:08:12,040 --> 04:08:17,000
we're going to charge more to certain entities based on their gross revenue and we're

2611
04:08:17,000 --> 04:08:18,580
going to charge less to other entities.

2612
04:08:20,280 --> 04:08:27,760
Now what we have to do under Prop 26 is we can't charge more to any entity beyond the time

2613
04:08:27,760 --> 04:08:32,580
that it takes to do the work associated with that entities program.

2614
04:08:33,280 --> 04:08:37,560
And so, as a result, if we still need to cost recover for the program,

2615
04:08:40,180 --> 04:08:45,280
then we, essentially, are forced into more across the board type structures.

2616
04:08:45,440 --> 04:08:53,500
That's not to say there isn't some gradation, and obviously you see that, and we just talked about the difference between the application fee and the renewal fee.

2617
04:08:54,100 --> 04:08:58,200
But in general, we're much more limited in how we can do that.

2618
04:08:58,200 --> 04:09:17,580
So we have a few things that we can do, but our hands are largely tied and some of the more obvious things that we would like to be able to do, which would be to really account for businesses, gross revenues or things like that,

2619
04:09:17,880 --> 04:09:23,540
are not factors that we're allowed to incorporate into a Prop 26 fee structure.

2620
04:09:27,360 --> 04:09:50,140
Thank you, James, for that. I know that one of the ways that we have been able to ease the burden or ease the impact of higher fees for those who are financially vulnerable, economically vulnerable, is to correlate or align enrollment into our various benefit programs and being able to do that. That's something that we're allowed to do.

2621
04:09:50,140 --> 04:10:03,040
Yes, and we have a county-wide policy regarding that across all of our fees, so that applies to every type of fee that the county has, consistent with our broader safety net services.

2622
04:10:03,180 --> 04:10:04,680
Including EHB fees.

2623
04:10:04,980 --> 04:10:05,460
That's right.

2624
04:10:05,880 --> 04:10:18,140
Yeah, and then do we have a mechanism for being able to track which ones of track or outreach or communicate which one of our fee customers are eligible for reduced fees?

2625
04:10:18,140 --> 04:10:28,860
We don't have a direct mechanism, it's really incumbent on those individuals to bring forward

2626
04:10:28,860 --> 04:10:36,500
that information because the databases aren't set up with, you know, they don't, for

2627
04:10:36,500 --> 04:10:44,160
very obvious reasons were very, and subject to a lot of state laws, we can't share benefits

2628
04:10:44,160 --> 04:10:50,040
information all across the rest of the organization, that information is considered relatively

2629
04:10:50,040 --> 04:10:55,420
sensitive and especially in this time with everything going on at the federal level, it

2630
04:10:55,420 --> 04:11:01,920
kind of heightens that issue. And so we actually need people to themselves identify the other

2631
04:11:01,920 --> 04:11:08,080
departments aren't allowed to pull from social services records. Yeah, folks need to self-identify

2632
04:11:08,080 --> 04:11:13,260
so that not creates an illness on us and to make sure that we provide clear communication that this

2633
04:11:13,260 --> 04:11:17,960
is a benefit or an augmentations that's available to folks who qualify.

2634
04:11:18,900 --> 04:11:23,820
And this also reminds me of the conversation that we had with CEPA and our new garbage

2635
04:11:23,820 --> 04:11:27,820
contract, being able to do a data sharing pilot with Debbs.

2636
04:11:28,420 --> 04:11:33,600
So I know I'm fully aware of the challenges, the difficulties, the red tape and also the

2637
04:11:33,600 --> 04:11:37,380
height and sense of concern with a hostile federal administration right now.

2638
04:11:37,580 --> 04:11:41,380
But I also know that this is a county that has to figure out to do things when no one else

2639
04:11:41,380 --> 04:11:48,380
has. And so I would hope that, well, I would like to request that for the thought be given

2640
04:11:48,380 --> 04:11:53,160
into this, whether it be a communication and outreach plan to be able to inform folks

2641
04:11:53,160 --> 04:11:59,980
that if you self-identify, that you may be able to avail yourselves of reduced fees. But also

2642
04:11:59,980 --> 04:12:04,300
at the same time, administratively, how do we create a mechanism of self-identifying mechanism

2643
04:12:04,300 --> 04:12:10,680
that doesn't put people in a situation where their data may be insecure and safe. I know

2644
04:12:10,680 --> 04:12:15,720
asking for all things in the world that it's not a direction to request for information and for

2645
04:12:15,720 --> 04:12:21,680
the discussion around this topic. I do want to circle back to some of the public comment

2646
04:12:21,680 --> 04:12:27,440
that I heard today. I'm not very familiar with body art inspections and that was referenced

2647
04:12:27,440 --> 04:12:33,600
earlier today. Can you shed some more light about what that entails? The fees associated with the

2648
04:12:33,600 --> 04:12:39,360
time that's associated with that? You want to know a little bit more about what a body art inspection

2649
04:12:39,360 --> 04:12:41,720
about personnel, to staff, body, our inspection.

2650
04:12:42,080 --> 04:12:45,400
So like, how many staff do we have to do something like that?

2651
04:12:46,080 --> 04:12:48,180
Like, what is the time that's afforded?

2652
04:12:48,360 --> 04:12:52,880
How, yeah, it really, I really appreciate some context.

2653
04:12:53,520 --> 04:12:55,700
Right, so some of our smaller programs are assigned

2654
04:12:55,700 --> 04:12:58,780
to a senior registered environmental health specialist,

2655
04:12:59,320 --> 04:13:03,580
because their small enough they can be handled by a single person.

2656
04:13:04,200 --> 04:13:06,720
They do all, we also always have backup people

2657
04:13:06,720 --> 04:13:08,160
trained for those as well.

2658
04:13:08,160 --> 04:13:15,500
So yes, this particular program is small enough, the body art program that it is headed up by one senior inspector.

2659
04:13:16,660 --> 04:13:24,520
And he does handle most all the inspections, the new facility evaluations, working with the practitioners as well.

2660
04:13:24,780 --> 04:13:34,540
He does have admin support and he does have a backup, but it is handled by and is not definitely not even a full FTE needed to carry out this program.

2661
04:13:38,340 --> 04:13:51,340
I think the only thing I would add to that is I think certainly public health and environmental health are dedicated to looking for ways to improve client services for the service experience for everyone we work with for our inspections.

2662
04:13:52,100 --> 04:14:02,040
And so noting some of the important public comment about accessing our systems. One of the things that this passage of the proposed fees will allow us to do is

2663
04:14:02,040 --> 04:14:06,500
recoup our costs to do things like higher certain vacancies we haven't been able to hire in the past

2664
04:14:06,500 --> 04:14:12,000
in general, as well as improved systems that we use for things like our computer systems,

2665
04:14:12,200 --> 04:14:16,800
our data tracking. And so I especially appreciated the public comment, noting how helpful it would

2666
04:14:16,800 --> 04:14:20,880
be to understand more about the clients we serve and make sure we're serving them as well as possible.

2667
04:14:21,480 --> 04:14:26,200
And I'm hopeful that this proposal will help enhance how quickly and how well we can do that.

2668
04:14:26,420 --> 04:14:31,440
I hope so too. And I fully appreciate that that's the North Star that are a department or a staff

2669
04:14:31,440 --> 04:14:36,360
your leadership is driving towards does greater efficiencies and faster service

2670
04:14:36,360 --> 04:14:42,140
times result and less staff time therefore lower fees or portioned fees.

2671
04:14:43,240 --> 04:14:47,160
Yeah I just wanted to say we will also we have to have our software system

2672
04:14:47,160 --> 04:14:52,400
replace we will be doing that this year and one of the nice advantages of the

2673
04:14:52,400 --> 04:14:57,540
new system will be that our clients will have a portal and my hope is like one of

2674
04:14:57,540 --> 04:14:59,700
issues I was hearing about how a facility.

2675
04:15:00,020 --> 04:15:08,760
May have different practitioners come and go, and they're supposed to keep us updated about that. And I was hearing that there was some issues about our system being updated.

2676
04:15:09,220 --> 04:15:15,020
That that actually will be something they can do themselves in the portal, and that they won't necessarily need our interface.

2677
04:15:15,560 --> 04:15:19,900
So I'm hoping that some of the efficiencies will be helped by our software system change.

2678
04:15:20,400 --> 04:15:25,380
Thank you, Dr. Underwood. I appreciate that. I can't remember. I just stress my appreciation,

2679
04:15:25,480 --> 04:15:31,580
but it's worth bearing again that thank you for extending the number of comparable counties in this report.

2680
04:15:32,080 --> 04:15:36,360
I know that was like the big last time that this discussion came up.

2681
04:15:36,500 --> 04:15:41,220
And when I looked at attachment three and saw how the new proposed rates stacked up against the same

2682
04:15:41,220 --> 04:15:47,240
or mostly similar fees from other counties. And it appears that we are not the most expensive county.

2683
04:15:48,140 --> 04:15:58,240
And that is a pleasant surprise considering some of the most populous and second-largest county in the comparison and we're typically known for a much higher cost of living.

2684
04:15:59,020 --> 04:16:07,140
So I was encouraged to see that we're not at the top of the chart there and that's not a competition I want to win either.

2685
04:16:08,380 --> 04:16:16,440
So Dr. Underwood, I know that we are very familiar with each other across various programs from food programs

2686
04:16:16,440 --> 04:16:21,320
to nail salons and I think we're going to be adding body art to our continued partnership

2687
04:16:21,320 --> 04:16:26,840
together to better understand this industry and how we could support them. But with that,

2688
04:16:26,860 --> 04:16:32,460
I make a motion to approve the recommended actions today with request for further information

2689
04:16:32,460 --> 04:16:38,700
how we can engage our fee customers so that they're able to avail themselves of discounted rates.

2690
04:16:39,420 --> 04:16:45,440
And also to further understand how we can be more efficient in terms of particularly around

2691
04:16:45,440 --> 04:16:51,080
the body art industry, which is something that I think is a new area for many of the board members.

2692
04:16:51,860 --> 04:16:54,460
I could say that because of our conversation last time.

2693
04:16:55,920 --> 04:16:56,840
I'll go ahead and second that.

2694
04:16:57,220 --> 04:17:01,900
Actually, I want to say that first, I want to thank staff for returning this report.

2695
04:17:02,360 --> 04:17:05,940
Incorporating those additional information with requested regarding mecos,

2696
04:17:06,380 --> 04:17:08,500
the body are also the facility fees.

2697
04:17:08,940 --> 04:17:12,980
I want to say huge thank you to the health trust for stepping out to help out

2698
04:17:12,980 --> 04:17:17,880
because for businesses that's huge and I'd only appreciate the outrageous deficit conduct of

2699
04:17:17,880 --> 04:17:22,520
the CBOs community based organizations and identifying a potential funding partner to help

2700
04:17:22,520 --> 04:17:27,800
also the application and your fees for the low income and micro enterprise home kitchen operators.

2701
04:17:29,500 --> 04:17:34,160
We are in a very challenging budget environment and the county continues to seek ways to support

2702
04:17:34,160 --> 04:17:42,960
some of our most impacted community members and I'm glad to see that the commitment has to

2703
04:17:42,960 --> 04:17:48,840
health-grange fees, some small businesses will see feed reductions, and that's only great.

2704
04:17:49,240 --> 04:17:54,360
However, some businesses, as we mentioned, like piercers, food truck operators will actually

2705
04:17:54,360 --> 04:18:00,220
experience feed increases. Some are small, but some are not. But the thing is these are

2706
04:18:00,220 --> 04:18:07,220
many of them are small independently owned operations. And that being said, we are facing fiscal

2707
04:18:07,220 --> 04:18:12,420
constraints driven in part by somewhat funding cuts that we see by federal government. And to

2708
04:18:12,420 --> 04:18:17,000
maintain the public health services. We certainly need to have full cost recovery. Also,

2709
04:18:17,060 --> 04:18:23,040
we need to do the proposition 26. We do not generate profit in this work. It really is just

2710
04:18:23,040 --> 04:18:29,340
to make sure that we are just covering the cost spent. So as much as I'll be supporting this

2711
04:18:29,340 --> 04:18:34,220
proposal today, I do want to end this important point. So making sure that we really need to

2712
04:18:34,220 --> 04:18:39,280
bring these fee updates to a board in a more regular basis and not wait so long for the delta

2713
04:18:39,280 --> 04:18:43,040
be so much so that these adjustments will be gradual and less disruptive.

2714
04:18:44,380 --> 04:18:50,360
That being said, I would like to ask the maker motion if she might accept to request

2715
04:18:50,360 --> 04:18:54,500
a report six months back into the Mecos program and any additional challenges and cost

2716
04:18:54,500 --> 04:19:00,320
it might arise, such requirements or restrictions from landlord for operators who are renters.

2717
04:19:02,060 --> 04:19:08,100
I am happy to accept the friendly amendment for a six month report back on the Mecos program

2718
04:19:08,100 --> 04:19:08,840
is that what you're asking?

2719
04:19:09,680 --> 04:19:16,060
Yeah, and I also, if this is a correct, okay, with the rules, I want to clarify my motion

2720
04:19:16,060 --> 04:19:20,740
to realize that I was not so clear, Tony's nodding his head.

2721
04:19:21,200 --> 04:19:21,860
Thank you.

2722
04:19:23,360 --> 04:19:27,620
So my original motion is to approve the recommended action today.

2723
04:19:28,680 --> 04:19:33,560
What they request for further information, I'm going to ask for in the form of an

2724
04:19:33,560 --> 04:19:41,380
agenda and the fall, about engagement opportunities and possibilities on how to make our

2725
04:19:41,380 --> 04:19:50,400
fee customers aware of the benefits of reduced potential reduced fees and how to avail themselves

2726
04:19:50,400 --> 04:19:57,960
of such benefits. Am I allowed to call it benefits? Reduce fees. I'll just say that. And how

2727
04:19:57,960 --> 04:20:03,540
to avail themselves is such reduced fees. And I'm trying to make the motion broad enough so

2728
04:20:03,540 --> 04:20:06,240
that you have this space you need to explore all avenues.

2729
04:20:06,820 --> 04:20:08,640
So that's why I'm struggling a little bit with the language here.

2730
04:20:08,820 --> 04:20:10,720
So let me know if I'm not going to give you that space.

2731
04:20:12,040 --> 04:20:18,220
And then secondly, I would like to report as part of the Office of Gender Report back.

2732
04:20:18,360 --> 04:20:24,320
A status, a check-in with our body art industry to see how the new fees have worked out.

2733
04:20:24,360 --> 04:20:29,000
If new efficiencies have been able to be rolled out, and just to see the better understand

2734
04:20:29,000 --> 04:20:30,880
the impact of how these fees have landed.

2735
04:20:31,740 --> 04:20:36,060
in addition to the six-month report back on the status of Mikos?

2736
04:20:37,120 --> 04:20:42,380
No, thank you. You'll be me too, and I really do think that I know so little about

2737
04:20:42,380 --> 04:20:47,280
the body of our program, and I think we do need to help sunshine the staffing issue,

2738
04:20:47,460 --> 04:20:53,360
just been mentioned by many of the speakers. First, I do want to thank the speakers that

2739
04:20:53,360 --> 04:20:58,480
came up and be so organized on your presentation of piggybacking each other in every

2740
04:20:58,480 --> 04:21:00,680
eating the same thing and that's really helpful for us

2741
04:21:00,680 --> 04:21:04,060
understand the situations. But clearly, there is a challenge.

2742
04:21:05,320 --> 04:21:08,420
And it's not clear because when the answer is being given,

2743
04:21:08,560 --> 04:21:09,520
I can see you shaking your head.

2744
04:21:10,000 --> 04:21:12,200
No, I don't see this what's going on in terms of

2745
04:21:12,200 --> 04:21:14,940
staffing. We're seeing that there are multiple people doing it.

2746
04:21:14,960 --> 04:21:18,420
But your experiences is barely one person is doing it.

2747
04:21:18,580 --> 04:21:20,840
So let's see, we could get that sunshine so that they can

2748
04:21:20,840 --> 04:21:24,680
understand how we could really help them to do better

2749
04:21:24,680 --> 04:21:27,600
in terms of out staffing and to make sure that they don't

2750
04:21:27,600 --> 04:21:34,220
have to wait a long time to get their permits or their answers necessary for, for continuing

2751
04:21:34,220 --> 04:21:35,720
their work and our community.

2752
04:21:36,200 --> 04:21:37,020
Thank you.

2753
04:21:38,830 --> 04:21:39,110
All right.

2754
04:21:39,270 --> 04:21:39,750
We got motion.

2755
04:21:39,950 --> 04:21:40,610
We got seconds.

2756
04:21:41,470 --> 04:21:44,410
And if no further comments, let's go take a vote.

2757
04:21:45,570 --> 04:21:46,390
Thank you.

2758
04:21:46,390 --> 04:21:52,650
Motion of Supervisor Yoon, seconded by President Lee, supervisor of a code.

2759
04:21:53,030 --> 04:21:53,250
Aye.

2760
04:21:53,650 --> 04:21:54,410
Supervisor Yoon?

2761
04:21:55,350 --> 04:21:56,290
Supervisor Ellenberg?

2762
04:21:57,410 --> 04:21:57,910
President Lee.

2763
04:21:57,910 --> 04:22:02,750
I as well. Motion carries four to zero. Thank you very much for coming today. Thank you for

2764
04:22:02,750 --> 04:22:07,390
the board. All right. We are very close to lunch, but the county

2765
04:22:07,390 --> 04:22:11,050
exact trying to tell me that he could do it really fast. So, James.

2766
04:22:11,830 --> 04:22:16,930
Just have two very quick items for the county executives report this afternoon. One is that

2767
04:22:16,930 --> 04:22:21,710
our office of emergency management and partners have been diligently preparing for the upcoming

2768
04:22:21,710 --> 04:22:27,890
Super Bowl. We will be fully activated in our emergency operations center throughout the entire

2769
04:22:27,890 --> 04:22:34,990
week and over the weekend as well. We are coordinating across jurisdictions regarding emergency

2770
04:22:34,990 --> 04:22:40,670
alerts. Folks who would like to receive Santa Clara County's emergency alerts related to

2771
04:22:40,670 --> 04:22:49,390
the Super Bowl should text SBLX to 888777. And that's a simple way. You can make sure that you've

2772
04:22:49,390 --> 04:22:55,510
got any public safety or other updates and stay informed in real time. My other update was related

2773
04:22:55,510 --> 04:23:01,070
federal appropriations, and we can talk more about that during the IGR report later today,

2774
04:23:01,650 --> 04:23:06,530
but like I said earlier, we're closely tracking whether there will be a shutdown, affecting

2775
04:23:06,530 --> 04:23:12,670
a number of federal departments, and we are also very closely tracking in specifically the

2776
04:23:12,670 --> 04:23:20,910
federal HHS appropriations bill that could have a tiny bit of good news for us here if it passes

2777
04:23:20,910 --> 04:23:26,730
as currently drafted. That concludes my report. Thank you. I'll note for the question, Tony.

2778
04:23:30,190 --> 04:23:35,510
At the January 26th, 2026 closed session by unanimous vote with all members present.

2779
04:23:35,710 --> 04:23:39,050
The board authorized the county to initiate litigation or file are joined in a

2780
04:23:39,050 --> 04:23:42,630
Mika's brief in one matter. The name of the action and the parties as well as the substance

2781
04:23:42,630 --> 04:23:47,530
of the litigation shall be disclosed once the brief is filed. It's any person upon inquiry.

2782
04:23:48,550 --> 04:23:52,290
And I should say once the brief for lawsuit is filed, that concludes my report.

2783
04:23:54,780 --> 04:24:02,400
Thank you, Tony. I've got 138. How about we break till 2015 with that work? Do my colleague?

2784
04:24:03,540 --> 04:24:05,800
Yes. All right, let's pick one for 2015. Thank you.

2785
05:03:36,820 --> 05:03:50,360
Okay, good afternoon. Actually, I already have two 18 on my clock. So let's see, I did see a third supervisor in the room here earlier. Of course, I need my third supervisor to get a coin.

2786
05:03:51,820 --> 05:03:54,840
Thank you. Yes, that is. That is my third supervisor. What can you have?

2787
05:03:56,140 --> 05:03:58,040
So let's go take a roll, please. Look.

2788
05:03:59,240 --> 05:04:00,980
Supervisor Abik Hoga.

2789
05:04:02,500 --> 05:04:03,620
It's absent.

2790
05:04:04,040 --> 05:04:05,260
Supervisor Yunk.

2791
05:04:05,580 --> 05:04:05,760
Here.

2792
05:04:06,400 --> 05:04:07,140
Supervisor Alvinberg.

2793
05:04:07,480 --> 05:04:08,040
I'm here.

2794
05:04:08,520 --> 05:04:09,600
Supervisor Anasas absent.

2795
05:04:09,880 --> 05:04:10,720
And presently.

2796
05:04:11,000 --> 05:04:11,920
Good afternoon, President.

2797
05:04:12,000 --> 05:04:14,600
So let's go start with our item number 12.

2798
05:04:14,680 --> 05:04:17,160
The Valley Homeless Healthcare Program Report.

2799
05:04:17,880 --> 05:04:17,900
Good afternoon.

2800
05:04:18,080 --> 05:04:18,340
Hi.

2801
05:04:18,500 --> 05:04:18,960
Good afternoon.

2802
05:04:19,280 --> 05:04:21,460
President Lee and members of the board.

2803
05:04:21,780 --> 05:04:25,460
My name is Kristi Raus, assistant nurse manager with Valley Homeless Healthcare Program.

2804
05:04:25,480 --> 05:04:27,320
And I'm here with Sergeant Yvonne G.

2805
05:04:27,320 --> 05:04:30,420
Medical Director and Selling Hode Director of Primary Care.

2806
05:04:32,080 --> 05:04:36,500
Today, in your board packet, we have a response to Vice President Renez's requested information

2807
05:04:36,500 --> 05:04:40,940
regarding our behavioral health services and the connections we have with the behavioral health

2808
05:04:40,940 --> 05:04:41,680
service department.

2809
05:04:42,160 --> 05:04:46,360
And then we have some qualitative information regarding patients that were diagnosed with colorectal

2810
05:04:46,360 --> 05:04:46,940
cancer.

2811
05:04:48,040 --> 05:04:53,180
We also have included our annual QI, the Quality Improvement Project that includes our health

2812
05:04:53,180 --> 05:04:58,300
for that in House population and as you know we do report on a few of those metrics quarterly.

2813
05:04:58,860 --> 05:05:01,900
So with that we're happy to answer any questions you may have.

2814
05:05:02,380 --> 05:05:05,400
Great. Thank you. Let's see. Any public would like to speak on the side of today?

2815
05:05:07,000 --> 05:05:08,220
We have no requests to speak.

2816
05:05:08,440 --> 05:05:11,660
Okay, close the public speaking portion just as well as I learned.

2817
05:05:12,220 --> 05:05:19,520
Thank you so much for the report. I was glad to see the 2026 homeless quality improvement

2818
05:05:19,520 --> 05:05:26,260
plan building on the success of the UDS metrics in 2025? I'm interested in learning a little

2819
05:05:26,260 --> 05:05:33,580
bit more about the HIV linkage to care metric. Can you explain just what that how you're

2820
05:05:33,580 --> 05:05:37,840
measuring that metric, maybe who some of the partners are that are involved?

2821
05:05:50,280 --> 05:05:55,520
Thank you, Supervisor Allen, I'm happy to answer that question. So I think for HIV linkage

2822
05:05:55,520 --> 05:06:02,240
to care we just always are looking at individuals who are newly diagnosed or have been living

2823
05:06:02,240 --> 05:06:08,980
with HIV and if they are connected to care which would really be if they've seen a provider

2824
05:06:08,980 --> 05:06:14,660
in the last 12 months. And so specifically for us, we're looking at the house population

2825
05:06:14,660 --> 05:06:21,400
that we interface with. We do see a lot of individuals. We are encountering a lot of individuals

2826
05:06:21,400 --> 05:06:27,540
where we are diagnosing HIV, and we are also able to provide their care. One of our new providers

2827
05:06:28,340 --> 05:06:35,200
is actually certified in HIV medicine as well. And so we can look at if they are following up with

2828
05:06:35,200 --> 05:06:40,940
us and continuing their medications or connected with the pace clinic. For linkage to care, we can

2829
05:06:40,940 --> 05:06:47,260
the partners are really primarily the pace clinic in terms of working together. We have a close

2830
05:06:47,260 --> 05:06:51,160
collaboration with their team and their outreach staff.

2831
05:06:53,760 --> 05:06:53,980
That's good.

2832
05:06:54,180 --> 05:06:54,460
That's clear.

2833
05:06:54,600 --> 05:06:56,580
I appreciate it.

2834
05:06:57,060 --> 05:06:57,360
Great.

2835
05:06:57,640 --> 05:06:58,920
That's the only question I had today.

2836
05:06:59,080 --> 05:06:59,840
Thanks so much for the report.

2837
05:06:59,840 --> 05:07:03,040
I'm happy to move a receipt of the report.

2838
05:07:04,020 --> 05:07:04,240
Second.

2839
05:07:05,500 --> 05:07:05,760
A motion.

2840
05:07:06,160 --> 05:07:06,320
Second.

2841
05:07:06,840 --> 05:07:08,120
I do have one quick question.

2842
05:07:08,760 --> 05:07:09,660
Just before we move on.

2843
05:07:09,980 --> 05:07:10,120
Presently.

2844
05:07:11,680 --> 05:07:13,580
Just wanted to clarify as the motion.

2845
05:07:14,420 --> 05:07:16,860
The recommended action or just the receipt of the report.

2846
05:07:16,860 --> 05:07:19,740
Oh, the recommended action.

2847
05:07:20,160 --> 05:07:20,920
Thank you.

2848
05:07:22,680 --> 05:07:23,440
OK, to second.

2849
05:07:24,140 --> 05:07:30,320
So my brief question is, when you go out there and figure out

2850
05:07:30,320 --> 05:07:33,500
that there might be that it's through your detection, you find out

2851
05:07:33,500 --> 05:07:35,180
that the visual has depression.

2852
05:07:36,220 --> 05:07:39,420
And we'll need to meet with a psychiatrist.

2853
05:07:40,380 --> 05:07:42,600
Whether it's a person's health visit.

2854
05:07:43,200 --> 05:07:45,800
Can you estimate what the weight time is?

2855
05:07:46,020 --> 05:07:47,520
Usually the same day.

2856
05:07:47,520 --> 05:07:53,080
Wow, that's great. Thank you. That's wonderful. Thank you. All right, let's go take a look.

2857
05:07:53,740 --> 05:07:56,840
We have a motion by Super Ezrealmberg, a second by Super Ezrealm.

2858
05:07:58,020 --> 05:07:58,480
Super Ezrealm.

2859
05:07:58,720 --> 05:08:03,560
Hi, Super Ezrealm. Yes, Super Ezrealmberg. Yes, I'm presently. I as well.

2860
05:08:03,840 --> 05:08:05,840
The motion carries for us here. Thank you very much.

2861
05:08:07,080 --> 05:08:12,580
And next we have our monthly legislative report from the office of intergovernmental relations.

2862
05:08:18,430 --> 05:08:19,450
Good afternoon

2863
05:08:19,450 --> 05:08:30,430
President Lee and supervisors, this is David Kompos here from the Sacramento Office and with you and

2864
05:08:30,430 --> 05:08:39,050
chambers are Monica Tong and Elaine Trin who are going to help with the presentation.

2865
05:08:40,570 --> 05:08:46,570
And if you can hear me okay, we'll begin with our presentation but I do want to ask if the

2866
05:08:46,570 --> 05:08:51,890
any executive if you want to say any remarks before we can get?

2867
05:08:53,010 --> 05:08:58,690
Yeah, I'll just share two things. One is David, I don't know if you were on earlier,

2868
05:08:58,890 --> 05:09:02,610
but we've already talked a little bit about the pending federal appropriations bills.

2869
05:09:04,470 --> 05:09:09,150
And just wanted to add that we are very focused on our state-related advocacy.

2870
05:09:09,490 --> 05:09:14,770
You're going to hear a tiny bit about that, but maybe we can explore that a little further in questions.

2871
05:09:16,150 --> 05:09:23,650
And just in recognition that the governor's budget proposal is really an opening position.

2872
05:09:23,890 --> 05:09:25,250
It's not the last word.

2873
05:09:25,850 --> 05:09:32,850
In fact, the governor's budget proposal pretty expressly differs a lot of things to the may revise.

2874
05:09:33,270 --> 05:09:39,650
And so we, while disappointed with the way that initial proposal addresses,

2875
05:09:39,650 --> 05:09:47,830
because HR-1-related impacts are not surprised and will be fully focused in the coming months

2876
05:09:47,830 --> 05:09:53,210
on addressing those impacts as part of the final product that the legislature ultimately

2877
05:09:53,210 --> 05:09:54,470
proves in June.

