[This transcript was generated automatically from audio using AI and hasn't been reviewed by a person -- it can contain mistakes, including plausible-sounding sentences that were never actually said. Treat it as a starting point, not a verbatim record.]

[17:24] 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.
[17:35] Supervisor Abhay Koga.
[17:38] Here. Supervisor Yoon. Here. Supervisor Ellen Burke.
[17:41] I'm here. Vice President Arrennance is absent. President Lee.
[17:46] Good morning, President. Good morning. You have a quorum.
[17:49] Thank you, Ronda. Would you please go ahead and give the interpretation the announcement, please?
[17:53] Yes, I'd like to our interpreters to translate the following into Spanish and then Vietnamese.
[18:02] If you are in chambers and requires Spanish or Vietnamese translation,
[18:07] translation devices are available at the back of chambers.
[18:10] The clerk can assist you with setup.
[18:12] Translation is also available in Zoom using the interpretation button.
[18:18] Additionally, as a gentle reminder for those public commenters,
[18:21] 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.
[18:35] Thank you, Ronda.
[18:37] So next moving to next is our touch of allegiance and may I please have supervisor Abikoga.
[18:43] Lead us in a touchable allegiance this morning, please.
[18:46] Thank you, please join me in rise to view our evil.
[18:54] I pledge allegiance to the flag of the United States of America and to the Republic for which it stands.
[19:02] One nation under God, individual with liberty and justice for all.
[19:08] Thank you.
[19:09] Thank you.
[19:12] And now I'll go ahead and pass it over to supervisor Elamberg to introduce just mornings
[19:16] and the kids today.
[19:18] Good morning, everyone.
[19:20] To begin today's meeting, I am honored to welcome Albert Wright to offer an invocation.
[19:26] Albert is a San Jose resident, a United States Navy veteran, and a accomplished engineer
[19:32] whose career spans decades at the forefront of semi-conductor manufacturing nanotechnology
[19:37] in advanced microscopy.
[19:40] He's the CEO and founder of Infinite Potential,
[19:44] and previously worked with industry leaders,
[19:46] including Hattachi, High Tech Knowledgeies, and Land Research,
[19:50] where he served as a senior master engineering technician
[19:53] and inventor supporting critical technologies
[19:56] used in integrated circuit manufacturing.
[19:59] Equally central to Albert's Life is his commitment
[20:02] to service and mentorship.
[20:04] He's a member of the 100 Black Men of Silicon Valley
[20:07] It serves as co-chair of mentoring where he dedicates his time to guiding African-American and Latino students
[20:13] in STEM education at Bernal Intermediate and Santa Clara and Santa Teresa High School here in San Jose.
[20:19] Through that work, he helps young people see pathways into careers that may not have otherwise imagined.
[20:25] Albert's life reflects a deep balance of technical experience, public service, and community leadership.
[20:30] And yet, none of these reasons were the driving force behind my inviting him to offer an
[20:38] invocation this morning.
[20:40] I met Albert at a recent SVLG convening, and the reason I introduced myself is that slung
[20:46] over his shoulder was a very long ram's horn that I recognized as the traditional instrument
[20:52] that is blown in synagogues around the globe on the Jewish New Year.
[20:56] I cycled up and asked him about his horn, and to my surprise he referred to it by its
[21:03] Hebrew name, a shofar. In my tradition, the loud blasts serve as a literal and figurative
[21:09] wake-up call to return to faith to good works and to community. In the moment, I knew I
[21:16] wanted Albert to blow the shofar at a board meeting at the beginning of our new year,
[21:25] and
[21:26] Please join me in welcoming Albert Wright to our chambers.
[21:35] The podium has a built-in microphone.
[21:38] Thank you.
[21:39] Good morning, Supervisors, Ellen Burke, and distinguished supervisors and our community from
[21:47] around the San Francisco Bay area.
[21:51] As supervisor, Ellen Berg mentioned, the show far or Ram's horn is used in Jewish celebrations.
[22:02] This particular show far is the African Kudu Antelopeard,
[22:12] you know, we'd be left to the left horn, I bet.
[22:14] And I proudly carry this around the nation, I call it my American Express, because literally
[22:26] it changes atmospheres and frequencies and mirrors.
[22:32] Like the United States military doing World War II involved the youth, the help of the
[22:44] to speak a language that could not be understood by the Japanese forces.
[22:51] So, the sounding of the show far is too an unconventional weapon of warfare.
[22:58] But it's a blessing. It's a blessing.
[23:01] One of my favorite movies,
[23:07] long ago,
[23:07] It was, who was, it's the bestest alone's first blood, where he was proposed to find the community law enforcement agency.
[23:19] You know, it wasn't his fault, and he declared, it wasn't my war, they true for blood.
[23:25] I love that line.
[23:28] And so as we have, as we, the people of the Santa Clara Valley, here in these hollow chambers
[23:40] of Silicon Valley, we have the opportunity to set a directive for our leadership for
[23:50] this coming 2026 year, and this is a very important year.
[23:55] I don't know if you guys are excited, but I am super excited.
[23:59] And I'm also the Vice President of the Silicon Valley,
[24:00] and that's favor of honor, which we're standing on business
[24:05] and opportunities for our members in the community
[24:09] to receive opportunities to make money, OK?
[24:15] And so with that, and everything that's going on in this
[24:20] in the nation and around the world the eyes of the world.
[24:26] I'm going to be looking back and I'm just excited about that because as I give the
[24:32] evocation and then sound the show far, I want you to receive the sound of the show far with
[24:39] great joy. There are four distinct sounds of the show far. The first sound is called
[24:46] It means it's a call to bring the congregation together.
[24:53] The second sound is called Severine.
[24:57] It's a call to broken this and repeat it.
[25:01] The third sound is called to Rua, a call to spiritual warfare.
[25:07] And the final sound is to hear Gordola.
[25:10] 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.
[25:21] 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.
[25:41] 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.
[26:09] So, my prayer for our leadership is that God would annoy your vision, that God would annoy
[26:16] your vision for we the people of Santa Clara County, and that that vision will align with
[26:23] his plans and his purposes for this valley of hearts delight.
[26:28] Let's pray.
[26:32] To El El Yon, the most high God, a prayer of invocation, directive for the governing body of
[26:39] Santa Clara County Board of Supervisors, Santa Clara,
[26:45] Holy Clarity, Santa Clara, Holy Clarity,
[26:49] Open the heavens Lord and open the earth.
[26:52] We welcome you King of Glory into the chambers of this hollowed hall for the earth is the
[26:57] Lord's and all is fullness, the sea and all day that dwells in, but you have chosen to give
[27:03] it to the kingdom of men in whom you are well pleased and we thank you Lord.
[27:08] Lord, at this Cairo's moment in time, on a day like no other day, humbly and boldly, we invoke
[27:15] you Holy Father, that you grant to our leaders this board of distinguished supervisors,
[27:21] that you would grant to them a spirit of wisdom and revelation in the knowledge of you,
[27:26] that the eyes of their understanding would be enlightened, flooded with light, for God you
[27:33] are light.
[27:34] 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.
[27:54] Lord, as your children and your creation, the Ecclesiah, that you have planted in this valley of
[28:00] heart to the light, we, this SEC Board of Supervisors, as a ruling body of governance in the
[28:08] great state of California, Bula, you claim it for yourself, make our invocation to our father
[28:15] in heaven, for your spirit of wisdom, revelation in the knowledge of who you are, and in
[28:21] insight into the hopes and inheritance for which you have called each of the supervisors.
[28:28] Lord, this is a vital time in our nation's history. As all the eyes will be on this land,
[28:36] the Bay Area from around this earth you've created for us. And as it has been said,
[28:42] so we say, as Go California so goes the nation. From these hollow halls we invoke you for Holy
[28:49] clarity. As you have granted and anointed this board of supervisors, the authority and future
[28:56] forward vision for this region. That vision, that future forward vision, that will shine
[29:02] like a bright light around the globe, Lord. Help our 2026 board of supervisors to come into
[29:09] divine alignment with your purpose. As the scissors are made, for many are the plans in a man's
[29:15] But it is your purpose that will stand, as the show for ourselves, speak Lord, for your servants are listening.
[29:23] Isaiah 2026 declares, verse 1, in that day shall this song be sung in the land of Judah.
[29:31] We have a strong city.
[29:34] Salvation will appoint for walls and bull walks.
[29:37] Lord, open the gates that the righteous nation which keep of your truth may enter in.
[29:43] Lord, you will keep them in perfect peace, whose mind is stayed on you, because we trust in you.
[29:49] Trust in you the Lord forever.
[29:52] For the Lord, Jehovah is everlasting strength.
[29:56] And so, Lord, as we...
[30:00] As I in this invocation, we again declare Lord God, open the heavens and open the earth.
[30:12] For Lord, you have been our dwelling place in all generations before the mountains were brought forth,
[30:17] or ever you had formed the earth and the world, even from everlasting, you are God, Olam Elb.
[30:26] 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
[30:34] 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
[30:42] So teach us
[30:43] The number our days
[30:45] That we may gain a heart of wisdom. Oh satisfy us early with your mercy
[30:50] that we may rejoice and be glad all our days.
[30:54] Return, O Lord, how long and have compassion
[30:56] on your service, these leaders.
[30:59] Make us glad according to the days in which
[31:02] you have afflicted us, the years in which we have seen evil.
[31:06] Let your work appear to your servants, these leaders,
[31:10] and your glory to their children,
[31:12] and let the beauty of the Lord our God,
[31:15] be upon us, and establish the works of our hands for us.
[31:19] Yes, established the works of our hands.
[31:23] Lord God, we thank you.
[31:26] And Lord, as you instructed in your children
[31:31] to design the silver trumpet,
[31:34] the silver trumpet was made by the hand of man.
[31:37] But the show far was made by the hand of God.
[31:42] The breath of man goes into the show far,
[31:45] but the voice of God comes out of it.
[32:00] Thank
[32:45] you so much.
[32:54] I appreciate your starting or meeting today. Thank you. And I assume everyone is wide awake now.
[33:01] 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.
[33:12] item number four. The first item in the German is an honor and memory of the Nielo
[33:18] cells Boac.
[33:23] So, I would like to take a moment to honor memory of the Nielo
[33:27] cells Boac, the beloved husband of our dear colleague and community leader, Thelma Boac,
[33:32] whom I have to honor to have met two decades ago, and proud to call great loyal friend
[33:37] for all these years. The Nielo, known to many simply as Dan, is not someone who sought public
[33:43] recognition, but his impact on community was deeply felt through the life of service he shared with
[33:49] Alma.
[33:50] The film was many years of public service and education and civic leadership, then was her
[33:54] steady source of encouragement, strength and support.
[33:57] Behind every dedicated public servant is often a partner who makes sacrifices, office guidance
[34:03] and provides a quiet reassurance to continue serving others, then embody that role of grace
[34:08] and humility.
[34:09] As I'm waving support, allow Thelma to fully dedicate yourself as not only a teacher, but
[34:15] principal to thousands of students, families, and the broader community, should serve
[34:20] so faithfully.
[34:21] Today we recognize not only Dan's memory, but also the powerful example partnership,
[34:26] love, and shared commitment to service that Dan and Thelma has represented together.
[34:33] The journey reminds us that public service is really a solo effort, it is sustained by family
[34:38] by love and by those who stand behind us every step of the way.
[34:45] On behalf of the Board of Surveys and the entire community, we extend a heartfelt condolences
[34:49] to Thelma and her family and we are on the dance life and legacy and the many lives
[34:54] touched through this quiet but profound support.
[35:00] Surveys, I hope you have a comment to me.
[35:04] All right, and on that, I would just like to ask of being honored to invite Mrs. Thama,
[35:13] a boy to come up and see a few words, so we flagged Dan's life and share your thoughts
[35:20] and hearts.
[35:22] Thank you.
[35:22] Thank you.
[35:31] Thank you.
[35:32] And good morning.
[35:33] Good morning.
[35:34] Thank you very much to Supervisor Rodoli and to the members of the Board of Santa Clara County.
[35:40] Board of Supervisors for remembering my husband and dad before your adjourning.
[35:47] Knowing that his dedication to supporting local community efforts was recognized by this
[35:55] honorable and esteemed body, which is our county.
[36:01] It means the world to me and to my family, especially during this very difficult time.
[36:08] So, with a grateful heart to all of you, thank you from the bottom of my heart for your
[36:14] kindness and your compassion.
[36:16] Thank you so much.
[36:19] Thank you, Thoma.
[36:27] Okay, and then we do a second agreement today, and I'm going to defer this one to
[36:33] Vice-as-Almbrick Young for the next adjournment.
[36:36] Please.
[36:37] Thank you.
[36:38] It is my solemn and sad honor to adjourn today's meeting
[36:42] in recognition of San Jose resident,
[36:45] advocate, and beloved friend, Roma Dawson,
[36:48] who's more than 40 years of service
[36:50] have left an indelible mark on our community.
[36:54] Roma dedicated her career to public service,
[36:57] education, and community building.
[36:59] She earned her bachelor's degree in psychology
[37:01] from the University of California Berkeley and pursue graduate studies at the University of Texas at El Paso.
[37:10] Early in her career, she taught GED courses to U.S. Army soldiers stationed in Germany.
[37:16] Roma was then drawn to local government through leadership training with the Coro Foundation.
[37:21] She went on to play a formative role in San Jose Civic Life.
[37:24] She was part of the Corps staff for Tom McKenaries first campaign for mayor of San Jose
[37:28] and later served on his City Hall staff.
[37:31] Roma's career included trusted leadership roles across City Hall and beyond.
[37:36] She served as Chief of Staff to Council Member Charlotte Powers, Assistant Campaign Manager
[37:41] for Susan Hammers, Mayoral Campaign, and as a core staff member of Zolafgren's first
[37:47] campaign for election to the Santa Clara County Board of Supervisors.
[37:51] She later worked in then Congresswoman Lovgren's district office, assisting residents with
[37:56] complex immigration matters during times of uncertainty and need.
[38:01] She continued her service at City Hall as a council assistant and senior council assistant
[38:06] to council members Cindy Chavez and Sam Lachardo, including during council member Lachardo's successful campaign for the mayor's seat.
[38:15] In each role, Romo is recognized for her knowledge, steady leadership, and deep respect for the communities she served.
[38:22] Beyond government, Roma made lasting contributions to San Jose's cultural and civic institutions.
[38:28] She served in leadership and advisory roles with the San Jose Parks Foundation,
[38:33] the San Jose Stage Company, the San Jose Convention and Visitors Bureau, the San Jose Arts Commission,
[38:39] and the Housing and Community Development Commission.