2878
05:09:55,470 --> 05:09:59,370
And just want to express a lot of appreciation for our IGR team, we're keeping them very busy.

2879
05:10:00,650 --> 05:10:06,030
And know that David and others are in Sacramento participating in that assembly health

2880
05:10:06,750 --> 05:10:13,690
We're one of the only counties invited to participate on the panel regarding the healthcare

2881
05:10:13,690 --> 05:10:14,410
effects.

2882
05:10:17,390 --> 05:10:22,350
Thank you, James, and if it's okay with the President and the Board will receive this.

2883
05:10:22,830 --> 05:10:24,150
Thank you very much.

2884
05:10:25,110 --> 05:10:31,530
We can go to the next slide, just as you know, the role that the Intergovernmental Relations

2885
05:10:31,530 --> 05:10:36,950
Office plays is to represent the interests of the county and both Sacramento and Washington

2886
05:10:36,950 --> 05:10:45,130
DC and given that we have a Trump president and a Republican Congress, our ability to influence

2887
05:10:45,130 --> 05:10:51,030
what happens in DC is limited, nevertheless we are still focused on doing everything we

2888
05:10:51,030 --> 05:10:56,730
can on that front that you're going to hear from Elaine Trent about some of the activity

2889
05:10:56,730 --> 05:11:04,150
in Washington DC and we actually will be going to DC in the near future and I believe that

2890
05:11:04,150 --> 05:11:06,150
as it only might be there as well.

2891
05:11:07,370 --> 05:11:12,690
So because of that, the focus really is on what we can do in Sacramento.

2892
05:11:14,070 --> 05:11:21,730
And before I turn it over to Monica, who's going to give you a more detail report on what's

2893
05:11:21,730 --> 05:11:23,830
happening in Sacramento, I want to note two things.

2894
05:11:23,950 --> 05:11:31,650
First, what James noted, the Assembly Committee on Health is doing a hearing right now.

2895
05:11:31,650 --> 05:11:38,910
And we are, in fact, the only county that has been invited to be a participant to present on that hearing.

2896
05:11:39,530 --> 05:11:48,790
And we are grateful to Dr. Dolly Goel, who is the chief clinical officer for population health and managed care for the county.

2897
05:11:49,590 --> 05:11:53,650
We're about the health care, who will be testifying shortly.

2898
05:11:53,650 --> 05:12:22,730
And so, you know, our staff is helping her and, you know, I think the fact that we're the only county tells you how many folks see Santa Clara in Sacramento, but the second point, and this is a really critical point, is that it is a very tough landscape in Sacramento, and the issues facing public hospitals and counties that run public hospitals and many respects,

2899
05:12:22,730 --> 05:12:29,510
are not entirely known to many of the members, and we have a lot of members who are relative

2900
05:12:29,510 --> 05:12:35,310
new to the role and who may not fully understand how public hospitals work, the role

2901
05:12:35,310 --> 05:12:40,830
of the play and healthcare in the state. And so a big part of our effort is really to educate

2902
05:12:40,830 --> 05:12:46,550
those members to make sure that they understand the challenges faced by Santa Clara and other

2903
05:12:46,550 --> 05:12:52,650
counties and especially counties that one public hospital. So with that, I'll turn it over

2904
05:12:52,730 --> 05:12:55,370
to Monica, and we'll proceed with the presentation.

2905
05:12:57,030 --> 05:12:57,710
Thanks so much, David.

2906
05:12:58,250 --> 05:13:03,170
The state legislature did return to Sacramento on January 5th, and they have definitely

2907
05:13:03,170 --> 05:13:04,390
hit the ground running.

2908
05:13:04,890 --> 05:13:09,590
In November, the Senate experienced a leadership change in Senator Lamone to

2909
05:13:09,590 --> 05:13:12,730
official oath of office as President Pro Tem on January 5th.

2910
05:13:13,710 --> 05:13:17,870
As you're aware, the governor released his fiscal year 2627 budget

2911
05:13:17,870 --> 05:13:23,770
proposal on January 9th and we'll talk a little bit about that in a bit, and last week

2912
05:13:23,770 --> 05:13:27,850
was the legislative council deadline, meaning that general requests to the legislatures

2913
05:13:27,850 --> 05:13:32,470
attorneys were made for potential bills. Many of these are spot bills, meaning language

2914
05:13:32,470 --> 05:13:37,930
has not been finalized. A few upcoming deadlines to put on your radar in the second year

2915
05:13:37,930 --> 05:13:44,530
of the two year cycle, January is extremely busy, and two year bills must pass their

2916
05:13:44,530 --> 05:13:51,830
house of origin so assembly bills out of the assembly and Senate bills out of the Senate by this week.

2917
05:13:52,510 --> 05:13:57,630
Related to bills this year's 2026 bill introduction deadline is February 20.

2918
05:14:02,760 --> 05:14:09,260
On to the budget, the governor announced a 348.9 billion dollar budget proposal in January

2919
05:14:09,460 --> 05:14:16,240
that addresses an estimated 2.9 billion projected shortfall, which we've discussed is much

2920
05:14:16,240 --> 05:14:21,440
smaller than the LAOs, 17.6 billion projected shortfall.

2921
05:14:21,940 --> 05:14:24,380
To be clear, this is the governor's proposed budget,

2922
05:14:25,140 --> 05:14:28,920
and his Department of Finance, as our county executive noted,

2923
05:14:29,520 --> 05:14:32,280
acknowledged a few things that the state is eagerly awaiting

2924
05:14:32,280 --> 05:14:35,220
the upcoming tax season, and additional guidance

2925
05:14:35,220 --> 05:14:38,380
from the federal government regarding HR1 implementation.

2926
05:14:39,860 --> 05:14:42,640
Department of Finance, Director Joe Stephenshal, described this

2927
05:14:42,640 --> 05:14:46,220
as a workload budget with no new significant funding

2928
05:14:46,220 --> 05:14:51,960
or Governor initiatives, while the state is still waiting for that HR1 guidance, the governor

2929
05:14:51,960 --> 05:14:56,280
did not include any mitigation to prevent disenrollment of safety net services.

2930
05:14:57,260 --> 05:14:59,900
IGR's focus remains on our three main state.

2931
05:15:00,000 --> 05:15:10,100
Meditation request with preserving enrollment in programs, providing state support for public hospitals, and allocating significant new resources for indigent care.

2932
05:15:10,500 --> 05:15:11,560
I'll turn it back over to David.

2933
05:15:14,540 --> 05:15:23,040
Thank you, Monica, and I want to highlight that the biggest challenge and priority for us is the budget.

2934
05:15:24,240 --> 05:15:32,980
And the three items that Monica noted are the things that not only are we pushing as a county,

2935
05:15:33,340 --> 05:15:37,980
but I think a number of other counties embrace as big issues.

2936
05:15:38,580 --> 05:15:43,660
And once again, the has to do with preserving enrollment in Medicare and Cal Fresh.

2937
05:15:44,860 --> 05:15:52,700
Making sure that there's support for public hospitals and making sure that there are resources provided to counties.

2938
05:15:52,700 --> 05:15:57,020
because there will be a need to provide additional

2939
05:15:57,020 --> 05:15:58,240
in-design care.

2940
05:15:58,920 --> 05:16:02,760
With that in mind, I do want to note that we,

2941
05:16:03,520 --> 05:16:07,720
to the leadership of the board, put together a legislative platform,

2942
05:16:07,920 --> 05:16:12,280
which support approved November 4th of this past year.

2943
05:16:13,480 --> 05:16:16,320
My job along with Aaron Evans,

2944
05:16:16,340 --> 05:16:20,060
Puedum, who is here in the Sacramento office,

2945
05:16:20,060 --> 05:16:27,040
is to shop around a lot of the field concepts and ideas that were approved by the board and

2946
05:16:27,040 --> 05:16:29,900
we're in the process of doing that.

2947
05:16:30,460 --> 05:16:37,340
There are fewer bills that folks can actually put forward and so it's a more challenging

2948
05:16:37,340 --> 05:16:43,940
time to get members to embrace some of the ideas that we have put forward or working hard

2949
05:16:43,940 --> 05:16:50,800
to make sure that happens, we will be providing additional reporting on sort of the progress

2950
05:16:50,800 --> 05:16:55,520
on those ideas as this work proceed to the next few days.

2951
05:16:56,560 --> 05:17:03,900
There has been some interest on some bill concepts and we have drafted a language that we have

2952
05:17:03,900 --> 05:17:11,480
provided to let council in their essentially language that is not final, but these are

2953
05:17:11,480 --> 05:17:18,480
stock bills that allow us to continue to pursue some of those ideas as pieces of legislation.

2954
05:17:19,200 --> 05:17:21,740
But again, you know, that's still a work in progress.

2955
05:17:22,240 --> 05:17:28,120
And many members are trying to figure out what they can agree to move forward, given everything

2956
05:17:28,120 --> 05:17:33,520
that's happening with the budget, challenges being, of course, at the top of the list,

2957
05:17:33,520 --> 05:17:40,720
terms of priorities for every member, and so we will continue to, you know, keep the

2958
05:17:40,720 --> 05:17:49,800
board updated on that. I think that the big issue is the uncertainty around that only

2959
05:17:49,800 --> 05:18:03,500
what happens at the federal level but also around tax season and what actually the budget

2960
05:18:03,500 --> 05:18:10,460
by the governor or is it closer to the $80 billion deficit that the legislative analyst's office

2961
05:18:10,460 --> 05:18:18,600
had previously indicated was the actual reality. So that's where we are in Sacramento with

2962
05:18:18,600 --> 05:18:24,760
the new leadership change in the state Senate. There are some things that are different. One of

2963
05:18:24,760 --> 05:18:33,420
things that we will say, and we welcome is the fact that Senator John Lair, who, for a

2964
05:18:33,420 --> 05:18:37,480
long time, represented a piece of part of Santa Clara County, is now a lot of care

2965
05:18:37,480 --> 05:18:44,420
budget, and we welcome that appointment, and, you know, I know that some folks have already

2966
05:18:44,420 --> 05:18:49,460
spoken to chair Lair, and we are in the process of setting up a more detailed conversation

2967
05:18:49,460 --> 05:18:54,580
with them. So with that, I'm going to turn it over to Elaine to just give you a very brief

2968
05:18:54,580 --> 05:19:00,660
overview of what's happening in Boston to DC today. Elaine? Thanks, David. As a county executive

2969
05:19:00,660 --> 05:19:05,500
mentioned earlier, we are following the federal appropriations process very closely. Just wanted

2970
05:19:05,500 --> 05:19:10,500
to note a few highlights in the appropriations bill. Late last week, the President signed the

2971
05:19:10,500 --> 05:19:15,700
Commerce Justice and Science bill that included 175,000 for our sexual assaults for

2972
05:19:15,700 --> 05:19:20,540
to exam program in the financial services and government spending bill that is pending

2973
05:19:20,540 --> 05:19:21,380
Senate action.

2974
05:19:21,600 --> 05:19:26,260
There is a million dollar in Congressually direct spending, included by Senators Padilla

2975
05:19:26,260 --> 05:19:28,320
and Shift for a small business center at BASC.

2976
05:19:28,700 --> 05:19:34,640
In the Labor HHS education bill also pending Senate action, it includes a elimination of the

2977
05:19:34,640 --> 05:19:38,520
Medicaid disproportionate share hospital cuts that was mentioned earlier during the study

2978
05:19:38,520 --> 05:19:43,420
session, as well as an extension of the telehealth flexibility through December 20, 27.

2979
05:19:43,420 --> 05:19:46,880
in the Transportation HUD bill, also pending Senate action.

2980
05:19:47,540 --> 05:19:50,320
There's three community project funding for the Santa Clara County,

2981
05:19:50,680 --> 05:19:52,560
including $3 million for 10 Kirk,

2982
05:19:52,880 --> 05:19:54,180
included by Representative Kana,

2983
05:19:55,400 --> 05:19:58,180
$850,000 for Agraver, Culture Resource Center,

2984
05:19:58,180 --> 05:19:59,800
included by Representative Lofgren,

2985
05:20:00,260 --> 05:20:02,840
and $250,000 for Marshall Cottle Park,

2986
05:20:03,000 --> 05:20:04,280
included by Representative Penetta.

2987
05:20:05,020 --> 05:20:08,600
Additionally, Agra is watching HR-1834,

2988
05:20:08,840 --> 05:20:11,060
which would have extended the enhanced premium tax credits

2989
05:20:11,060 --> 05:20:12,280
for their Affordable Care Act,

2990
05:20:12,280 --> 05:20:14,400
which passed the House earlier this month,

2991
05:20:15,460 --> 05:20:18,200
it is still pending action in Senate as well.

2992
05:20:18,560 --> 05:20:20,140
And with that, the answer of presentation.

2993
05:20:21,540 --> 05:20:24,460
I will just add one more note,

2994
05:20:24,660 --> 05:20:28,140
I propose what the County Executive indicated.

2995
05:20:28,740 --> 05:20:30,520
When you look at what's happening in Sacramento

2996
05:20:30,520 --> 05:20:32,900
because of the changes,

2997
05:20:33,580 --> 05:20:35,520
because of the decisions that the federal government

2998
05:20:35,520 --> 05:20:37,820
you have a situation where just about everyone

2999
05:20:37,820 --> 05:20:41,360
in California is coming to Sacramento to ask for money.

3000
05:20:41,360 --> 05:20:48,320
And so as we think about how we can influence what happens in Sacramento in this landscape,

3001
05:20:48,860 --> 05:20:54,320
it is important for us to work in partnership and coalition with a lot of other players,

3002
05:20:55,060 --> 05:21:01,140
not only other counties, other cities, but also associations like C-SAC and others.

3003
05:21:01,980 --> 05:21:08,540
And so that is how we are approaching this work. And in many respects, you have to not only do

3004
05:21:08,540 --> 05:21:14,660
your typical lobbying but you really have to take steps to influence the decisions of key

3005
05:21:14,660 --> 05:21:20,160
players and that requires the better understanding of what their respective districts are

3006
05:21:20,160 --> 05:21:26,180
dealing with and working with those jurisdictions to make sure that we are approaching the

3007
05:21:26,180 --> 05:21:31,300
right individuals with the right information about what's happening that only statewide but in

3008
05:21:31,300 --> 05:21:37,040
the respective districts and that really is the strategy that we are, you know, are they're taking

3009
05:21:37,040 --> 05:21:46,100
And it requires for us to work very closely with other players and spend more time developing

3010
05:21:46,100 --> 05:21:47,080
those relationships.

3011
05:21:48,220 --> 05:21:54,640
And so the county executive is very involved in that process and just to give you a context

3012
05:21:54,640 --> 05:21:56,700
for where we are in Sacramento.

3013
05:21:57,000 --> 05:22:02,400
It's a very interesting time, very challenging time, but also an opportunity for accounting

3014
05:22:02,400 --> 05:22:09,060
like us to lead on issues that are really critical to all of us.

3015
05:22:09,640 --> 05:22:10,840
That concludes our presentation.

3016
05:22:13,380 --> 05:22:13,900
Thank you, David.

3017
05:22:14,520 --> 05:22:15,900
Do we have any public like to speak on the side?

3018
05:22:17,260 --> 05:22:18,800
We have no requests to speak.

3019
05:22:19,620 --> 05:22:20,040
Thank you.

3020
05:22:20,240 --> 05:22:22,260
Any questions from my board members?

3021
05:22:26,000 --> 05:22:27,300
Do you have questions from my board members?

3022
05:22:27,360 --> 05:22:28,080
Thank you, President Lee.

3023
05:22:28,120 --> 05:22:30,080
Thank you so much for the presentation.

3024
05:22:31,120 --> 05:22:35,680
Just question and guarding the bills that we are looking for sponsorships on.

3025
05:22:36,460 --> 05:22:42,920
What is expected, how's going, you know, there's a deadline coming up.

3026
05:22:43,260 --> 05:22:45,200
Could you just elaborate on that process?

3027
05:22:47,730 --> 05:22:48,110
Yes.

3028
05:22:48,850 --> 05:22:51,270
We have a number of bills.

3029
05:22:51,270 --> 05:22:53,650
If I made sure the chair is supervised traffic code,

3030
05:22:53,830 --> 05:22:58,930
we have a number of fill ideas that were adopted by the board

3031
05:22:58,930 --> 05:23:03,050
that we are shopping around to different members.

3032
05:23:03,050 --> 05:23:17,330
And, you know, there are different stages for each idea, and we're conversations with members of our delegation who are thinking about whether or not to carry some of those bills.

3033
05:23:18,350 --> 05:23:33,030
And, you know, we can give more detail reports on each one of those, but for instance, you know, we are a conversation with Assemblymember Caldera on a bill that would essentially restore our ability to

3034
05:23:33,030 --> 05:23:40,330
to enter into some contracts, the authority that was previously given to us, which actually

3035
05:23:40,330 --> 05:23:46,950
is Assemblymember Caldra, carried for us that bill is sunsetting, so we are the process of

3036
05:23:46,950 --> 05:23:53,330
trying to extend the sunset and we are working with them on that issue.

3037
05:23:54,210 --> 05:24:01,990
There are other ideas around, for instance, information on the use of place of birth in

3038
05:24:01,990 --> 05:24:06,110
enforcement where in conversations with not only members of our delegation would also

3039
05:24:06,110 --> 05:24:13,170
sit at a dean who is looking to do a piece of legislation and involvement involving

3040
05:24:13,170 --> 05:24:20,130
immigration and access to certain information by federal agencies and so we are, you know, working

3041
05:24:20,130 --> 05:24:27,150
with him to see if that's something that he would carry for us. We are also working with assembly

3042
05:24:27,150 --> 05:24:36,070
member-pellerin on transitional shelter care facilities, there's an interest on potential legislation.

3043
05:24:36,810 --> 05:24:43,130
We're also working on a bill involving our medical examiner and we're in conversations

3044
05:24:43,130 --> 05:24:48,110
with a couple of different offices on that piece of legislation.

3045
05:24:48,110 --> 05:25:15,390
As you can see, this is a very interesting time because you have each office trying to figure out what their priorities will be and we're making sure that they have the information on each one of the ideas that the Board adopted as potential bills and we're working closely with each department and with County Council to make sure that we're providing them the information.

3046
05:25:15,390 --> 05:25:38,210
Great. Thank you. Regarding the federal side, I was looking at the list of projects or funding requests that we made to the different members of Congress and very grateful to them and for advocating for our projects and it seems like there's quite a bit of success this year.

3047
05:25:38,210 --> 05:25:47,250
I was reading my own number of Congresses report out that this might be an area of bipartisan partnership.

3048
05:25:48,290 --> 05:25:53,270
I didn't notice that for Representative Lakarta, we hadn't made any requests.

3049
05:25:54,350 --> 05:26:00,450
I thought at some point I had mentioned our homestead, Fiddil Expressway,

3050
05:26:00,450 --> 05:26:07,190
safe routes to school project, we're in need of some funding there, but was that request made?

3051
05:26:08,870 --> 05:26:11,390
And if not, I guess, can we put that on for this table?

3052
05:26:12,370 --> 05:26:12,810
Sorry, sorry.

3053
05:26:13,190 --> 05:26:14,250
I got it all.

3054
05:26:14,790 --> 05:26:15,350
Yes, please.

3055
05:26:16,510 --> 05:26:17,150
Hi, Supervisor.

3056
05:26:17,290 --> 05:26:18,190
Thank you for the question.

3057
05:26:18,650 --> 05:26:25,130
Yes, we did submit the request for the homestead, safe routes to school,

3058
05:26:25,130 --> 05:26:31,750
project to representative Lakarto. Unfortunately, it was not selected to move forward. It is

3059
05:26:31,750 --> 05:26:36,230
something that it's on our radar and I believe we do regular reports to you let. So definitely

3060
05:26:36,230 --> 05:26:41,510
something we can continue looking at. Great. Thank you. And then regarding this small business

3061
05:26:42,650 --> 05:26:49,770
center, the vast, which is a great concept. I know there's some of the programs are online and

3062
05:26:50,410 --> 05:26:54,390
And, you know, being a former small business owner myself,

3063
05:26:54,950 --> 05:26:59,190
I definitely put priority on how we can help small businesses.

3064
05:26:59,510 --> 05:27:05,110
So my hope or request is that can we advertise the center

3065
05:27:05,710 --> 05:27:08,550
throughout the county, because I think there are businesses

3066
05:27:08,550 --> 05:27:11,630
throughout the county that can benefit from the resources

3067
05:27:11,630 --> 05:27:14,090
that will be in place there.

3068
05:27:14,370 --> 05:27:17,050
That's why my supervisor will work with the team on that.

3069
05:27:17,070 --> 05:27:17,370
Great.

3070
05:27:17,870 --> 05:27:18,570
Thank you.

3071
05:27:18,570 --> 05:27:25,730
And I may add the supervisor on the federal piece, you know, because I know for instance that San Jose, I think Spotlight,

3072
05:27:25,870 --> 05:27:34,470
we have had something on what Congressman Ricardo had been sort of working on.

3073
05:27:35,050 --> 05:27:39,570
We have made every single request that has been asked of us to make, you know,

3074
05:27:40,430 --> 05:27:48,390
unfortunately we don't have the final say on what an individual office adopts, you know,

3075
05:27:48,390 --> 05:27:59,390
circle back. I do want to add that in terms of bill ideas at the state level. I think I mentioned a few things, but I want to say that there are a number of things that we're working on.

3076
05:27:59,390 --> 05:28:08,430
the board to prove we're pursuing issues around housing in Rina and we are exploring a

3077
05:28:08,430 --> 05:28:15,390
potential legislation on that. There's also issues involving the medical integration

3078
05:28:15,390 --> 05:28:22,290
and we're working closely with County Council on that. I mentioned the medical examiner.

3079
05:28:22,290 --> 05:28:28,390
I mentioned the contract change that sounds sitting that Assembly Member Collar is working with us.

3080
05:28:28,390 --> 05:28:38,270
We also have a DMB pilot that we know that President Lee, that's a priority for him, that was also adopted in the board platform.

3081
05:28:39,390 --> 05:28:44,730
So a lot of balls in the air, if you want more detail, happy to provide it.

3082
05:28:44,970 --> 05:28:47,410
All right, thank you. Thank you so much.

3083
05:28:48,430 --> 05:28:52,330
Do you need a motion to receive the report?

3084
05:28:53,170 --> 05:28:55,730
There doesn't need to be a motion. No, it's just information.

3085
05:28:56,250 --> 05:28:56,850
Thank you.

3086
05:28:59,190 --> 05:28:59,670
Okay.

3087
05:29:02,880 --> 05:29:03,740
No question by colleagues.

3088
05:29:04,040 --> 05:29:05,680
Thank you.

3089
05:29:05,840 --> 05:29:06,240
First of all, yeah.

3090
05:29:06,240 --> 05:29:07,900
Thank you so much for the comprehensive report.

3091
05:29:08,080 --> 05:29:08,760
A lot of things happening.

3092
05:29:09,280 --> 05:29:15,400
It's great to see that many of our local member of our legislators, near bias, taking these

3093
05:29:15,400 --> 05:29:19,460
very important positions at the Senate, the committee chair level.

3094
05:29:19,720 --> 05:29:23,860
So I think that certainly gives a little more emphasis of asking for some of these requests

3095
05:29:23,860 --> 05:29:24,320
in the future.

3096
05:29:24,600 --> 05:29:25,460
Thank you.

3097
05:29:25,460 --> 05:29:32,980
On the federal side, I do see the various community projects being put in. Is there any idea

3098
05:29:32,980 --> 05:29:38,380
when we may find out what a this would be a propany type of potential timeline would give in

3099
05:29:38,380 --> 05:29:39,900
Guestment at this point?

3100
05:29:42,840 --> 05:29:44,800
Elaine, do you have any thoughts?

3101
05:29:45,480 --> 05:29:51,020
Thank you, sir. Advisor for the question. Yes, it is quite a process, supervisor. Each

3102
05:29:51,020 --> 05:29:55,980
federal agency that is responsible for overseeing that funding has our own process in timeline,

3103
05:29:55,980 --> 05:29:59,960
where they issue their agreement and work directly with the department to, uh, kind of roof.

3104
05:30:00,000 --> 05:30:08,220
We'll find this scope. So for best guests, I would say at least another several months at a minimum.

3105
05:30:08,980 --> 05:30:24,620
And if I may add President Lee, this is that we will be going to Washington DC and meeting with members of our delegation, including some of the members that have made these requests. So we hope to have more detail and more information after those visits.

3106
05:30:25,440 --> 05:30:26,780
Great. Thank you.

3107
05:30:28,040 --> 05:30:34,180
And let's see, there's one bill that I just saw was being voted on yesterday.

3108
05:30:34,700 --> 05:30:41,600
I think it's SB, I believe 694, I don't expect you have the answer for me, but if you give me a quick update,

3109
05:30:41,860 --> 05:30:48,800
I'll just just let me know, I appreciate it, relaying to the claim shorts issue for veterans.

3110
05:30:49,960 --> 05:30:50,640
Happy to do that.

3111
05:30:50,820 --> 05:30:51,180
Thank you.

3112
05:30:51,700 --> 05:30:51,800
All right.

3113
05:30:51,860 --> 05:30:52,840
Thank you.

3114
05:30:53,720 --> 05:30:54,600
And that's all I have.

3115
05:30:55,020 --> 05:30:55,200
All right.

3116
05:30:55,200 --> 05:30:59,560
No further questions. Let's move on to our next item. Thank you so much.

3117
05:30:59,780 --> 05:31:03,280
I appreciate it. Thank you.

3118
05:31:13,430 --> 05:31:16,290
All right, moving. I just want to let everybody know that because my statement

3119
05:31:16,290 --> 05:31:22,450
talks about SPX-694, my AI and my phone immediately wanted to tell me what SP694 does.

3120
05:31:24,210 --> 05:31:27,670
It's kind of scary. What they're listening and now something we want to respond to you.

3121
05:31:27,970 --> 05:31:30,710
All right, good. Yes, they're moving to item number 14.

3122
05:31:33,300 --> 05:31:37,600
Well, if I may have been Dr. Sarah Redman, I'll talk to Sarah and I'm joined by my colleagues

3123
05:31:37,600 --> 05:31:45,640
when you can hear and Heidi, everyone from SSA, to respond to a request, I think, from Supervisor

3124
05:31:45,640 --> 05:31:50,680
Allen Berg in the entirety of the board, now several months ago to understand the current

3125
05:31:50,680 --> 05:31:55,620
state of home visitation programs, many of which are operated either by the Public Health

3126
05:31:55,620 --> 05:32:01,720
Department or partners in the community and often with the fierce collaboration and support

3127
05:32:01,720 --> 05:32:09,020
of our partners in DFCS, specifically in response to a study conducted with collaboration with

3128
05:32:09,020 --> 05:32:15,680
first five, to see how we can sustain and in places and hands access to these important

3129
05:32:15,680 --> 05:32:21,160
services that reach into families' homes to give the best understanding of what they're

3130
05:32:21,160 --> 05:32:26,840
experiencing and what they need at a time, especially for new parents and infants when families

3131
05:32:26,840 --> 05:32:34,600
can be vulnerable and have an opportunity to be set on a healthier, more wholesome path to thriving.

3132
05:32:35,400 --> 05:32:41,820
Now, what we bring to you at this today, looks at the work that is still happening across

3133
05:32:41,820 --> 05:32:47,400
the county, including in collaboration with non-county partners to do this work.

3134
05:32:47,580 --> 05:32:56,820
But at the opportunity area at a moment where due to both budgetary constraints and the policy

3135
05:32:56,820 --> 05:33:03,380
to invest in expansion is extremely limited and so really the priority of both our departments

3136
05:33:03,380 --> 05:33:09,440
at this time is focusing on sustaining the efforts we do have while ensuring we are as prepared

3137
05:33:09,440 --> 05:33:15,880
as we possibly could be to expand when new resources do become available and so you see

3138
05:33:15,880 --> 05:33:21,500
before you the report that goes into great detail on these elements and we're prepared to take

3139
05:33:21,500 --> 05:33:26,860
your questions today. I'll see if my colleagues have anything you want to add. Okay, thank you.

3140
05:33:27,020 --> 05:33:31,360
Thank you. May I check to any public or like to speak in this item?

3141
05:33:31,620 --> 05:33:32,540
No, request to speak.

3142
05:33:32,980 --> 05:33:34,240
Okay, close that. Yes, would I.

3143
05:33:38,940 --> 05:33:41,060
Let's like their lives. Let me verify that.

3144
05:33:41,060 --> 05:33:48,460
Okay, let's pause for a second while we go through the court submission for item number 14.

3145
05:33:48,460 --> 05:33:49,620
and

3146
05:33:56,500 --> 05:34:02,420
we do have some cards apologies, and some hands have also raised at this time, so let

3147
05:34:02,420 --> 05:34:03,240
me just count.