[38:42] She also held a longstanding leadership association with tapestry and talent,
[38:47] including serving as its president, helping to elevate the arts
[38:50] as a vital part of San Jose's community life.
[38:53] Roma's legacy is one of dedication, integrity, and quiet impact.
[38:58] Through decades of service, she helped shaped policies, campaigns, institutions, and cultural spaces that continue to benefit residents today.
[39:07] 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.
[39:16] 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.
[39:27] 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.
[39:43] Romas Sunshine is here in Chambers and her husband Daniel has joined us on Zoom.
[39:48] We're also honored to be joined by some of Romas dear friends.
[39:52] After Supervisor Young offers some remembrances of her own,
[39:56] Alan Bite Kathy Sutherland and Carol Watts both close friends of Roma to come up and share some more about her.
[40:02] Supervisor Young.
[40:04] Thank you, Supervisor.
[40:05] Alan Bite.
[40:07] Excuse me.
[40:07] 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.
[40:17] Roma spent her life doing what she believed in, making it our county stronger, fair, and more thoughtful.
[40:23] She served as a policy analyst from multiple elected officials.
[40:27] And what's particularly novel is the list of whose offices and administrations she worked for.
[40:31] Tom McEnnery, so a lawfgrin.
[40:34] Sunni Chavez, Sam LaCardo.
[40:36] This is because Roma was just not known
[40:38] for her knowledge, skills, and expertise,
[40:40] but also her integrity.
[40:42] Her energy, dedication, and skill
[40:44] made her trusted across political lines
[40:47] and for people to seek her counsel during challenging moments.
[40:52] Deeply committed to civic engagement,
[40:53] she was a lifelong time board member
[40:55] at the League of Women Voters of San Jose in San Eclera.
[40:59] She served on the board directors of the League of Women Voters
[41:01] of the Bay Area, including us co-present from 2022 to 2025.
[41:06] In addition, she gave her time and leadership to many local commissions, just as Supervisor
[41:10] Elmerberg had listed, including two terms in San Jose City Arts Commission.
[41:15] I first met Roma during the 2016 Measure A Affordable Housing Bond Measure Campaign.
[41:21] It was the first campaign I ever ran, but it was not hers.
[41:24] And she made sure we were on the path towards victory, because the stakes were so high.
[41:29] 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.
[41:39] 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.
[41:57] Remo is always a trusted friend advisor who always made sure that you knew she was watching
[42:01] not for you, but not just because of who you were. She was watching out for you as her
[42:07] commitment to watch out for this county. Roma believes behind a loving family, her sunshine,
[42:13] her husband Daniel, a legacy of service, fairness, and leadership in the community of friends
[42:19] who could say that they were made better by Roma's friendship and engagement. May her memory be
[42:25] blessing to us all in inspiration during these challenging and troubling times when steadfast leadership
[42:30] defined by integrity is needed now more than ever. Thank you. Thank you. Kathy and Carol.
[42:48] Thank you supervisors for this great honor for Roma. She was a true friend to everybody in Santa Clara Valley.
[42:55] I'd like to introduce her son Sean and her husband Daniel and her son Scott are also listening
[43:03] I have comments from Supervisor Chavez, Roma worked for Cindy when she was at City Hall and so I'd like to read those.
[43:13] 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.
[43:28] She was dogged in her pursuit of equity and she worked hard to make sure no one was left behind.
[43:34] Roma worked through many organizations and candidates to make sure women were represented in important debates
[43:40] and in elected and appointed leadership positions.
[43:45] When she believes strongly in an idea, she worked hard to make it so.
[43:49] She was a champion for housing for all the environment, access to health care and reproductive health care.
[43:56] She left no stone unturned when fighting for our rights.
[44:03] Roma was a type of friend who could see when those around her needed to be hugged and encouraged without a word being spoken.
[44:10] She loved others deeply, and for those of us blessed to call her a friend we are better for knowing her.
[44:17] To her family, she loved each of you fiercely.
[44:20] She was always your champion.
[44:22] I am deeply grateful to you for sharing the amazing Roma Dawson with all of us.
[44:27] I am deeply sorry for your loss.
[44:31] And then my comments, if you ever spent more than 15 minutes with Roma Dawson, you would
[44:38] quickly find out the three things she loved and cared deeply about and she could speak fast.
[44:44] So she let you know.
[44:45] 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.
[44:57] Every conversation brought up a chance for Roma.
[45:03] 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.
[45:30] She will be greatly missed by me and everyone who you are.
[45:35] Thank you.
[45:46] My name is Carol Watts, and I'm the chair of the Leaks Women Voters of Santa Clara County and
[45:52] Vice President of Women Voters of Santa Clara.
[45:57] Roma was one of the most active members in the League of Women Voters.
[46:01] She served as the current co-president of the League of Women Voters of the Bay Area.
[46:06] was a legislative analyst for LWV California's housing and homelessness to committee.
[46:12] She was also active in projects of the five leagues in Santa Clara County.
[46:18] She was on our board of directors in San Jose Santa Clara, Charter Housing and Homeless
[46:24] Committee, was an active member of membership action climate change and she was just working
[46:30] on a new project that was going to help us all learn more about the possibility of democracy
[46:36] to dollars in our local government.
[46:40] She joined the League in 2013 after all the years that you just heard about, which are just
[46:44] amazing, and we were so lucky that she brought her experience and her positive energy
[46:49] to the many levels of the League of Women Voters.
[46:52] She loves to do a deep dive on complex policy issues and develop programs showcasing the challenges
[46:59] and potential solutions of issues.
[47:01] She was proud of San Jose, passionate about the environment, the arts, and the league.
[47:08] She leaves behind a legacy of positive impact on the league, the community, and those who
[47:13] knew her, especially her beloved family.
[47:16] She's greatly missed by all of us, rest in peace, Roma.
[47:24] Thank you, All.
[47:25] And may ram us.
[47:26] Memory, be fair, passing.
[47:29] As I said mentioned earlier, many public officials of many also help us with sizes and
[47:35] Rona is absolutely one of those true examples of serving so many really influential and
[47:41] powerful leaders of our community.
[47:44] Just look at her name, even as of last year, she was serving as a commissioner in San Jose
[47:49] and was complaining about why mobile home companies could just raise their rent illegally.
[47:54] This is the type of work she does every single day, whether she's an office or helping others.
[48:00] So I just want to say thank you so much for all your amazing work and you're definitely going to be so dearly.
[48:05] Thank you very
[48:09] much.
[48:10] Okay, the next moving on we actually have the commendations of pronations, which is item 5.
[48:16] 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.
[48:23] So as you?
[48:40] Thank you.
[48:41] Good morning, everyone.
[48:42] I'm going to switch gears a little bit in our program here.
[48:47] The members of the Public Health Department are joining me today because today we are
[48:52] proclaiming February as national children's dental health month, raising awareness about the
[48:57] importance of oral health for children, families, and Santa Clara County.
[49:01] The American Dental Association of Zers February as national children's dental health month,
[49:06] What the goal promoting the importance of good or a hygiene and raise awareness about preventing
[49:10] childhood tooth decay, a common but preventable chronic disease.
[49:15] Cravidies remain the most common preventable chronic disease amongst children, and poor or a
[49:20] health can contribute to mystical, difficulty, concentrating, and long-term health challenges.
[49:25] In fact, chronic, like tooth decay, cavities is one of the top leading causes of chronic absenteeism,
[49:34] In the effects children of color and communities, immigrant communities, and low-income communities disproportionately more than other communities.
[49:41] Children with poor oral dental health or lack of access to dental care are four times more likely to have chronic absenteeism in school,
[49:50] leading to lifelong learning challenges.
[49:52] So this is an important issue and as a mom of an eight-year-old who loves to brush her teeth or social claims.
[50:00] What I would love to tell other young parents is that the most important thing is for them to find
[50:05] to find a oral health exciting to know that's part of their complete health, and that's what we focus on
[50:10] at a younger age, right?
[50:12] 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
[50:16] of you, so that you could be the best version of you.
[50:19] 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.
[50:24] I have with me Dr. Rudman, or a public health officer, and along with her is Samaya.
[50:30] Angelica Brandy, Janki Suma, Lucy, the team that makes sure that every child, every youth in
[50:35] Santa Clara County has access to dental hygiene and oral care and health education for their parents.
[50:41] So I think you ladies for all your hard work, and let's hear it for Dr. Rudman.
[50:49] Thank you so much, Supervisor Young.
[50:51] Thank you, President Lee, and Board of Supervisors for this important recognition of February
[50:56] as national children's dental health month, and despite being the doctor on the day as
[51:02] supervisor young, nailed it exactly with respect to the, you know, always have a spot
[51:08] in the public health department should you need one. I exactly why it is so important to
[51:14] think beyond just the cosmetic components of dental care, that our dental care, and especially
[51:20] the dental care dental health of our children is reflected in the rest of their health and their
[51:26] ability to thrive for their young lives. It is a major impact on school, success on school,
[51:33] attendance, and it affects every part of someone's body from your heart health to your brain health
[51:40] to your learning and your mental health. And so that's why the public health department,
[51:44] our partners at Santa Clara Valley healthcare and dental care providers all over the county
[51:50] find this message of national children's dental health month to be so important. In the public
[51:56] health department, a key thing we do is look at the data from across the county to understand
[52:01] who's impacted by different health problems and therefore what solutions do our community members
[52:06] most need their government to be focusing on? You will see released in the next couple of months
[52:12] and updated oral health needs assessment update that unfortunately reflects that even in
[52:17] a county like this one where we devote significant efforts to making sure our youth have
[52:22] access to oral health care. We still see significant inequities in preventive dental care service.
[52:29] We see families face significant barriers to care. And so by promoting oral health today,
[52:36] promoting oral health literacy, strengthening our community partners, and focusing on prevention.
[52:41] Santa Clara County can achieve the equitable access to health care, especially oral health care,
[52:47] that we know our youth needs and that folks of all ages need.
[52:52] In our public health department in particular, we're excited for a couple of new ventures
[52:56] over the coming months.
[52:58] Some of which partner exactly with the agencies we know most closely serve our communities
[53:03] in need.
[53:04] We're working with our WIC program, our women infants and children nutrition program, to educate
[53:09] parents and caregivers about oral health, we're working with school district nurses, partnering
[53:14] for a poster campaign in schools, we're working with Evergreen to enhance through social
[53:21] media and prove messaging around importance of oral health and we're working with our home
[53:25] visitation nurses to integrate oral health messaging in all of our services that bring
[53:30] health into new families' homes. So with that, I'll offer an additional thank you to our
[53:39] who in addition to brushing your own teeth and like I do with my kido fighting to get them to
[53:44] brush theirs and maybe even floss.
[53:47] Thank you for everyone's efforts to help bring this important issue to the forefront and
[53:52] keep our kids healthy and safe.
[53:54] Thank you.
[53:56] Thank you.
[54:01] All right.
[54:01] We also, in the coming months, you're going to be hearing about from the county promotions about
[54:05] the happy teeth dental event.
[54:07] It's a really cool because what it does is that we provide free dental screenings and community
[54:11] for families, no appointments, necessary, no charges, whatsoever, and with new, new local rules
[54:17] and laws, children entering teak and kindergarten needs to have their teak examination,
[54:23] their dental health examination, and the happy teak that Sullivan also provides for that
[54:27] no cost appearance to make sure there are no disruptions to the show's education.
[54:30] Thank you, ladies, for this incredible lift and making sure that this important issue is on
[54:34] everyone's forefront. All right, we're going to turn it back to take a photo, so sorry.
[54:38] 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.
[54:48] 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.
[55:01] Think about that. Flossing daily would save lives.
[55:04] Just think about it.
[56:27] Thank you.
[56:32] Thank you.
[56:33] Thank you.
[56:33] Thank you.
[56:33] Thank you.
[56:33] Thank you.
[56:33] Supervisor Reynas is not with us today, but she is also a member of the Human Trapping Commission,
[56:39] which I serve as chair alongside coach here's district attorney Jeff Rosen and chair
[56:43] Bob Johnson.
[56:45] And I am pleased to join me.
[56:47] Members of the Human Trapping Commission.
[56:50] Today, we also have members of our human trafficking task force.
[56:56] You?
[57:00] You also have the San Jose Airport.
[57:07] Okay.
[57:10] Good morning.
[57:12] 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.
[57:21] And as Sharon Denella, Pearl of Flores,
[57:27] Ruth Silver-Talb, she was here, but she had to leave
[57:30] Lieutenant Kimana Josh Singleton, Sergeant Casey, Jessica Jenkins, Julie Jarrett, and of
[57:37] course, my co-chair here, Jeff Rosen.
[57:41] Human trafficking happens in our neighborhoods, along our quarters, and two people who
[57:45] deserve safety, dignity, and care.
[57:47] California is one of the largest sites of human trafficking in the country, but we are combating that.
[57:53] We're going to change that narrative and outcome.
[57:55] Trafficking takes many forms including sex trafficking, labor trafficking, and domestic servitude.
[58:00] And behind every horrible statistic is a real person, a child, a neighbor, a family member.
[58:05] These individuals and the communities they touch are forever impacted.
[58:09] In Santa Clara County, we take human trafficking personally.
[58:12] By proclaiming January as human trafficking prevention month,
[58:15] We were saying clearly the prevention matters,
[58:18] survivors matter, and our county will continue to show up
[58:22] an coordinated fashion that centers trauma in clients' first.
[58:26] As we prepare to host major sporting events this year,
[58:29] including the Super Bowl and Bayes March Madness and the FIFA World Cup,
[58:33] we know that large events can increase vulnerability
[58:35] and ultimately human trafficking because economics drives exploitation.
[58:40] That's why our county has joined the safety for the Bay Campaign, a multi-lingual public
[58:47] awareness campaign across Santa Clara, Alameda, Solana counties and total expands across
[58:53] the nine Bay Area counties to ensure that there is a resource for survivors and for those
[58:58] who spot something, see something, say something.
[59:01] This effort is about prevention, about sharing resources and about making people know that
[59:06] they are not alone and that help is available.
[59:08] This is what communities centered public safety looks like, and not this time I'd like to invite
[59:12] my co-chair District Attorney Jeff Rosen to share some words.
[59:19] Thank you, supervisor. In the run up to the Super Bowl in the people world cup and March
[59:23] madness, I want to assure the community that the Santa Clara County Human Trafficking Task Force
[59:28] is ready for the influx of visitors, which may include traffickers. We run the largest anti-human
[59:36] trafficking task force in the Bay Area.
[59:39] We have two prosecutors, more than five law enforcement officers,
[59:43] full time as a part of this task force,
[59:45] along with our partners in the community community solutions,
[59:48] the YWCA, and the entire South Bay Coalition
[59:51] against human trafficking.
[59:53] In the lead up to these large sporting events that are coming here
[59:57] to our area, there are more than 50 person out.
[1:00:00] All that have been deployed to disrupt trafficking efforts. In the last couple of years, we've had
[1:00:09] enormous successes in rescuing victims of human trafficking and bringing perpetrators to justice.
[1:00:16] Just a few months ago, we launched a large operation and closed more than 10 operational
[1:00:21] brothels and saved more than 40 commercial sex workers.
[1:00:28] Thank you.
[1:00:29] Thank you.
[1:00:31] And those efforts are a result of the strong collaboration between law enforcement
[1:00:35] and the community-based organizations which help trafficking survivors.
[1:00:40] So a supervisor, young said, if you see something, say something, and then we will do something.
[1:00:46] Something good that will help victims and prosecute perpetrators.
[1:00:50] Thank you.
[1:00:56] Now, Senate Clara County is known as a national leader on this front against human trapping
[1:01:01] in prevention.
[1:01:03] And that's only possible because of the unique collaboration we have across all partners
[1:01:07] and communities.
[1:01:09] So at the time I'd like to invite, Sharon Denella, the director of the South Bay Coalition
[1:01:14] to end human trafficking to say a few words.
[1:01:19] Thank you, Supervisor Yong and D.A. Rose and in Santa Clara County we've seen work happening
[1:01:25] since 2003, even though 2010 is when National Human Trafficking Prevention Month started.
[1:01:32] But we've been working behind the scenes to build capacity in Santa Clara County to identify
[1:01:37] and respond to human trafficking.
[1:01:39] Our county's protocols and funding priorities reflect best practices and leadership in the
[1:01:43] fight against trafficking.
[1:01:45] We've seen the Board of Supervisors really take a stand against human trafficking and supporting
[1:01:50] survivors.
[1:01:51] The Human Trafficking Commission is a one of a kind.
[1:01:53] We have seen survivors from every part of the world here.
[1:01:57] We have seen all forms of trafficking, sex trafficking on mine and in the streets.
[1:02:02] We've seen labor trafficking and salons in restaurants, construction sites and in the fields.
[1:02:07] We have street vendors who have been exploited, domestic servitude, and debt bondage has happened.
[1:02:13] And we've seen trafficking cases that intersect with domestic violence and sexual assault.
[1:02:18] What we know is that economic drives exploitation.
[1:02:21] And so with three major sporting events happening and beginning in just a few short weeks,
[1:02:25] we need to bolster our efforts to be able to create a safe community where help is available
[1:02:30] for community members and visitors alike.
[1:02:33] San Jose, Maneta International Airport has recently implemented a robust training for all
[1:02:37] badge staff through Freedom Insight.
[1:02:40] That means all badge staff are going to be able to identify and respond to human trafficking.
[1:02:45] And as mentioned, we launched a website safety for the Bay.org.
[1:02:48] This is a resource navigator for anybody feeling unsafe, and it's not just for human trafficking.
[1:02:54] It's for any way that somebody might feel unsafe.
[1:02:57] That might be domestic violence, sexual assault, housing insecurity.
[1:03:01] Increasingly, we know that immigration protections are a major concern.
[1:03:05] There may be hate crimes or other types of violence.
[1:03:07] This website is to help navigate people to the help that they need,
[1:03:11] whether that's a confidential advocate, an attorney, or if they want to report something to the law enforcement.
[1:03:16] So, we encourage you to check out the site in the coming months.
[1:03:19] This site will be translated to make it accessible to all of our community members.
[1:03:24] And that's through the partnership with this Board of Supervisors, our county and really across the region.
[1:03:29] We invite you to join us in combating human trafficking and promoting a safer community.
[1:03:35] Thank you.
[1:03:39] Thank you.
[1:03:40] Safety for the Bay.org and for as a number four, safety for the Bay.org, a resource navigator,
[1:03:47] service navigator information source by developed by trusted messengers, and really developed by
[1:03:54] it's very common formed in development with the survivors from trafficking informing us
[1:03:59] what would have been helpful to them during their time of need. Okay, and I also want to give
[1:04:02] a shout out, there's so many partners as part of this effort over the years, from our health care providers
[1:04:07] to our labor movement, to our office support of housing making sure that emergency shelters are
[1:04:11] available for those who need it most. So we're on part of this together, and I want to thank
[1:04:16] My colleagues on the board, and also our administration for being champions of this issue.
[1:04:20] And I'm going to invite everybody join me on the day as to join me down here for a photo to
[1:04:24] proclaim January as human trafficking prevention month.
[1:04:28] And remember, safety for thevay.org.
[1:04:30] Thank you.
[1:05:59] So
[1:06:26] before we move to the public comments today, I would like to share a personal story.
[1:06:30] So, this Sunday, over breakfast, I actually asked my daughters, a very simple question, I thought,
[1:06:37] who was pretty and good?
[1:06:39] Well, their answer was very immediate and innocent.
[1:06:41] And says, oh, that's me.
[1:06:43] So, I had to explain.
[1:06:45] Pretty and good were not adjectives.
[1:06:48] They were people.
[1:06:50] Extraordinary names we should never forget.
[1:06:53] Alex, pretty, and Renee, good were 237-year-old American citizens,
[1:06:57] who were gunned down by ICE agents and brought daylight in Minneapolis two weeks apart.
[1:07:02] Both were horrifically labelled as, quote, domestic terrorists and quote.
[1:07:07] But the truth tells a very different story.
[1:07:11] Act Freddy was an ICU nurse who spent his days saving the lives of our veterans at the VA hospital.
[1:07:16] René Nicole Good was a loving mother, deeply cherished by her family and friends.
[1:07:21] And thanks to brave bystanders who recorded these killing from multiple angles on their cell phones,
[1:07:26] The truth is now visible to the world, directly contradicting what DHS officials initially claimed or attempted to conceal.
[1:07:35] 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.
[1:07:46] and these were not isolated incidents.
[1:07:50] An in-bit Minneapolis, a 57-year-old citizen
[1:07:54] was dragged out of his home wearing only boxes
[1:07:56] and crock and freezing temperatures
[1:07:57] after ICE agents ignored to citizenship documents
[1:08:00] right inside the house.
[1:08:02] A US Army veteran was detained
[1:08:04] and interrogated for eight hours.
[1:08:07] A five-year-old child was taken by ICE agents
[1:08:10] and flown to detention facility in Texas.
[1:08:13] No woman was arrested and publicly photographed, her image later manipulated using AI to make her look hysterical, and many, many more.
[1:08:24] These acts were so egregious that even Republican senators publicly condemned them, even President Trump himself acknowledged these tragedies.
[1:08:32] And so yesterday, he removed the Minneapolis-Iscanander, Mr. Bavino, and bar-dicture secretary,
[1:08:39] Nome, from visiting the city.
[1:08:41] As civil vote will be coming soon to our county,
[1:08:45] I sorry said that they will be here.
[1:08:47] So let me be absolutely clear.
[1:08:50] No one is above the law.
[1:08:53] There is no such thing as absolute immunity, and there is no license to kill.
[1:08:58] If anyone comes into our county mask, spreading terror, breaking laws, offending our
[1:09:04] residents, they will be arrested by our sheriff deputies and police officers and be held
[1:09:09] accountable on the full force of our federal and state law before our courts and judges.
[1:09:19] And when you hear the term domestic terrorists, I ask you to think about this.
[1:09:24] Who are the aggressive mask gunmen stopping cars, breaking down doors, abducting our neighbors,
[1:09:29] Covering up crimes, spreading lies, and terrorizing communities across American cities.
[1:09:36] As I told my daughters, remember Alex Pretty and Renee Good.
[1:09:40] These were brave Americans who stood up for the most vulnerable among us,
[1:09:46] and who exercised the constitutional rights to protect our freedom and rule of law.
[1:09:51] honor their sacrifice, tell their stories, teach them to our next generation and do not allow
[1:10:01] lies, politics, or internet memes to erase their courage and sacrifice.
[1:10:08] And we must demand a full and independent investigation to their tragedies so that those
[1:10:13] responsible must be prosecuted and held accountable.
[1:10:19] These are tragedies that's happening not only in Minneapolis, but across our country.
[1:10:25] So I'm going to ask our clerk around to please go ahead and display the slide.
[1:10:32] We have heard repeated falses about individuals being killed by ICE agents.
[1:10:37] I mentioned Alex Freddie, I mentioned René Nicole Good, Keith Porter, but there are also many, many others.
[1:10:43] And so today I want to take a moment to acknowledge the lives we know that happened last.
[1:10:49] Behind me on the screen are the names of more than 40 people that have died in an ice
[1:10:54] cavity, custody, or were killed by ice agents since 2025, and I ask that we all take
[1:11:01] a moment of silence to honor these victims
[1:11:28] and may them rest in peace and rest in power.
[1:11:31] Thank you.
[1:11:33] Thank you very much, everybody.
[1:11:39] Next, we move to our public comments, Pirate, which is an item reserved for members of
[1:11:44] like to address the board on items not on this agenda, any public wish to speak on the agenda
[1:11:49] should speak at this time. And please fill out the speaker card and return it to our clerk.
[1:11:54] We will call up the 30 names now, then the remainder names when they'll be called at the end of
[1:11:58] the agenda. In person speakers will be called first followed by Zoom speakers and no further requests
[1:12:03] to speak a big step that under the continued public comment. The reminder for public on the Zoom,
[1:12:08] as soon as the first public speaker in the chamber starts speaking, no more speakers will be taken.
[1:12:13] 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.
[1:12:22] But you can also show your support by simply raising your hands and shaking quietly.
[1:12:27] Thank you for your cooperation to keep our meeting moving orderly.
[1:12:32] Ronda, how many speakers we have this morning?
[1:12:35] I currently have 14 speakers in chambers and four on Zoom.
[1:12:44] All right. So let's do one minute each. Thank you.
[1:12:50] 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.
[1:13:00] Sabrina Fernandez, Patricia Mora, Veronica Saldiver, Natasha Walker, Alberta Cortez, Adam Cole,
[1:13:16] Zebb Velvman, and Carlton's show Alan.
[1:13:22] Go ahead.
[1:13:27] Yes, we could hear you, but we'll see.
[1:13:30] Perfect.
[1:13:32] Welcome.
[1:13:33] I'm here because I'm worried about our salary as much as I can to be able to see it in a moment.
[1:13:44] It's a situation that is very complicated, very difficult, economy, every time it's more difficult.
[1:13:51] And it's not necessary for a moment.
[1:13:53] We have come to many times, I hope this occasion, if you don't listen,
[1:13:58] We need your support.
[1:14:00] The union is for you.
[1:14:02] We want you to support us.
[1:14:04] Thank you.
[1:14:06] Thank you.
[1:14:08] And our translator?
[1:14:10] Are you ready to translate?
[1:14:13] Yes.
[1:14:16] I'm here because I am very concerned because of our salary.
[1:14:20] The scalekeepers at home.
[1:14:25] We have a friendly break.
[1:14:26] It's very difficult.
[1:14:34] 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.
[1:14:51] Good morning. My name is Veronica Sadivar. I have a kid with autism and severe asthma. I work in tech.
[1:14:58] and I'm a single one with three kids in golf.
[1:15:00] Service to be able to, for me to be able to work and contribute to society. I'm a poll in the negotiations,
[1:15:07] and how the current is trading these providers. We're not giving them livable wages and the opportunity
[1:15:13] to try. You are denying them the American dream that you are leaving behind that podium. So please do something
[1:15:21] with the power we gave you. Thank you.
[1:15:30] 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.
[1:15:40] He said the restrainer, which is government, will be taken away.
[1:15:44] It's like everybody here is an anarchist.
[1:15:47] You're all, you're all talk, you know, Jeff Rosen.
[1:15:50] I think about that guy who calls in for four years saying his kids are being molested.
[1:15:54] And I think he's Jeff lying.
[1:15:56] They're all just, he's all talk about Obama and Clinton.
[1:15:58] We're stronger than Trump on illegal aliens.
[1:16:00] You know, but they're all talk and now they're going against the nation against, but it's happening.
[1:16:06] This is what Paul said would happen before he comes.
[1:16:08] The Christians in Thessalonica were deceived.
[1:16:11] They're quit their jobs. They're just looking up, I guess, and Paul said, hey, Jesus is not coming back yet.
[1:16:17] It's not time. The restrainer, which is government, will be taken out of the way.
[1:16:23] And then Christ will return when evil is abounding and it certainly is abounding.
[1:16:28] She'd be ashamed of yourself.
[1:16:30] I've been trying to save America.
[1:16:41] My name is Patricia Mora.
[1:16:44] I'm a provider of the YHNCC, I'm a year-old.
[1:16:49] My sister Maria.
[1:16:50] She has a very special need.
[1:16:53] She's a part of her mother's mother.
[1:16:56] She can't eat anything.
[1:16:59] She can't eat it.
[1:17:00] She can't eat it.
[1:17:01] I'm here.
[1:17:03] She's a lot of love.
[1:17:05] There is a lot of need.
[1:17:09] And not only us, but also us.
[1:17:11] We need a good salary.
[1:17:14] We are here for the union.
[1:17:16] And we want to fight, and we have to listen,
[1:17:21] to support us with our salary.
[1:17:25] We need the best help, because we are in a place where everything is more expensive than ours.
[1:17:32] My family and I need their support.
[1:17:36] and mejores coberturas médicas.
[1:17:42] Estamos negociando por un año y necesitamos.
[1:18:11] 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.
[1:18:22] 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.
[1:18:32] Also, we know that living here is even more expensive than living anywhere else.
[1:18:41] My family and I need support, we need better health coverage, and we have been here for
[1:18:47] a year negotiating.
[1:18:49] Thank you.
[1:18:58] Good morning, Board.
[1:18:59] This is Adam Cole with Seema.
[1:19:01] Seema and RNPA shared a brief memo with the Board regarding the layoff notices that our
[1:19:06] members received earlier this month.
[1:19:08] 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.
[1:19:21] 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.
[1:19:37] We have several asks and suggestions in the memo that we shared and we're looking for the board's
[1:19:42] leadership to make sure that this process gets a dialed in before the large cuts that we all know
[1:19:46] are coming.
[1:19:47] Thank you for your support.
[1:19:57] Morning board members.
[1:19:58] My name is Carlton Sean Allen Jr., I am a senior trainer and staff developer in the office
[1:20:04] of Wellness and Experience at SCVH and a senior member.