3148
05:34:08,100 --> 05:34:12,400
Looks like I have 10 in chambers and two hands raised in Zoom.

3149
05:34:12,820 --> 05:34:18,320
Okay, let's try to do one minute each. Sure. Our first five speakers are Jennifer Lloyd,

3150
05:34:19,520 --> 05:34:25,140
Yelisa Donno, Liz Salis, Angelica Lehano.

3151
05:34:28,040 --> 05:34:29,480
I'm sorry about that, yes.

3152
05:34:29,540 --> 05:34:30,080
That's okay.

3153
05:34:30,100 --> 05:34:32,540
We gotta be lined up.

3154
05:34:33,020 --> 05:34:33,180
Oh, yes.

3155
05:34:33,280 --> 05:34:34,740
So the mic is right there on the podium.

3156
05:34:35,500 --> 05:34:38,580
And as soon as you start speaking, the time would start counting.

3157
05:34:38,740 --> 05:34:39,200
Thank you.

3158
05:34:39,900 --> 05:34:40,380
Good afternoon.

3159
05:34:40,460 --> 05:34:41,880
I'm Jennifer Keller, her Lloyd.

3160
05:34:41,920 --> 05:34:43,680
I'm the Executive Directorate for S5.

3161
05:34:44,320 --> 05:34:48,660
And our program was the author of the feasibility study that you are reviewing today.

3162
05:34:48,660 --> 05:34:55,700
I think I have to start by acknowledging the critical importance of a service like home visiting in a time

3163
05:34:55,700 --> 05:35:00,900
like we are living in now where the environment and the climate of fear is substantial.

3164
05:35:01,600 --> 05:35:07,440
So having trust of messengers who are able to connect with families in their homes are critical.

3165
05:35:08,160 --> 05:35:15,860
I understand the report talks about implementation of Calam and medical reimbursement as being challenging and it absolutely is.

3166
05:35:15,860 --> 05:35:22,260
However, it's not an overnight solution, and if we don't invest in building the infrastructure

3167
05:35:22,260 --> 05:35:28,920
around medical now to reimburse some of these services, we may lose the opportunity to access

3168
05:35:28,920 --> 05:35:30,180
those benefits later.

3169
05:35:30,920 --> 05:35:32,880
Also, I want to just identify, home visiting.

3170
05:35:32,980 --> 05:35:38,320
If one program goes down, it will place heavy stress on many of our other systems, including

3171
05:35:38,320 --> 05:35:39,200
our health system.

3172
05:35:39,300 --> 05:35:42,300
So, we need to consider that as we look at the overall context.

3173
05:35:42,860 --> 05:35:43,380
Thank you.

3174
05:35:43,380 --> 05:35:44,140
Good

3175
05:35:49,770 --> 05:35:55,410
afternoon, supervisors, my name is Angelica Lujano, the director of Somos, Mayfer.

3176
05:35:56,230 --> 05:36:01,930
I want to thank the world and especially supervisors, Suzan, Ellen Bird.

3177
05:36:02,890 --> 05:36:07,730
For her leadership in advocacy for home visiting and early childhood system in Santa Clara County.

3178
05:36:08,870 --> 05:36:16,910
Through the Santa Clara County, home visiting, home visiting programs currently served over 6,900 families each year.

3179
05:36:16,910 --> 05:36:23,530
So, most may-for is perhaps to be part of this ecosystem tool or part-in-child-plus partnership

3180
05:36:23,530 --> 05:36:26,870
with first five Santa Clara County and part-in-child-plus national.

3181
05:36:28,210 --> 05:36:34,950
At this time, in the political climate, many families are fearful to leave their homes and

3182
05:36:34,950 --> 05:36:35,630
stay support.

3183
05:36:36,090 --> 05:36:43,970
Home-based-in-vuralist-made families, they are providing trust, relationship-based care when

3184
05:36:43,970 --> 05:36:45,010
is needed most.

3185
05:36:45,010 --> 05:36:50,250
Thank you for recognizing the importance of this work and for your continuous partnership.

3186
05:36:51,530 --> 05:36:52,190
Thank you.

3187
05:36:57,480 --> 05:36:57,660
Thank you.

3188
05:36:57,660 --> 05:36:58,240
Okay, good afternoon.

3189
05:36:58,600 --> 05:37:01,520
My name is Lisa Aless and I serve as a Parential Plasso Visiting.

3190
05:37:02,120 --> 05:37:02,600
I'm a supervisor.

3191
05:37:03,360 --> 05:37:07,420
I want to thank the board and like my director mentioned, especially

3192
05:37:07,420 --> 05:37:12,400
Supervisors and Ellen Burke for all her leadership and advocacy in the home visiting systems.

3193
05:37:13,640 --> 05:37:18,280
Our Parential Plasso program is delivered by a home grown promotor as who come from the

3194
05:37:18,280 --> 05:37:23,520
communities and families they support and serve. They share the same language, culture and

3195
05:37:23,520 --> 05:37:29,520
live experiences, which helps build trust in a very real and meaningful way. This

3196
05:37:29,520 --> 05:37:35,300
connection allows our families to feel seen, understood, and respected, not as clients,

3197
05:37:35,580 --> 05:37:41,960
but as partners. So for many families, their home visitors become a steady source of guidance

3198
05:37:41,960 --> 05:37:47,740
and encouragement and connection to resources. We see our caregivers gaining confidence in

3199
05:37:47,740 --> 05:37:51,180
raising their role as first and best teachers.

3200
05:37:51,680 --> 05:37:55,920
Their children strengthening their development and families feeling less alone.

3201
05:37:56,800 --> 05:38:00,860
So when we invest in this workforce, we're not only supporting our promotoras, but we're

3202
05:38:00,860 --> 05:38:07,000
lifting women, men and strengthening families in creating long-termist ability for our children

3203
05:38:07,000 --> 05:38:08,140
across our county.

3204
05:38:08,580 --> 05:38:15,900
So this is the human impact that our home visitation families receive, and they just, it's

3205
05:38:15,900 --> 05:38:19,640
I just support the thrive, so thank you for your time.

3206
05:38:20,300 --> 05:38:22,060
Thank you before we go to the next speaker.

3207
05:38:22,860 --> 05:38:27,620
I want to note that I feel the timer was set for two minutes on that one, and I want to

3208
05:38:27,620 --> 05:38:29,280
make sure that we are right.

3209
05:38:29,620 --> 05:38:33,360
It was set for one minute, but there was an issue in the back that it didn't start at

3210
05:38:33,360 --> 05:38:34,080
the appropriate time.

3211
05:38:34,200 --> 05:38:34,500
It's about it.

3212
05:38:34,500 --> 05:38:34,840
I apologize.

3213
05:38:36,340 --> 05:38:39,600
And before you make sure everyone gets the same time, thank you.

3214
05:38:40,780 --> 05:38:42,060
I'll call a few more speakers.

3215
05:38:42,060 --> 05:38:51,660
Victor Vesquez, Arlene Mora, Liliana Strada, Irma Beltran, Leslie Serrano, and Sunnyly.

3216
05:38:52,380 --> 05:38:52,880
Thank you.

3217
05:38:53,020 --> 05:38:53,380
You may proceed.

3218
05:38:58,800 --> 05:38:59,000
Yes.

3219
05:38:59,140 --> 05:38:59,640
Just speak to them.

3220
05:39:00,240 --> 05:39:00,800
Awesome.

3221
05:39:01,500 --> 05:39:02,680
I always have to put the mic down.

3222
05:39:02,840 --> 05:39:03,860
I'm like, oh, this is nice.

3223
05:39:04,600 --> 05:39:04,980
Good afternoon.

3224
05:39:05,700 --> 05:39:06,520
Board of Supervisors.

3225
05:39:06,680 --> 05:39:07,780
My name is Naili Sedano.

3226
05:39:07,800 --> 05:39:09,680
And I'm a manager at Somos May Fair.

3227
05:39:10,380 --> 05:39:16,440
And I'm here to talk about an advocate for the home visiting programs and expansion throughout the county.

3228
05:39:16,440 --> 05:39:23,900
The families who benefit most from home visiting are the same families who would be most impacted by the HR1 cuts,

3229
05:39:24,280 --> 05:39:29,840
low income families, medical patients, and households that quickly fall into crisis without consistent support.

3230
05:39:30,620 --> 05:39:37,760
The county Latino Health Assessment continues to show persistent disparities impacting Latino children and families.

3231
05:39:38,020 --> 05:39:43,920
Home visiting is a proven strategy to address these inequities early and prevent deeper systems involvement later.

3232
05:39:43,920 --> 05:39:45,380
We cannot go backwards.

3233
05:39:45,640 --> 05:39:49,360
Family should not be told to seek funding elsewhere for essential services as a county.

3234
05:39:49,520 --> 05:39:53,160
We have the responsibility to invest in women and children and in prevention and in

3235
05:39:53,160 --> 05:39:53,940
systems that work.

3236
05:39:54,240 --> 05:39:58,060
Home visiting should be funded, sustained, and prioritized across the county level.

3237
05:39:58,380 --> 05:39:59,180
Thank you.

3238
05:40:04,240 --> 05:40:08,300
Dear supervisors in the board, as the parent child plus program supervisor at Catholic

3239
05:40:08,300 --> 05:40:12,360
Church of Santa Clara County, I'm here in support of sustaining county investments in home visiting

3240
05:40:12,360 --> 05:40:13,160
programs.

3241
05:40:13,400 --> 05:40:17,500
Home visiting programs are especially critical in today's political and economic uncertainty.

3242
05:40:17,500 --> 05:40:24,220
Home visitors provide more than guidance, they are consistent, trusted partners who bring stability and connection during stressful times.

3243
05:40:24,660 --> 05:40:29,260
By showing up week after week, listening without judgment and supporting parents in everyday routines.

3244
05:40:29,800 --> 05:40:36,240
Recently, I support a family by connecting them to immigration services and securing early intervention for their toddler who has speech delay.

3245
05:40:36,740 --> 05:40:42,640
These connections can be like changing for families who might otherwise be experienced navigating complex systems.

3246
05:40:42,640 --> 05:40:44,880
Programs like parent child plus are essential.

3247
05:40:45,180 --> 05:40:48,780
They give children and families the tools, support, and stability they need to

3248
05:40:48,780 --> 05:40:50,680
thrive even in uncertain times.

3249
05:40:50,980 --> 05:40:51,880
Thank you.

3250
05:41:19,570 --> 05:41:24,770
I confirm that these programs are a key to support and stability for the

3251
05:41:24,770 --> 05:41:25,930
families vulnerable.

3252
05:41:26,570 --> 05:41:31,010
Our team, which reflects the diversity of communities, offers a

3253
05:41:31,010 --> 05:41:32,870
powerful and expert support.

3254
05:41:33,310 --> 05:41:35,590
Programming programs, such as Parangio Plas,

3255
05:41:35,830 --> 05:41:39,150
Fortalecena, the parents, such as Primero, seducadores, and

3256
05:41:39,150 --> 05:41:43,130
Proportionate children, the base for the school, and a

3257
05:41:43,130 --> 05:41:44,350
adoptive development.

3258
05:41:44,350 --> 05:41:47,290
Protégere, these inversions, is an imperative,

3259
05:41:47,790 --> 05:41:50,130
strategic, to garantize an opportunity,

3260
05:41:50,910 --> 05:41:53,210
equitable, for all the children of the condado,

3261
05:41:53,450 --> 05:41:54,210
of Santa Clara.

3262
05:41:54,470 --> 05:41:54,790
Gracias.

3263
05:41:56,290 --> 05:41:58,730
I sense, and translate it first.

3264
05:42:00,800 --> 05:42:02,520
Yes, grazine, as a professional,

3265
05:42:03,040 --> 05:42:05,080
and as a re-education.

3266
05:42:05,600 --> 05:42:08,440
I would like to continue asking for your support.

3267
05:42:08,960 --> 05:42:10,240
Since, in my experience,

3268
05:42:11,500 --> 05:42:14,540
it's very important to continue the home visits

3269
05:42:14,540 --> 05:42:20,840
to confirm these programs that gave stability to the community and help the parents and the

3270
05:42:22,400 --> 05:42:27,060
children and for the children to have a very successful experience at school.

3271
05:42:48,020 --> 05:42:49,180
to maintain their children.

3272
05:42:49,720 --> 05:42:52,900
These expressions affect all the family and the small children

3273
05:42:52,900 --> 05:42:53,620
also feel.

3274
05:42:54,080 --> 05:42:55,760
The impact is evident.

3275
05:42:56,080 --> 05:42:58,460
A peer benefit from Calwork with special needs.

3276
05:42:58,820 --> 05:43:01,000
In front of our physical and physical properties,

3277
05:43:01,540 --> 05:43:03,460
despite their conditions of health,

3278
05:43:03,680 --> 05:43:06,280
there will be a chance to visit them and always be present.

3279
05:43:07,780 --> 05:43:10,220
Participating in the interactive and interactive

3280
05:43:10,220 --> 05:43:11,180
during visits.

3281
05:43:11,540 --> 05:43:13,640
Suija is receiving the therapy of Able,

3282
05:43:13,980 --> 05:43:15,980
and she has observed her great progress

3283
05:43:15,980 --> 05:43:19,460
with the support of the therapist and the Specialist Education Infantile.

3284
05:43:19,620 --> 05:43:21,360
Thank you so much for the service that you have now

3285
05:43:21,360 --> 05:43:23,360
visited my son for his son,

3286
05:43:23,760 --> 05:43:25,440
as well as the requirements.

3287
05:43:25,840 --> 05:43:28,980
This is possible thanks to the team of professionals

3288
05:43:28,980 --> 05:43:32,240
with the community that proposed to support

3289
05:43:32,240 --> 05:43:33,480
culturally the families.

3290
05:43:33,980 --> 05:43:35,500
That was very impressive.

3291
05:43:35,620 --> 05:43:38,600
How much you put in there?

3292
05:43:38,900 --> 05:43:39,880
That's a good translation, please.

3293
05:43:41,280 --> 05:43:44,020
Thank you for continuing the investment

3294
05:43:44,020 --> 05:43:53,180
in school programs, because especially for Latino communities that undergo stress and economic

3295
05:43:53,180 --> 05:43:59,400
uncertainty. And especially I've seen a parent who is part of their health conditions,

3296
05:44:00,320 --> 05:44:06,840
they actually benefit from the visit they never miss the opportunity to attend the program,

3297
05:44:07,160 --> 05:44:12,760
they acted participate in it and they have a daughter involved in speech language and with

3298
05:44:12,760 --> 05:44:21,700
help of professionals and experts. They can give it a daughter more opportunity. So we would

3299
05:44:21,700 --> 05:44:27,800
like to continue to invest in this program and also in home business.

3300
05:44:29,890 --> 05:44:36,690
Dear board members, I'm here to support a suggestion of the county investment in home visiting

3301
05:44:36,690 --> 05:44:42,150
program. As an early learning specialist with cadre attorneys of Santa Clara County, I work

3302
05:44:42,150 --> 05:44:47,790
with families who juggle, work, school and everyday challenge. I am working with the Spanish

3303
05:44:47,790 --> 05:44:52,630
speaking mother of her three-year-old who's navigating challenges with sleeping and ongoing health

3304
05:44:52,630 --> 05:44:57,690
concerns. Through all our visits we have successful establish a constantly daily routine

3305
05:44:57,690 --> 05:44:59,650
engage in an early learning activity.

3306
05:45:00,000 --> 05:45:07,000
And connecting her with valuable, community resources for additional support. She truly, she truly

3307
05:45:07,000 --> 05:45:14,080
values the value, the assistantship, her CV and managed and effectively to manage the stress

3308
05:45:14,080 --> 05:45:19,740
and financial unable. On certain surrounding her child's medical needs and has expressively

3309
05:45:19,740 --> 05:45:25,420
a appreciation and relieved in support receiving support and also expressed how heartwarming

3310
05:45:25,420 --> 05:45:30,020
to see her child has grown during her visits and smiley and connecting.

3311
05:45:30,800 --> 05:45:31,640
Thank you.

3312
05:45:37,520 --> 05:45:40,020
This supervisor and the board, my name is Sunnyly.

3313
05:45:40,100 --> 05:45:42,560
I am an early learning measure lead with Catholic charity.

3314
05:45:43,080 --> 05:45:45,840
And I walk slowly with the family who often fail at

3315
05:45:45,840 --> 05:45:47,820
economy, dress, while raising young children.

3316
05:45:48,280 --> 05:45:49,820
Program my parents, travelers.

3317
05:45:50,240 --> 05:45:52,080
Provide more than early learning support.

3318
05:45:52,400 --> 05:45:54,480
We build just connection and hope.

3319
05:45:55,360 --> 05:45:58,780
This month, I have honor, raturizing a cow or family from the program.

3320
05:45:58,780 --> 05:46:01,660
This model, who raised in two children with autism,

3321
05:46:02,160 --> 05:46:04,780
worked in relatively hard to support her children's development.

3322
05:46:05,400 --> 05:46:07,980
Together, we have said early intervention survey and

3323
05:46:07,980 --> 05:46:11,040
directed strategy that has helped her feel more confident in a parent.

3324
05:46:11,560 --> 05:46:14,120
Today, the family feel empowered and better

3325
05:46:14,120 --> 05:46:15,900
rebelled to navigate available resources.

3326
05:46:16,620 --> 05:46:19,420
She has also laid her second daughter on our home

3327
05:46:19,420 --> 05:46:22,020
business in wireless, so in her continued commitment

3328
05:46:22,020 --> 05:46:23,220
to her children's growth.

3329
05:46:23,880 --> 05:46:25,940
Moments like this remind me why did work mother,

3330
05:46:25,940 --> 05:46:28,100
because parents of their trained and family support

3331
05:46:28,100 --> 05:46:29,520
parents and give children a strong

3332
05:46:29,520 --> 05:46:30,860
foundation for the future.

3333
05:46:31,100 --> 05:46:31,800
Thank you for listening.

3334
05:46:38,730 --> 05:46:39,510
Good afternoon, Victor,

3335
05:46:39,710 --> 05:46:40,110
at Somos.

3336
05:46:40,210 --> 05:46:41,030
I want to thank the Board,

3337
05:46:41,130 --> 05:46:41,870
especially the supervisor,

3338
05:46:42,230 --> 05:46:44,150
Ellenberg, for protecting children,

3339
05:46:44,290 --> 05:46:44,930
youth and families.

3340
05:46:45,210 --> 05:46:46,650
I'm here today as a new parent.

3341
05:46:47,270 --> 05:46:49,230
I urge you to sustain these critical programs

3342
05:46:49,230 --> 05:46:51,190
in a kind of national tax.

3343
05:46:51,630 --> 05:46:53,330
Brown families are primary target.

3344
05:46:53,750 --> 05:46:54,530
We're living in fear,

3345
05:46:54,750 --> 05:46:56,130
due to immigration enforcement,

3346
05:46:56,690 --> 05:46:57,810
and anti-immigrant sentiment,

3347
05:46:58,410 --> 05:46:59,830
leading to family separations,

3348
05:47:00,110 --> 05:47:01,030
traumatized children,

3349
05:47:01,030 --> 05:47:06,510
and public executions. Communities are in fear of accessing resources and these programs

3350
05:47:07,030 --> 05:47:11,610
are spaces where people will find trust, support and hope.

3351
05:47:11,930 --> 05:47:16,430
Our Board needs to name racial justice as a core value again and send our brown families

3352
05:47:16,430 --> 05:47:21,290
and protect these critical services and them. It is time to collectively refuse to balance

3353
05:47:21,290 --> 05:47:26,190
the budget of the back of brown children, women and families. Also urge the county to

3354
05:47:26,190 --> 05:47:31,330
Center Latino Health Assessment, so funding decisions align with documented community needs,

3355
05:47:31,870 --> 05:47:36,570
services, and resources, protecting brown children and families must remain a county priority.

3356
05:47:37,030 --> 05:47:37,990
Thank you for your partnership.

3357
05:47:41,280 --> 05:47:45,780
Moving to our Zoom speakers, our next speaker is Saul Ramos. You will have one minute.

3358
05:47:49,730 --> 05:47:52,310
Good afternoon, Supervisors. This is Saul Ramos,

3359
05:47:52,510 --> 05:47:55,990
Quadietz, almost May 3. We're very supportive of sustaining and enhancing the home

3360
05:47:55,990 --> 05:47:57,030
the institution strategy.

3361
05:47:57,890 --> 05:47:59,090
I'm speaking from East San Jose,

3362
05:47:59,370 --> 05:48:00,910
alongside families with young children

3363
05:48:00,910 --> 05:48:03,150
who are navigating fierce risks to my solution.

3364
05:48:03,310 --> 05:48:05,410
And the county's own public health data shows

3365
05:48:05,410 --> 05:48:09,230
that many of our families face higher barriers

3366
05:48:09,230 --> 05:48:11,530
to be under care, greater economic strain,

3367
05:48:11,630 --> 05:48:13,150
and worsening mental health outcomes,

3368
05:48:13,550 --> 05:48:16,050
and those conditions begin early in a child's life.

3369
05:48:16,670 --> 05:48:18,910
Home visiting works because they meet families

3370
05:48:18,910 --> 05:48:19,630
where they are.

3371
05:48:19,670 --> 05:48:22,030
It builds trust and intervenes before crisis.

3372
05:48:22,770 --> 05:48:24,710
Our home visitors connect families to food,

3373
05:48:24,710 --> 05:48:29,210
housing stability, healthcare, early learning assessments, strengthening parent confidence

3374
05:48:29,210 --> 05:48:31,970
and child development, all of that at the same time.

3375
05:48:32,290 --> 05:48:36,210
And sustaining this work is not only the right thing to do it is physically responsible.

3376
05:48:37,290 --> 05:48:42,930
Home visiting is an investment that protects families now and will save us public dollars down the road.

3377
05:48:43,150 --> 05:48:47,510
So I want to thank you for your efforts and I think the leadership of Supervisor Elberg in this effort.

3378
05:48:47,770 --> 05:48:49,130
Thank you.

3379
05:48:49,450 --> 05:48:52,410
Our next speaker is General Garcia. You'll have one minute.

3380
05:48:54,800 --> 05:48:59,180
Hello, my name is Janelle. I'm a home visitor within the program, a parent shop plus with

3381
05:48:59,180 --> 05:49:04,220
Somel's May Fair. I would like to ask for the continuous support working for the home

3382
05:49:04,220 --> 05:49:08,200
visitation programs and working directly with the families for the past four years has allowed

3383
05:49:08,200 --> 05:49:12,960
me to get an insight look of what our community needs or wants. It allows me to support and guide

3384
05:49:12,960 --> 05:49:17,120
the families to the resources they search for. I see their strengths and growth within the

3385
05:49:17,120 --> 05:49:21,260
two years I spend with them. Programs like home visitation allows these families to become their

3386
05:49:21,260 --> 05:49:25,600
leaders and advocates for their family and community. It allows children to be

3387
05:49:25,600 --> 05:49:29,820
school ready by the time the program completion, and it strengthens the connection

3388
05:49:29,820 --> 05:49:32,940
between child and caregiver. I believe it is important to keep these programs

3389
05:49:32,940 --> 05:49:37,420
active for our community as it gives equal opportunities from the start. Thank you.

3390
05:49:38,340 --> 05:49:42,580
We had one additional speaker that raised our hand before the key was closed. Our next speaker

3391
05:49:42,580 --> 05:49:45,540
is Cam Nguyen. Cam you will have one minute?

3392
05:50:02,460 --> 05:50:03,860
Yeah.

3393
05:50:58,300 --> 05:51:00,860
Hello. Yes, we can hear you, Greg.

3394
05:51:04,080 --> 05:51:04,700
Good afternoon.

3395
05:51:05,760 --> 05:51:06,940
Thank you for the board.

3396
05:51:07,360 --> 05:51:09,180
I'm just support.

3397
05:51:10,720 --> 05:51:12,000
I'm just.

3398
05:51:12,000 --> 05:51:12,600
Our cabin.

3399
05:51:13,660 --> 05:51:15,960
And I'm just going to talk to the

3400
05:51:16,340 --> 05:51:16,680
Um,

3401
05:51:17,220 --> 05:51:20,460
When I get to start start over your.

3402
05:51:20,460 --> 05:51:20,920
Um,

3403
05:51:21,560 --> 05:51:23,540
Audio quality is very hard to hear.

3404
05:51:23,780 --> 05:51:27,660
So maybe you can get a little closer to the speaker and try again.

3405
05:51:27,700 --> 05:51:28,680
Thank you.

3406
05:51:30,000 --> 05:51:31,720
What moment did

3407
05:51:34,280 --> 05:51:35,120
you get in this career?

3408
05:51:35,480 --> 05:51:36,620
Oh, much better, yes.

3409
05:51:36,740 --> 05:51:37,340
Go ahead.

3410
05:51:41,410 --> 05:51:42,210
Can you do it better?

3411
05:51:44,420 --> 05:51:45,680
Just now was good.

3412
05:51:45,840 --> 05:51:47,380
Go ahead, go ahead, go ahead, go ahead.

3413
05:51:52,200 --> 05:51:54,180
Good, well, provide so many tools.

3414
05:51:54,900 --> 05:51:56,300
And I'm

3415
05:51:58,990 --> 05:52:00,950
talking, and then I'm talking,

3416
05:52:01,530 --> 05:52:07,570
with a Catholic support group who come to the home

3417
05:52:07,570 --> 05:52:12,330
of my family, and have a support

3418
05:52:12,330 --> 05:52:21,630
having with the parents, children's programs, they have to support the children with the

3419
05:52:21,630 --> 05:52:26,270
program, the land development for the language field,

3420
05:52:28,390 --> 05:52:31,150
and support what they have as

3421
05:52:31,150 --> 05:52:37,370
a police example development in the home. They have to connect the parents to the children

3422
05:52:37,370 --> 05:52:45,930
and be confident through the children so that it can be ready for the reading and studying

3423
05:52:45,930 --> 05:52:46,710
program.

3424
05:52:47,310 --> 05:52:54,010
And, nicely, I hope that we can have further support.

3425
05:52:54,250 --> 05:53:03,050
Our families are about to register for our second drive into the program and we do hope

3426
05:53:03,050 --> 05:53:08,230
that repairing this will help my children to develop better

3427
05:53:08,230 --> 05:53:10,610
and I look forward to further support

3428
05:53:10,610 --> 05:53:14,330
so that the program can continue and support

3429
05:53:14,330 --> 05:53:18,110
to our families and their level and to see the child

3430
05:53:18,110 --> 05:53:19,730
for less a few years.

3431
05:53:20,130 --> 05:53:21,230
Thank you very much.

3432
05:53:24,000 --> 05:53:25,000
That concludes public comment.

3433
05:53:25,540 --> 05:53:28,160
Great, okay, we'll close the public speaking portion.

3434
05:53:28,540 --> 05:53:29,320
Yes, supervisor, Amber.

3435
05:53:29,800 --> 05:53:30,780
Thank you.

3436
05:53:31,100 --> 05:53:34,380
I want to begin by thanking all of the partners

3437
05:53:34,380 --> 05:53:42,140
In this work, first five public health, social services agency, the CBOs of the Home Visiting

3438
05:53:42,140 --> 05:53:46,700
Collaborative, and thank you as well to the folks who came as public speakers, whether

3439
05:53:46,700 --> 05:53:53,440
providers of or recipients of home visiting services, hearing about your experiences is really

3440
05:53:53,440 --> 05:53:53,900
vital.

3441
05:53:54,900 --> 05:54:00,900
I want to just emphasize to everyone, the gravity of the work being done here.

3442
05:54:00,900 --> 05:54:07,400
Time and again, we hear our leaders, including myself, say that we need to meet people where they are.

3443
05:54:07,940 --> 05:54:15,900
And as cliched as that phrase may seem, it could not be more true when it comes to supporting families who rely on home visiting services.

3444
05:54:16,700 --> 05:54:29,480
The families who may benefit most from home visiting services are also the very same families we have emphasized are likely to be most affected by the HR1 cuts.

3445
05:54:29,480 --> 05:54:36,760
low-income medical eligible patients and other folks who could easily fall into crisis without

3446
05:54:36,760 --> 05:54:42,920
proper support and services. Currently, home visiting programs throughout the County Home

3447
05:54:42,920 --> 05:54:52,340
Visiting Collaborative serve more than 6,900 families annually. A significant goal of this work

3448
05:54:52,340 --> 05:54:59,080
is to ensure and support a safe home environment and develop support the development of a

3449
05:54:59,080 --> 05:55:04,700
healthy, loving, and supportive relationship between a child and their parent or caregiver.

3450
05:55:05,840 --> 05:55:07,980
This work is not insignificant.