[1:20:07] Today I'm here to speak about all my colleagues that are moving through this transition
[1:20:13] and what uncertainty and concern over the past weeks, managers and staff have been notified
[1:20:18] their positions may be eliminated and have been directed to seek information through
[1:20:24] union channels.
[1:20:25] At the same time, key details needed to understand the next steps, such as position lists and
[1:20:31] you're already information and available vacancies have not been fully shared.
[1:20:36] This has left many employees in a space without clear answers or knowing what comes
[1:20:42] When people are told, these things, this is not wellness, and this is not from a trauma-informed perspective.
[1:20:51] We can do better, and we need to do better for our staff and our members of our community.
[1:20:57] From a trauma-informed perspective.
[1:20:59] Thank you.
[1:21:07] Good morning, Board.
[1:21:08] Does that film in with Seema?
[1:21:10] I want to emphasize this.
[1:21:12] If someone tells you that the layoff process is complicated and difficult to get right,
[1:21:18] Please, don't believe it.
[1:21:20] It's serious, yes, but not that difficult.
[1:21:23] And the county has done this smoothly for decades past.
[1:21:27] The county can do so again with a simple rule.
[1:21:30] Followed seniority, engage with your unions
[1:21:33] and ask before you make changes to the process.
[1:21:37] Don't decide behind closed doors and implement without notice.
[1:21:41] Notice matters and seniority matters.
[1:21:43] Get it right, and employees will be less upset
[1:21:45] in a terrible time of wayops.
[1:21:48] SEMA and R&DA understand the budget deficit and the wrenching decisions that will have to be made ahead.
[1:21:55] We would rather be partnering with the county and maintaining our services as well as increasing revenue rather than fighting about process and violations.
[1:22:05] Thank you for your kind of attention.
[1:22:08] I'm Nicola Hadden call forward the rest of the in person public speakers.
[1:22:14] Alberto Cortez, Solia Copeland, Alan Kamara, Robin Rittas, Andrew Jean, and Maria Durant.
[1:22:28] Go ahead.
[1:22:32] Hello, good morning, Board of Supervisors. My name is Natasha Walker.
[1:22:36] I'm with SCIU 2015.
[1:22:37] I am a critical care provider for my daughter who is 23 years old.
[1:22:44] This she says at home pretty much full time now, and I am here asking as a public
[1:22:50] servant of this county myself, and on the advisory board for IHSS, I'm asking our county
[1:22:56] CEO to be a beacon of light by showing the nation how to put those with disabilities and
[1:23:01] families and the state's master plan for aging first. This critical
[1:23:06] safety program is a backbone of the county health system. The money paid to
[1:23:10] critical care providers goes directly back into the local economy. It is
[1:23:15] difficult for us to find providers and it's going to become more difficult
[1:23:19] with your current wage offer. As it is, we sent you the board sent you a
[1:23:26] recommendation letter in September and we have not heard back from you yet and it
[1:23:31] as a solution in there, as well.
[1:23:33] We'd appreciate your input.
[1:23:34] Thank you.
[1:23:42] My name is Maria Durand.
[1:23:43] So this is an element of my apologies for keeping
[1:23:46] on your office regarding harassment and stocking.
[1:23:49] I was a previous county employee.
[1:23:51] I'm going to stocking her harassment, previous departments.
[1:23:55] They have labor meat, mental, and I'm not.
[1:23:58] Sounded they have a few specific multiple cases.
[1:24:01] I have 25 cases.
[1:24:03] Three sexual assaults.
[1:24:05] One such a group by law enforcement.
[1:24:06] And to also to that my apologies for keeping you on email, I need your help with this case.
[1:24:13] My granddaughter has been placed in danger, her father was killed along forcement.
[1:24:17] So, I don't know how County has considered her as an assessment by CC.
[1:24:20] I'll let her systems next when they haven't watched.
[1:24:22] I need her help. My apologies, keep calling you.
[1:24:25] My name is Marianne Durand.
[1:24:27] 1059 Park Avenue. She's blocked my address.
[1:24:31] But the considered her as for has not stopped.
[1:24:34] Do I desire a deforestaff member of parties?
[1:24:38] No, no, don't apologize.
[1:24:40] Thank you.
[1:24:44] If you can hang on for a minute, I will have someone from my office come down and connect with you.
[1:24:52] Good morning, Board of Supervisors.
[1:24:53] My name is Alan Kamar from R&PA.
[1:24:57] To this supervisor, we want to come and talk to you and ask for your commitment.
[1:25:02] All label organization within the county has a layoff language.
[1:25:05] And that layoff language tells you how the county can walk with the unions.
[1:25:11] So if there is a layoff, like my seamer partners just stated, you can follow those rules.
[1:25:17] Today, as the 27, we still have not received our seniority at least.
[1:25:22] Meanwhile, all our members have been notified that some of them may lose their position.
[1:25:27] In five section five of RMB contract as a layoff language, in five point one is stated that the
[1:25:36] county will provide senior release to the union before any layoff that's announced.
[1:25:43] While we're passed out today, the 27th will still have us receive it.
[1:25:46] And encourage you please.
[1:25:48] We want to walk with you.
[1:25:50] Please.
[1:25:51] Thank you.
[1:25:58] Good morning.
[1:25:59] My name is Andrew Tian.
[1:26:00] I am Assistant Nurse Manager at BMCIDOT,
[1:26:04] acute psychiatric services.
[1:26:06] I'm here to represent RNPA, all my nurses,
[1:26:10] and all my assistant nurse managers.
[1:26:13] I just want to say that it's recommended
[1:26:17] to have 50 best per 100,000 people
[1:26:19] and we have 2 million population in Santa Clara County,
[1:26:24] and we have 48 acute psychiatric beds.
[1:26:27] And here are the people who take care of them.
[1:26:30] As a system nurse managers, we are on the floor.
[1:26:33] We're part of a core staffing where there are nine out of 10 days
[1:26:38] on the floor taking care of our patients.
[1:26:41] The most acute population in our county.
[1:26:44] And I understand the situation that I tested it by the dollar.
[1:26:49] I'm here to say that we are the best bang for your buck.
[1:26:53] We take care of the patients.
[1:26:54] on the way also to take care of all the administrative services at the U.N., thank you very much.
[1:27:09] I've been with the county for 47 years. I am an assistant nurse manager and I really
[1:27:19] want the board to understand the assistant nurse managers supposedly or told with work cut
[1:27:27] because to bring us into compliance with the other units in the hospital.
[1:27:33] These cuts were tried once before.
[1:27:37] I don't remember the air, but they were cut once before.
[1:27:41] Quickly they realized that we are on the floor and that we need to be replaced.
[1:27:48] And we became non-compliant with the staffing ratios.
[1:27:52] state came involved. It became an issue. We met with the county. There were many meetings.
[1:28:03] I was part of that team. These positions were replaced within months because they realized
[1:28:10] there was no cost saving. Nothing has been done to look at the impact of these cuts.
[1:28:17] Thank
[1:28:22] you.
[1:28:28] Who do I give this to?
[1:28:45] Ron, do we have any more in person's figure?
[1:28:48] Or do we go to Zoom now?
[1:28:50] So I did have two in person's figures that did not speak.
[1:28:55] Soliat, Copeland, and Alberta Cortez.
[1:29:00] And since I do not see them coming forward, let's move on to our Zoom speakers.
[1:29:06] Our first Zoom speaker is Ronald Owen.
[1:29:08] One
[1:29:14] of the most dream that we target lubrication
[1:29:16] option is the California Department of Public Health.
[1:29:18] I'm a black man who loves all humanity.
[1:29:21] I would just start to learn what how many of us are sitting
[1:29:23] on table 14, 2022.
[1:29:25] We know these vaccines are by killing people of color, blacks,
[1:29:27] Latinos, indigenous people at about two times
[1:29:29] the rate of white Americans.
[1:29:31] I've informed this board that the vaccines are killing people
[1:29:33] in writing under the July 29th, 24th.
[1:29:36] And the person on November 5, 2024.
[1:29:39] And writing, again, on December 10, 2024,
[1:29:42] And now, today, I've informed COVID-19 vaccines are killing people to all California's border survivors.
[1:29:49] I've prepared it to 51 border survivors, thus far.
[1:29:52] Senator Public Health Department is still promoting administering.
[1:30:00] 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.
[1:30:16] Thank you. Our next speaker is Julia Dree.
[1:30:26] Yeah, Julie Dree calling in for the third time for view County California.
[1:30:29] a 20-year resident of Sunnyvale, California.
[1:30:32] I want to tell you, President Lee, that five years ago today, your public health department
[1:30:36] injected my mother with the no toxic poison, Moderna, lot number 029L20A with the first
[1:30:44] of four deadly shots that killed her.
[1:30:47] She lived in Sunnyvale and she worked hard for Silicon Valley.
[1:30:51] You people need to look up her marriage report 2431-153.
[1:30:55] There are 89 people dead from that one toxic lot alone.
[1:30:58] I have come here before you three times.
[1:31:02] She was the best friend of Carmen and Larry Stone.
[1:31:09] She worked for Sunnyville Community Services.
[1:31:12] She was the Silicon Valley Icon,
[1:31:13] its Technetics, and some Mexican.
[1:31:15] She made rainbow dresses for me and my friends
[1:31:19] and Sunnyville rainbow girls.
[1:31:21] She made the Sunnyville Metro Bay owners
[1:31:23] and the Sunnyville Little League.
[1:31:25] She demands.
[1:31:29] Thank you, our next speaker is, parent.
[1:31:33] Yes, a little more than you all.
[1:31:34] Jeff Rosen just said that if you see something, say something and we'll do something good.
[1:31:41] Those words are the exact words about sex trafficking.
[1:31:45] It's a complete lie.
[1:31:46] I told Jeff Rosen personally, that my ex-wife was letting him make my son, beginning when he was 13.
[1:31:54] It was unnecessary basing with the children.
[1:31:56] There was sexual contact between children and all this led to abrupt,
[1:32:01] and severe personality changes for my kids.
[1:32:06] And his response to doing something good
[1:32:08] was to file charges against me to conceal the abuse
[1:32:12] because his political supporter is involved in all of this.
[1:32:18] I've both brought this information online.
[1:32:21] If you want to see it, the Google's DA,
[1:32:23] Jeff Rose, and Sex Graphicking Edition, all those types
[1:32:26] of the other top-greens also see what I'm talking about.
[1:32:28] Jeff Rose, and it's not telling the truth.
[1:32:30] Thank you so much for your time.
[1:32:35] Thank you, our next speaker is Gosmer.
[1:32:43] Business pay a lot of money.
[1:32:45] Good morning.
[1:32:46] Well, if that's in the can,
[1:32:48] where you're counting sons at the hospital
[1:32:51] is letting out un-house people with no place to go.
[1:32:57] Regional, one of the un-house employees
[1:33:00] has been the regional pre-time.
[1:33:03] She had the money, she lived in her car,
[1:33:06] with her husband and regional team letting her out.
[1:33:09] Now, I don't understand why there's no place
[1:33:12] that regional, or corner, or billion things
[1:33:15] can maybe house somebody that has no place.
[1:33:19] Oconer is the worst.
[1:33:21] They have brought out so many announced people
[1:33:23] with no place to go.
[1:33:25] Some of them aren't even well, and they still are them out.
[1:33:28] This woman's yesterday should not have been messed up
[1:33:31] or kicked out, but regional did.
[1:33:34] 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.
[1:33:45] And that concludes our public speakers.
[1:33:50] Thank you very much, Rhonda.
[1:33:52] 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.
[1:34:01] And Rhonda, would you please read the various update to our consent calendar?
[1:34:06] We have a request from administration to hold item 29 to February 10th, 2026.
[1:34:13] Item 29 is to approve retroactive second amendment to agreement with Board of Trustees of
[1:34:19] Leland Stamford Junior University relating to providing cardiovascular and thoracic surgery
[1:34:26] physician services, increasing the maximum contract amount by $6,777,849 from $6,611,134
[1:34:41] to $12,688,983 and extending the agreement for a 36-month period through February 28, 2020.
[1:34:54] 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.
[1:35:13] There's a request from administration to hold item 57 to date, and certain item 57 is to
[1:35:21] prove second amendment to agreement with Santa Clara Valley Transportation Authority, relating
[1:35:27] to providing supplemental law enforcement services, amending the scope of services and
[1:35:33] cost recovery in and amount equal to the county's cost of providing services with no change
[1:35:39] to the term of the agreement.
[1:35:41] Correction, the item number 59C, the item should reflect that it is jointly submitted with
[1:35:47] President Lee, item number 59C is adopted commendation for use star productions on the
[1:35:54] occasion of the 11th anniversary of a Holy Tent San Jose Lunar New Year Tent Festival,
[1:36:01] San Jose 2026 for celebrating and preserving Vietnamese heritage and culture around us Lee.
[1:36:09] request from administration to hold item number 61 to February 10th, 2026 approved request for
[1:36:18] preparation modification number 101 for $1 million increasing estimated revenue and
[1:36:26] expenditure appropriations in the consumer and environmental protection agency budget relating
[1:36:33] to eradication of glassy-winged sharpshooter and pierces disease control.
[1:36:40] And this concludes our consent calendar update.
[1:36:44] Thank you very much, Ronda.
[1:36:46] Do any more of the changes that took my call that gets?
[1:36:50] I don't have changes, but comments on a few items.
[1:36:56] First item 28, during last year's budget discussions, it was deeply invokedly concerned about
[1:37:03] potential contraction of family housing services after learning that the state had not yet
[1:37:08] allocated funding to the bringing family's home program. This program specifically aims to
[1:37:14] reduce homelessness among families that are connected to the child welfare system. And it's
[1:37:20] critical of course to ensure that children's most basic needs are met to improve stability
[1:37:25] in a system where a child's safety is of the utmost concern. I was relieved to see that the state
[1:37:31] has renewed funding through 2020-8,
[1:37:35] and allocated just over $3 million to our county.
[1:37:39] This funding will provide rapid rehousing
[1:37:40] and stabilization services to 145 families.
[1:37:45] I want to express my appreciation to SSA leadership,
[1:37:49] especially DFCS director Wendy Canier-Roush
[1:37:53] for your advocacy alongside other child welfare directors
[1:37:56] in the state to sustain this program.
[1:37:59] Good work.
[1:38:00] items 45 and 46. Again, not pulling either from consent, but just want to make some general
[1:38:07] statements about the importance of each. The county's poet laureate program has been
[1:38:13] in effect for 18 years and serves as a testament to this county's commitment to elevating
[1:38:18] the arts as part of the public good and ensuring our communities are seen and celebrated.