3451
05:55:08,900 --> 05:55:14,920
It reflects a baseline of preventative care that can force all adverse childhood experiences

3452
05:55:14,920 --> 05:55:20,840
which ample research has shown to be factors in everything from poor educational outcomes

3453
05:55:20,840 --> 05:55:24,340
to housing instability to criminogenic behavior.

3454
05:55:24,340 --> 05:55:31,480
It is a deeply vulnerable thing for a young family to welcome a stranger into their home,

3455
05:55:31,540 --> 05:55:35,480
even briefly, who is there to watch them engage with their child.

3456
05:55:36,440 --> 05:55:43,340
Building trust quickly is critical to the success of these visits as is demonstrating

3457
05:55:43,340 --> 05:55:49,540
the many additional supports that may be available to that young family if they would

3458
05:55:49,540 --> 05:55:50,980
benefit from them.

3459
05:55:50,980 --> 05:55:59,840
Removing this benefit could be directly responsible for perpetuating another generation of trauma, poverty, and instability.

3460
05:56:01,120 --> 05:56:03,000
We know that home visiting is cost effective.

3461
05:56:03,700 --> 05:56:11,920
The return on investment for such programs ranges between $1.75 and $5.70 for every dollar spent.

3462
05:56:12,700 --> 05:56:17,980
Home visiting can improve healthy development, education, economic wellbeing, and overall health,

3463
05:56:17,980 --> 05:56:21,080
further yielding economic savings to the county.

3464
05:56:21,660 --> 05:56:24,120
When healthy children become healthy adults,

3465
05:56:24,740 --> 05:56:28,140
the county spends fewer dollars on costly and high

3466
05:56:28,140 --> 05:56:29,480
intensity services.

3467
05:56:31,100 --> 05:56:34,280
I am encouraged to see the partnership with first five

3468
05:56:34,280 --> 05:56:35,200
moving forward.

3469
05:56:35,900 --> 05:56:38,940
The extraordinary circumstances related to our budget

3470
05:56:38,940 --> 05:56:40,760
will not last forever.

3471
05:56:41,740 --> 05:56:44,700
And we need to remain positioned to expand

3472
05:56:44,700 --> 05:56:46,840
as soon as dollars are available.

3473
05:56:46,840 --> 05:56:54,280
So, with this in mind, I have a few clarifying questions and then we'll make a motion.

3474
05:56:55,320 --> 05:57:00,220
First, to Dr. Redmond, could you say a little bit about how public health

3475
05:57:00,220 --> 05:57:06,460
has engaged with first five thus far on the areas of partnership that are identified in the report?

3476
05:57:07,240 --> 05:57:10,560
I'm happy to, and please, that are first five partners.

3477
05:57:10,560 --> 05:57:12,760
I'm happy to share your information as well.

3478
05:57:13,340 --> 05:57:15,440
Yeah, she'll probably poke me later if I forget anything.

3479
05:57:15,440 --> 05:57:19,420
because let me just make clear, Jennifer, if you want to add you are absolutely welcome.

3480
05:57:19,800 --> 05:57:20,060
Go ahead.

3481
05:57:20,320 --> 05:57:24,160
I will say part of the reason I joke about that is that we do work so closely with first

3482
05:57:24,160 --> 05:57:26,680
drive as do our partners in SSA.

3483
05:57:27,060 --> 05:57:32,680
I think I'll start by thanking first five for their leadership for the fact of this report,

3484
05:57:33,260 --> 05:57:37,120
which has been so helpful in highlighting exactly as you described the deep importance of

3485
05:57:37,120 --> 05:57:38,020
home visitation.

3486
05:57:38,720 --> 05:57:43,200
And I think one of the things we've grappled with in bringing this item back has been how

3487
05:57:43,200 --> 05:57:48,720
visitation in and of itself is often carried out through a series of different types of programs,

3488
05:57:49,100 --> 05:57:54,180
some of which by nurses, some by community health workers, some by mental health experts,

3489
05:57:54,560 --> 05:57:59,120
their child development experts, all of whom bring slightly different lenses and ways to make sure

3490
05:57:59,120 --> 05:58:04,200
we're reaching people with the services they need. And so in terms of public health collaboration with

3491
05:58:04,200 --> 05:58:11,440
first five, I know that they take a leadership role and our network, in fact, you know, I'm going

3492
05:58:11,440 --> 05:58:13,540
let the experts speak, let me stop.

3493
05:58:14,120 --> 05:58:16,340
So both Heidi also knowing where she comes from,

3494
05:58:16,400 --> 05:58:18,180
but Jennifer, please take it away.

3495
05:58:18,440 --> 05:58:20,340
Is it because that really, thank you.

3496
05:58:20,340 --> 05:58:21,320
Thank you, Supervisor.

3497
05:58:22,280 --> 05:58:25,980
So first five collaborates regularly with public health

3498
05:58:25,980 --> 05:58:28,020
on both the Home Visiting Collaborative

3499
05:58:28,020 --> 05:58:29,700
as they are active participants.

3500
05:58:30,200 --> 05:58:34,080
And also on implementing our CalWorks Home Visiting Program,

3501
05:58:34,680 --> 05:58:37,520
those dollars fund both public health,

3502
05:58:37,520 --> 05:58:45,300
nurse operated home visiting programs as well as it is a personal funding source for the

3503
05:58:45,300 --> 05:58:51,180
parent child plus program. First five actually utilizes four funding sources, which, by the

3504
05:58:51,180 --> 05:58:56,500
way, is typical for almost every home visiting program that we stand up in this county and also

3505
05:58:56,500 --> 05:59:05,120
statewide because none of the funding sources often can cover the cost as a whole. But so we do

3506
05:59:05,120 --> 05:59:13,200
operate together on implementation, I think where we have not yet really collaborated and was going

3507
05:59:13,200 --> 05:59:19,040
to be one of my requests that I did not get to in my one minute is, you know, meeting together

3508
05:59:19,040 --> 05:59:23,100
with the managed care plans to really talk through the barriers.

3509
05:59:23,340 --> 05:59:24,820
There's literally my next question.

3510
05:59:25,080 --> 05:59:25,760
Oh, there you go.

3511
05:59:26,820 --> 05:59:29,520
I think they have met with the managed care plans.

3512
05:59:29,940 --> 05:59:31,520
We have met with the managed care plans.

3513
05:59:31,520 --> 05:59:33,360
We have met with public health.

3514
05:59:33,760 --> 05:59:44,760
We haven't closed the circle, and I think we don't have a complete picture of exactly what the barriers are and what the opportunities are to address them.

3515
05:59:45,120 --> 05:59:59,960
For example, we can leverage the medical implementation resources from the first five network where they are implementing pieces of that and then public health certainly has a lot more expertise in terms of some of the state.

3516
06:00:00,000 --> 06:00:04,560
Local government meeting, level sources, as well as how caloric funding is going to be implemented.

3517
06:00:05,060 --> 06:00:15,100
Because to be candid, I think if that money is cut at all, it is likely going to need to sustain public health positions, and will no longer fund a parent child plus.

3518
06:00:15,100 --> 06:00:19,260
And that was a consideration that we almost had happened this last year.

3519
06:00:20,320 --> 06:00:25,300
Thank you. Is there anything you want to add, Sarah, about the managed care plan involvement?

3520
06:00:25,760 --> 06:00:31,680
No, I mean, I think exactly, as Jennifer was saying, we need to close that loop, but there

3521
06:00:31,680 --> 06:00:33,700
have been some productive conversations happening.

3522
06:00:33,900 --> 06:00:39,940
I think exactly to your point of, we have not given up on Calame, but there are major barriers

3523
06:00:39,940 --> 06:00:44,960
to overcome and making sure that it actually fills the gap we need, and who should the board

3524
06:00:44,960 --> 06:00:45,400
be interested?

3525
06:00:45,580 --> 06:00:50,020
We can talk about some other work that public health does to help get us to that point.

3526
06:00:52,260 --> 06:01:17,700
I have been meeting with the managed health care plans as well, and I do think as outlined in the report, there may be some opportunities to support our CBOs directly to work with the managed health plans to access some of the dollars for the ECM and the enhanced care management and community supports, but we may not be able to be in the middle of that.

3527
06:01:17,700 --> 06:01:21,200
We have to connect the dots outside of the county.

3528
06:01:21,880 --> 06:01:22,280
Thank you.

3529
06:01:22,460 --> 06:01:26,040
The goal should always be get the care where it's needed.

3530
06:01:26,200 --> 06:01:28,760
And I'm agnostic, whether we're delivering it

3531
06:01:28,760 --> 06:01:32,120
or first five or a CBL.

3532
06:01:33,180 --> 06:01:37,480
I heard you, Jen, reference the four different funding streams.

3533
06:01:38,660 --> 06:01:41,900
Thankfully, I know you have a brilliant finance director

3534
06:01:41,900 --> 06:01:47,200
in Maureen, but thinking about the state funding

3535
06:01:47,200 --> 06:01:56,520
streams, any federal that's left, I'll turn back to Dr. Redman, what kind of creative

3536
06:01:56,520 --> 06:02:04,680
strategies are you thinking about so that public health can help sustain these home-visiting

3537
06:02:04,680 --> 06:02:13,700
programs given the budget situation post HR1 and realizing that the general fund dollars are

3538
06:02:13,700 --> 06:02:15,420
not going to play a significant role.

3539
06:02:15,420 --> 06:02:21,580
Well, I will say, so some of that work does predate even this particular referral in which

3540
06:02:21,580 --> 06:02:27,680
public health is still able to draw down Title 19 dollars for a huge number of our programs

3541
06:02:27,680 --> 06:02:34,480
that serve families and homes, especially new parents and infants. And so we have maximize

3542
06:02:34,480 --> 06:02:40,760
making sure that we are qualifying for every dollar we possibly can, some of which including

3543
06:02:40,760 --> 06:02:46,680
even in the supportive services that train the same nurses or support workers who facilitate

3544
06:02:46,680 --> 06:02:52,040
those programs so that every federal dollar that we are possibly eligible for is coming into the county.

3545
06:02:53,020 --> 06:03:00,020
I think we've certainly been on the lookout for creative brand new funding sources, but not been finding a lot coming in that realm.

3546
06:03:00,620 --> 06:03:09,720
And so I do think that the tricky piece around CalAIM, which I think where there may be much more satisfying information coming to the board,

3547
06:03:09,720 --> 06:03:16,160
will be when we bring back our community health worker information that is coming both as a referral

3548
06:03:16,160 --> 06:03:20,800
from the Latino Health Assessment on what would it look like if we had a truly comprehensive

3549
06:03:20,800 --> 06:03:27,260
community health worker system and network that covered our in particular Latino community

3550
06:03:27,260 --> 06:03:34,880
members but because we had a similar program serving our Asian Pacific Islanders that we lost or the

3551
06:03:34,880 --> 06:03:41,040
funding sunset for. We know that the findings of that Latino Health Assessment study will also help us

3552
06:03:41,040 --> 06:03:46,800
solve problems to sustain that work for other communities, other SNPs. What we are finding

3553
06:03:47,460 --> 06:03:53,320
is there are problems everything from what the actual Calam reimbursement is, what qualifies for it,

3554
06:03:53,420 --> 06:04:04,760
and who qualifies for it, including the certification of community health workers in order to

3555
06:04:04,760 --> 06:04:09,640
grassroots on the ground home visitation services, especially with community members, often

3556
06:04:09,640 --> 06:04:15,000
don't have the back office ability to do things like become medic health billers. And so we're

3557
06:04:15,000 --> 06:04:20,560
seeing whether it is specific to programs that do home visitation or not in that community health

3558
06:04:20,560 --> 06:04:25,960
worker work, helping organizations that are nearly ready to build, CalAIM, bill medical to do so,

3559
06:04:26,580 --> 06:04:31,160
helping folks who are not yet certified as community health workers to get certified and helping

3560
06:04:31,160 --> 06:04:36,640
organizations often with support of other CBOs to have the ability to become

3561
06:04:36,640 --> 06:04:40,160
medical billing eligible. So I think that is sort of the next big promising

3562
06:04:40,160 --> 06:04:45,600
funding source. The problem is it still may not be enough and it's not a switch

3563
06:04:45,600 --> 06:04:48,640
we can turn on overnight. It's something we're taking continuous steps toward.

3564
06:04:49,540 --> 06:04:52,500
Absolutely. Thank you. None of this will be enough.

3565
06:04:53,260 --> 06:04:58,080
And speaking of funds, sun setting, Wendy, maybe I'll look to you for this. The

3566
06:04:58,080 --> 06:05:15,580
family first prevention services act funding is I think expiring or sunsetting at the end of this year is that correct and and if so can you share more about what you're envisioning in the coming years around this in similar programs.

3567
06:05:15,580 --> 06:05:29,620
Absolutely. So there is part of that funding is Sun setting in June of 2026. However, there is other funding that has a longer expiration spent expanded until June of 2028.

3568
06:05:30,680 --> 06:05:42,540
Department of Family and Children Services in collaboration with Public Health and our partnership with first five is actually funding the parent child plus as part of one of our strategies around the family's first work as a promising practice.

3569
06:05:42,540 --> 06:05:50,500
We are using state block allocated grant dollars that is that allocation that doesn't expire until 2028.

3570
06:05:50,880 --> 06:05:59,000
It is meant as a bridge gap for counties to take a look at promising practices that could possibly go to the clearing house as evidence-based practice

3571
06:05:59,000 --> 06:06:03,460
so that then it would make us eligible to pull down federal funding in the future.

3572
06:06:04,100 --> 06:06:08,520
So we are just like Sarah had talked to Redmond and talked about items and sort of preparation.

3573
06:06:08,520 --> 06:06:14,720
This is our preparation work to prepare us for possibly other revenues later to get at federal

3574
06:06:14,720 --> 06:06:18,920
prevention dollars, so it's an investment for us in the parent child plus.

3575
06:06:19,780 --> 06:06:20,800
Thank you so much.

3576
06:06:21,000 --> 06:06:28,520
That's really just exactly what I had hoped to hear that we're going to keep the infrastructure

3577
06:06:28,520 --> 06:06:29,500
moving forward.

3578
06:06:29,660 --> 06:06:31,880
We're going to remain ready.

3579
06:06:32,420 --> 06:06:36,920
We're sort of the understudies that can go on at any second where you're not leaving.

3580
06:06:37,340 --> 06:06:38,420
I don't know where I'm going with that.

3581
06:06:38,420 --> 06:06:39,700
not leaving the theater.

3582
06:06:40,200 --> 06:06:41,680
Let me move to a motion.

3583
06:06:42,360 --> 06:06:46,720
My motion is to receive the report and direct administration

3584
06:06:47,220 --> 06:06:50,680
to return to this board in six months

3585
06:06:50,680 --> 06:06:55,860
with an update on the partnership between county and first five

3586
06:06:55,860 --> 06:06:58,520
regarding efforts to expand home visiting,

3587
06:06:59,120 --> 06:07:01,600
including convening a meeting with first five

3588
06:07:01,600 --> 06:07:03,800
and managed care plan partners.

3589
06:07:04,460 --> 06:07:06,460
The update should include the feasibility

3590
06:07:06,460 --> 06:07:14,160
and meaningful progress of any and all of the four areas of partnership identified in the report.

3591
06:07:14,940 --> 06:07:20,820
In addition, the Motion Direct Administration to return no later to the board,

3592
06:07:21,160 --> 06:07:25,320
no later than the second meeting in January of 2027,

3593
06:07:26,200 --> 06:07:32,760
with formal strategies or a work plan to provide support and assistance to community-based organizations,

3594
06:07:32,760 --> 06:07:40,260
looking to bill either the CHW or Collean benefits for home visiting. I chose this date

3595
06:07:40,260 --> 06:07:48,260
because by January 2027 the state will have entered its next 1115 medical

3596
06:07:48,260 --> 06:07:52,940
weaver cycle and let I think we'll have a better knowledge of the long-term

3597
06:07:52,940 --> 06:07:57,920
sustainable strategies that community-based organizations can use to fund home

3598
06:07:57,920 --> 06:08:03,860
visiting programs and if all of that is clear to you, I will look for a second.

3599
06:08:04,520 --> 06:08:09,720
Happy to second the very comprehensive motion and I believe all my questions I was going

3600
06:08:09,720 --> 06:08:14,040
to ask has been already discussed so thank you so much to everyone for your leadership on

3601
06:08:14,040 --> 06:08:14,600
this.

3602
06:08:14,900 --> 06:08:21,820
Thank you staff to our partners and talk community members here today for making sure that we understand

3603
06:08:21,820 --> 06:08:25,680
the benefits of this program, the gains of it with clarity and what it means to our families

3604
06:08:25,680 --> 06:08:26,760
rely on it.

3605
06:08:26,760 --> 06:08:28,300
So thank you so much. Happy second.

3606
06:08:28,840 --> 06:08:29,780
Thank you for the support.

3607
06:08:30,180 --> 06:08:32,900
We take care of babies, literally, everything is better.

3608
06:08:34,580 --> 06:08:35,400
Thank you very much.

3609
06:08:35,580 --> 06:08:37,680
There's only one to support this strongly.

3610
06:08:37,760 --> 06:08:39,940
And thank you so much for the speaker that came out

3611
06:08:39,940 --> 06:08:41,980
to talk about how important this program is.

3612
06:08:42,320 --> 06:08:44,960
I'd have a question of a timeline here,

3613
06:08:45,460 --> 06:08:46,880
which is when do you think this,

3614
06:08:46,880 --> 06:08:49,840
you might come back to the board with the strategies

3615
06:08:49,840 --> 06:08:51,520
to partner with first five,

3616
06:08:51,660 --> 06:08:53,920
to the Clara Family Health Plan and all the agencies,

3617
06:08:53,920 --> 06:08:56,460
I think

3618
06:08:58,830 --> 06:09:03,510
if it was the direction to come back in six months, I think the public health side

3619
06:09:03,510 --> 06:09:05,470
can meet that.

3620
06:09:05,470 --> 06:09:05,650
Okay, good.

3621
06:09:06,070 --> 06:09:07,410
Thank you.

3622
06:09:07,410 --> 06:09:08,490
Thank you.

3623
06:09:08,490 --> 06:09:08,690
Perfect.

3624
06:09:09,210 --> 06:09:09,670
Thank you.

3625
06:09:09,870 --> 06:09:10,650
And that's all I have.

3626
06:09:11,090 --> 06:09:11,770
And no further comments.

3627
06:09:12,110 --> 06:09:12,790
Please take a look.

3628
06:09:13,530 --> 06:09:16,870
We have a motion by Supervisor Elinberg and a second by Supervisor Jung.

3629
06:09:17,530 --> 06:09:18,490
Supervisor Abacoga?

3630
06:09:18,570 --> 06:09:18,830
I.

3631
06:09:19,230 --> 06:09:19,770
Supervisor Jung?

3632
06:09:20,170 --> 06:09:20,250
Yes.

3633
06:09:20,610 --> 06:09:21,490
Supervisor Elinberg?

3634
06:09:22,050 --> 06:09:22,230
Yes.

3635
06:09:22,350 --> 06:09:23,050
And presently?

3636
06:09:23,290 --> 06:09:23,790
I as well.

3637
06:09:23,790 --> 06:09:26,590
Motion carries for us now. Thank you so much.

3638
06:09:31,070 --> 06:09:33,910
All right moving to item 15 which is

3639
06:09:33,910 --> 06:09:38,830
recommendations from the Office for the Housing and the Behavior Health Services Department

3640
06:09:38,830 --> 06:09:44,110
on the efforts to strengthen the county's partnership with cities and homelessness.

3641
06:09:47,270 --> 06:09:47,630
And I see

3642
06:09:47,630 --> 06:09:54,570
we have a director of Ash, KJ Cumminski and also from our Behavior Health Service Department

3643
06:09:55,970 --> 06:09:59,210
Dr. Sherry Terrell. Good afternoon.

3644
06:09:59,910 --> 06:10:01,470
Good afternoon, President Lee.

3645
06:10:01,910 --> 06:10:04,130
Members of the Board, KJ Kaminski.

3646
06:10:04,950 --> 06:10:06,990
Director of the Office of Support of Housing.

3647
06:10:07,670 --> 06:10:11,050
Join by Sherry Terrell, Director of Behavioral Services Department.

3648
06:10:11,570 --> 06:10:14,810
I'm going to provide a brief verbal report and share some highlights

3649
06:10:14,810 --> 06:10:18,530
of the work that we included in the report today

3650
06:10:18,530 --> 06:10:20,710
and will also be available for questions.

3651
06:10:20,710 --> 06:10:26,910
This report response to two referrals approved by the Board in September and October that include

3652
06:10:26,910 --> 06:10:31,990
eight areas of work and it's related to the coordination of services with the City

3653
06:10:31,990 --> 06:10:34,710
San Jose as well as other cities across our county.

3654
06:10:35,490 --> 06:10:42,310
In the report we numbered the items one through eight we provided an update on the status

3655
06:10:42,310 --> 06:10:47,150
of each of those referrals as well as the departments that are responsible for working

3656
06:10:47,150 --> 06:10:52,510
on those efforts and there is a narrative report on each of them.

3657
06:10:53,170 --> 06:10:59,850
Just wanted to start with a very brief background on the county's role as it relates to

3658
06:10:59,850 --> 06:11:01,190
our supportive housing system.

3659
06:11:01,630 --> 06:11:06,990
As the continuum of care lead agency OSH plays a coordinating role for our supportive

3660
06:11:06,990 --> 06:11:12,390
housing system county wide, that includes sort of tracking the capacity and outcomes

3661
06:11:12,390 --> 06:11:19,090
of our housing programs overseeing our shelter hotline, developing and updating our quality assurance

3662
06:11:19,090 --> 06:11:21,150
standards for how programs are operated.

3663
06:11:21,890 --> 06:11:27,610
But the county is also the largest funder of services for unhoused folks in our community

3664
06:11:27,610 --> 06:11:35,610
with investments of nearly 450 million across the departments, the behavioral health services

3665
06:11:35,610 --> 06:11:39,690
department, OSH and the Valley Homeless Health Care Program.

3666
06:11:40,730 --> 06:11:45,010
Additionally, the county has made significant investments in shelter in temporary housing.

3667
06:11:45,230 --> 06:11:52,850
We currently support over 2,000 beds across 20 sites, countywide, and that represents $45 million

3668
06:11:52,850 --> 06:11:54,550
in funding for those services.

3669
06:11:55,490 --> 06:12:00,550
Many of these investments have been ongoing for more than a decade, but the county has worked

3670
06:12:00,550 --> 06:12:05,650
hard to expand our temporary housing option since 2020, which is aligned with our community

3671
06:12:05,650 --> 06:12:10,290
plan to end homelessness goal to double temporary housing capacity.

3672
06:12:11,410 --> 06:12:18,430
We have added 899 temporary housing bed since we set that goal in 2020.

3673
06:12:19,850 --> 06:12:24,810
I mentioned these two roles as a coordinator but also a funder because some of the work

3674
06:12:24,810 --> 06:12:33,350
reported on in this in the report are related to either the county as an operator but some

3675
06:12:33,350 --> 06:12:41,410
the county as a coordinator. In addition to shelter operations funded through OSH, our

3676
06:12:41,410 --> 06:12:45,370
valley homeless health care program partners and behavioral health services department

3677
06:12:45,370 --> 06:12:50,510
have been working closely with OSH and our partners across our support of housing

3678
06:12:50,510 --> 06:12:54,930
system to provide services to shelter residents, to permanent support of housing

3679
06:12:54,930 --> 06:13:01,890
residents across the county for many years. As you see in this report we're currently

3680
06:13:01,890 --> 06:13:07,890
building on this partnership, and I'm going to share just a couple of highlights. First,

3681
06:13:07,950 --> 06:13:13,990
related to item number one, this is to expand direct medical and behavioral health services

3682
06:13:13,990 --> 06:13:17,510
to city funded shelters in the city of San Jose.

3683
06:13:19,830 --> 06:13:22,970
Behavior health and OSH and BHHP have been

3684
06:13:22,970 --> 06:13:28,950
working on expanding services to city funded shelters and building on work that exists in other

3685
06:13:28,950 --> 06:13:30,730
shelters across the county.

3686
06:13:31,690 --> 06:13:34,810
We've been providing the county has been providing these services

3687
06:13:35,790 --> 06:13:40,130
to shelters such as the Sunnyvale family shelter,

3688
06:13:40,930 --> 06:13:45,210
the shelters in Mountain View, the Mountain View Home Keys site,

3689
06:13:45,850 --> 06:13:48,810
other shelters in San Jose, like the Ricardo Reception

3690
06:13:48,810 --> 06:13:51,950
Center, JSI, MSI, and in South County

3691
06:13:51,950 --> 06:13:53,110
at the Gilroy Armory.

3692
06:13:54,190 --> 06:13:57,990
So the work to expand to the city's emergency

3693
06:13:57,990 --> 06:14:03,470
interim housing site is building on those established practices across shelters throughout

3694
06:14:03,470 --> 06:14:11,950
the county. As with our work at county funded shelters, the goal is to connect shelter residents

3695
06:14:11,950 --> 06:14:18,890
to medical care, whether provided on site or at another location. The first phase of this work

3696
06:14:18,890 --> 06:14:24,830
is piloting this partnership at the Bernal emergency interim housing site as well as the Ru for

3697
06:14:26,910 --> 06:14:38,150
The BHHP mobile medical services are visiting the sites to provide onsite services as well as connecting shelter residents to medical and behavioral health services.

3698
06:14:39,130 --> 06:14:49,950
Offsite and behavioral health services department is deploying community health workers to those shelter sites to connect residents to mental health and substance use treatment services.

3699
06:14:49,950 --> 06:14:59,350
but also training staff to help shelter residents engage in their benefits and health care while they're staying at the shelter.

3700
06:15:00,110 --> 06:15:08,530
In this work we'll be tracking the number of residents that are connected to services through these efforts and the report includes some results today.

3701
06:15:10,110 --> 06:15:14,910
The other item I want to highlight is our work related to item number 7.

3702
06:15:16,150 --> 06:15:23,090
This is our ongoing work with all cities across the county to preserve and expand temporary housing opportunities.

3703
06:15:23,090 --> 06:15:28,950
The approved referral was to consider options for expanding temporary housing capacity,

3704
06:15:29,110 --> 06:15:32,090
beginning with the top three homelessness impacted cities.

3705
06:15:32,590 --> 06:15:37,870
The cities with the highest number of unhoused people are San Jose Gilroy and Mountain View.

3706
06:15:43,150 --> 06:15:48,070
And as it relates to our work with the city of Gilroy,

3707
06:15:48,470 --> 06:15:52,410
we are currently working to sustain operations at the Gilroy Armory,

3708
06:15:52,950 --> 06:15:55,770
which we understand the city intends to sell.

3709
06:15:55,770 --> 06:16:04,930
We are also working with the City of Mountain View to sustain our safe parking programs and the Mountain View Home Keysight.

3710
06:16:06,410 --> 06:16:13,950
We are, we've met with those cities, both county administration and the OSH team has met with both of those cities,

3711
06:16:13,950 --> 06:16:22,870
but we also are meeting with cities across the county as part of our planning for the updated community plan to end homelessness.

3712
06:16:23,610 --> 06:16:31,090
And I want to note that we do that work, whether it was the Mount View site, our work with the

3713
06:16:31,090 --> 06:16:36,450
Palo Alto Home Key site, some of the expansions that have happened over the last several

3714
06:16:36,450 --> 06:16:42,790
years have been in close partnership with City staff. And with the update to the community plan,

3715
06:16:42,950 --> 06:16:50,330
we are working with the cities to identify regional priorities, regional goals, that will be

3716
06:16:50,330 --> 06:16:58,210
presented as regional plans that are aligned with the community-wide goals that are identified

3717
06:16:58,210 --> 06:17:05,330
through our process. So we're seeking to build upon the successes that we have seen,

3718
06:17:06,330 --> 06:17:12,850
and also are looking always looking for additional funding opportunities, but those are,

3719
06:17:12,970 --> 06:17:17,810
that's the primary challenge that we face right now in terms of expansion and really focused

3720
06:17:17,810 --> 06:17:23,170
on sustaining our investments as across the committee.

3721
06:17:23,630 --> 06:17:24,950
With that, we're happy to answer questions.

3722
06:17:28,760 --> 06:17:30,980
Oh, sorry. Any questions we have here?

3723
06:17:31,340 --> 06:17:33,680
Well, I don't see a bit. How will this do to public first?

3724
06:17:35,240 --> 06:17:38,920
Just a moment. And confirming no requests to speak.

3725
06:17:39,660 --> 06:17:42,240
Okay, close the public speaking portion. Yes.

3726
06:17:42,280 --> 06:17:42,840
So Vice-Young.

3727
06:17:43,260 --> 06:17:44,100
Thank you.

3728
06:17:44,540 --> 06:17:46,000
K.J. Sherry. Thank you so much.

3729
06:17:46,000 --> 06:17:50,120
I'm so pleased to see that progress is being made on addressing

3730
06:17:50,120 --> 06:17:54,500
homelessness but the City of San Jose and through this partnership as a city with the largest

3731
06:17:54,500 --> 06:17:58,740
unhoused population in the county. We clearly have a need to see this done quickly and done

3732
06:17:58,740 --> 06:18:03,700
right. I do have some questions as it relates to the areas of work that you've outlined. Mainly

3733
06:18:03,700 --> 06:18:10,080
timing issues and some of the where the shared responsibilities are. I really, as some of this

3734
06:18:10,080 --> 06:18:20,100
work just got underway and the initial reporting from the medical mobile van and BHP at the

3735
06:18:20,100 --> 06:18:24,880
that. And I was also equally happy to read that behavior health is working on a training plan

3736
06:18:24,880 --> 06:18:29,700
for case managers as city owned size. I think this level of cross training is going to do

3737
06:18:29,700 --> 06:18:36,940
as a great deal of good and serving our clients and our most vulnerable. Are the dedicated liaison

3738
06:18:36,940 --> 06:18:41,360
noted in the Lechva existing staff who are having this added to their portfolio of work are

3739
06:18:41,360 --> 06:18:42,380
these new rules?

3740
06:18:47,920 --> 06:18:51,200
Sorry, this related the behavioral health dedicated liaison.

3741
06:18:53,610 --> 06:18:53,810
Yeah.

3742
06:18:53,810 --> 06:19:04,750
Thank you for the questions supervisor, they are existing community health workers that are working with one of our contract provider agencies, and so we've deployed them to support this work.

3743
06:19:05,110 --> 06:19:08,530
Were there any budgetary or staff impacts or staffing changes?

3744
06:19:09,190 --> 06:19:11,770
The need to facilitate this.

3745
06:19:12,150 --> 06:19:16,690
Not at this time, we've been able to utilize our existing resources to help support this initiative.

3746
06:19:16,910 --> 06:19:18,670
I appreciate that, music to my ears.

3747
06:19:18,670 --> 06:19:26,110
Yeah, I had no doubt but thank you for confirming and then recognizing the lift to integrate our systems so that there is one hotline

3748
06:19:26,110 --> 06:19:27,810
I understand that will take some time

3749
06:19:28,470 --> 06:19:38,290
It's also going to take some outreach as well. So is there a parallel path being considered for shared outreach with the city of San Jose to make sure that all of our

3750
06:19:38,290 --> 06:19:42,370
Our our residents and clients in need of our services know that there's only one hotline to call in the future

3751
06:19:42,870 --> 06:19:44,790
Yes, that would be part of the plan

3752
06:19:44,790 --> 06:19:53,730
And as when we are ready to make that transition, we OSH has a outreach, plays an outreach

3753
06:19:53,730 --> 06:19:58,190
coordination role brings together all outreach providers across the county, both city

3754
06:19:58,190 --> 06:20:04,070
funded, county funded advocates, non-profit advocates and community-based organizations.

3755
06:20:04,850 --> 06:20:11,410
And we will be utilizing that infrastructure in our coordination role to make sure that the messaging

3756
06:20:11,410 --> 06:20:18,250
is clear to our residents, the whole intent here is to make access easier and to reduce the

3757
06:20:18,250 --> 06:20:23,630
number of places that people have to call or show up to get a referral to shelter so we'll

3758
06:20:23,630 --> 06:20:30,610
be doing some, be doing a lot of outreach to make sure that message gets to the people who are

3759
06:20:30,610 --> 06:20:35,350
experiencing homelessness. Yeah, thank you, KJ. And I know that the, the, a lot of the works,

3760
06:20:35,530 --> 06:20:40,770
the benchmarks are in progress right now because this is a recent undertaking. So thank you so much

3761
06:20:40,770 --> 06:20:43,630
for preparing this so quickly and being able to come back

3762
06:20:43,630 --> 06:20:45,810
to the board with the very timely update.

3763
06:20:47,370 --> 06:20:49,950
I have some more questions about the other parts of the referral,

3764
06:20:50,090 --> 06:20:53,810
but one of the requests I'll be making along with my motion today

3765
06:20:53,810 --> 06:20:59,250
is that you, the KJU and your team and Sherry,

3766
06:20:59,350 --> 06:21:02,010
your respective team members or yourself.

3767
06:21:02,550 --> 06:21:05,270
If we could have a report back on the status of the progress

3768
06:21:05,270 --> 06:21:06,990
before the end of the fiscal year,

3769
06:21:07,230 --> 06:21:09,870
and also one more time before the end of the calendar year.

3770
06:21:12,720 --> 06:21:20,880
And then I'm going to move on to some questions about the 19 million dollars delegation of

3771
06:21:20,880 --> 06:21:23,480
authority that's being recommended, that's one of the recommended actions.

3772
06:21:24,260 --> 06:21:28,500
How do we intend to use it if we come to an agreement on this approach with the city?

3773
06:21:28,600 --> 06:21:30,200
Do we have plans for it yet?

3774
06:21:32,490 --> 06:21:34,010
I know it's homelessness prevention.

3775
06:21:34,910 --> 06:21:36,850
Any specifics you could provide on that?

3776
06:21:37,250 --> 06:21:43,250
Yes, the funding would be used 100% to augment the county's existing homelessness prevention program,

3777
06:21:43,250 --> 06:21:49,410
which can very much use the additional funds this program as the board is aware was

3778
06:21:49,410 --> 06:21:57,270
the subject of a rigorous controlled study and has shown incredible efficacy in preventing

3779
06:21:57,270 --> 06:22:02,930
and avoiding homelessness and so the intention would be the 19 million would be an additional

3780
06:22:02,930 --> 06:22:05,350
augmentation to that program.

3781
06:22:05,350 --> 06:22:06,510
Thank you, James.

3782
06:22:07,530 --> 06:22:15,910
I just appreciate that this work that we're doing today is something that our staff, our

3783
06:22:15,910 --> 06:22:20,770
line staff, have been wanting to see and making recommendations for a number of years.

3784
06:22:21,550 --> 06:22:26,810
So I know that as makers of referrals and motions, we sometimes get credit as elected

3785
06:22:26,810 --> 06:22:27,370
for this.

3786
06:22:27,450 --> 06:22:33,070
I really want to make sure for the record that this latest phase of partnership and collaboration

3787
06:22:33,070 --> 06:22:34,850
really came from our staff.

3788
06:22:34,850 --> 06:22:40,350
Both on the county side and the city side seeing where the gaps were in our integration so I'll give that shout out

3789
06:22:41,030 --> 06:22:47,130
I'd like to make a motion to receive the report and approve the delegation of authority with the report back

3790
06:22:47,130 --> 06:22:51,730
On the status of implementation or progress of our collaboration with the city

3791
06:22:52,430 --> 06:22:55,930
Before the end of the fiscal year and one more time before the end of the calendar year

3792
06:22:58,030 --> 06:23:02,210
Happy to second the mission if I can make a few comments. Thank you

3793
06:23:02,210 --> 06:23:09,070
Thank you to Professor Young, and thank you to staff, KJ, and staff for bringing this

3794
06:23:09,070 --> 06:23:09,450
forward.

3795
06:23:10,190 --> 06:23:16,410
I'm just very, obviously, supportive, I think, that this growing sense of cooperation

3796
06:23:16,410 --> 06:23:20,890
with the, in partnership with the CEO of San Jose is really important to give in

3797
06:23:20,890 --> 06:23:21,650
that San Jose.

3798
06:23:21,750 --> 06:23:32,190
It is the largest city, and it does have the largest number of unhoused according to the

3799
06:23:32,190 --> 06:23:35,550
And as administrators of the coordinated entry system

3800
06:23:35,550 --> 06:23:39,450
and provider of major, the majority of wrap around services

3801
06:23:39,450 --> 06:23:42,390
and case work management, it makes perfect sense

3802
06:23:42,390 --> 06:23:45,950
that we prioritize coordination with the city of San Jose.

3803
06:23:46,790 --> 06:23:51,590
I do, though, hadn't given that I represent nine, eight other cities

3804
06:23:51,590 --> 06:23:55,850
in my district really appreciate that the county

3805
06:23:55,850 --> 06:23:57,790
is working with all of our cities.

3806
06:23:58,190 --> 06:24:01,190
And when I've discovered in my conversations

3807
06:24:01,190 --> 06:24:07,970
and on this issue, working on this issue for a number of years is that in more and more

3808
06:24:07,970 --> 06:24:14,850
I am seeing is that each city has their special circumstances and so we really need to look

3809
06:24:14,850 --> 06:24:20,950
at each city, city by city, and come up with solutions that are tailored to those respective

3810
06:24:20,950 --> 06:24:21,690
issues.

3811
06:24:22,030 --> 06:24:27,470
For instance, in Mountain View, we have a high vehicle-dwelling population, and part of that

3812
06:24:27,470 --> 06:24:32,270
due to a lawsuit settlement that required the city to produce a map of where the

3813
06:24:32,270 --> 06:24:37,110
vehicle dwellers can park. South County City's, we talked about it at our last

3814
06:24:37,110 --> 06:24:42,410
humid, humid meeting, meeting has a high agricultural worker population. I

3815
06:24:42,410 --> 06:24:49,470
didn't appreciate staff bringing that up to. And then what I just recently had a

3816
06:24:49,470 --> 06:24:57,450
conversation with the service provider at one of our safe parking lot programs and

3817
06:24:57,450 --> 06:25:05,570
He had shared the challenges specifically mainly seniors are having in transitioning into

3818
06:25:05,570 --> 06:25:08,470
permanent affordable housing solutions.

3819
06:25:09,030 --> 06:25:12,990
I think part of that maybe because of their restricted incomes.

3820
06:25:14,510 --> 06:25:23,750
So I'm hoping that we can look at that more carefully as we work on this upcoming plan

3821
06:25:23,750 --> 06:25:25,450
to end homelessness cycle.

3822
06:25:25,450 --> 06:25:33,910
So, as a regional issue, I'm glad that we're trying to work closely together rather than

3823
06:25:33,910 --> 06:25:41,390
pointing figures or leaning, laying, laying, laying at any when jurisdiction, and I appreciate

3824
06:25:41,390 --> 06:25:46,650
that we're looking again at all solutions, safe parking, emergency, interim housing, as well

3825
06:25:46,650 --> 06:25:52,910
as permanent supportive housing, and looking at where the people are and who they are, and I

3826
06:25:52,910 --> 06:25:57,410
that I'll give a, I don't have significant impact.

3827
06:25:58,190 --> 06:26:02,730
So, and then, of course, for the health care providers, I appreciate the work that you're doing

3828
06:26:02,730 --> 06:26:07,590
at coordinate with our shelters in support of housing programs.

3829
06:26:08,410 --> 06:26:11,570
So, with that, thank you and happy to second-the-motion.

3830
06:26:12,970 --> 06:26:13,530
Thank you.

3831
06:26:17,010 --> 06:26:25,130
I am frankly very surprised to see how big this issue is, and to have no public comment.

3832
06:26:25,150 --> 06:26:31,910
being given today on this very specific issue. Given how many people have been talking about

3833
06:26:33,150 --> 06:26:39,690
on shelter homelessness or on the different cities and counties because this is exactly the

3834
06:26:39,690 --> 06:26:45,090
good news we want to tell the world that the counties and cities are absolutely working together

3835
06:26:45,090 --> 06:26:51,630
to solve these issues. I guess sometimes as the bad news is when they get to get out there,

3836
06:26:51,630 --> 06:26:55,530
Good news in how this doesn't get published, so I just want to make sure that people understand

3837
06:26:55,530 --> 06:27:00,770
how hard different jurisdictions are working together to get to where we are of these proposals

3838
06:27:00,770 --> 06:27:04,850
and we're looking for even better outcome as we move forward.

3839
06:27:06,090 --> 06:27:12,010
The term homelessness has been so misunderstood or been abused by certain individuals politically

3840
06:27:12,010 --> 06:27:17,670
otherwise to put certain image what homelessness means and as we know this is a far more

3841
06:27:17,670 --> 06:27:19,630
complicated and complex issues.

3842
06:27:20,450 --> 06:27:22,970
As my colleague has stated, and like the supervisor,

3843
06:27:23,450 --> 06:27:24,970
I'd be curious that, you know, different cities,

3844
06:27:25,130 --> 06:27:27,370
different locations, a different type of homeless,

3845
06:27:28,610 --> 06:27:30,730
less issue, right, what it is vehicles.

3846
06:27:31,270 --> 06:27:33,930
And even some of those vehicles, like the RVs, for example,

3847
06:27:34,410 --> 06:27:35,530
not necessarily, they don't have home.

3848
06:27:35,630 --> 06:27:36,510
They might have home some way off.

3849
06:27:36,630 --> 06:27:39,150
They just don't want to have to rent another place,

3850
06:27:39,350 --> 06:27:41,150
which is very expensive while they're working here,

3851
06:27:41,270 --> 06:27:42,270
and they go home for the weekend.

3852
06:27:42,410 --> 06:27:43,390
Things like that, right?

3853
06:27:43,650 --> 06:27:45,110
So everybody has a very different issue.

3854
06:27:45,290 --> 06:27:47,310
And so that's why I think it's important to have

3855
06:27:47,310 --> 06:27:53,290
different solutions. I'm working to tailor these solutions on the need and I just want to really

3856
06:27:53,290 --> 06:27:59,250
give a huge thanks to our office support housing, our behavior, health services and your team for

3857
06:27:59,250 --> 06:28:06,370
coming of these solutions and how we're going to tackle them one by one and this is not an easy lift.

3858
06:28:06,790 --> 06:28:10,450
This doesn't mean you would end homelessness by doing what we're doing here but it would certainly

3859
06:28:10,450 --> 06:28:16,810
make a huge dent onto this issue and that we are coordinating with not just one city. In this case

3860
06:28:16,810 --> 06:28:20,630
Sounds as we stayed here, but we are going to be working with all the other cities as well

3861
06:28:20,630 --> 06:28:26,090
to make sure that our service will be given to our residents that need it and making those

3862
06:28:26,090 --> 06:28:27,330
accessible to all.

3863
06:28:27,450 --> 06:28:28,210
Thank you very much.

3864
06:28:28,670 --> 06:28:30,150
And what further do you want us to take a vote?

3865
06:28:31,010 --> 06:28:35,330
We have a motion by Super-Zone and a second by Super-Rezer Abacoga, Super-Rezer Abacoga.

3866
06:28:35,950 --> 06:28:39,710
I, Super-Rezer Yung, yes, Super-Rezer Ellenberg, yes, and President Lee.

3867
06:28:39,990 --> 06:28:40,470
I as well.

3868
06:28:40,630 --> 06:28:40,810
Thank you.

3869
06:28:41,010 --> 06:28:42,010
The motion carries 4-Zone.

3870
06:28:47,930 --> 06:28:53,570
Okay, moving on to item number 16, which is report from the Office of CountExec,

3871
06:28:53,650 --> 06:28:58,450
relating to the services, is a place budget for budget and contract management system.

3872
06:28:58,970 --> 06:29:03,030
And this is actually an informational item only, and no actions needed.

3873
06:29:03,290 --> 06:29:03,890
Go ahead, James.

3874
06:29:04,750 --> 06:29:12,750
This is a report back to referral from Supervisors, Elmberg, and Abhay Koga, related to information

3875
06:29:12,750 --> 06:29:20,030
And regarding Object 2, we've laid out several categories of information that we will be providing

3876
06:29:20,030 --> 06:29:26,650
as part of this year's recommended budget process regarding Object 2 spending from the past.

3877
06:29:27,590 --> 06:29:32,550
Also included is an update on the county's budget management system and timeline related

3878
06:29:32,550 --> 06:29:38,150
to that as well as an update on the county's contract management system implementation and

3879
06:29:38,150 --> 06:29:46,470
timeline. Just to be clear, given competing resources and prioritization, administration is

3880
06:29:46,470 --> 06:29:52,030
prioritizing the implementation of the budget system ahead of the contract system, not because

3881
06:29:52,030 --> 06:29:58,210
both aren't important. They both are important, but realistically, the budget system is an essential

3882
06:29:58,210 --> 06:29:59,870
system that we have to have.

3883
06:30:00,000 --> 06:30:08,480
Up and running in place, as soon as possible. We're happy to answer questions that the Board may have.

3884
06:30:09,040 --> 06:30:11,260
Thank you. First, any public lift to speak on this item?

3885
06:30:11,700 --> 06:30:14,200
We do have one request to speak on Zoom.

3886
06:30:15,080 --> 06:30:16,300
Pardon us to two minutes.

3887
06:30:17,060 --> 06:30:17,120
Okay.

3888
06:30:18,140 --> 06:30:20,060
Parent, you will have two minutes to speak.

3889
06:30:21,640 --> 06:30:22,460
Yes, thank you.

3890
06:30:22,720 --> 06:30:29,380
I really hope that we can address in our budget this time around all the waste,

3891
06:30:29,380 --> 06:30:35,240
especially what's coming out of the just attorneys office I mentioned before about Daniel

3892
06:30:35,240 --> 06:30:42,140
Chung that he was just trying to protect my children and me and now we're paying him

3893
06:30:42,140 --> 06:30:47,180
we paid him over four years we paid him over 800,000 dollars plus we're fighting the litigation

3894
06:30:47,800 --> 06:30:54,260
over what because he wrote an op-ed and he forgot to put that he was writing in his personal capacity

3895
06:30:54,260 --> 06:30:56,910
I mean that's just crazy to me that

3896
06:30:57,870 --> 06:31:05,810
We're throwing away all of this money when he wants to come back to work and he should come back to work because he's really dedicated to protecting the community.

3897
06:31:06,950 --> 06:31:07,890
So that's the first thing.

3898
06:31:08,010 --> 06:31:22,570
And the second thing was there was an article, a few articles, a few years back, about this fraternage up rows and altering time sheets to gift public money to a bunch of his lawyers.

3899
06:31:23,330 --> 06:31:32,090
And I mean, when he was confronted about it, I saw the video, you know, he said, I ordered

3900
06:31:32,090 --> 06:31:32,750
this to happen.

3901
06:31:35,810 --> 06:31:42,030
And then he retaliated against James Sibley for blowing the whistle on the skin.

3902
06:31:42,650 --> 06:31:43,350
So we don't know.

3903
06:31:43,450 --> 06:31:44,490
He's still doing it.

3904
06:31:44,550 --> 06:31:45,170
We don't know.

3905
06:31:45,710 --> 06:31:47,610
He retaliates against whistleblowers.

3906
06:31:47,610 --> 06:31:55,870
He makes everybody scared, he even James Siddley said he has a culture of fear in that

3907
06:31:55,870 --> 06:32:02,030
office, so we don't know what he's doing, so we really need to look closely because we

3908
06:32:02,030 --> 06:32:10,690
can't have all this waste when we're having a deficit now, so thank you so much for your

3909
06:32:10,690 --> 06:32:11,210
time.

3910
06:32:12,790 --> 06:32:13,850
That concludes public comment.

3911
06:32:16,460 --> 06:32:17,080
Thank you.

3912
06:32:17,520 --> 06:32:18,140
So that's on, Burke.

3913
06:32:18,520 --> 06:32:18,780
Yes.

3914
06:32:18,780 --> 06:32:20,520
Thank you.

3915
06:32:20,520 --> 06:32:25,620
Thank you, James, for walking us through the high levels of the report.

3916
06:32:25,880 --> 06:32:33,200
And thank you to Supervisor Abba Koga for your partnership and for all of our colleagues for supporting this referral.

3917
06:32:33,960 --> 06:32:45,080
I think it is one of our primary responsibilities as fiduciaries to the county to thoroughly understand the systems, which form the backbone of our budgeting and contracting efforts.

3918
06:32:45,080 --> 06:32:55,520
I appreciate administrations willingness to implement meaningful system changes, which will support our internal decision making process and increase public transparency.

3919
06:32:56,720 --> 06:33:06,320
The actions outlined in this report are a good start, but in my view are not sufficient to accomplish the goals of the original referral,

3920
06:33:07,040 --> 06:33:14,020
which were to implement first short term improvements, which will enable greater transparency during the upcoming budget cycle.

3921
06:33:14,020 --> 06:33:21,460
And second, long-term system-based solutions which will enable more detailed budgeting and contract reporting.

3922
06:33:22,540 --> 06:33:28,440
So I'll share my understanding of how the actions in this report move us closer to those outcomes.

3923
06:33:29,580 --> 06:33:33,600
My bigger concern right now is regarding the short term improvements.

3924
06:33:34,360 --> 06:33:41,640
This report indicates that administration will provide a breakdown of FY2425 object to spending.

3925
06:33:41,640 --> 06:33:51,320
The original request, contrary to the original request, which specified providing that information in advance of the recommended budget,

3926
06:33:51,860 --> 06:33:59,140
this report proposes providing that information to the board on May 1st in conjunction with the recommended budget.

3927
06:34:00,040 --> 06:34:09,820
And while spending actual spending information from the most recent completed fiscal year provides a snapshot of what department budgets generally look like,

3928
06:34:09,820 --> 06:34:26,920
The delay in reporting this information to the board 10 months after the end of the fiscal year means that this information won't account for any of the impacts of HR1 and could have limited utility in a conversation about next year's budget, or I think even this year's budget.

3929
06:34:27,620 --> 06:34:33,520
So I still maintain that we need the actual spending figures for 2425 information sooner.

3930
06:34:33,520 --> 06:34:40,060
And we also need comparable information, even if it's only estimates, for the current fiscal year.

3931
06:34:40,780 --> 06:34:49,520
When we discuss next year's budget, I think it's also fair to expect this board to ask for the same information again, even if only approximations,

3932
06:34:50,060 --> 06:34:53,480
to contextualize the scale and impact of any reductions.

3933
06:34:54,260 --> 06:35:06,360
I have another request or thought regarding the proposed subcategories within object 2 and it's related to that fourth category of other services and supplies.

3934
06:35:06,760 --> 06:35:22,540
I'd like to see supplies as its own standalone category, but that to me still feels like a very broad patch all, especially in talking about something like the health system, which will have significant cost for materials and supplies as well as contract services.

3935
06:35:23,360 --> 06:35:28,900
I also think it would make sense to separate utility costs into a standalone category.

3936
06:35:29,900 --> 06:35:34,440
I do look forward to hearing from my partner on this referral and the rest of our colleagues.

3937
06:35:35,440 --> 06:35:40,680
So I'll end by offering a motion and then look for a second.

3938
06:35:40,960 --> 06:35:44,920
I'll move receipt of the report with the following direction to administration.

3939
06:35:44,920 --> 06:35:58,400
Number one, report to the Board of Supervisors at one of the March 2026 BOS meetings with a breakdown of Object 2 spending for fiscal 2425.

3940
06:35:59,420 --> 06:36:11,140
Second, provide an approximate or estimated breakdown of FY2526, Object 2 spending, no later than May 1st, 2026.

3941
06:36:11,140 --> 06:36:29,240
Number three, within each of those reports, please split the proposed category of other services and supplies into three separate categories for other supplies, sorry, other services, supplies and utilities.

3942
06:36:30,680 --> 06:36:32,020
And we'll look for a second.

3943
06:36:32,020 --> 06:36:35,020
Thank you.

3944
06:36:35,580 --> 06:36:37,700
Yes, I'm happy to second that motion.

3945
06:36:38,580 --> 06:36:39,340
Thank you so much.

3946
06:36:39,460 --> 06:36:42,440
Supervisor Elemberg for your leadership on this item.

3947
06:36:43,200 --> 06:36:44,940
I do have a couple of other items.

3948
06:36:45,500 --> 06:36:48,680
I would like for the consideration to add to the motion.

3949
06:36:49,380 --> 06:36:53,420
But just again, thanks to staff for your work on this.

3950
06:36:54,060 --> 06:36:56,240
I know it's not the most exciting topic,

3951
06:36:56,240 --> 06:37:15,220
But, especially given the time, I believe a stable and transparent budget is really the foundation for everything the county does for its residents, so it's critical that we look the drill down and really understand what's in the budget that we have.

3952
06:37:15,220 --> 06:37:20,620
I, you know, who said it many times, I take my few-to-share, I response very very seriously.

3953
06:37:21,100 --> 06:37:28,280
And I really do want to understand the nuances of our budget, and I also want our community to be able to understand it.

3954
06:37:29,040 --> 06:37:36,440
I have leaders in our community, including a city mayor, who has told me that they've tried to look at our budget to understand it,

3955
06:37:36,440 --> 06:37:47,260
And it's a good thing to have community leaders that engaged and willing to volunteer their time and to suggest ideas to make our budget document more user friendly.

3956
06:37:47,820 --> 06:38:02,580
I look forward to continuing this conversation and again request that the administration share budget proposals in March so that our offices can have more time to review the complexities of this budget and be better prepared for our April committee meetings.

3957
06:38:02,580 --> 06:38:11,580
I also want to request administration to create a, well, actually, I think I will hold off on the other requests.

3958
06:38:12,260 --> 06:38:25,900
So in addition to the supervisor, Ellen Bergs' motion, I wanted to request that we have a contract management system reporting demonstration to the board offices,

3959
06:38:25,900 --> 06:38:33,580
So that they can communicate desire reporting capability to administration before it comes back in August and again

3960
06:38:33,580 --> 06:38:38,460
That's we've received requests from community leaders that they're interested in it

3961
06:38:38,460 --> 06:38:40,060
So if we could get that

3962
06:38:40,060 --> 06:38:42,200
Do our offices sooner

3963
06:38:42,200 --> 06:38:45,500
We can also get some community feedback on that

3964
06:38:46,180 --> 06:38:54,900
Before sorry just before I accept that it sounds it sounds fine. I just want to check that the timing will does that

3965
06:38:55,900 --> 06:38:58,340
work to do it before August?

3966
06:38:59,220 --> 06:39:03,320
I'll look to key about whether you can

3967
06:39:03,320 --> 06:39:07,560
think you can demonstrate the contracting system

3968
06:39:07,560 --> 06:39:09,480
in the August timeframe.

3969
06:39:17,840 --> 06:39:18,100
Thank you.

3970
06:39:18,260 --> 06:39:20,500
We can certainly provide to the Board offices

3971
06:39:21,500 --> 06:39:23,520
the report templates

3972
06:39:24,420 --> 06:39:27,420
and how to utilize the dashboards,

3973
06:39:27,680 --> 06:39:29,120
which are publicly available.

3974
06:39:30,180 --> 06:39:31,300
And then through those conversations,

3975
06:39:31,300 --> 06:39:34,760
as we can, if there are additional requests

3976
06:39:34,760 --> 06:39:36,860
that we can sort of take that under advisement.

3977
06:39:37,120 --> 06:39:41,720
I might suggest, I think, the most productive approach

3978
06:39:41,720 --> 06:39:44,900
might be to have procurement staff meet individually

3979
06:39:44,900 --> 06:39:46,820
with each board office, and walk through it.

3980
06:39:47,020 --> 06:39:49,620
Instead of trying to do some demonstration here

3981
06:39:49,620 --> 06:39:52,780
and chambers, which I just think, well, take a lot of time

3982
06:39:52,780 --> 06:39:53,700
and not be as productive.

3983
06:39:54,620 --> 06:39:56,560
Yes, you did mean individually, right?

3984
06:39:56,660 --> 06:40:00,460
Yes, so we're off for the each of our offices to have that.

3985
06:40:00,460 --> 06:40:14,500
I'm glad to add that and just wanted emphasize, I think if we're aligned here that we want to make sure that we're doing it in sufficient time for changes to me made.

3986
06:40:14,720 --> 06:40:25,520
For example, there's a type of data that we're interested in seeing displayed or being pulled that wasn't in part of the initial configuration that we're not told it's to late.

3987
06:40:25,640 --> 06:40:26,800
This is all set.

3988
06:40:26,800 --> 06:40:27,660
Yes.

3989
06:40:29,080 --> 06:40:29,200
Yeah.

3990
06:40:30,100 --> 06:40:30,340
Understood.

3991
06:40:31,000 --> 06:40:31,220
Okay.

3992
06:40:31,660 --> 06:40:32,100
Thank you.

3993
06:40:33,300 --> 06:40:39,440
And the last item was, if we could receive the department budget proposals in early

3994
06:40:39,440 --> 06:40:44,600
March, so that we can be better prepared for the committee discussions that will

3995
06:40:44,600 --> 06:40:46,420
be happening in April.

3996
06:40:46,520 --> 06:40:50,120
And I know that might move up the county executive timeline.

3997
06:40:50,260 --> 06:40:50,700
Yeah.

3998
06:40:51,060 --> 06:40:54,600
That poses some really serious challenges for us.