[1:38:24] At our last board meeting, current poet laureate, Yosima Reyes, reminded us of the importance
[1:38:29] of community showing up for one another and this is what every one of us at the county does
[1:38:34] every day. From the board to executive administration to line staff and health care workers,
[1:38:40] we meet people where they are and try to make things better in their lives. I want to express
[1:38:45] appreciation to SV creates our partner in this work and all the poets including the youth
[1:38:51] poet laureates who have held this post in the past. Secondly, I want to uplift the work of our
[1:38:58] libraries, including the update in item 46, to better meet the needs of our communities
[1:39:03] efficiently and effectively in this time of financial uncertainty. I serve on the Joint
[1:39:10] Powers Board for our libraries and witness the passion of people working to serve our
[1:39:14] communities at every meeting. These days, as Supervisor Lee noted, maybe dark in many ways,
[1:39:22] but libraries continue to be a beacon for the best parts of community.
[1:39:26] 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.
[1:39:36] Okay, I have a motion to have a second.
[1:39:38] I mean, it was hoping for quick clarification and I'm happy a second, but the yellow sheet looks different.
[1:39:46] It had item 60s as a being pulled, but is that no longer being pulled?
[1:39:51] That's correct yet, that's no longer being pulled.
[1:39:53] Is it 61 that we are adding?
[1:40:01] I believe it's 56 that was pulled on to regular off of consent.
[1:40:06] Okay, great.
[1:40:07] Thank you.
[1:40:07] I'll just try to follow along with this and it didn't match.
[1:40:11] So, with that, yes, I'll second the lesson.
[1:40:13] Thank you.
[1:40:14] Motion second.
[1:40:15] Let's see if we have any speaker on the consent item agenda.
[1:40:21] I currently have one speaker in chambers and no speakers on Zoom.
[1:40:26] Let's do two minutes, go ahead.
[1:40:30] All right, with that, we are closing out the Zoom queue and our in-chamber speaker is Mary Ying.
[1:40:42] And for the consent item agenda, please state the consent item number to identify which item you're speaking on.
[1:40:48] Thank you so much for saying.
[1:40:54] Good morning, here for number 58,
[1:40:57] probation department. I'm speaking on behalf of Terrell Pena. My name is Mary Ang. I'm
[1:41:03] a board member of Opportunities for Change. And he could not be here. Our lived experience
[1:41:09] CEO is the single father, Seoul custody of a three-year-old. He brought her home from the
[1:41:15] day she was born. So they had a preschedule appointment that couldn't be changed. So we want
[1:41:23] really affirmed the amazing impact the CEO program has had on several of our clients.
[1:41:30] I wanted to highlight two of them, theodore and Vernon.
[1:41:33] So Teddy, he came straight out of county jail to work and to stay with us.
[1:41:39] And we discovered that he had this incredible untapped subrosa computer nerd skill set.
[1:41:47] He'd never been able to work in the computer industry.
[1:41:50] On the second day he went to the CEO program and what that did for him was power building.
[1:41:58] He was able to immediately make money, get skills training on his resume, he enrolled
[1:42:02] in college as a result of the CEO, counselor, urging him on, he really enjoyed working with
[1:42:09] that case worker.
[1:42:10] So I really want to let you know that we feel the daily impact of your support for this program.
[1:42:16] 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.
[1:42:26] I point to him as an example of wealth with pride.
[1:42:31] So many of our clients have tremendous skill sets and they earn their living wealth without pride.
[1:42:41] Wealth earned on the backs of hurting people and communities.
[1:42:46] We have an effective program to turn that around.
[1:42:49] I want to thank you for this program.
[1:42:51] The only negative is you have to be an active probation or parole to use it.
[1:42:56] Thank you.
[1:42:57] Thank you.
[1:42:59] And this concludes our public speakers.
[1:43:01] Okay, go ahead and let's call it the rule.
[1:43:04] Call the vote.
[1:43:07] Supervisor Avacoga?
[1:43:08] Aye.
[1:43:09] Supervisor UM?
[1:43:10] Yes.
[1:43:11] supervisor Ellenberg? Yes. Presently. I as well. Motion carries for the zero. And that was
[1:43:18] on motion of supervisor Ellenberg, seconded by supervisor Avigalga. Great. Thank you very much
[1:43:25] Ronda. And moving to item number eight, setting the time, sir, in no early 1930, that's
[1:43:30] strongly, it's not the problem. Item eight is reporting, reclaning to Senator Clara Valley
[1:43:36] health care. This is only an information item, and no action is actually needed today.
[1:43:43] And we do have our staff here presenting including our CEO here, Hufflepuff's system,
[1:43:50] Paul Lorenz.
[1:43:51] Go ahead.
[1:43:55] Thank you, President Lee, members of the board, Paul Lorenz, CEO for Santa Clara Valley
[1:43:59] Health Care. I do have members of our leadership team here, which I'd like for them to
[1:44:04] introduce themselves, and then we'll move on with the presentation.
[1:44:07] Good
[1:44:11] morning, I'm Rino Sharma, I'm the CFO for the Health System.
[1:44:15] Good morning, Fongwen, Chief Medical Officer for the Health System.
[1:44:20] But it was your mic on?
[1:44:22] Yes, can you hear me?
[1:44:23] A little bit better now, thank you.
[1:44:25] Fongwen, Chief Medical Officer, thank you.
[1:44:30] Brian McBeth, Chief Quality Officer, Interim Hospital Executive
[1:44:33] at Santa Clara Valley Medical Center.
[1:44:37] Hi, good morning.
[1:44:38] Felicia Tornebany, I'm the physician executive at O'Connor Hospital.
[1:44:42] Cliff Wang, I'm the Associate Chief Medical Officer for the Health System.
[1:44:47] Again, thank you members of the Board for the opportunity to talk about not only the implications
[1:44:53] related to HR-1, but also state change, it's put-
[1:45:00] Clearly, what we are facing as a health care system was in this market in Santa Clara County.
[1:45:06] I think it's really important that we have this opportunity to engage with the board to fully understand
[1:45:11] the implications that we are dealing with. As you can note, we will be providing a brief overview of the health system.
[1:45:20] attention on some of our key challenges and opportunities, we'll be looking at some operating
[1:45:28] statistics relative to the health system and relative to the market in general. We will
[1:45:35] be touching on the federal and state budget challenges as a result of HR1 in the state and
[1:45:42] then getting into what we were doing to mitigate those challenges relative to our mid-year budget
[1:45:47] and also going into fiscal year 2627 as you well know we are working with county executive,
[1:45:56] not only in the major budget which would be presented but also looking at 2627 budget recommendations.
[1:46:05] And then we can get into the Q&A which I really want to get to as quickly as possible.
[1:46:08] So what I'm going to do is try to go through these slides as quickly as possible but touch on the key points.
[1:46:20] 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.
[1:46:32] As you well know, we serve one and four residents in the County of Santa Clara.
[1:46:39] We serve close to 60 to 70% of the Medicaid population.
[1:46:42] And thus, the implications of HR1 disproportionately affects your healthcare system more so than
[1:46:50] any other healthcare system in the county of Santa Clara and what touch on that in upcoming
[1:46:55] slides.
[1:46:57] But what's also really important to understand is that just like any other healthcare system,
[1:47:03] your healthcare system is dealing with significant cost increases, structural cost increases
[1:47:09] that require us to either generate more revenue or to find other ways to cut cost in order
[1:47:17] to bring value-based health care to our community.
[1:47:22] In this market, many of you understand that because we serve a preponderance of individuals
[1:47:29] on Medicaid, we are also seeing a shift in the market relative to the Medicare population.
[1:47:35] Your health system, which I've shown in future slides, has grown significantly in serving
[1:47:40] the Medicare population at the same time
[1:47:43] we're seeing our population age.
[1:47:46] And so we have the health care system
[1:47:47] have to adapt to that.
[1:47:51] And all of us know what Medicare reimburses
[1:47:54] health care providers today is the challenge.
[1:47:57] And therefore, what you were seeing at the shift
[1:48:00] from other providers to your public health care system,
[1:48:03] safety and that system.
[1:48:05] So the reliance on your health care system
[1:48:07] is going to continue to grow,
[1:48:08] not only because the implications related to HR one-around Medicaid, but also because of other
[1:48:15] individuals that are going to have to depend on your health care system for care, just
[1:48:19] not the Medicare population, but as you well know, the subsidies related to cover California
[1:48:27] are no longer in place. And so we are already seeing individuals drop coverage. And these are
[1:48:35] individuals up to 400% of FPL up to 500% of FPL.
[1:48:40] So we are seeing an evolving market, but also seeing changes in the pair adequacy of reimbursement
[1:48:48] in healthcare in general.
[1:48:51] As a safety net system, your board is also aware that we are fully committed to equitable
[1:48:56] access to healthcare.
[1:48:58] That is our mission, that is our purpose, and thus what we are seeing is not only a shift
[1:49:03] of individual reliant on our health care system in general because of payer reimbursement
[1:49:10] challenges.
[1:49:11] But we're also seeing a shift of individuals that disproportionately are those communities
[1:49:16] of color.
[1:49:18] And it is up to us to figure out how we balance access to care in these fiscal challenges
[1:49:24] to ensure that everyone in our community has access to health care that they're able to maintain
[1:49:30] basic health care services.
[1:49:33] And as a healthcare system, your board is very much aware that when we were running one hospital,
[1:49:39] Valley Medical Center was overwhelmed. In other words, we did not have the physical capacity in 2019 to
[1:49:46] care for all the needs of our community. Your board was insightful and made the bold decision to acquire
[1:49:54] two hospitals to further expand the healthcare system so that we would have the physical capacity to
[1:50:01] over the growing needs of our community, and that it was also the case when we acquired
[1:50:06] regional medical center central to a major population that depends and needs access to
[1:50:15] healthcare services in our community.
[1:50:18] We have evolved into a healthcare system that just normally serves as a safety net, but
[1:50:24] is the backbone of healthcare in this county because the fact is that individuals, whether
[1:50:30] You have coverage or not, are disproportionately affected by their ability to actually seek
[1:50:38] access to care.
[1:50:39] You can have coverage, but that doesn't necessarily mean that you have access to health care.
[1:50:44] And that is why this public health care system is so critical, because we provide that
[1:50:48] access irrespective of your coverage.
[1:50:55] So one of the areas that I consistently get asked about is, why do we, as a health care
[1:51:02] system continue to invest in this system.
[1:51:08] And the reality is that what we're typically focused on is what
[1:51:13] is in front of us.
[1:51:14] So we are confronted with HR1 implications, financial challenges
[1:51:19] that are unprecedented.
[1:51:22] But the reality is that, normally, do we have to deal with that,
[1:51:25] but we have to think about what our future looks like
[1:51:28] and how we can strategically manage the situation
[1:51:32] in front of us, but be prepared to make sure that we are a viable system in two years from now,
[1:51:38] three years or five years from now, because we are a public system that is not going to go away,
[1:51:43] and we have to find ways to balance the financial needs and the healthcare needs of our community.
[1:51:52] We are a comprehensive and integrated system unlike any other public healthcare system in the state,
[1:51:58] and we have the opportunity to leverage that.
[1:52:01] to actually grow the system and bring value based health care to our community.
[1:52:06] We have a strong market presence, as you all know,
[1:52:10] that was one of the reasons why the community supported us around measure A
[1:52:14] because they understand the value of what we bring to the community.
[1:52:20] We actually have very prestigious and nationally recognized service lines
[1:52:26] beyond the fact that we are considered to safety net.
[1:52:31] people actually seek out care in our system because of the outcomes that we have relative to their health care.
[1:52:39] So it's really important to understand that a safety net system, your investments in this system has
[1:52:44] allowed us to actually leverage the system to actually compete in the marketplace for individuals
[1:52:51] that want quality health care. And you see that knowledge in terms of individuals that have to access
[1:52:58] care and a system around trauma care, but you see that in our rehabilitation center, you
[1:53:03] also will see that in many other service lines such as oncology, pediatric and women's
[1:53:08] health care.
[1:53:11] We have the opportunity to leverage this system to deal with the fiscal challenges that we
[1:53:16] have going forward and we have the capacity to do so.
[1:53:22] Next slide, as your board is well aware, we have a wide array of essential services.
[1:53:27] I've mentioned a few, it's important to understand that as such we serve the broader community.
[1:53:39] We're not only a safety net system but individuals, as I said, rely on us for emergency room care, trauma care, et cetera.
[1:53:48] The next slide, this slide here highlights some of those important points.
[1:53:53] one and four sunny Clark County residents, as I mentioned, access
[1:53:57] care in our system, and because of regional medical center, that number continues to grow.
[1:54:04] We provide nearly half of all emergency room visits in this county through our four hospitals.
[1:54:13] We operate two of the three trauma centers at Valley Medical Center.
[1:54:16] You have an adult level one.
[1:54:18] You have a level two pediatric trauma center, and now we have regional medical centers.
[1:54:22] Those two trauma centers provide 75% to 80% of the trauma care in this county.
[1:54:30] Every 11 minutes, a 911 call in Santa Clara County results in a patient's being transported to one of your four hospitals.
[1:54:41] 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.
[1:54:49] And I've mentioned, of course, a rehab center and burn center receiving national recognition
[1:54:54] because of the quality of care that we provide.
[1:54:58] The next slide, as a public system, unlike any other hospital system, we provide other
[1:55:06] essential public health and community health programs.
[1:55:11] Some of these programs are listed here, as you well know, they range from a child advocacy
[1:55:16] Center, our safe programs, which are other sexual assault forensic programs, our homeless
[1:55:23] health care programs, we provide gender affirming care,
[1:55:31] and we provide care to individuals
[1:55:36] that in the community typically would go to a public health department for caring treatment
[1:55:41] ranging from sexual transmitting diseases to immunizations. These are services provided
[1:55:47] within your public health care system.
[1:55:50] And these services are valued at close to $180 million dollars.
[1:55:54] That is where your county investment goes beyond just providing health care.
[1:55:59] We provide community health care services that are essential to our entire county resident community.
[1:56:08] Your board in 2023 knows that we consolidate it and we merge custody health services as
[1:56:15] being part of Santa Clara Valley Health Care.
[1:56:18] That allows us to leverage the clinical expertise,
[1:56:22] manage patient care between the custody health center
[1:56:25] and our specialty clinics, as well as our
[1:56:27] inpatient acute psychiatric unit, and our acute inpatient unit.
[1:56:33] If you note the statistics in terms of the gel population,
[1:56:38] the average daily census there is around 27-50,
[1:56:41] and approximately 30 to 35% of that population has a serious and mental illness.
[1:56:48] That is one of the reasons why it's so important that we have this close relationship
[1:56:54] and that integration into Santa Clara Valley healthcare was so critical moving forward.