3999
06:40:54,600 --> 06:41:00,220
So, as you can imagine, we have, there's lots of departments,

4000
06:41:03,000 --> 06:41:04,720
we receive, we're supposed

4001
06:41:04,720 --> 06:41:10,300
to receive their proposals at the beginning of February, and we spend the month of February,

4002
06:41:10,480 --> 06:41:15,580
and it consumes a huge portion of the month, meeting with departments to go through

4003
06:41:16,800 --> 06:41:21,220
those, and then they come to the committees in April.

4004
06:41:22,100 --> 06:41:27,260
We can endeavor to get those two board offices as early as possible,

4005
06:41:30,680 --> 06:41:33,340
but I do need an opportunity

4006
06:41:33,340 --> 06:41:39,100
to actually be able to review those proposals before they just show up on a public forum.

4007
06:41:40,700 --> 06:41:48,180
So we will work to get them out early, but I don't think early marches likely feasible,

4008
06:41:48,180 --> 06:41:51,900
but hear the requests to get them get them out as soon as possible.

4009
06:41:52,500 --> 06:41:57,420
Would two weeks prior to the committee meetings be reasonable?

4010
06:41:59,780 --> 06:42:01,920
Probably for several of the committees.

4011
06:42:02,580 --> 06:42:05,440
I don't have in front of me the committee schedule for April,

4012
06:42:06,800 --> 06:42:08,860
but we'll endeavor to do that.

4013
06:42:09,600 --> 06:42:16,220
Okay. We just need time too, as well, to look at the information.

4014
06:42:16,220 --> 06:42:20,900
Absolutely. And just to add something, this is something we say, no matter how many times

4015
06:42:20,900 --> 06:42:29,200
I say this and how many employee forums, I 100% guarantee not every departmental proposal will

4016
06:42:29,200 --> 06:42:33,900
make it in the recommended budget. And there will be proposals in the recommended budget that

4017
06:42:33,900 --> 06:42:40,400
we're not made by departments. And so I will keep repeating that caveat too because sometimes

4018
06:42:40,400 --> 06:42:45,760
people get extremely worked up about departmental proposals that may or may not.

4019
06:42:45,760 --> 06:42:51,620
in their certainly in their full form or even in a modified form and making sense.

4020
06:42:51,620 --> 06:42:56,380
And we also have to look at how departmental proposals interact with each other, sometimes

4021
06:42:56,380 --> 06:43:00,580
departments propose things that affect other departments as well.

4022
06:43:01,260 --> 06:43:09,960
So we'll continue to reiterate all those caveats, but yes, we will endeavor very hard

4023
06:43:09,960 --> 06:43:12,800
to have them two weeks in advance of the committee rights.

4024
06:43:14,340 --> 06:43:22,960
I appreciate that and I hope you understand it. Again, it's our attempt to understand

4025
06:43:22,960 --> 06:43:28,640
as much of that detail too. I know that's your job counting executives, but I do think

4026
06:43:28,640 --> 06:43:34,940
it's important for us as supervisors to also understand what the requests are, what

4027
06:43:34,940 --> 06:43:41,360
the trade-offs are, making sure that they're aligned with the board's priorities. We just

4028
06:43:41,360 --> 06:43:47,160
as much time as we can have as long as it goes through the voluminous budget that we have.

4029
06:43:48,220 --> 06:43:53,100
So, yes, if you can endeavor to do two-weeks prior to our committee meeting, so I'll be great.

4030
06:43:53,500 --> 06:43:56,540
Absolutely. So, this is where the two items have been announced.

4031
06:43:56,540 --> 06:44:02,820
It sounds like the second one isn't a friendly amendment unless we describe it as best efforts.

4032
06:44:04,500 --> 06:44:07,980
That's right. That's right. Happy to do that, the great. Thank you.

4033
06:44:07,980 --> 06:44:09,880
Okay, motions, I can get the question.

4034
06:44:10,540 --> 06:44:12,780
Spadium, and I think, yeah, yeah.

4035
06:44:12,840 --> 06:44:17,380
Thank you, spoiler, I will be supporting support of the motion.

4036
06:44:17,880 --> 06:44:19,860
But I do have some questions, well, really.

4037
06:44:21,720 --> 06:44:23,540
James, and key, thank you.

4038
06:44:23,580 --> 06:44:24,560
Thank you for the report.

4039
06:44:25,180 --> 06:44:28,680
I remember in prior years as middle management,

4040
06:44:28,880 --> 06:44:32,060
that staff was able to had some autonomy

4041
06:44:32,060 --> 06:44:35,180
making decisions about their overall object to budget

4042
06:44:35,780 --> 06:44:36,960
to prioritize reductions.

4043
06:44:36,960 --> 06:44:42,280
I remember being asked to do that when I ran my own program, where would I need object 2 funds,

4044
06:44:42,540 --> 06:44:46,520
how much of it, or what balance of object 1 and object 2 I was able to give up.

4045
06:44:46,920 --> 06:44:51,820
So, but essentially, do you foresee any changes to that approach given the new reporting capabilities

4046
06:44:51,820 --> 06:44:53,500
by these four subcategories?

4047
06:44:53,780 --> 06:44:58,400
Will staff still have some autonomy or program managers have a autonomy to be able to declare

4048
06:44:58,400 --> 06:44:59,980
where an object 2.

4049
06:45:00,000 --> 06:45:10,280
Would they, would they want to shift funds? That's correct. So the budget appropriates funds pursuant and consistent with the county budget act at the object level.

4050
06:45:11,220 --> 06:45:21,960
So departments have discretion on allocation within the object and that will remain the case. That's the legal level of appropriations.

4051
06:45:24,000 --> 06:45:30,640
The information that's being requested is as I understand it and effort to understand how

4052
06:45:30,640 --> 06:45:35,500
departments are intending to utilize those budgets, but there will be no legal change in

4053
06:45:35,500 --> 06:45:36,380
the appropriation.

4054
06:45:36,640 --> 06:45:38,980
So object 2 is one big category.

4055
06:45:39,440 --> 06:45:45,160
Object 1 is as well, and as are the other objects, we don't talk about there's several other

4056
06:45:45,160 --> 06:45:45,880
objects as well.

4057
06:45:45,900 --> 06:45:49,940
We don't talk about them because they're not as relevant to the day-to-day operation

4058
06:45:49,940 --> 06:45:58,060
and programming, but there's fixed assets and debt service and so forth, but Object One is

4059
06:45:58,060 --> 06:46:04,120
staff costs and Object Two services and supplies, and the board's formal approval of the

4060
06:46:04,120 --> 06:46:11,300
budget specifies for each budget unit and each fund, the appropriation at the object level and

4061
06:46:11,300 --> 06:46:14,300
for other than that.

4062
06:46:14,580 --> 06:46:20,500
Thank you, James, for that assurance, and to key, I just want to say I'm really looking

4063
06:46:20,500 --> 06:46:22,600
forward to the budget software rollout.

4064
06:46:22,760 --> 06:46:27,620
We often do ribbon cuttings for new buildings and new new parks and things.

4065
06:46:28,140 --> 06:46:32,580
I don't think I've ever written a ribbon cutting for a new software rollout, but just don't

4066
06:46:32,580 --> 06:46:36,820
say that's how monumental this is to be able to give us, I mean, I'm especially looking

4067
06:46:36,820 --> 06:46:40,240
for these systems of grades for contracting and I'm especially looking forward to being

4068
06:46:40,240 --> 06:46:45,500
able to the, the quote, run real time reports with apples to apples comparisons of spending

4069
06:46:45,500 --> 06:46:50,100
by category and contract across all parts of the organization. I think Cindy used to call

4070
06:46:50,100 --> 06:46:55,900
that the book of business. And I know Joe had always made similar requests for that level

4071
06:46:56,520 --> 06:47:01,680
of analysis and understanding of our budget. So thank you, Tiki. Thank you for your efforts

4072
06:47:01,680 --> 06:47:02,400
on this.

4073
06:47:03,580 --> 06:47:05,240
We're very excited about that.

4074
06:47:05,400 --> 06:47:11,700
The procurement piece of it is something that I've been wanting for many, many, many years

4075
06:47:11,700 --> 06:47:18,160
going back to when I was first at Deputy Kenny Council in the county and had to work on

4076
06:47:18,160 --> 06:47:23,160
a little discovery related project from the Attorney General's Office wanting a Norse spending

4077
06:47:23,980 --> 06:47:29,080
on certain categories of equipment and I had to go from department to department to

4078
06:47:29,560 --> 06:47:36,920
Manually gather that information so this is long time coming. Oh, yeah, maybe we you know what with that

4079
06:47:36,920 --> 06:47:43,860
With that caveat, I think we'll do a ribbon cutting. I mean confetti cannons. I'd love to have you ever been cutting something in front of something

4080
06:47:44,700 --> 06:47:46,040
Transparent right transparency

4081
06:47:47,220 --> 06:47:50,920
Can you are looking in that direction am I thinking the wrong person

4082
06:47:55,900 --> 06:48:03,440
Thank you, Azika, Peytoni, thank you, all right, so all my shoutouts to you and appreciation.

4083
06:48:04,000 --> 06:48:10,560
It's a long time coming like James said, and we'll figure out some type of ribbon cutting to commemorate this new software rollout.

4084
06:48:10,840 --> 06:48:12,320
Thank you.

4085
06:48:13,100 --> 06:48:14,820
Yes, I think I'm just missing.

4086
06:48:14,820 --> 06:48:20,420
This is motion by Syvizer, Alan Burke, and seconded by Syvizer Abbey Koga.

4087
06:48:20,860 --> 06:48:23,340
Syvizer, I thought you said you will not be supporting this motion.

4088
06:48:23,560 --> 06:48:24,640
Is that what you said? Oh no, sorry.

4089
06:48:24,640 --> 06:48:28,260
I said spoiler alert. I will support this motion by just had questions.

4090
06:48:28,480 --> 06:48:28,620
Okay.

4091
06:48:28,620 --> 06:48:29,760
One of you put everybody at ease.

4092
06:48:30,620 --> 06:48:30,920
Okay.

4093
06:48:31,540 --> 06:48:33,760
I'll be more clear next time.

4094
06:48:33,980 --> 06:48:34,880
President, thank you.

4095
06:48:35,060 --> 06:48:35,540
Thank you.

4096
06:48:36,280 --> 06:48:37,120
Let's leave the day.

4097
06:48:37,420 --> 06:48:38,160
So, all right.

4098
06:48:38,780 --> 06:48:41,100
No, thank you so much again for bringing up this referral.

4099
06:48:41,260 --> 06:48:43,000
I think this will help, I guess, transparency

4100
06:48:43,000 --> 06:48:46,160
and getting the public, you know what we do every day.

4101
06:48:46,460 --> 06:48:47,780
Sometimes it's hard to read up much it,

4102
06:48:48,240 --> 06:48:50,040
but I just want to thank staff for the additional

4103
06:48:50,040 --> 06:48:53,300
air fresher put in to make this clearer for everybody.

4104
06:48:53,900 --> 06:48:55,400
So, not for you to do less tick to vote.

4105
06:48:55,800 --> 06:48:57,300
We have a motion by Supervisor Elmber.

4106
06:48:57,380 --> 06:48:59,120
You're in a second by Supervisor Abacoga.

4107
06:48:59,500 --> 06:49:00,300
Supervisor Abacoga?

4108
06:49:00,820 --> 06:49:01,900
I, Supervisor You.

4109
06:49:02,340 --> 06:49:02,480
Yes.

4110
06:49:03,160 --> 06:49:03,820
Supervisor Elmber?

4111
06:49:04,380 --> 06:49:04,960
And presently.

4112
06:49:05,180 --> 06:49:05,740
I as well.

4113
06:49:05,940 --> 06:49:06,200
Thank you.

4114
06:49:06,480 --> 06:49:08,640
Thank you.

4115
06:49:08,640 --> 06:49:09,940
All right.

4116
06:49:09,940 --> 06:49:13,020
And next, we are moving to item 17,

4117
06:49:13,460 --> 06:49:16,940
relating to the 2025 measure A in the penance

4118
06:49:16,940 --> 06:49:18,680
citizens, oversight committee,

4119
06:49:19,260 --> 06:49:21,100
James, that's your lights on to hit.

4120
06:49:22,040 --> 06:49:22,980
Yes, so good afternoon.

4121
06:49:23,360 --> 06:49:28,640
This item is part of us fulfilling our promises

4122
06:49:28,640 --> 06:49:34,020
associated with the successful passage of 2025 measure A.

4123
06:49:34,440 --> 06:49:38,960
Building on this county's incredibly successful model,

4124
06:49:38,960 --> 06:49:46,980
working off of the 2016 housing bond, the 2025 measure A ordinance,

4125
06:49:47,160 --> 06:49:51,900
included similar language, that there would be an oversight

4126
06:49:51,900 --> 06:50:00,000
to process to audit the spending of the proceeds from 2025 measure A.

4127
06:50:00,360 --> 06:50:03,140
I want to be really clear about what this isn't.

4128
06:50:03,140 --> 06:50:07,740
It is not an advisory committee regarding spending plans.

4129
06:50:08,680 --> 06:50:12,480
It's not to determine how the funding is allocated.

4130
06:50:13,080 --> 06:50:17,020
Those are decisions consistent with the discussion we just had in the last item.

4131
06:50:17,080 --> 06:50:24,360
Those are decisions that are lawfully made by the Board of Supervisors as part of the annual budget process.

4132
06:50:25,380 --> 06:50:31,480
The purpose of this committee consistent with the 2016 housing bond oversight committee

4133
06:50:31,480 --> 06:50:46,900
is to do after the fact verification that we indeed did spend those proceeds the way we said we would consistent with the approved budget that the board has adopted.

4134
06:50:48,000 --> 06:50:55,300
Administration is recommending using the Successful 2016 Measure A over-site committee structure.

4135
06:50:55,740 --> 06:51:02,160
That structure has been praised in numerous forums, including by the civil grand jury and many others.

4136
06:51:02,720 --> 06:51:08,880
For its success in auditing and verifying the spending of those 2016 housing bond proceeds,

4137
06:51:09,620 --> 06:51:16,880
our recommendation is to basically adapt to that same structure and format for the purpose of this 2020

4138
06:51:17,760 --> 06:51:20,720
And with that, we're happy to answer questions.

4139
06:51:22,540 --> 06:51:23,240
Thank you, James.

4140
06:51:23,800 --> 06:51:25,840
Yes, anybody in public would like to speak on this item?

4141
06:51:26,420 --> 06:51:28,080
We do have speakers for this item.

4142
06:51:28,140 --> 06:51:32,900
I have one speaker in chambers, and it appears to be one moment

4143
06:51:34,500 --> 06:51:36,780
about five speakers on Zoom.

4144
06:51:37,560 --> 06:51:38,760
One, two, five in Sims.

4145
06:51:38,940 --> 06:51:38,960
Okay.

4146
06:51:38,960 --> 06:51:39,960
There's six in top.

4147
06:51:40,240 --> 06:51:41,340
Okay, there's the one in each.

4148
06:51:42,020 --> 06:51:42,280
Okay.

4149
06:51:42,860 --> 06:51:45,680
Our first speaker in chambers is Emily Korin.

4150
06:51:45,680 --> 06:51:51,060
And Apology said, one minute or two minutes?

4151
06:51:53,990 --> 06:51:54,210
Please.

4152
06:51:54,370 --> 06:51:57,750
Oh, actually, please go to the podium because there's a building

4153
06:51:57,750 --> 06:51:58,870
Mike, yes, exactly.

4154
06:51:59,750 --> 06:52:01,190
And we'll start talking.

4155
06:52:02,770 --> 06:52:03,390
Hi.

4156
06:52:03,710 --> 06:52:08,110
I'm Emily Korin, the Director of Governance and Advocacy at the Santa Clara County Medical Association.

4157
06:52:09,270 --> 06:52:13,470
We represent over 4,800 physicians in Santa Clara County.

4158
06:52:13,470 --> 06:52:19,170
The Association recommends that you include Dr. Carol Somersel in the Measure A Citizens

4159
06:52:19,170 --> 06:52:20,110
Oversight Committee.

4160
06:52:20,330 --> 06:52:26,630
She is an OBGYN and SCCMA Council member and was recently re-elected as a member of the

4161
06:52:26,630 --> 06:52:28,810
El Camino Health Care District Board of Directors.

4162
06:52:29,270 --> 06:52:30,110
Thank you for your consideration.

4163
06:52:30,710 --> 06:52:32,310
Thank you.

4164
06:52:33,190 --> 06:52:34,630
Moving on to our Zoom speakers.

4165
06:52:34,830 --> 06:52:36,250
Our first speaker is Parent.

4166
06:52:36,650 --> 06:52:37,150
Parent.

4167
06:52:37,150 --> 06:52:38,330
You will have one minute.

4168
06:52:46,070 --> 06:52:46,230
Parent.

4169
06:52:46,350 --> 06:52:47,950
Your mic is open?

4170
06:52:51,800 --> 06:52:52,080
Yes.

4171
06:52:52,080 --> 06:52:56,840
I just wanted to make sure that we didn't give any measure A funds to this attorney Jeff Rosen.

4172
06:52:57,220 --> 06:53:03,640
I know you guys say you guys determined that, but I want to make sure that we relay that to this oversight committee.

4173
06:53:05,180 --> 06:53:10,960
I know he's been asking for measure A funds and he turned to investigate you guys.

4174
06:53:11,500 --> 06:53:22,060
Don't be intimidated by him. He's using money to sex traffic children in this county by covering up the sexual abuse of children.

4175
06:53:22,060 --> 06:53:29,940
and by incentivizing assaults against parents who don't want their kids rape.

4176
06:53:30,280 --> 06:53:35,560
Measure A funds should go to hospitals and to healthcare, not the sex trafficking children.

4177
06:53:37,040 --> 06:53:40,600
I posted an information online. If you guys want to see it, if you Google D.A.

4178
06:53:40,600 --> 06:53:45,900
Jeff Rosen petitioned sex trafficking, all those terms together within the top three results.

4179
06:53:46,320 --> 06:53:49,380
You'll see exactly what I'm talking about. Please like, share this committee.

4180
06:53:49,380 --> 06:53:52,820
It doesn't give any money to Jeff Rose, thank you so much for your time.

4181
06:53:53,760 --> 06:53:57,220
Our next speaker is Joe Caffaro, Joe you'll have one minute.

4182
06:54:00,700 --> 06:54:03,140
Good afternoon, Joe Caffaro, the hospital council.

4183
06:54:04,480 --> 06:54:08,380
I would like to thank you for a leadership in establishing an independent citizen over

4184
06:54:08,380 --> 06:54:12,640
psych committee and for your continued commitment to transparency and accountability.

4185
06:54:13,860 --> 06:54:18,540
Measure A was placed on the ballot and direct response to a fiscal emergency created by

4186
06:54:18,540 --> 06:54:24,880
term one. Those approved this measure with a clear expectation of these funds would assist in mitigating

4187
06:54:24,880 --> 06:54:30,740
the reduction of healthcare access and safety net services. We respectfully ask the Board to

4188
06:54:30,740 --> 06:54:35,980
consider adding a designated hospital council seat to the proposed OPEC committee membership for

4189
06:54:36,820 --> 06:54:44,990
from an executive to chosen by the hospital council objectives Santa Clara County. Thank you.

4190
06:54:46,360 --> 06:54:50,520
Our next speaker is Vaughan Villeverde. Vaughan, you will have one minute.

4191
06:54:52,900 --> 06:54:56,660
Good afternoon, members of the Board. My name is Vaughan Villeverde, director of advocacy and

4192
06:54:56,660 --> 06:55:01,580
co-chair of the health equity work group of the real coalition. I'm speaking today in support

4193
06:55:01,580 --> 06:55:07,180
of the administration's recommendation to establish a independent oversight committee for the 2025

4194
06:55:07,180 --> 06:55:11,980
measure a sales tax measure and we agree that an oversight body is key to ensure accountability

4195
06:55:11,980 --> 06:55:18,340
and that revenue is that legally and it weighs that aligned with the promise made to voters during the campaign.

4196
06:55:18,900 --> 06:55:31,820
However, in structuring the oversight committee, I'd also urge the Board and administration to include the voices of people with a big experience in this committee, both for the valuable perspectives they could provide to these conversations.

4197
06:55:31,820 --> 06:55:41,580
But to also signal to the community who are in no small part responsible for passing this critical sales tax measure that the county is committed to transparency and meaningful community engagement

4198
06:55:41,580 --> 06:55:50,820
We at Aki and at the real coalition want to underline how important it is to include diverse voices in settings like these as we make our tough decisions. Thanks so much

4199
06:55:51,880 --> 06:55:56,100
Our next speaker is Carmen Martinez, Carmen you have one minute

4200
06:55:57,960 --> 06:56:02,000
Good afternoon, Board of Directors, my name is Garmin and I'm the Director of Organizing

4201
06:56:02,000 --> 06:56:03,060
with Leadinghouse Contraganet.

4202
06:56:03,540 --> 06:56:07,280
Thank you for your leadership throughout Measure A campaign for the commitment of safeguarding

4203
06:56:07,280 --> 06:56:11,340
the life-serving services provided by our county health and hospital system.

4204
06:56:11,980 --> 06:56:16,200
Measure A pass because Boarders understood the industry of protecting such a care, particularly

4205
06:56:16,200 --> 06:56:20,200
for us to serve the under-resource communities for our already bearing the front of shifting

4206
06:56:20,200 --> 06:56:21,260
federal and safe funding.

4207
06:56:21,840 --> 06:56:26,280
As we move into the implementation, I hope that you continue and that this spirit of partnership

4208
06:56:26,280 --> 06:56:30,120
transparency and community engagement. First, the committee should reflect the values and

4209
06:56:30,120 --> 06:56:33,660
the test that guided the measure a campaign and the line with voter expectations.

4210
06:56:34,360 --> 06:56:38,200
Rather, as keeping it as a narrow legal compliance body, we urge the board to empower

4211
06:56:38,200 --> 06:56:43,580
the committee as a recommended bottom body. One capable of advising how funds should most

4212
06:56:43,580 --> 06:56:49,140
effectively meet the community's health needs. Second, the committee must reflect a full diversity

4213
06:56:49,140 --> 06:56:54,640
of our county, especially those impacted by health inequities. I encourage you to include representation

4214
06:56:54,640 --> 06:56:56,520
to every community, community clinics,

4215
06:56:56,660 --> 06:56:57,480
and on-profit organizations,

4216
06:56:57,800 --> 06:56:59,620
but I'm a bodice to hear her help, experts.

4217
06:57:00,800 --> 06:57:02,140
And that concludes public comment.

4218
06:57:03,820 --> 06:57:05,300
All right, thank you very much.

4219
06:57:06,820 --> 06:57:09,920
I do want to add just one other comment I meant to make earlier,

4220
06:57:11,240 --> 06:57:12,640
which is of course the,

4221
06:57:13,500 --> 06:57:15,700
the item in front of the board just now is the structure.

4222
06:57:16,600 --> 06:57:19,380
Who is specifically nominated to the different seats

4223
06:57:19,380 --> 06:57:21,940
would be up to individual board members.

4224
06:57:21,940 --> 06:57:28,560
there's wide, wide discretion associated with many, many of the seats with representation

4225
06:57:28,560 --> 06:57:34,540
from broad swaths of the community and so some of the comments that have been received

4226
06:57:34,540 --> 06:57:40,540
both in writing and made today during public comment can easily be accounted for as individual

4227
06:57:40,540 --> 06:57:45,560
board members bring forward specific nominees for different seats. I just wanted to distinguish

4228
06:57:45,560 --> 06:57:52,640
that it is not in front of the board today to determine individuals who may sit in any seat.

4229
06:57:54,810 --> 06:57:55,330
Thank you.

4230
06:57:55,650 --> 06:57:58,370
I feel like I'd like to serve as you.

4231
06:57:58,790 --> 06:57:59,830
Yes, thank you.

4232
06:58:00,670 --> 06:58:03,890
So, James, I'm just going to repeat what I just heard you say.

4233
06:58:04,170 --> 06:58:09,990
So, for clarification, today's vote does not appoint anyone to the oversight committee.

4234
06:58:10,310 --> 06:58:10,870
That's correct.

4235
06:58:10,890 --> 06:58:14,690
We're seeking input on the structure, and then once the committee is actually formed,

4236
06:58:14,690 --> 06:58:24,830
If the board adapts these recommendations consistent with the 2016 structure, then individual board members will bring forward nominations to the different seats.

4237
06:58:24,930 --> 06:58:31,980
Just as you normally do for all of the other bodies that the board appoints individuals to.

4238
06:58:32,810 --> 06:58:44,150
Right, and then the structure that we are delivering over here over today is the same structure that was lifted out of the 2016 measure a affordable housing bond measure oversight committee.

4239
06:58:44,150 --> 06:58:58,450
That's correct, and there was a structure that was originally proposed by Supervisor Chavez and Supervisor Cortese as a mechanism to help ensure community trust coming out of the successful 2016 housing bond.

4240
06:58:58,890 --> 06:59:07,530
And like I said, it's it's worked well. It's been heavily praised and we have lifted and adapted that same structure in the recommendation here.

4241
06:59:07,530 --> 06:59:17,850
Yeah, and I legit remember that at the time of that initial proposal, there was some criticism that it was overkill or just way too much or way too

4242
06:59:19,230 --> 06:59:25,530
Strenuous and Dave and Cindy continued forward on words with that model, which has since then received

4243
06:59:26,810 --> 06:59:32,810
praise them, silver grandjuries, awards from other auditors, for out-odding themselves, like

4244
06:59:32,810 --> 06:59:34,290
just simply has set a new standard.

4245
06:59:34,990 --> 06:59:41,230
Yes, it's been really successful, and it's worked well, and we have high confidence in

4246
06:59:41,230 --> 06:59:41,830
that structure.

4247
06:59:42,250 --> 06:59:46,850
Yeah, and what I remember about this structure, too, is that the allocation or the decision-making

4248
06:59:46,850 --> 06:59:52,490
process of how the funds will be used, risk with the body on this day is, and that the

4249
06:59:52,490 --> 06:59:59,410
that can make sure that then the operational steps that follows, that the money is allocated.

4250
07:00:00,000 --> 07:00:07,040
In line with the direction and the wishes of this board. That's right, it's basically a way to validate and ensure that we did what we said we would do.

4251
07:00:07,380 --> 07:00:16,720
Yeah, and I'll speak for myself as a member of the board. I see myself making decisions and allocations on the basis of my stakeholders, my community members,

4252
07:00:26,240 --> 07:00:29,980
my.

4253
07:00:29,980 --> 07:00:36,260
answers you have my full commitment that I will be informed by your feedback to make sure that

4254
07:00:36,260 --> 07:00:41,400
I pass a vote that is in line with our needs and our desires and hopes and wishes for

4255
07:00:41,400 --> 07:00:45,840
securing medical access and quality care for everyone and that the oversight committee

4256
07:00:45,840 --> 07:00:52,140
based on this composition will watch us like a hop to make sure that every dollar is spent exactly the way this board

4257
07:00:52,140 --> 07:00:52,820
has voted.

4258
07:00:52,980 --> 07:00:54,060
That's correct.

4259
07:00:54,480 --> 07:00:54,660
Great.

4260
07:00:54,660 --> 07:00:57,640
And then one specific question,

4261
07:01:00,320 --> 07:01:06,040
could you tell me, I'm curious to the specific, the level

4262
07:01:06,040 --> 07:01:14,560
of specificity in terms of the recommendation for a dedicated seat to a current or former

4263
07:01:14,560 --> 07:01:21,000
physician, some would say that that's a narrow take on healthcare expertise, also considering

4264
07:01:21,000 --> 07:01:27,100
the conversations we've had today about community health workers, culture competency, and the

4265
07:01:27,100 --> 07:01:33,820
broad range of care that can show up in community. And you know what we found, what I

4266
07:01:33,820 --> 07:01:38,780
found as a board member when it comes to appointing commissioners, sometimes narrow, narrowly

4267
07:01:38,780 --> 07:01:44,360
tailored qualifications can make it challenging to find candidates. I would just love to hear

4268
07:01:44,360 --> 07:01:46,680
more about your rationale behind that category.

4269
07:01:46,680 --> 07:01:52,700
We swapped out the seat that was on the 2016 committee, the reserve for an attorney.

4270
07:01:53,220 --> 07:01:58,080
How many specifics do we swap, we swapped the attorney for physician like I said we just

4271
07:01:58,080 --> 07:02:05,220
tried to adapt the 2016 structure. Obviously opened any input from the board but that was what we did

4272
07:02:05,220 --> 07:02:10,640
as we swapped the attorney with physician. And then other seats on this board would be able to reflect

4273
07:02:10,640 --> 07:02:13,500
to broaden our definitions of health and community health.

4274
07:02:13,580 --> 07:02:19,700
Absolutely, civic organization, labor, business, general public, of course, could be anybody.

4275
07:02:21,120 --> 07:02:28,360
And healthcare advocate would encompass, I think anyone interested in advocacy related to healthcare very broadly.

4276
07:02:29,380 --> 07:02:39,960
So the seats are all quite broad. The only ones that are a little narrower are the auditor or public accountant public finance seat, which is the same as

4277
07:02:39,960 --> 07:02:46,180
on the 2016 bond measure committee, and then, like I said, the attorney was replaced with

4278
07:02:46,180 --> 07:02:46,580
physician.

4279
07:02:47,120 --> 07:02:49,980
Yeah, well, that's by the auditor's love us for those vaccinations.

4280
07:02:51,020 --> 07:02:56,480
So I made to receive through port and direct statutory port back with an ordinance to establish

4281
07:02:56,480 --> 07:03:01,380
the 2025 measure aid independence that is in oversight committee, as I recommend the staff

4282
07:03:01,380 --> 07:03:07,560
and them accompanying the SIGGenda item, and I just want to say I love, I know this is a

4283
07:03:07,560 --> 07:03:13,720
different measure A, but still loving that 2016 measure A has some some presence and influence

4284
07:03:13,720 --> 07:03:15,540
in in this application.

4285
07:03:16,840 --> 07:03:17,260
Yes, President.

4286
07:03:17,800 --> 07:03:18,640
Thank you.

4287
07:03:18,720 --> 07:03:20,200
I'm happy to second the motion.

4288
07:03:20,680 --> 07:03:27,640
I just had one very more specific question, so we will each of us supervisor will point

4289
07:03:27,640 --> 07:03:30,820
when will we be assigned these categories to set?

4290
07:03:30,900 --> 07:03:35,900
Yes, so the way of the process works is the clerk of the board will believe it's a random

4291
07:03:35,900 --> 07:03:36,460
assignment.

4292
07:03:36,460 --> 07:03:41,960
to the individual offices to bring forward nominees and of course the board has to as a whole

4293
07:03:41,960 --> 07:03:46,880
approve those nominations for appointment but they do have a random I think it's a randomized

4294
07:03:46,880 --> 07:04:06,440
process and then it moves from office to office in rotation order. Is it a yearly rotation or will there be

4295
07:04:06,980 --> 07:04:19,220
This is the specific mechanics I have to defer to the clerk of the board's office, but it's a process that they currently utilize for the 2016 committee as well as a few others and it would be the same process.

4296
07:04:19,340 --> 07:04:24,020
It will all be spelled out in the ordinance that before the board.

4297
07:04:24,660 --> 07:04:34,820
But we're not proposing a different bespoke process. We're proposing to utilize the the same process that the clerk's office uses for that existing body as well as several others.

4298
07:04:34,820 --> 07:04:35,740
Okay, great.

4299
07:04:35,920 --> 07:04:36,900
Thank you.

4300
07:04:38,800 --> 07:04:39,740
So that's the little number.

4301
07:04:40,660 --> 07:04:41,300
Thank you.

4302
07:04:41,920 --> 07:04:49,120
Supervisor Yang, I really was hearing your comment about the first category and while

4303
07:04:49,120 --> 07:04:57,260
really only lawyers or lawyers, I do feel that this category first one could be broadened

4304
07:04:57,260 --> 07:05:02,140
to include a professional health care provider.

4305
07:05:03,160 --> 07:05:06,180
Does that defeat the purpose?

4306
07:05:06,180 --> 07:05:12,780
of objections, that would include nurses and not sure who else would fall into that category

4307
07:05:12,780 --> 07:05:14,220
of professional healthcare provider.

4308
07:05:14,440 --> 07:05:17,420
But regulations assistance, yeah, yeah, peace.

4309
07:05:17,840 --> 07:05:19,220
Yeah, I think that would be totally fine.

4310
07:05:19,680 --> 07:05:19,880
Okay.

4311
07:05:20,200 --> 07:05:26,720
Then I would like to add that friendly amendment to be a broader healthcare provider category.

4312
07:05:27,540 --> 07:05:30,240
Oh, I think that's a great amendment to the motion.

4313
07:05:30,720 --> 07:05:31,400
We have to have that.

4314
07:05:31,640 --> 07:05:32,360
Oh, I'm sorry to interrupt.

4315
07:05:32,360 --> 07:05:38,180
What the, yeah. So, branding the physicians or the doctor, medical doctor, physician

4316
07:05:38,180 --> 07:05:44,320
category, to be healthcare provider, professional provider. I'm distinguishing it still from

4317
07:05:44,320 --> 07:05:48,980
number three, which is a healthcare advocate, which of course could also be a provider, but

4318
07:05:48,980 --> 07:05:54,100
doesn't need to be. I think that gives us the flexibility that I think we'll do good. That

4319
07:05:54,100 --> 07:05:58,700
will do this over-set committee good. So, I'm happy to accept that friendly amendment. I look

4320
07:05:58,700 --> 07:06:00,060
to my seconder?

4321
07:06:00,140 --> 07:06:04,980
Could I just clarify, do you mean to import current or retired?

4322
07:06:05,400 --> 07:06:05,960
Yes, please.

4323
07:06:06,560 --> 07:06:06,580
Okay.

4324
07:06:06,580 --> 07:06:06,720
Sure.

4325
07:06:07,520 --> 07:06:07,960
Thank you.

4326
07:06:08,180 --> 07:06:08,740
Keep it broad.

4327
07:06:11,070 --> 07:06:11,130
Okay.

4328
07:06:12,390 --> 07:06:16,190
So first of all, thank you so much for this report and I really think this is why so

4329
07:06:16,190 --> 07:06:21,190
we've built on the success from the previous measure A and experience and many counties

4330
07:06:21,190 --> 07:06:23,150
are really following what we're doing.

4331
07:06:23,150 --> 07:06:31,470
I do a one potential comment or friendly amendment to consider for the maker.

4332
07:06:32,030 --> 07:06:35,770
As we were looking at how this funds is being used in this oversight,

4333
07:06:36,370 --> 07:06:40,810
I only want to make sure that our custody healthcare system is being put in mind.

4334
07:06:41,470 --> 07:06:45,430
The healthcare teams now jails are so integral part of our community,

4335
07:06:46,170 --> 07:06:50,230
and will not be immune to these budget cuts, and we need to ensure that they are not undervaluing

4336
07:06:50,230 --> 07:06:55,510
to make these budgetary decisions. So for these reasons, I'm trying to see if there's

4337
07:06:55,510 --> 07:07:01,250
any way we could incorporate one of the recommendations to look for folks who have

4338
07:07:01,250 --> 07:07:05,710
expertise in Stessie Health on the self-alpsi committee to make sure that the spending

4339
07:07:05,710 --> 07:07:08,630
on this area is also a review of appropriate context on understanding.

4340
07:07:10,170 --> 07:07:11,750
I'm sorry, what was the last part of the project?

4341
07:07:11,770 --> 07:07:16,830
Oh, trying to find somebody that has some expertise in custody health on this

4342
07:07:16,830 --> 07:07:21,690
I also like committee to ensure that the spending of the area is reviewed with appropriate

4343
07:07:21,690 --> 07:07:23,350
context, understanding.

4344
07:07:24,970 --> 07:07:30,990
President Lee, I really appreciate the focus on our Encussive Health Care Services.

4345
07:07:31,090 --> 07:07:35,070
That's something that's often overlooked in the Grand Landscape of Policy Decision Making.

4346
07:07:35,510 --> 07:07:41,010
I do feel that at this point where we've landed with the structure of the committee will

4347
07:07:41,010 --> 07:07:44,770
allow us the board flexibility in being able to

4348
07:07:44,770 --> 07:07:46,410
to appoint someone with that expertise.

4349
07:07:47,170 --> 07:07:48,770
At the end of the day, we're going to appoint,

4350
07:07:48,890 --> 07:07:51,350
and I feel like the categories give us that space.

4351
07:07:51,630 --> 07:07:54,290
I want flexibility, but I certainly want to keep that in mind.

4352
07:07:54,770 --> 07:07:56,870
And it's important consideration for us and look at this all.

4353
07:07:57,230 --> 07:07:58,070
Thank you, President.

4354
07:07:58,270 --> 07:07:59,330
I really appreciate your thoughtfulness.

4355
07:07:59,550 --> 07:07:59,910
Thank you.

4356
07:08:00,050 --> 07:08:02,810
Certainly falls into the category of a professional health care provider.

4357
07:08:03,190 --> 07:08:03,470
Thank you.

4358
07:08:03,630 --> 07:08:04,890
And I have a good idea.

4359
07:08:05,970 --> 07:08:06,430
Thank you.

4360
07:08:07,190 --> 07:08:07,750
All right.

4361
07:08:08,330 --> 07:08:15,210
Okay, do you think I'll change? No. Okay, and we have spoken by the public. We have our motion.

4362
07:08:15,390 --> 07:08:18,590
We have a second. There's no further comments. Let's take a look.

4363
07:08:19,370 --> 07:08:22,930
Um, we have a motion by super as a young. And a second by super as a ribocoke.

4364
07:08:23,570 --> 07:08:27,110
Um, super as a ribocoke? I, super as a young? Yes.

4365
07:08:27,490 --> 07:08:33,090
Super as a limber? Yes. And presently. I as well. Thank you. That's four and a message.

4366
07:08:33,670 --> 07:08:38,230
Thank you. Now we move to consider items previously removed from the

4367
07:08:38,230 --> 07:08:45,130
and down there I believe we only have one item today, which is item 56 considered recommendations

4368
07:08:45,130 --> 07:08:51,650
really leading to the surveillance use policy for the automated license plate readers,

4369
07:08:52,050 --> 07:08:57,890
ALPR for the City of Sertoga, the City of Cortino and the town of Los Alto's Hills.

4370
07:08:58,950 --> 07:09:03,210
And we have Sheriff Shonson. Good afternoon. Thanks for being so patient with us.

4371
07:09:04,650 --> 07:09:13,290
good afternoon. In the interest of time, you do have this was a consent item. We're here to answer any questions you may have.

4372
07:09:13,550 --> 07:09:21,670
Her concerns that you may have in regards to this item, so with that I will pause and see if unless you need a description of what we're talking about.

4373
07:09:22,070 --> 07:09:23,390
We all have to report.

4374
07:09:25,950 --> 07:09:29,550
It looks like now and this consensus that now needs a presentation.

4375
07:09:30,150 --> 07:09:30,990
I think we're great.

4376
07:09:31,390 --> 07:09:31,910
So let's see.

4377
07:09:32,090 --> 07:09:35,290
Should we check to see how many in the public would like to speak on the sidemps?

4378
07:09:36,010 --> 07:09:41,430
We currently have four speakers in chambers and one moment for the zoom.

4379
07:09:41,870 --> 07:09:43,290
We have two speakers on zoom.

4380
07:09:44,190 --> 07:09:45,290
So for a total of six.

4381
07:09:45,390 --> 07:09:45,850
Six.

4382
07:09:46,150 --> 07:09:47,230
List of two minutes each.

4383
07:09:48,770 --> 07:09:52,690
Our first speakers are Victor Vasquez.

4384
07:09:52,690 --> 07:10:00,030
J.P. Connolly, Missairu, Mendoza, and Jeremy Burroughs.

4385
07:10:00,030 --> 07:10:01,110
Please make your way to the podium.

4386
07:10:08,800 --> 07:10:11,140
Hello President of the Board and Supervisors of the Commission.

4387
07:10:11,420 --> 07:10:14,100
The Clara Minimum is measuring, and I'm here with Amigos de Guadalupe,

4388
07:10:14,240 --> 07:10:19,460
and I tend to urge the Board of Supervisors to reject the P,

4389
07:10:20,300 --> 07:10:24,560
which is the approval of surveillance policy for our environmental license plates.

4390
07:10:24,560 --> 07:10:30,880
License plate readers raise a massive privacy concerns regarding our data Jews store and share

4391
07:10:30,880 --> 07:10:37,320
These databases give a governmental agencies more control and tools to surveil are

4392
07:10:37,320 --> 07:10:41,160
In harm our immigrant communities and our communities of colors

4393
07:10:41,160 --> 07:10:50,160
This has been documented instances in which the data collected by license place had been shared with federal agencies like ice and

4394
07:10:50,160 --> 07:10:52,980
violation of a state law and policies.

4395
07:10:53,300 --> 07:10:57,140
Flag cells, the I-Cloud connected cameras to police departments

4396
07:10:57,140 --> 07:11:01,440
and private customers across the nation's put license plates,

4397
07:11:02,380 --> 07:11:05,540
readings that they collect into their own servers

4398
07:11:05,540 --> 07:11:09,280
and allow police to do nationwide searches

4399
07:11:09,280 --> 07:11:12,120
for a resultant from the database.

4400
07:11:12,980 --> 07:11:16,140
Sorry, records revealed that many of the searches

4401
07:11:16,140 --> 07:11:23,720
What carry out by local officers and behalf of ICE for immigration purposes, including the notorious

4402
07:11:23,720 --> 07:11:30,440
enforcement and removal operation division. I urge you to take a stand today and reject

4403
07:11:30,440 --> 07:11:34,760
number B and item 56. Thank you for your attention.

4404
07:11:39,890 --> 07:11:44,510
Thank you, Vaskas. Overall, automated license plate readers track where people drive,

4405
07:11:45,090 --> 07:11:49,250
when they travel, who and who they associate, this surveillance happens continuously,

4406
07:11:49,250 --> 07:11:52,390
would I individual suspicion and would ought to warrant?

4407
07:11:52,710 --> 07:11:56,590
This is a concern for privacy and or civil liberties for amendments.

4408
07:11:56,810 --> 07:12:00,830
Specifically, the user-floc safety makes these concerns even more

4409
07:12:00,830 --> 07:12:04,450
students since there's documented history of them working with in-supportive

4410
07:12:04,450 --> 07:12:09,010
eyes operations despite local and state-century policies that are put in place.

4411
07:12:09,450 --> 07:12:12,690
Public records request including in Colorado and California,

4412
07:12:13,330 --> 07:12:16,930
show these instances happening in their activity and working closely with eyes.

4413
07:12:16,930 --> 07:12:21,570
This is not hypothetical. It's already happening. So our cities and counties can pass

4414
07:12:21,570 --> 07:12:27,010
century policies, but those policies are meaningless unless we cut ties with companies,

4415
07:12:27,610 --> 07:12:35,450
systems, and contracts that are used against us and work for ICE. In practice, when we don't cut

4416
07:12:35,450 --> 07:12:41,430
these ties, we are in fact working with them and going against our policies, our values, and what

4417
07:12:41,430 --> 07:12:46,570
we say, and what we value in terms of public safety for our undocumented community, but all of

4418
07:12:46,570 --> 07:12:48,930
as who are being recorded.

4419
07:12:49,670 --> 07:12:53,870
This kind of data collection definitely impacts immigrant communities,

4420
07:12:54,470 --> 07:12:55,690
but it does not stop there.

4421
07:12:56,050 --> 07:12:58,010
Once mass surveillance systems are normalized,

4422
07:12:58,690 --> 07:13:01,370
everyone is subject to tracking, profiling, and misuse.

4423
07:13:02,130 --> 07:13:05,870
I urge this board to cut the ties with any flawed system

4424
07:13:05,870 --> 07:13:09,010
or affiliate system with them and establish a stronger,

4425
07:13:09,210 --> 07:13:11,990
more enforceable protections that prohibit data sharing

4426
07:13:11,990 --> 07:13:14,030
with federal immigration authorities.

4427
07:13:14,030 --> 07:13:21,710
Senate clear, County must take, again, real actions to protect civil rights, public safety, and community trust.

4428
07:13:22,030 --> 07:13:22,470
Thank you.

4429
07:13:27,680 --> 07:13:28,060
Good afternoon.

4430
07:13:28,760 --> 07:13:33,040
President Lee and rest of the Board of Supervisors, Jeremy Bruce, with Amigos De Guadalupe,

4431
07:13:33,160 --> 07:13:36,220
Center for Justice and Empowerment, and we're a part of I-PIN.

4432
07:13:36,740 --> 07:13:41,600
For decades, Senate clear, County has been a beacon for immigrant rights, and especially

4433
07:13:41,600 --> 07:13:45,700
in today's political climate at a time where immigrants are under relentless attack.

4434
07:13:45,700 --> 07:13:53,780
We need bold and courageous leaders to stand up and reject policies that prove harmful or for our most vulnerable neighbors.

4435
07:13:54,800 --> 07:14:00,660
License plate readers raise huge privacy issues regarding how our data is used and shared.

4436
07:14:01,300 --> 07:14:07,660
These databases give our governmental agencies more opportunities to surveil and harm our immigrant communities.

4437
07:14:08,540 --> 07:14:15,220
There have been documented instances in which the data collected by license plates have been shared with federal agencies.

4438
07:14:15,220 --> 07:14:18,680
like ICE, in violation of state laws and policies.

4439
07:14:19,760 --> 07:14:24,940
Our communities should be able to drive and walk along our streets without worrying how their

4440
07:14:24,940 --> 07:14:26,780
information will be used or shared.

4441
07:14:27,500 --> 07:14:33,660
So we asked the Board to take a stand today and say no to flop or automated license plate

4442
07:14:33,660 --> 07:14:35,660
free to civilians in our county.

4443
07:14:36,080 --> 07:14:36,640
Thank you.

4444
07:14:40,680 --> 07:14:41,360
Good afternoon.

4445
07:14:41,660 --> 07:14:42,240
Supervisors.

4446
07:14:42,420 --> 07:14:47,920
My name is Ronald Paolo with Silicon Valley Rising and I think as other speakers have already

4447
07:14:47,920 --> 07:14:54,740
spoken today. I'd like to urge you before adopting any license by reader policy to take

4448
07:14:54,740 --> 07:14:57,700
a careful look at the implications of this vote.

4449
07:14:57,700 --> 07:14:59,980
Flock the company that powers

4450
07:15:00,000 --> 07:15:06,560
This automated license plate readers is not neutral technology. This is technology that makes information

4451
07:15:06,560 --> 07:15:13,200
about the lives and activities of Santa Clara County residents directly available, not only to the federal

4452
07:15:13,200 --> 07:15:18,340
agencies that have shown such a profound lawlessness of late and a disregard for local community,

4453
07:15:18,960 --> 07:15:25,220
but also this information is potentially available to a range of private actors. Look carefully

4454
07:15:25,220 --> 07:15:31,500
at the fine print, who owns the data, who can access the data, who can sell the data,

4455
07:15:31,800 --> 07:15:34,680
how long is that data stored, where does that data live?

4456
07:15:35,000 --> 07:15:40,460
Because the failed to do this level of due diligence is to hand surveillance machine directly

4457
07:15:40,460 --> 07:15:43,460
into the hands of ice and other private actors.

4458
07:15:43,960 --> 07:15:47,840
To fail to ask these questions and get very clear on the front end, it's to continue with

4459
07:15:47,840 --> 07:15:51,060
the policy that potentially undermines the substance of our sanctuary policies.

4460
07:15:51,060 --> 07:15:55,460
In Texas, Flock cameras were used to track and surveil women who were seeking reproductive

4461
07:15:55,460 --> 07:15:56,360
health care.

4462
07:15:56,920 --> 07:15:59,460
Flock has a long track record of this kind of collaboration.

4463
07:16:00,240 --> 07:16:05,540
Major investors in Flock include Peter Teal and Mark Anderson, two outspoken opponents

4464
07:16:05,540 --> 07:16:09,240
of many of the humanistic and democratic values of this county espouses.

4465
07:16:10,100 --> 07:16:15,040
Flock, along with Palantir, another Peter Teal company, are part of a surveillance ecosystem

4466
07:16:15,040 --> 07:16:18,620
that is gathering and centralizing ever more information to all Americans.

4467
07:16:19,200 --> 07:16:24,620
This is concerning stuff, and so I urge this board to take this vote very seriously before

4468
07:16:24,620 --> 07:16:27,260
moving forward and consider the implications of our community.

4469
07:16:27,400 --> 07:16:28,400
Thank you so much.

4470
07:16:30,390 --> 07:16:31,650
Moving to our Zoom speakers.

4471
07:16:31,890 --> 07:16:33,870
Our first speaker is Kimberly Wu.

4472
07:16:34,390 --> 07:16:35,610
Kimberly, you'll have two minutes.

4473
07:16:40,960 --> 07:16:41,740
This is for advisors.

4474
07:16:42,140 --> 07:16:45,220
I'm Kimberly Wu, and I'm a community organizer from Cypher.

4475
07:16:45,440 --> 07:16:46,480
I'm also a number five.

4476
07:16:47,140 --> 07:16:50,740
On behalf of Cypher, I strongly oppose Sanitano County Sheriff's

4477
07:16:50,740 --> 07:16:54,240
new contract plot, and I urge to end our county's contract

4478
07:16:54,240 --> 07:16:56,800
of plot through a post of dangerous surveillance tools

4479
07:16:56,800 --> 07:16:59,520
that can be accessed by ICE to terrorize communities

4480
07:16:59,520 --> 07:17:00,900
and separate our families.

4481
07:17:01,980 --> 07:17:06,340
The power plots, ALPRs, to plot the retain and analyze

4482
07:17:06,340 --> 07:17:08,940
location data for every driver on the road,

4483
07:17:09,220 --> 07:17:12,220
violates a fourth amendment, might try to see.

4484
07:17:12,680 --> 07:17:15,080
By centrally enabling masks, we're less tracking

4485
07:17:15,080 --> 07:17:16,800
that stocks and individual movements

4486
07:17:16,800 --> 07:17:19,880
in a twisted form of persistent judgment to them.

4487
07:17:19,880 --> 07:17:24,720
And that's the technology creates such massive data privacy constitutional violations

4488
07:17:24,720 --> 07:17:30,040
that sign a world with care health on you, ACLU, a newly found community, electronic

4489
07:17:30,040 --> 07:17:36,000
funding, financial fund nation, see what the city of San Jose was in stream in basings.

4490
07:17:36,380 --> 07:17:41,060
San Jose's unweighed cameras automatically retain the locations of drivers to find tire

4491
07:17:41,060 --> 07:17:41,620
of you.

4492
07:17:41,880 --> 07:17:45,960
And they were in the San Jose police to instantly, we could shut up places where we would

4493
07:17:45,960 --> 07:17:47,880
throughout the city do not tire a time.

4494
07:17:47,880 --> 07:17:50,980
There is no evidence that licensed plate readers

4495
07:17:50,980 --> 07:17:52,560
meaningfully reduced crime.

4496
07:17:52,900 --> 07:17:55,860
In fact, they actually create a dangerous, unsafe accident,

4497
07:17:56,240 --> 07:17:58,780
because harms the privacy of well-documented women.

4498
07:17:59,340 --> 07:18:01,440
The records will be all that many data searches

4499
07:18:01,440 --> 07:18:03,340
will carry it out by local officers

4500
07:18:03,340 --> 07:18:06,080
on behalf of ICE for immigration purposes,

4501
07:18:06,660 --> 07:18:08,180
including in the choice enforcement

4502
07:18:08,180 --> 07:18:10,000
and removal operations decisions

4503
07:18:10,000 --> 07:18:13,380
to separate our families and debilitate our community.

4504
07:18:14,160 --> 07:18:16,580
Our communities, our people should be able to drive

4505
07:18:16,580 --> 07:18:18,580
to drop this kids off school,

4506
07:18:19,020 --> 07:18:21,440
drive to a ton of medical appointments and drive to work,

4507
07:18:21,820 --> 07:18:24,080
that worrying how the information will be used,

4508
07:18:24,400 --> 07:18:25,560
stored, and shared.

4509
07:18:26,280 --> 07:18:28,040
But that's an increased immigration force

4510
07:18:28,040 --> 07:18:30,820
that comes to Super Bowl, and a very unsanified county.

4511
07:18:30,920 --> 07:18:32,940
We're calling unsanified county leadership

4512
07:18:32,940 --> 07:18:36,000
to stop these influx families and show no county data

4513
07:18:36,000 --> 07:18:38,460
as shared directly or into actual supplies.

4514
07:18:38,880 --> 07:18:40,700
This is how it's attached to our immigrant communities.

4515
07:18:41,280 --> 07:18:41,500
Thank you.

4516
07:18:42,300 --> 07:18:44,060
Our next speaker is who you trim,

4517
07:18:44,600 --> 07:18:45,520
who you have two minutes?

4518
07:18:45,520 --> 07:18:52,600
Good afternoon, Supervisors, this is Sweet Tran, Con from Siren.

4519
07:18:53,500 --> 07:18:56,720
I'll make my comments focused and brief here.

4520
07:18:57,340 --> 07:18:58,700
I'll disclose to you right off the bat.

4521
07:18:58,880 --> 07:19:00,360
We currently actually do have a lawsuit,

4522
07:19:01,040 --> 07:19:05,240
where we're represented by EFF and ACLU to challenge

4523
07:19:05,240 --> 07:19:09,460
the open access to data collected by block systems

4524
07:19:09,460 --> 07:19:11,280
through law enforcement.

4525
07:19:12,200 --> 07:19:15,620
A reason for doing that is because we recognize that

4526
07:19:15,620 --> 07:19:20,800
everybody wants public safety and people want traffic, you know, road safety and all of that.

4527
07:19:21,520 --> 07:19:26,860
But this is a very dangerous tool to create. What we're doing is creating a system where

4528
07:19:26,860 --> 07:19:32,200
everybody's movements can be tracked 24 hours a day, seven days a week in this data stays in place.

4529
07:19:32,800 --> 07:19:37,140
And the thing is what we call in the here about our concerns about flock is, hey, you know,

4530
07:19:37,260 --> 07:19:45,600
we have rules in place, we have a voter pause in place to make sure that this doesn't get into the

4531
07:19:45,600 --> 07:19:50,880
surveillance tool is that faith in that and trust in that deep ends on who is in power

4532
07:19:50,880 --> 07:19:57,140
and whether or not that system is going to stay strong or stay firm in protecting residents

4533
07:19:57,140 --> 07:20:03,840
when those kind of power dynamics change. We're seeing that at the federal level. So a lot of

4534
07:20:03,840 --> 07:20:09,760
here in concerns exist with mass data systems because all of this information is being put into place

4535
07:20:09,760 --> 07:20:20,520
And until we are confident that we can have the kind of protections that are everlasting or that will sustain regardless of our power dynamics can change,

4536
07:20:21,020 --> 07:20:26,580
we have to be incredibly careful about any expanded use of a mass data gathering system.

4537
07:20:27,260 --> 07:20:30,140
So we do encourage you to oppose this.

4538
07:20:30,360 --> 07:20:36,120
The demand that we have in our lawsuit is to ensure that any access to data gathered by cloth,

4539
07:20:36,120 --> 07:20:41,620
require that law enforcement get a warrant first that is that one additional

4540
07:20:41,620 --> 07:20:45,140
step to get it and of course I don't want to put that as a reason to support this

4541
07:20:45,140 --> 07:20:48,980
but it is an additional concern that we have to make sure we'll be further

4542
07:20:50,260 --> 07:20:56,010
berserker and that concludes public comment thank you very much for the speakers yes

4543
07:20:57,170 --> 07:21:05,170
supervisor Alanberg I have things to say but you pulled it so I'm happy to refer to you

4544
07:21:05,170 --> 07:21:06,790
All right. Thank you. Thank you.

4545
07:21:07,850 --> 07:21:10,390
We were trying to be polite. Like you go first.

4546
07:21:10,510 --> 07:21:11,230
Now you go first.

4547
07:21:11,550 --> 07:21:13,150
We all have things to say.

4548
07:21:14,170 --> 07:21:15,670
Chair of Chonson. Can I ask?

4549
07:21:15,970 --> 07:21:20,150
Do we currently the county or I guess this question is both for you and for our administration?

4550
07:21:20,490 --> 07:21:24,270
Does the county of Santa Clara currently have any contracts with flock?

4551
07:21:24,550 --> 07:21:25,170
We do not.

4552
07:21:25,290 --> 07:21:26,150
Do not.

4553
07:21:26,590 --> 07:21:30,450
And today's recommended action is to approve a surveillance use policy for

4554
07:21:30,450 --> 07:21:35,190
the cities of Saratoga, Cupertino, and TenoLas Altas for their automated license plate

4555
07:21:35,190 --> 07:21:35,550
reader.

4556
07:21:35,770 --> 07:21:36,310
That is correct.

4557
07:21:36,610 --> 07:21:37,310
Are those?

4558
07:21:37,790 --> 07:21:41,070
Or will this result and then having a contract with lock?

4559
07:21:41,450 --> 07:21:43,870
Well, each of them do have a contract with lock.

4560
07:21:44,070 --> 07:21:49,770
They are the purchasers of this equipment, so they contract independently with lock.

4561
07:21:50,910 --> 07:21:56,710
We, because we provide law enforcement services to those cities, we are the overseer of

4562
07:21:56,710 --> 07:22:01,090
that automated license plate reader and the data and how it's used.