[1:57:02] It also brings about some financial security, relative to services provided at custody health services.
[1:57:08] We are committed to make sure that we continue to support custody health services financially
[1:57:14] through the enterprise fund to ensure that we can manage through the consent decree and
[1:57:19] the significant challenges that we have in that setting.
[1:57:25] The next slide, I think you're very much aware of that we provide services all the way from the
[1:57:29] North County to the South County and everything in between all the way across to Melpetus.
[1:57:35] both primary care and acute hospital care services as well as specialty services.
[1:57:44] The next chart map heat map shows, in this county, 400 percent of FPL, what's important
[1:57:53] to note about 400 percent of FPL, a family of four was an income of $128,000 falls into
[1:58:01] this category,
[1:58:05] 62,600 for an individual.
[1:58:08] And as you would note, via this map chart of this heat map,
[1:58:14] that our facilities are central to those populations.
[1:58:19] It's central, obviously, with regional medical center,
[1:58:22] but as you would note, to St. Louis Regional Hospital
[1:58:27] in the South County.
[1:58:31] In that population of 400% of P.L.
[1:58:33] include those that are on Metacow, but also individual that are on covered California and
[1:58:39] Metacow.
[1:58:44] The next chart is the Metacow enrollment, and you can also see from this chart, it's a subset
[1:58:51] of the 400%, but the important thing to note here is that your health system provides care
[1:58:57] to over 60 to 70% of the Metacow population.
[1:59:02] And regional medical center is central to that population, with in a five-mile radius of
[1:59:09] regional medical center close to 50% of the medical eligible's live in that vicinity.
[1:59:20] The next chart provides for some patient demographics around age and ethnicity.
[1:59:26] You will note that under race and ethnicity that close to 50% of the population served by
[1:59:32] health system are of Hispanic or Latino ethnic background. What's also important to note
[1:59:40] is the age demographics where we've seen a shift into 65 plus and older being served by your
[1:59:47] health care system. It is now 18 percent of our patient population which is actually the highest
[1:59:55] percentage of all patient age segments that we serve.
[2:00:00] That's a healthcare system. It's evenly distributed, as you would note, in terms of age groupings.
[2:00:11] The paramax, this chart of substance that I've shared was the board in the past, and there's two
[2:00:16] notable bits of information here that you should focus on. One is the transition of the
[2:00:26] implementation of ACA, where the number of uninsured dropped from 20% down to about 3% in
[2:00:34] your healthcare system. What we were most concerned about is that being reversed due to HR1.
[2:00:42] The other important note about this chart is the increase in the Medicare population growing from
[2:00:47] 16% to 37%. And that is due to the fact that the hospital care that we provide at O'Connor
[2:00:55] St. Louise and now regional medical center have a high population of medical recipients, excuse me, Medicare recipients.
[2:01:07] This next chart actually provides a little bit more in-depth perspective of how Santa Clara Valley health care compares to other hospitals.
[2:01:14] Our PMX is represented by 84% of medical and Medicare, government sponsored coverage compared
[2:01:25] to other hospitals.
[2:01:26] You can see that Valley Medical Center is by far the largest medical provider at 46% compared
[2:01:34] to the next closest, which is Stanford.
[2:01:40] The next chart provides for a little bit of information for your board about each of the
[2:01:46] And you can see, O'Connor Hospital and Regional Medical Center, as well as Saint Louise,
[2:01:52] having a very high percentage of Medicare, which was one of the reasons, as I've noted,
[2:01:58] that we've seen increase in our Medicare patient population.
[2:02:01] It has to do with accessibility to hospital inpatient beds.
[2:02:06] So geographically, your healthcare system is located in essential communities throughout Santa Clara County.
[2:02:17] Operational volume, 800 acute patient days are provided through your four hospitals, representing
[2:02:30] over 300,000 patient days annually.
[2:02:38] 750 emergency room rooms on average per day, sometimes at number per day exceeds 800 in
[2:02:47] emergency rooms in the four hospitals. While we provide 4,226% of the birth in the county,
[2:02:55] we provide 80% of the medical birth in Santa Clara County and that number continues to grow.
[2:03:07] The next chart, moving on, Santa Clara Valla Healthcare represents 38% of the licensed acute hospital
[2:03:16] care beds and provides for close to 34% of the hospital patient days in Santa Clara County.
[2:03:25] Of all hospitals.
[2:03:26] We are the largest provider of health care, acute hospital patient days, emergency room
[2:03:32] visits in the county of Santa Clara.
[2:03:40] The next chart, which has to do with arm C, and I wanted to call this chart out specifically.
[2:03:45] As you well know, when we acquired regional medical center, we had done some projections.
[2:03:52] Those projections are represented by the dotted line, which showed that by the 11th or 12th months,
[2:04:00] we would approach 179 in terms of our hospital daily census.
[2:04:06] We have far exceeded that as you would note, in the months of December,
[2:04:14] we were at an average daily census of 199.
[2:04:19] In January, we were actually at a census now
[2:04:22] of an ADC of 210.
[2:04:26] On some days, the census at Regional Medical Center
[2:04:28] reaches a high of 218 on a given day.
[2:04:35] Far beyond what we had anticipated.
[2:04:37] This has translated into the next chart
[2:04:40] into a much more favorable financial performance.
[2:04:44] This is year-to-day through November where you can see that our revenues due to our patient volumes
[2:04:50] are favorable by close to $30 million.
[2:04:54] This is halfway through the year, actually five months through the year.
[2:04:58] Our expenses obviously have gone up, but at the same time the variance in terms of net income
[2:05:04] has been favorable by close to $17.5 million.
[2:05:09] This is through the first five months of the current year.
[2:05:12] That is actually contributing to our ability to address some of the budget challenges that
[2:05:17] we're confronted with related to HR1 and also the state impacts.
[2:05:25] The next chart, I do want to emphasize a couple things here is that as you well know,
[2:05:31] your board has invested in a new facility for acute psychiatric services for both the adult
[2:05:37] population but also children in adolescence.
[2:05:41] And for children in adolescence, it's the first time that your health care system is going
[2:05:46] to be able to serve families in Santa Clara County, keep children, in our community, close
[2:05:53] to home so that we can have the best outcome and best experience given these difficult
[2:05:59] times for our families that we have to care for.
[2:06:03] And people would say, what is the difference between investing in a facility like this
[2:06:09] why you're having such financial challenges.
[2:06:12] Two things that you should walk away with,
[2:06:15] and I think your board clearly understands this.
[2:06:17] This is a one time capital investment that your board has made
[2:06:21] for the long-term future in the state ability
[2:06:24] of critical healthcare services for our residents.
[2:06:29] So this is not something that we are looking at short-term,
[2:06:32] but we are looking at future of healthcare for our residents.
[2:06:36] And at top of it, the financial mix relative to serving children and adolescents along with
[2:06:43] adult population will put us in a much better and favorable financial situation given the
[2:06:50] pair of mix and reimbursements that we expect under this new model in this new facility.
[2:06:56] Staff will be able to care for our patients in a much more safer manner.
[2:07:01] 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.
[2:07:16] 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.
[2:07:28] 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.
[2:07:39] This facility will have approximately 215 treatment rooms, 215 treatment rooms, providing urgent care service for both our adult and pediatric population.
[2:07:52] But also providing primary care and internal medicine, women's health care and pediatric care in general.
[2:08:05] And as you board well and know, it is very important as our health care system evolves.
[2:08:12] 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.
[2:08:25] This slide provides for the overall impact of HR1.
[2:08:31] I think you're bored and understand that nationally,
[2:08:35] it's a one trillion dollar impact on Medicaid,
[2:08:40] in Santa Clara County.
[2:08:43] It's about one billion dollars.
[2:08:47] But what people should walk away from this is
[2:08:51] that millions of individuals will lose healthcare coverage and their ability to access care will
[2:08:58] be tremendously impacted.
[2:09:03] This is not about what's in front of us, but we also know in healthcare if individuals
[2:09:09] do not have access to healthcare today, it presents long-term costs to health systems that
[2:09:17] trying to provide for basic healthcare needs in essential healthcare services.
[2:09:24] The next slide provides for a detail summary over the course of the next several years of the impacts of HR1.
[2:09:36] We already, in the current year, have faced some challenges.
[2:09:40] I'll provide a chart that was shown that we're looking at 200 million dollars for the current fiscal year.
[2:09:46] But this chart kind of lays out with some of those implications are and I want to touch on a few of these.
[2:09:54] The first one took place in July of 2025 when the federal government put a limit, a cap on directive payments.
[2:10:04] And your board is well aware that we receive directive payments as a supplemental to Medicare reimbursement.
[2:10:13] because base medical fee for service reimbursement is so low that there's no system that can sustain services,
[2:10:21] particularly a system that disproportionately serving the medical population.
[2:10:26] So we rely heavily on those direct repayments.
[2:10:29] We receive close to three quarters of billion dollars,
[2:10:32] $750 million dollars via these direct repayments for which we put up a match.
[2:10:42] When we acquired regional medical center, we acquired regional medical center prior to this taken effect.
[2:10:50] 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.
[2:11:01] That was the first major blow to the health system, financially.
[2:11:06] Subsequent to that, because its cap, we do not receive a cost of living adjustment, a 3%
[2:11:13] cost of living adjustment to the direct repayments, because its cap, 3% of $750 million,
[2:11:24] is close to $234 million. So all of these, as you can see, as the provisions are implemented,
[2:11:34] it slowly create a financial stressor on the system that simply is not sustainable unless we
[2:11:43] make some really difficult decisions.
[2:11:47] One of the most important things to note about this chart is the implementation of the
[2:11:52] six-month readie termination.
[2:11:54] So those individuals that are currently on medical are going to have to go through a readie termination
[2:11:59] every six months.
[2:12:00] 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.
[2:12:12] That's per individual.
[2:12:14] So a family of four, multiply that by by 35 dollars, and that's what a family four would have to pay.
[2:12:21] We fully expect, because a number of these different provisions that individuals are going to start to fall off enrollment into Metacow.
[2:12:29] And we'll talk about the importance of making sure that we do everything possible to keep
[2:12:33] individuals enrolled in Metacal.
[2:12:39] The next chart talks about what we refer to as the state-only program, which is unsatisfactory
[2:12:47] immigration status of those currently enrolled in the state-only Metacal program.
[2:12:54] In Santa Clara County, there are 72,000 individuals enrolled in this program.
[2:12:59] We already seen a decline in individuals in the second of our patient population,
[2:13:10] which is one of the contributing factors to our 200 million dollar projected loss.
[2:13:17] This is something the state has chosen to do on top of the impacts of HR1.
[2:13:23] So not only do we have federal implications, but we have state implications as a result of this.
[2:13:29] I want to point out that in July of 2026, not only does your health system through our primary
[2:13:37] care clinics, our federally qualified health centers, not only will we be impacted, but also
[2:13:44] the community health centers in the county.
[2:13:47] So Gardner Health, Oki, all the community health centers that are federally qualified will
[2:13:53] lose what they call as a prospective payment to round out their reimbursement to serve this
[2:14:01] patient population.
[2:14:02] That has been taken away in some situations, community health centers estimate a loss of
[2:14:11] cost of 60 to 70 percent of their patient revenue per encounter.
[2:14:17] So this is quite significant not just for our health system but also for our community health
[2:14:22] or ship clinics. And I would say to you that the challenge that we face is that keep in mind,
[2:14:29] people are accessing care via their medical homes. They will lose that opportunity unless we come
[2:14:37] up with some alternative strategy. And we want to make sure that individuals maintain access
[2:14:41] to primary care.
[2:14:46] And we will talk about some of our strategies there. Then on top of it, they will also
[2:14:50] the state will be implementing the $30 per month premium for individuals in this population.
[2:14:58] We expect that the enrollment...
[2:15:00] We have individuals to drop up to no less than 50% drop in enrollment because of these changes.
[2:15:15] So, what are we doing to try to mitigate some of these challenges?
[2:15:19] And this is something that our county executive James William is spoken to and your board is very much aware of.
[2:15:25] Obviously, we have to manage our cost, find ways to increase our revenue.
[2:15:29] 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.
[2:15:59] and increase our revenue per patient day and per visit.
[2:16:05] So our primary focus is to figure out how we maintain access and continue to grow the
[2:16:11] system in a value-based way to ensure that we can deal with these financial challenges.
[2:16:17] We are not going to be able to cut ourselves, make reductions to the tune of $200 million
[2:16:25] or in the subsequent years, $160 million or even $300 million.
[2:16:31] We have to find ways to generate revenue to continue to provide access
[2:16:35] into marine value-based care to our community at a lower cost.
[2:16:41] The second strategy that your board is very much aware
[2:16:45] is that we are looking to the state to support public hospitals.
[2:16:50] As you well know, public hospitals make up 6% of the hospitals in the state of California,
[2:16:57] but we provide for 30% of the Medicaid visits and services, so just think about that
[2:17:05] ratio.
[2:17:05] 6% of the hospitals are public hospitals, but yet we provide 30% of the Medicaid services
[2:17:13] in the state of California.
[2:17:15] In Santa Clara County it's a much higher percentage, we're at 60 to 70 percent, but you
[2:17:21] can see what the value of public hospitals are and this is a state program and we believe
[2:17:26] the state should be stepping up to support public hospitals.
[2:17:30] We provide for over 50 percent of the trauma and burn care centers in the state of California
[2:17:37] And we train 50% of the physicians in the state of California as public systems.
[2:17:46] So we do look to the state for that support and we are working with our delegation and
[2:17:53] others to ensure that they understand the importance of supporting public hospitals.
[2:17:58] Then, of course, measure A was a big, big lift, and it really does reflect the community's
[2:18:08] support of your public system, and they do understand that we are just not a safety net
[2:18:14] system for those that are uninsured or unmedicated, we are a safety net system for every resident
[2:18:23] of this community,
[2:18:27] something that I, you know, I have to say that everyone was in the health
[2:18:30] system, and I know it was in the county is very proud of, and it would not have come
[2:18:37] about unless we have a system that people respect and understand in terms of what value we bring
[2:18:44] to the community.
[2:18:48] And I do have to acknowledge our workforce for that, our doctors and our nurses
[2:18:52] that work day in a day out to provide that love of care.
[2:18:57] I've mentioned the next slide, please, that we're looking
[2:19:01] with all the provisions of HR1 implement,
[2:19:04] implement it close to $1 billion in last revenue.
[2:19:09] What we're looking at is $200 million for the current year,
[2:19:14] that we will be presenting to your board at mid-year.
[2:19:17] That is our target.