4563
07:22:02,570 --> 07:22:03,050
Thank you, Sheriff.

4564
07:22:03,510 --> 07:22:08,370
And the reason I ask, I just want to, I know this is a weird, like administrative

4565
07:22:09,990 --> 07:22:15,790
bureaucratic path, windy road here, and just to clarify that no member of this administration

4566
07:22:16,450 --> 07:22:20,570
has entered into a contract of flock or approved a contract of flock directly.

4567
07:22:21,350 --> 07:22:21,910
That's true.

4568
07:22:22,250 --> 07:22:28,370
And I just also, I want to thank all of our members of community who came up for public comment.

4569
07:22:29,030 --> 07:22:36,670
Thank you for tracking our agendas and our consent items so carefully and thoroughly to be able to raise your concerns for us.

4570
07:22:37,070 --> 07:22:42,230
And what the concerns I heard today are about this specific vendor that has been proven to be problematic

4571
07:22:42,230 --> 07:22:46,070
in the National Landscape during a very tumultuous time.

4572
07:22:46,290 --> 07:22:51,210
Presently, I'm just remembering, you know, back to once upon a time at the beginning of this meeting,

4573
07:22:52,310 --> 07:22:59,090
that we opened with a moment of silence for the victims of ice violence,

4574
07:22:59,690 --> 07:23:02,450
and what we're closing today with as concerns,

4575
07:23:02,770 --> 07:23:08,870
more community members of continued exposure and harm coming from ice.

4576
07:23:08,870 --> 07:23:11,250
vis-à-vis this flock vendor,

4577
07:23:13,370 --> 07:23:16,930
so I of the three cities I also know that the town of Los

4578
07:23:16,930 --> 07:23:22,590
Alto Cills used to have a contract with flock and they've since suspended that contract.

4579
07:23:23,710 --> 07:23:30,070
And then I was also recently informed to that the city of Santa Cruz has also canceled

4580
07:23:30,070 --> 07:23:31,530
their contract with flock.

4581
07:23:34,370 --> 07:23:43,730
So I would like to make a motion today to defer this vote, but I understand that the

4582
07:23:43,730 --> 07:23:48,470
policies in place is that was approved two years ago is sunsetting, right?

4583
07:23:48,470 --> 07:23:49,110
That's correct.

4584
07:23:49,990 --> 07:23:57,610
So I would make a motion for a one-month extension of the existing policy that was originally

4585
07:23:57,610 --> 07:24:03,750
scheduled to send set for the City of Saratok and the Tana-Los Alto Hills into deferred

4586
07:24:03,750 --> 07:24:08,110
today's recommended action, this vote to continue this conversation at the second meeting

4587
07:24:08,110 --> 07:24:13,750
of February. The reason I'm asking for this deferred, is that during that time, my request is

4588
07:24:13,750 --> 07:24:19,550
that the County Council's office and the administration work together to evaluate the issues

4589
07:24:19,550 --> 07:24:26,750
with flock and give us an overview of the investigation and an overview of the basis for the contract

4590
07:24:26,750 --> 07:24:33,430
cancellations that have occurred in Los Alta Cills, with Santa Cruz, and potentially any other

4591
07:24:33,430 --> 07:24:37,750
jurisdictions that have recently canceled their contract with Flock.

4592
07:24:38,770 --> 07:24:43,710
What I'm hearing from public comment and feedback, community feedback is that this cancellation

4593
07:24:43,710 --> 07:24:50,310
is happening in response to a number of concerns over egregious data sharing contrary to policies.

4594
07:24:51,710 --> 07:24:56,330
In other words, my request is so that my request is for, I understand what's going on with

4595
07:24:56,330 --> 07:25:01,570
and so that we can have a more informed discussion when this comes back.

4596
07:25:01,790 --> 07:25:09,570
And Tony, from your, from this analysis, please make public what you can for the portions of your analysis,

4597
07:25:10,250 --> 07:25:15,690
that cannot be made public, please send those pieces to the full board and a confidential memo.

4598
07:25:16,390 --> 07:25:22,230
Make sure that gives you more room to have this, the level of transparency that our community is requesting.

4599
07:25:22,230 --> 07:25:24,230
Happy to do that, Supervisor.

4600
07:25:24,550 --> 07:25:24,830
Okay.

4601
07:25:25,010 --> 07:25:32,450
Second, your motion with an additional request for the report, and I will be transparent as

4602
07:25:32,450 --> 07:25:39,730
well that I was prepared to abstain on this consistent with my past votes aside from the

4603
07:25:39,730 --> 07:25:40,850
flock issue.

4604
07:25:41,470 --> 07:25:50,350
So, I want to be clear that I wasn't looking for a different angle here, but what I would

4605
07:25:50,350 --> 07:25:56,950
the report to include, whether it has to be confidential or not, is whether if the majority

4606
07:25:56,950 --> 07:26:05,590
of the board were to vote to approve these contracts with the cities in the future, is

4607
07:26:05,590 --> 07:26:13,970
it appropriate and enforceable for us to limit or prescribe what companies they can contract with?

4608
07:26:15,330 --> 07:26:24,070
And I really want us to be cognizant here, that even if we are not the ones contracting,

4609
07:26:25,130 --> 07:26:25,870
we're complicit.

4610
07:26:25,930 --> 07:26:28,410
This is one degree of separation.

4611
07:26:29,170 --> 07:26:32,830
And while I understand that these cities have, you know,

4612
07:26:32,830 --> 07:26:40,310
I'm sure admirable intentions of this is how they believe they can increase traffic

4613
07:26:40,310 --> 07:26:49,370
safety or other public safety, the methodology is problematic and particularly today, given

4614
07:26:49,370 --> 07:26:56,370
what we are seeing and understanding how information is being used to weaponize and hunt

4615
07:26:56,370 --> 07:27:05,210
people. I don't think this county should have any part of this kind of work, whether it's one,

4616
07:27:05,210 --> 07:27:11,310
three degrees separated. So, supporting your motion today, but clear that my underlying vote

4617
07:27:11,310 --> 07:27:16,850
would have been to abstain from up. Is that a second? That was a second in there. Yes.

4618
07:27:17,170 --> 07:27:21,570
Okay. I just want to clarify the motion. You mentioned two of the three cities. I didn't

4619
07:27:21,570 --> 07:27:28,670
mark here is a Cupertino. Well, the existing surveillance use policy with Cupertino

4620
07:27:28,670 --> 07:27:33,550
Um, is uh, is not sunsetting is that right?

4621
07:27:34,650 --> 07:27:35,710
Yes, that's correct.

4622
07:27:35,990 --> 07:27:44,690
If you, um, uh, the vote to extend the sunset for Seratoga and Mosaltos Hills would allow for the

4623
07:27:44,690 --> 07:27:48,330
Sheriff's Office to continue operating those systems during the extension.

4624
07:27:48,930 --> 07:27:53,190
You don't need to make a similar extension as to Cooper China because that does not sunset until June

4625
07:27:54,270 --> 07:28:04,750
In the request to combine all three cities and to a singular use policy that that vote will be deferred to the second meeting in February

4626
07:28:04,750 --> 07:28:11,190
Following more information about what's happening with flock. Does that sound okay? I mean date. Did that is that clear?

4627
07:28:11,930 --> 07:28:17,750
Sorry, does that make sure that that's yeah, that's clear to me and I think that that was our understanding of the motion

4628
07:28:17,750 --> 07:28:19,670
Yeah, Sheriff Johnson is that clear?

4629
07:28:19,970 --> 07:28:22,970
Yeah, that is clear and I would just like to say

4630
07:28:22,970 --> 07:28:41,410
Again, we're talking about the surveillance use policy, and I know it's getting conflicted with the company, the vendor, because that is our current vendor, or these contract cities, current vendor, and there's concerns, and I'm empathetic to those concerns, especially from the ones I heard about with the community.

4631
07:28:42,010 --> 07:28:47,470
But what I will say to this county is we are very good in making sure guardrails are in place.

4632
07:28:47,470 --> 07:28:59,290
We were very good about making sure policies are there to protect everyone in this community, and I do believe these policies are very well prepared and put together

4633
07:28:59,290 --> 07:29:06,310
In fact, I would say we probably have one of the most restrictive policies regarding license plate readers

4634
07:29:06,310 --> 07:29:12,910
definitely in the region if not the state, and I do think it's important that we may

4635
07:29:12,910 --> 07:29:18,330
be informed the community of exactly what those policies are, as mentioned by one of

4636
07:29:18,330 --> 07:29:23,110
the speakers, how long the data is stored, who we share the data with, because we don't

4637
07:29:23,110 --> 07:29:28,090
share it, it's just that simple. The Santa Clara Sheriff's Office does not share data with

4638
07:29:28,090 --> 07:29:32,890
any federal agencies, and we really don't share it with anybody other than ourselves. I think

4639
07:29:32,890 --> 07:29:35,030
That's really important for the community to understand

4640
07:29:35,030 --> 07:29:37,150
is how we're utilizing this data.

4641
07:29:37,990 --> 07:29:41,010
It is not ever used for hunting individuals.

4642
07:29:41,370 --> 07:29:45,130
It is not ever used for immigration purposes,

4643
07:29:45,890 --> 07:29:48,270
because that's truly something very, very important

4644
07:29:48,270 --> 07:29:49,010
to this community.

4645
07:29:49,370 --> 07:29:51,830
And I understand that and I take that very seriously

4646
07:29:51,830 --> 07:29:54,790
and I take responsibility for that.

4647
07:29:55,130 --> 07:29:58,910
So again, I think this is something that needs to be looked at.

4648
07:29:59,030 --> 07:29:59,970
So I appreciate that.

4649
07:30:00,000 --> 07:30:25,660
But I do want to say it has been very effective for these contract cities in regards to keeping those cities a little safer. Over the period that we've had them, which is a short period of two years, we're talking about 66 individuals who've been arrested for very, I mean, crimes that range from carjacking to assault, to loaded weapons to robbery. We're not just talking about traffic enforcement.

4650
07:30:25,660 --> 07:30:31,020
We're talking about community safety so again whether we agree with the vendor or not

4651
07:30:31,020 --> 07:30:37,720
I do think there's value in the technology and I do think this is something we shouldn't just dismiss because of the vendor

4652
07:30:37,720 --> 07:30:39,760
We can look at other options

4653
07:30:39,760 --> 07:30:40,700
so

4654
07:30:40,700 --> 07:30:42,360
Thank you

4655
07:30:42,360 --> 07:30:46,740
Chef Johnson, thank you for for your words here. I I would go out on a limmer

4656
07:30:46,740 --> 07:30:50,320
I know you said that we may have one of the most strictest use policies

4657
07:30:50,320 --> 07:30:55,380
I'm gonna say we do have the strictest use policy. We have very intense guardrails

4658
07:30:55,380 --> 07:31:03,080
Thanks to former supervisor Symedian, who really dedicated much of his career to ensuring the protection of data and safety.

4659
07:31:03,820 --> 07:31:05,980
I think with all that, we're on the same page.

4660
07:31:06,520 --> 07:31:12,180
I think what I'm hearing today is the concerns is that we may have a vendor that doesn't follow policy.

4661
07:31:12,660 --> 07:31:22,080
And that the reasons that they have found termination after termination, their various contracts with jurisdictions, is that they're not abiding by what they sign potentially.

4662
07:31:22,080 --> 07:31:30,780
Which is why I'm asking county council administration to do a review of what's been going on with lock why they're contracts have been canceled

4663
07:31:30,780 --> 07:31:35,020
But my my intention today is not to

4664
07:31:36,300 --> 07:31:39,320
It's it's not to chastise our surveillance use policy

4665
07:31:40,280 --> 07:31:45,000
Like I said I think it's one of the strictest ones. No you said was one of the strict ones

4666
07:31:45,000 --> 07:31:51,520
I think it's a strictest one period and protecting our residents privacy and data in in

4667
07:31:51,520 --> 07:31:57,480
I would never want the use of public funds to go towards corporation that would

4668
07:31:58,180 --> 07:32:06,300
Frequently flout that and again, all I would ask is and during that review is that we look at those areas where the contracts have

4669
07:32:06,880 --> 07:32:09,880
Or information has been shared to see if their

4670
07:32:10,640 --> 07:32:17,320
Policies were as strict as ours because again the only way that data can be shared is by the organization that holds a data

4671
07:32:17,320 --> 07:32:19,100
which is us so

4672
07:32:19,580 --> 07:32:24,080
The vendor can't even share the data unless we give them permission to share the data.

4673
07:32:24,380 --> 07:32:25,720
Could I get clarification, Sheriff?

4674
07:32:26,880 --> 07:32:30,260
Did the cities that have the contract not access the,

4675
07:32:30,260 --> 07:32:31,720
not have access to the data?

4676
07:32:31,920 --> 07:32:32,880
I trust our organization.

4677
07:32:33,300 --> 07:32:33,620
Yeah, no.

4678
07:32:33,640 --> 07:32:36,160
We are the ones that have access to it for investigations.

4679
07:32:37,460 --> 07:32:40,740
So the cities don't have access for any purpose.

4680
07:32:41,000 --> 07:32:43,120
No, I mean, I could clarify that, but I'm all 100%.

4681
07:32:43,920 --> 07:32:45,580
100% and I was just confirmed.

4682
07:32:45,700 --> 07:32:47,880
But were the only ones that have access to the data?

4683
07:32:47,880 --> 07:32:51,980
No reason to keep bringing this up. I think it's really important that the community understands it.

4684
07:32:52,620 --> 07:32:56,840
Yes, there are things that may happen in other parts of this country, even in this state.

4685
07:32:57,140 --> 07:33:00,200
But when it comes to Santa Clara Sheriff's Shents, Santa Clara County,

4686
07:33:00,860 --> 07:33:04,040
we are not communicating or sharing our data period.

4687
07:33:04,680 --> 07:33:06,320
Thank you for the clarification, Sheriff.

4688
07:33:07,460 --> 07:33:10,780
I haven't ever had concerns about our operation or organization.

4689
07:33:11,080 --> 07:33:16,320
And I know that you've stood with our immigrant communities since day one of a mutaking office.

4690
07:33:16,960 --> 07:33:24,360
I would like to add a further request to my motion today that if Sheriff and your engagement with the

4691
07:33:24,360 --> 07:33:30,540
cities of Cupertino in Sunnyvale, if you could prevent them with provide them with other options for other vendors.

4692
07:33:30,800 --> 07:33:33,440
Yeah, you mentioned Sunnyvale just for record clarification.

4693
07:33:33,560 --> 07:33:39,060
Oh, I'm sorry. Yes, sorry. Sunnyvale and Los Altos. Oh, but Los Altos has already canceled their contract with Flock.

4694
07:33:39,220 --> 07:33:45,980
Yeah, but, and again, for fairness, I do think, you know, without having represented from Los Altos here.

4695
07:33:45,980 --> 07:33:50,360
There were other reasons, I don't know if it was just because it was flocked.

4696
07:33:50,420 --> 07:33:54,620
They had purchased numerous cameras over the years at a cost.

4697
07:33:55,040 --> 07:33:58,720
And I think the budgetary constraints may have been a factor for that.

4698
07:33:58,940 --> 07:34:00,600
But again, I'm not going to speak on their behalf.

4699
07:34:00,880 --> 07:34:02,620
And I'm not trying to speak on their behalf either.

4700
07:34:02,920 --> 07:34:07,400
Hence, my request for further investigation in analysis of actually what went down with

4701
07:34:07,400 --> 07:34:13,920
these contracts, contract cancellations, and that are there other vendors besides flock out

4702
07:34:13,920 --> 07:34:14,420
in the market?

4703
07:34:18,100 --> 07:34:25,480
So during this one-monthing section, extension, as we're doing more research and providing more information to the board for an informed discussion,

4704
07:34:26,020 --> 07:34:33,760
Sheriff, can I ask you to also share, provide with Los Altoes and Saratoga?

4705
07:34:34,400 --> 07:34:35,700
Am I make up cities now?

4706
07:34:36,180 --> 07:34:37,740
It's Saratoga, Los Altoes.

4707
07:34:38,000 --> 07:34:43,660
I got it.

4708
07:34:43,660 --> 07:34:47,480
I was just there last night and lost health to lost health.

4709
07:34:52,180 --> 07:34:55,880
It's I'm spoiled by getting to be the only district inside one city.

4710
07:34:57,080 --> 07:35:02,220
So if I could ask Sheriff that you provide them with other options for vendors as well.

4711
07:35:02,440 --> 07:35:05,860
Yeah, I mean I think those conversations already happened.

4712
07:35:06,520 --> 07:35:08,500
So but yes, to answer your question we can.

4713
07:35:08,800 --> 07:35:09,640
Okay, thank you.

4714
07:35:09,640 --> 07:35:14,340
And that's it for me, and President, turn it back to you.

4715
07:35:15,180 --> 07:35:15,380
Oh, good.

4716
07:35:15,520 --> 07:35:18,660
I'm glad you mentioned the difference between Los Altoes and

4717
07:35:18,660 --> 07:35:21,020
Altoes Hills because they are two separate cities.

4718
07:35:21,500 --> 07:35:24,120
And I've heard that a resident from Los Altoes Hills,

4719
07:35:24,260 --> 07:35:27,660
when you live in Los Altoes, she was very upset about it.

4720
07:35:28,420 --> 07:35:29,080
So, this is separate.

4721
07:35:29,500 --> 07:35:31,520
In any case, just this, but no.

4722
07:35:31,960 --> 07:35:36,860
First, I just want to thank my colleague for very thoughtful discussion

4723
07:35:36,860 --> 07:35:43,660
on this very important topics, for those of us who have been on the board a little longer

4724
07:35:43,660 --> 07:35:48,240
be in Surveys, I remember, have always been very familiar with all former colleagues who

4725
07:35:48,240 --> 07:35:56,280
buys us medium, who truly has been the strongest protector regarding these privacy issues

4726
07:35:56,980 --> 07:36:04,100
on cameras, LPR, license plate readers, and then that's the reason why this county really

4727
07:36:04,100 --> 07:36:09,360
as strong as laws or policies on these specific institutions.

4728
07:36:09,900 --> 07:36:12,040
So I just want to say thank you for these thoughtful discussion.

4729
07:36:12,260 --> 07:36:14,900
I look forward to every part coming back to us in a month.

4730
07:36:15,180 --> 07:36:16,260
He's makes face, doesn't it, Russia?

4731
07:36:16,660 --> 07:36:18,140
And make sure we do the right things.

4732
07:36:18,580 --> 07:36:20,420
Thank you very much for all the input.

4733
07:36:21,640 --> 07:36:23,600
And I think we have a public come up.

4734
07:36:23,740 --> 07:36:24,900
Do you have some more to say?

4735
07:36:24,900 --> 07:36:25,740
I have a proposal.

4736
07:36:25,960 --> 07:36:26,220
I have a proposal.

4737
07:36:26,220 --> 07:36:28,340
Before we continue to clarify the record,

4738
07:36:28,680 --> 07:36:31,440
I just wanted to confirm that the secondary degrees

4739
07:36:31,440 --> 07:36:38,120
with that amendment to the motion regarding direction to approach the cities with the alternate

4740
07:36:38,120 --> 07:36:38,740
vendors.

4741
07:36:42,380 --> 07:36:42,580
Okay.

4742
07:36:42,940 --> 07:36:43,700
Motion seconded.

4743
07:36:43,840 --> 07:36:44,100
And yes.

4744
07:36:44,180 --> 07:36:44,760
So I was on the Coga.

4745
07:36:44,940 --> 07:36:45,220
Yes.

4746
07:36:45,220 --> 07:36:45,840
Thank you.

4747
07:36:46,420 --> 07:36:50,860
I will actually not be supporting the alternate motion.

4748
07:36:51,960 --> 07:36:54,480
I read it as the sheriff mentioned.

4749
07:36:54,480 --> 07:37:00,060
This is really about the surveillance policy and I think it's important to have the strongest

4750
07:37:00,060 --> 07:37:03,680
policy that we can, and this wouldn't enable that.

4751
07:37:03,960 --> 07:37:09,880
It would also consolidate the three cities into one, which I think helps in streamlining

4752
07:37:09,880 --> 07:37:18,400
and making it easier to enforce the policy, and I, you know, very much appreciate the

4753
07:37:18,400 --> 07:37:25,660
many concerns, and I share a lot of them, and it seems like the issue is that this

4754
07:37:25,660 --> 07:37:32,400
In vendor, my understanding is the policy actually mentions this vendor, but it would allow

4755
07:37:32,400 --> 07:37:41,140
it to by changing it to ALPRs to enable a different vendor to be under this policy.

4756
07:37:41,920 --> 07:37:48,780
So to me, I was looking at it as a policy that would strengthen our position and maybe enable

4757
07:37:48,780 --> 07:37:58,780
us to even move away from this specific vendor if we needed to do so. I will say I voted for

4758
07:37:59,960 --> 07:38:08,080
these cameras and Mountain View as a city council member after much deliberation and extensive research

4759
07:38:08,080 --> 07:38:16,780
and information. Yes and we always have to be mindful and careful of how the data is shared and

4760
07:38:16,780 --> 07:38:20,540
make sure that it's not shared and used in correct ways.

4761
07:38:21,080 --> 07:38:26,640
But I have to say that we use cameras for our fast track

4762
07:38:26,640 --> 07:38:30,020
transponders in our expressways.

4763
07:38:30,200 --> 07:38:35,680
I visited a country in Asia that uses cameras all

4764
07:38:35,680 --> 07:38:36,560
around their city.

4765
07:38:36,580 --> 07:38:41,320
There means city, and it provides emergency response,

4766
07:38:41,320 --> 07:38:51,920
safety running buses on time, monitoring the number of, you know, taxi, it's a transportation tool, a transit tool.

4767
07:38:52,520 --> 07:38:57,740
So there's definitely, you know, beneficial uses to these cameras.

4768
07:38:58,600 --> 07:39:04,360
And I, you know, and I asked and about this, you know, there's going to be trade-offs.

4769
07:39:04,360 --> 07:39:19,440
And I asked if you know the folks in this city had dealt with the issues privacy and security and they said that yes, they've had those discussions and debates, but certainly there's pros and cons.

4770
07:39:20,080 --> 07:39:27,580
And I think it is worthwhile to have that full conversation and discussions, so I very much support everything else.

4771
07:39:27,580 --> 07:39:39,660
I just think it's important to have a strong policy in place at this time, and so that's why I will not support the notion to delay, but I would prefer to have that policy in place now.

4772
07:39:39,660 --> 07:39:46,320
And I will say in terms of Los Santos Hills, which is in my district, as is Saratoga and Cupertino,

4773
07:39:46,800 --> 07:39:52,180
I have heard from many members of the community who support the cameras.

4774
07:39:52,380 --> 07:39:57,740
There's a neighborhood in Los Santos Hills that were the residents got together and purchased

4775
07:39:57,740 --> 07:40:06,500
them themselves. So, again, and I'll say, and we got 8 to 1 support for the cameras in this community.

4776
07:40:06,500 --> 07:40:14,340
So, I think there's a lot of information and a lot of discussion to be had, but I believe

4777
07:40:14,340 --> 07:40:19,560
a policy is important to have in place, so I will not support the notion.

4778
07:40:19,820 --> 07:40:20,900
Thank you.

4779
07:40:24,350 --> 07:40:31,430
So, there's some additional information I'd like to debate based on the exchange, Tony,

4780
07:40:31,570 --> 07:40:39,390
and with your agreement, can you include in the memo confirmation of who gets access

4781
07:40:39,390 --> 07:40:43,510
to the information I'm understanding from the sheriff that it's just their office, that's great.

4782
07:40:43,790 --> 07:40:54,490
I just want us to have the full picture, does CLEATS get it? Is there any leakage in this

4783
07:40:54,490 --> 07:40:56,990
in this system? Can that analysis be included, please?

4784
07:40:57,570 --> 07:40:58,950
Yeah, absolutely. Thank you.

4785
07:40:59,070 --> 07:41:02,090
Is that all right? Yeah, absolutely. More information is always going to be better. Thank you.

4786
07:41:02,090 --> 07:41:05,110
And we'll certainly confer with the sheriff's office on it.

4787
07:41:05,990 --> 07:41:08,810
Supervisor Abicaga, I appreciate your comments.

4788
07:41:09,010 --> 07:41:14,710
I want to clarify that my motion today doesn't end the existing use policy.

4789
07:41:14,890 --> 07:41:20,510
It actually is intended to allow for further information and conversation to happen without

4790
07:41:20,510 --> 07:41:23,930
any disruption to the existing usage of cameras.

4791
07:41:25,070 --> 07:41:31,310
I think the alternative is that I cannot support moving forward with the recommendation that's

4792
07:41:31,310 --> 07:41:36,210
on the, that's, that's, on the ledge file today.

4793
07:41:36,790 --> 07:41:40,470
So I'm asking for an extension, extension, the existing use permit,

4794
07:41:40,770 --> 07:41:44,210
so that it doesn't sense it, so that there's no description to service.

4795
07:41:44,750 --> 07:41:49,170
Well, we do our due diligence for further information about this very controversial vendor.

4796
07:41:49,870 --> 07:41:52,990
So of course, you are free to vote, however you want.

4797
07:41:53,030 --> 07:41:54,570
I just want to add that layer of clarification,

4798
07:41:54,850 --> 07:41:56,770
that I'm trying to avoid any disturbance in service.

4799
07:41:57,790 --> 07:41:59,590
Yeah, I appreciate that.

4800
07:41:59,650 --> 07:42:05,170
I guess, again, I look at this as we were taking the specific vendor out and expanding it,

4801
07:42:05,410 --> 07:42:10,870
so that allows for us to continue to die a log and then to explore other vendors.

4802
07:42:11,050 --> 07:42:16,110
And I'll say, I think, when I voted for this as a city council member, I don't know that we,

4803
07:42:16,230 --> 07:42:21,270
there were other vendors, every city in this county, because we were the last ones,

4804
07:42:21,270 --> 07:42:24,350
I believe in Mountain View to adopt it has flock.

4805
07:42:24,730 --> 07:42:27,830
I imagine every city now is having this discussion.

4806
07:42:28,370 --> 07:42:31,250
And so it's important to be a part of that conversation.

4807
07:42:32,030 --> 07:42:35,430
But in the meantime, to be able to expand out

4808
07:42:35,430 --> 07:42:38,630
and look at other alternatives is, I think, worthwhile.

4809
07:42:39,270 --> 07:42:40,030
Thank you.

4810
07:42:44,520 --> 07:42:44,740
OK.

4811
07:42:45,240 --> 07:42:47,460
If there's no further comments for a go take the vote?

4812
07:42:47,640 --> 07:42:47,840
Sure.

4813
07:42:49,140 --> 07:42:50,720
We have a motion by Supervisor Young,

4814
07:42:50,800 --> 07:42:52,680
and a second by Supervisor Ellen Berg.

4815
07:42:53,160 --> 07:42:53,960
Supervisor Abacoka?

4816
07:42:55,900 --> 07:42:56,380
Yes.

4817
07:42:57,800 --> 07:42:57,960
Yes.

4818
07:42:58,540 --> 07:42:58,780
Presently?

4819
07:42:59,060 --> 07:42:59,140
Yes.

4820
07:42:59,140 --> 07:42:59,360
Yes.

4821
07:42:59,800 --> 07:42:59,840
As well.

4822
07:43:01,040 --> 07:43:02,380
The motion carries 3-1.

4823
07:43:04,120 --> 07:43:04,520
Thank you.

4824
07:43:05,000 --> 07:43:08,720
Well, now is moving to the end of our agenda.

4825
07:43:14,260 --> 07:43:16,300
With that, we will be able to adjourn our meeting.

4826
07:43:16,940 --> 07:43:21,240
Our next meeting will be held on Tuesday, February 10th at 9.30 a.m.

4827
07:43:21,260 --> 07:43:22,620
Right here is the inflation channel.

4828
07:43:23,340 --> 07:43:26,200
So again, thank you to our clerks of security staff on administration.

4829
07:43:27,320 --> 07:43:32,280
Before you all go, I just want to give another familiar reminder that we have a state of the county,

4830
07:43:32,400 --> 07:43:33,880
2026 coming up soon.

4831
07:43:35,200 --> 07:43:40,580
We have two Friday the 13th this year, and we'll be holding our state of county on the second one,

4832
07:43:40,800 --> 07:43:45,420
March 13th, 2026, and I'll honor to host the event right here also,

4833
07:43:45,760 --> 07:43:47,240
beginning at 545 PM.

4834
07:43:47,560 --> 07:43:52,800
We hope that you'll be able to join us and make sure to RCP to our on our web page on district three.

4835
07:43:52,800 --> 07:43:54,460
Thank you so much for being here.

4836
07:43:54,960 --> 07:43:55,340
Thank you.

4837
07:43:56,020 --> 07:43:56,920
Have a nice day.