[2:19:18] We're estimated $160 million for FY2627, that is after Measure A of $300 million and then
[2:19:30] in 2027 and 28, when most of the provisions of HR1 are fully implemented, we are looking
[2:19:39] at a much more difficult, hill to climb relative to loss to revenue related to Medicaid.
[2:19:46] that is in twenty seven twenty eight. And so we're trying to get ahead of that curve and
[2:19:52] trying to mitigate this as much as possible.
[2:19:56] Those are make one comment. That chart assumes no money from our state-related strategies.
[2:20:03] I just wanted to clarify that.
[2:20:08] And that chart also reflects that we are not looking for any additional general fund contribution.
[2:20:18] going forward. So we're trying to manage within the current general fund contribution along with
[2:20:24] dealing with all of these other revenue losses to your health system.
[2:20:30] The next slide I'm not
[2:20:31] going to spend too much time on this but this gives you a breakdown of the $200 million in the
[2:20:36] lost revenue as you would note the $67 million in lost direct repayments that was prior to
[2:20:42] to the acquisition required regional medical center,
[2:20:46] then HR1 came online, that alone was $67 million.
[2:20:52] And then, of course, you see the other items,
[2:20:56] including lost fee for service revenue
[2:20:59] and impact of the federal government decision
[2:21:04] around the MCOTACs.
[2:21:09] So our strategy says, I'm sorry,
[2:21:12] will you just say that sentence again, not the MCOTACs?
[2:21:14] So when the federal government implemented changes due to directed payments and the ability
[2:21:22] of counties in the state to put up the match, to draw down additional federal dollars,
[2:21:32] they cap that and also created a situation where the expected increases the state was
[2:21:42] an implement for medical fee for service reimbursement.
[2:21:46] That was all lost in that.
[2:21:48] The state has to now review the program,
[2:21:51] determine how best to leverage what they can relative
[2:21:55] to federal revenue.
[2:21:57] So more to come on that from the state.
[2:22:03] The other thing I would mention, supervisor
[2:22:05] Ellen Burgess, that there was a specific allocation
[2:22:09] in there outside of the fee for service,
[2:22:12] where we would, as a public system, expect to receive about $15 million directly, which
[2:22:20] is also lost because of that.
[2:22:27] So the budget mitigation strategy, as I mentioned, we are looking to improve the revenue
[2:22:32] picture via our revenue cycle.
[2:22:36] I'll share some numbers with you, but we've made some marked improvement around our revenue
[2:22:41] cycle.
[2:22:43] We are also focused on making sure that our contracted pair rates are more in line with
[2:22:53] the market, whether it has to do with medical, Medicare, or commercial.
[2:22:59] We're really focused on making sure that our contracts reflect what we should be receiving
[2:23:05] in this marketplace.
[2:23:08] And then, of course,
[2:23:12] you will hear a little bit more about our payer strategies, but again,
[2:23:16] one of our strategies to make sure that it's many individuals that qualify for some
[2:23:20] government program coverage, that they remain enrolled.
[2:23:25] If they do not remain enrolled, that becomes an un-reimbursed cost to your healthcare system,
[2:23:31] thus further exacerbating our financial situation in shortfalls.
[2:23:37] As I mentioned, we're focused on operational efficiencies and cost savings.
[2:23:44] Let me give you this perspective, which is on the next slide, which is important to understand.
[2:23:52] Of the $200 million that we're coming to your board in terms of solutions,
[2:23:59] we have $40 million in revenue improvement that we've identified,
[2:24:04] close to $90 million in an operation of efficiencies and cost savings, that operation of
[2:24:12] efficiency is reflected in terms of revenue, as opposed to more so cost reductions.
[2:24:22] If we're able to improve the efficiency of our hospital patient flow, meaning discharge
[2:24:31] of patients to free a bed for other patients where we can actually get reimbursement, that makes
[2:24:40] the difference. So patient flow and hospital efficiency is a key factor in that revenue as well
[2:24:48] as well as outpatient visits. So what we are trying to do is become a lot more efficient in
[2:24:53] the way we manage our schedules and see patients. The more patients we see, the better for the patient
[2:25:01] in terms of access, but we are also able to generate revenues to further mitigate some of these
[2:25:08] financial losses.
[2:25:11] And then we are looking at service line restructuring and consolidations in terms of annoying
[2:25:16] efficiency, but also allowing us to utilize high-cost resources and much more effective manner.
[2:25:26] I'm not going to go through the next slide in much detail, but these are some of the areas
[2:25:31] focus around revenue cycle, ranging from charge capture to coding and documentation to regular claims
[2:25:41] denial audits and review, but also having much more favorable contracts in terms of our reimbursement
[2:25:50] for various payers. The next few slides are an example of some of the improvements that we've seen.
[2:26:01] I'm going to touch on these and I'll let the note speak if there's something more to cover,
[2:26:07] but the short of it is that in epic, we're utilizing a tool called Revenue Guardian to identify
[2:26:15] opportunities where comparative markers would suggest that we should have a higher revenue reimbursement
[2:26:22] base.
[2:26:24] And so you can see just in this chart, in this short period of time, there's been a 29% improvement
[2:26:31] in our facility charge reimbursement or charge capture.
[2:26:37] And then also you see that on the next chart on the professional fee.
[2:26:43] And I do have to give a lot of credit to our physicians and staff on this because they're
[2:26:49] one that are working with us to make sure that our documentation and coding is optimal
[2:26:57] in order for us to get the higher base of reimbursement.
[2:27:02] And so you can see, if we're able to have a much more optimal charge capture that
[2:27:08] are net revenue is going to be much better as a system, and this is contributing greatly
[2:27:14] to our ability to deal with some of these financial challenges that we have.
[2:27:18] We are also adopting, next slide,
[2:27:24] 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.
[2:27:46] but our ability to bring this type of technology will improve efficiency, will allow us to improve
[2:27:54] productivity and performance in our system, and this is also allowed us to implement this
[2:28:03] technology not just in terms of revenue cycle, but clearly in clinical setting.
[2:28:14] These charts
[2:28:15] provide for a little bit more detail relative to some of the areas that we're looking
[2:28:21] to adopt AI. Either very similar to what other health systems are adopting and will improve
[2:28:30] our ability to not only generate revenue but also provide for better care for our patients.
[2:28:38] The next slide touches on our market payer strategies. Let me just say this about market
[2:28:45] air strategies. We know about the major pairs being medical, Medicare, or commercial. What you should
[2:28:53] also understand that with each of these categories you have different insurance companies or
[2:29:00] different pairs, right? So in medical, as you well know, we have a situation where we have
[2:29:08] some of the cross, we have family health plan, we have our own health care plan, but we also
[2:29:14] have IPAs that take risk and pay us, so it's a very complicated scheme relative to each of
[2:29:23] these payers and it's really important that we understand that and have strategies to address
[2:29:27] it.
[2:29:28] In medical, James has talked about and you're very familiar with our strategy to move to a single
[2:29:34] plan model where we can maximize reimbursement, but also manage or cost much more effectively
[2:29:42] in utilization of services.
[2:29:45] That's one example, but in each of these areas, whether it's Medicare or commercial,
[2:29:50] we have to take the same level of interest in terms of what's going on around us and relative
[2:29:58] to what's going on.
[2:30:00] Within our own system, in terms of the level of a pair of adequacy.
[2:30:08] The uninsured and uninsured, the primary care
[2:30:13] access program that your board is familiar with, we are looking to revise that program given the impacts
[2:30:23] of HR1 in the expected increase of individuals that will be uninsured. So we are looking at putting
[2:30:30] other program that is much more robust and addresses those implications. I will tell you that
[2:30:38] some of our estimates suggest that we are at 3% unsure that number can easily go up to
[2:30:48] 10% 15% within the next year or two, which is part of the reasons that you see such a large number
[2:30:57] in terms of lost medical revenue.
[2:31:00] It all has to do with individuals that are not enrolling in coverage or have the ability to
[2:31:06] have coverage.
[2:31:11] Operation efficiencies, I won't spend much time on this slide other than to once again stress
[2:31:17] that we as a healthcare system have the ability to generate revenues through our ability
[2:31:26] to be much more efficient and cost effective in terms of how we deliver care.
[2:31:30] And so we are heavily focused on that.
[2:31:37] The next slide, what we attempted to do in our mid-year proposal was to come up with
[2:31:46] $200 million, as I mentioned, was to
[2:31:52] try to mitigate the $200 million without impacting services.
[2:31:59] To a large degree, you know, we have done that much through the revenue initiatives.
[2:32:04] We also, we're trying to figure out strategies in which we can better utilize our most valuable resource, which is our staffing.
[2:32:16] We are going to be recommending 218 positions to be deleted from our budget.
[2:32:24] I don't say layoffs, because many of these individuals of the field positions,
[2:32:32] which represents around
[2:32:38] 44, 47 positions.
[2:32:44] These individuals will have an opportunity to move into a vacant position in another program or service.
[2:32:51] So the other item that you will note on the slide is that we are reallocating 86.6FTEs to activate the new behavioral civilian.
[2:33:00] 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.
[2:33:21] The reason that the number in terms of field positions relative to the total is where
[2:33:33] it's at today is because over the past nine months we were very careful not to
[2:33:38] fill positions in anticipation of these budget challenges.
[2:33:46] So that is why we're able to give up more vacant positions in field positions in
[2:33:49] to meet our budget obligation.
[2:33:58] The next slide in terms of service line restriction consolidation, this gives you some perspective
[2:34:05] of both administrative, realignment that's going on within the healthcare system, but also
[2:34:12] clinical service lines.
[2:34:17] And of course, range from women's healthcare to cardiac care in other specialties.
[2:34:28] 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.
[2:34:39] Thanks Paul.
[2:34:40] The natural progression of any major health system is to really, with multiple hospitals, it's developed clinical service lines.
[2:34:48] We created that cardiac care service line to really integrate and consolidate health care across our system.
[2:34:55] There are really three drivers that you think about in terms of why you want to do that.
[2:35:00] The first is really quality and safety.
[2:35:03] For you to be really good at doing complex cardiac procedures, such as thoracic, organic
[2:35:10] dissection or advanced coronary bypass surgeries or pulse frequency ablations for cardiac
[2:35:18] arrhythmias, you really have to concentrate certain services in various locations.
[2:35:23] you can't have them across the whole system.
[2:35:25] I'm going to allow us for more standardization of your protocols to be able to have enough
[2:35:29] on-call coverage for those types of procedures.
[2:35:33] The second is really resource use in staff wisely.
[2:35:39] We know that many of these types of procedures require very specialized training, so you
[2:35:44] want to be able to sort of strategize where you put those staff in personnel as well as equipment.
[2:35:51] 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.
[2:36:00] 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.
[2:36:07] The third is actually just, you know, financial and regulatory stewardship in order for us to really do well at any of these endeavors.
[2:36:15] is we have to be very effective both from a patient standpoint and in terms of looking at our
[2:36:22] cost.
[2:36:23] So by organizing your care in a very integrated way, we think that this is how you can maintain
[2:36:31] national standards, improve your quality, and then also improve your throughput and efficiency.
[2:36:37] Our hope is that whenever you start your journey in our system with a heart problem, you will
[2:36:43] get the best cardiac care using all of the available resources in our system and that's why
[2:36:49] we organize the system in a way that is much more effective.
[2:36:54] Thank you, Dr. Wang, and so that's just an example of why we focus on a service line strategy
[2:36:59] in such a large health system that we have, so we're leveraging our assets.
[2:37:07] The next item I want to talk to Tornabini to talk about because it's been a lot of conversation
[2:37:11] within our workforce about this topic of service to the aging population.
[2:37:18] Thank you.
[2:37:19] As part of the growing national recognition of the importance of optimizing care for older adults,
[2:37:27] we are pursuing becoming age-friendly.
[2:37:30] Specifically, we are starting that program at OConnor Hospital.
[2:37:34] There are different programs that health systems can put into place in order to achieve that age-friendly designation.
[2:37:46] But it's important to understand that these programs not only meet the requirements of being age-friendly,
[2:37:54] but they also form the clinical basis for care transformation for older adults.
[2:38:00] We have applied at O'Connor Hospital to become an age-friendly hospital.
[2:38:09] We heard last Friday that the IHI had accepted our application and we are now an age-friendly
[2:38:17] health system participant.
[2:38:21] We will be working on implementing a new framework of care for older adults that's based
[2:38:27] on four clinical pillars, what matters,
[2:38:31] mentation, mobility, and medications.
[2:38:36] We will be starting that in the perioperative area
[2:38:38] and then spreading that across other units
[2:38:41] in the hospital.
[2:38:43] Our goal is to improve the outcomes for our patients
[2:38:48] by reducing the incidence of delirium,
[2:38:52] falls, readmission, readmissions,
[2:38:56] functional decline and polypharmacy of our older patients. In a future phase, we will also
[2:39:03] be looking to transform our geriatric care in our outpatient environment. So in implementing this,
[2:39:13] we hope to set up the system to not only improve the care that we're providing our older adults,
[2:39:19] but also improve the value that we're providing our community.
[2:39:27] Thank you, Dr. Hornebini.
[2:39:28] So it gives you some insight in terms of some of the planning that's going on with our health,
[2:39:33] within our health care system looking toward the future.
[2:39:37] And this does provide a basis for sustainability,
[2:39:40] in terms of not on providing access to care,
[2:39:43] but also from a financial perspective in having a place to the market.
[2:39:49] The next slide I do want to share with your board that we did ask staff to give input relative to budget ideas.
[2:40:01] We received over 600 responses from our workforce in a matter of 60 days.
[2:40:09] These ideas fall into one of these eight categories that are before you.
[2:40:13] And as you would note, many of the malign with many of the items that I have presented today
[2:40:20] around cost control in efficiency.
[2:40:27] So I'm very, very pleased to share with you that there's been a level of staffing engagement
[2:40:32] that has been very productive and fruitful.
[2:40:35] We are adopting many of them in moving forward with those suggestions.
[2:40:40] The
[2:40:44] next slide, I just want to summarize that we have coming to your board at me, you're
[2:40:51] about 200 million. The goal for that 200 million is to reflect on going reduction or
[2:41:02] improvement in our bottom line. That's ongoing because it's cumulative. As you well know, we
[2:41:11] 200 million dollars this year next year another 160 million dollars and another 280 million
[2:41:18] dollars. So we have to find ways to make sure that we lower the cost or find ways to generate
[2:41:25] ongoing revenue to deal with those losses. Regional medical center has noted contributed to our
[2:41:33] ability to meet these targets, and we'll continue to.
[2:41:39] There are 13% of over the budget census today,
[2:41:44] and we fully expect that that will continue.
[2:41:48] So we are providing not only access to care,
[2:41:51] but we are finding a financial solution going forward,
[2:41:55] so that we can sustain the system.
[2:41:58] And then, of course, revenue cycle improvements
[2:42:01] and pair of strategies.
[2:42:05] We've seen a 7.5% gross year over year in our revenue.
[2:42:12] That's about $104 million.
[2:42:15] So these are efforts that we're going to continue to focus on going forward.
[2:42:20] And then an example that I've given here is primary care,
[2:42:24] where year over year there's been an increase in efficiency of 10%
[2:42:29] in terms of seeing more patients.
[2:42:32] So, now, again, are we providing more access to care,
[2:42:36] but this will allow us to generate the revenue
[2:42:38] to further offset the lost revenues in other areas.
[2:42:43] So, this is where we're focused.
[2:42:45] We are going to do everything possible
[2:42:47] to minimize impact to staff, minimize the impact to services.
[2:42:54] And this is our strategy going forward.
[2:42:57] And, you know, because you have such a robust
[2:42:58] and integrated healthcare system, and we're able to leverage those assets.
[2:43:05] I think we do have a pass forward.
[2:43:11] I just want to share a couple of comments as we turn to questions.
[2:43:16] I first want to express tremendous gratitude to Paul specifically and to the incredible team that he has working with him.
[2:43:25] 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.
[2:43:46] he leads with compassion, integrity, wisdom, and I really cannot overemphasize how fortunate
[2:43:55] we are in this time and with so much that has been happening at Santa Clara Valley Healthcare
[2:44:01] to have Paul's leadership. And he's surrounded himself with an incredible team not just
[2:44:07] the folks you see here, although each of them this is certainly true, but a much broader team
[2:44:13] of leadership across our healthcare system, dedicated public servants, and that includes the
[2:44:19] entirety of the workforce, working day in and out.
[2:44:22] And the initiatives that you've seen highlighted here reflect a values-based focus that is
[2:44:29] a focus on centering the patients that we serve, where some of the most vulnerable families
[2:44:34] in our community, but also on recognition that we serve every family in our community.
[2:44:39] and moving forward a litany of initiatives that seek to minimize disruption to the system,
[2:44:49] maximize revenue for the system, and mitigate impacts on our workforce and most importantly
[2:44:55] on the patients that we serve.
[2:44:58] So I want to just extend.
[2:45:00] Government is gratitude to the leadership across the system. This is coming off the heels, mind you.
[2:45:06] I think context is important. This is coming off the heels of the incredible 80 day acquisition of regional medical
[2:45:14] center, the pandemic, the transformations happening more broadly in the healthcare space, the 2019 acquisition of the other two hospitals.
[2:45:24] These are all hugely generationally transformative changes for any healthcare system.
[2:45:31] We've had all of them occur in just a matter of a handful of years, and we have to acknowledge that as well.
[2:45:40] 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
[2:45:51] to address the new challenge that has been foisted on us by the federal and state government.
[2:46:04] Thank you James, and thank you very much, Bob. I don't see any questions or lights on my colleague.
[2:46:10] I'm telling you, I want to open up a public when I get out. Yeah, let's see, how many
[2:46:13] are the public electors pick on this item?
[2:46:18] I currently have one speaker on Zoom, and that is all.
[2:46:23] Okay, just two minutes. All right. For our speaker, are we going to close the queue?
[2:46:28] are speaker on Zoom as parent?
[2:46:33] Yes, thank you for the presentation.
[2:46:36] While people, they have choices.
[2:46:40] They can get private insurance.
[2:46:43] They can go to private providers.
[2:46:46] They don't have to go to our public health care system.
[2:46:51] But when it comes to children being molested,
[2:46:55] the county has them an awfully on seeing them,
[2:46:59] specifically at the Child Advice and my children are being molested, my son is already confirmed
[2:47:05] that my ex-wife was letting a man rape woman and there's a signs of sexual abuse for all
[2:47:11] the other children and I can't get the county to provide screening for my children and that's
[2:47:18] because my former attorney she wants the sexual abuse to get to you and it doesn't make sense
[2:47:24] to meet up. One person can dictate how the county spends its money when it's a mandated
[2:47:32] service that my kids get a screening. Everybody here knows that when the things that
[2:47:39] I've reported that a screening is mandatory, they've never received one and they need one
[2:47:45] and I can't get one and it's just a real shame that we're touting on all these great things
[2:47:50] about our health care system, and I can't get a screening for my kids.
[2:47:54] And it's not just me.
[2:47:56] There are a lot of other parents who are complaining about these issues here at the Child
[2:47:59] Advocacy Center that either they can't get a screening when they do, when there's apparent
[2:48:07] child molestation, the county won't affirm it.
[2:48:12] And the child molestation just continues.
[2:48:14] I mean, look at what happened to violent books is kids.
[2:48:16] They got molested to lower 18 and when they sued the person, after they turned 18, I mean
[2:48:22] it's just as terrible that we're allowing sexual abuse to be so rampant in this county
[2:48:27] for children and I've asked Paul Orens, can you facilitate a screen for my kids and he's
[2:48:34] just sorry?
[2:48:37] And it's concludes our public speakers.
[2:48:40] Thank you.
[2:48:40] Just like to read this response, which is that California law prohibits the disclosure of
[2:48:47] information related to and in this case you have suspected child abuse and we are now
[2:48:52] authorized by a lot to speak to specific of any particular case. The law also requires
[2:48:57] child welfare departments, neatly cross report, please have a reviews to law enforcement.
[2:49:02] And the public can be assured that our county takes a allegations child abuse and neglect
[2:49:06] seriously and takes your appropriate action. Thank you. And now go to my colleagues. I see
[2:49:11] the lights. I see you supervisor Abikuga. Thank you, President Lee. I have quite a few questions
[2:49:17] so I'm happy to start and limit it to the 10 minutes that you want it.
[2:49:22] Yeah, let's do 10 minutes each, just to keep it moving.
[2:49:25] Great.
[2:49:25] Nobody got enough of us all the time.
[2:49:27] I want to talk about that.
[2:49:28] But just remind that this information item today and no actual action needed to be taken.
[2:49:35] Thank you.
[2:49:36] Great.
[2:49:36] Thank you.
[2:49:37] And thank you so much to staff for bringing this forward.
[2:49:41] This is really exactly the type of information that I was,
[2:49:46] I've been seeking, and I also just want to say thank you to all of you, especially under the leadership of Paul.
[2:49:53] 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.
[2:50:06] So with that, I appreciate what you shared about improving
[2:50:11] medical base rates, maximizing contract revenue, utilizing AI,
[2:50:16] and I have definitely have some comments on that area
[2:50:20] and some questions.
[2:50:22] But I guess that's just started out with the overall plan,
[2:50:26] the three-pronged plan.
[2:50:29] I wasn't sure, I know it was mentioned,
[2:50:32] but I guess that it has concerns about the state support
[2:50:35] because it sounds like it's not necessarily going to be there as much as we expected.
[2:50:40] And so was hoping you could maybe touch on that a little further as to what we really might
[2:50:47] be able to fix it.
[2:50:48] Yeah, I can talk more about it, but it actually might be better timed, happy talk about it now,
[2:50:54] but we also have later on, we have later on the agenda, the monthly legislative report,
[2:51:00] and that might actually be a better spot in on the agenda to talk about it, but we have a
[2:51:03] strategies we're pursuing on the state front that I'd love to lay out in detail.
[2:51:08] And I guess this is also like the backup plan if we don't get that finding from the state.
[2:51:15] Yeah, so what you see on if you go for example to slide 26.
[2:51:20] These are cumulative annual amounts, so they stack, but these are year over year impacts, right?
[2:51:27] two hundred million ongoing, one sixty ongoing, two sixty ongoing.
[2:51:33] And these numbers assume that the state does nothing.
[2:51:41] So to the extent that we are successful in our state strategies that will help mitigate these impacts.
[2:51:49] And if we are not successful in obtaining any assistance from the state,
[2:51:56] 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
[2:52:23] out additional productivity or revenue-based options and at some point you then tip over into needing
[2:52:30] to look at service closures. So we're very fortunate that nothing coming in front of the board
[2:52:36] at mid-year is a service closure, but we cannot say that that will be the case in the future
[2:52:45] our absent success on our state-related strategies to help bridge the gap.
[2:52:53] Thank you.
[2:52:55] As you look at service line consolidation, what criteria did you use to determine whether
[2:53:02] service should be restructured, centralized, or discontinued?
[2:53:08] How do you incorporate geographic access?
[2:53:13] That is a great question.
[2:53:16] The typically in healthcare and Dr. Lincoln speak to this is that you look at volume.
[2:53:26] You create centers of excellence because in healthcare if you do not have the volume, you're
[2:53:32] unable to maintain competencies relative to the quality in the outcome of care.
[2:53:38] So it's not just staff, but health care outcomes are achieved when you have volume.
[2:53:44] 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.
[2:53:58] Because your health outcomes are better, then you are able to create what we consider to be a reputation in the community,
[2:54:07] relative to health outcomes, and so you're able to then build upon that.
[2:54:12] A perfect example is a rehabilitation center.
[2:54:15] Yes. So we have acute rehab center at Valley Medical Center.
[2:54:18] All the patients from the other hospital, whether it's regional or
[2:54:22] Connor, or Satan, we've come to Valley for that rehabilitation care.
[2:54:28] And it is at that center, we have the centers of excellence,
[2:54:31] because of the competencies of staff and the levels care that we provide.
[2:54:35] And that's no different than any other service line, whether it's oncology or women's health care.
[2:54:41] I'm not sure if Dr. Wing or Dr. Foam, you want to add to that.
[2:54:45] But it is focused on quality and access at the same time.
[2:54:50] It's a hub and spoke model, if you will.
[2:54:53] Okay, great.
[2:54:54] I did want to as Dave, I had a friend whose husband had an accident and spinal surgery
[2:55:01] and was transferred from his hospital to our rehab center
[2:55:06] and had an incredible experience.
[2:55:09] And this is just a few months ago, like in the fall
[2:55:12] and apparently he's walking.
[2:55:14] So just, she was just delighted.
[2:55:17] And so I wanted to relay that.
[2:55:19] So thank you.
[2:55:20] Did you have some further comments on that?
[2:55:23] I was going to ask, I was going to explain that,
[2:55:26] in our process of looking at cardiac care service,
[2:55:28] we did look geographically, you know,
[2:55:30] where the cardiac care is,
[2:55:32] we know that around the regional east side
[2:55:35] is clearly the South County as well.
[2:55:39] And so when I talk about cardiac care services,
[2:55:41] even though we're concentrating some services,
[2:55:43] particularly highly complex cardiac surgeries
[2:55:46] at Valley Medical Center,
[2:55:48] we are also spreading out some of our resources
[2:55:51] for cardiac care, for instance,
[2:55:53] when I talk about electrophysiology service,
[2:55:56] if you have a heart rhythm abnormality,
[2:55:58] We have that at regional medical center and we have that at O'Connor as an example because we know that's where
[2:56:04] We'd like to place those kinds of procedures and stuff. So we're not concentrating everything in one place
[2:56:09] 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
[2:56:17] Great. Thank you
[2:56:18] And another example. I just have to add this because sometimes
[2:56:21] When we speak of cardiac care at St. Louis Regional Hospital
[2:56:26] If you will notice recently, we opened up a cardiac program there so that we can have studies
[2:56:32] in testing done in the community so it's more accessible.
[2:56:37] Once again, it's an example of the hub and spoke model.
[2:56:40] Great.
[2:56:41] Thank you.
[2:56:43] I talked about volume and part of that goes in hand in hand with productivity and I understand
[2:56:51] their primary care clinics are growing and that's really great. Can you share a little bit more
[2:56:58] about what investments we could make to expand primary care access and, again, all parts
[2:57:04] of the county to get to that break even productivity level? Really good question. So as you've
[2:57:13] noted, primary care is a heavy focus for us as a health care system because that is where people
[2:57:19] should be receiving the preventive health care, and it is also important to understand that
[2:57:26] primary care is the front door into health care. The primary care system provides for the medical
[2:57:33] home to help individuals navigate their care throughout the system, whether it be referrals to
[2:57:39] specialties and so forth. So what we are trying to do and what we are actually doing is currently
[2:57:46] evaluate in our current physical capacity at all of our sites to determine whether or not we can
[2:57:51] add additional providers. So we're trying to maximize our current facilities to the full extent
[2:57:57] possible. The other thing that we're doing is trying to work with our staff to change and improve
[2:58:04] on the workflows so that we can actually ensure that we're using every available appointment slot.
[2:58:12] Now, in other words, making sure that our no-show rate is lower with our contact in patients
[2:58:19] if not, we can schedule another patient in, so we're trying to maximize our current capacity
[2:58:26] and at the same time identify improvements in efficiencies relative to how we schedule
[2:58:32] in make appointments.
[2:58:33] And the other thing that we're doing is also looking at telehealth as an option, virtual
[2:58:41] visits as well, which will allow us to not only improve access in timelyness of care,
[2:58:48] but also be much more convenient for our patient population.
[2:58:54] I'm looking at Dr. Wayne, because he's also helping in primary care or Dr. Fong Nguyen
[2:58:59] around the physician coverage.
[2:59:00] Supervisor, I can also add that recognizing how important is to invest in the future generation of primary care physicians.
[2:59:10] Now we are in the process of transitioning the family medicine training program at O'Connor.
[2:59:17] into the health system, so we'll become the sponsoring institution, and with that, you know,
[2:59:25] with the commitment of all those residents who chose to come to a program that get trained
[2:59:32] in a public sector. Hopefully that will be a conduit for future physician workforce that is dedicated
[2:59:39] to our patient and our community as well, right? And then the item that Dr. Noon just referred to is
[2:59:44] going to be one of the proposals as part of the mid-year, which includes actually a strategic
[2:59:48] augmentation of resources to bring that program into the county and not only achieve
[2:59:56] the pipeline that's been discussed, but also.
[3:00:01] Thank you. I think my ten minutes to set up, if I will, hopefully, can have a second round later, but thank you.
[3:00:08] 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.
[3:00:26] I have questions about a couple of the slides, but first, just a general, one, what is happening
[3:00:34] with the disproportionate share payments that I think are part of a waiver? Are those going
[3:00:39] away?
[3:00:40] So, I can speak a little, I was going to give an update in the kind of executive report.
[3:00:44] But there is one of the appropriations bills pending in front of the U.S. Senate.
[3:00:50] Would actually kick out the current scheduled cuts to those dish payments through 2028?
[3:01:00] It did pass the House of Rep.
[3:01:03] Would extend until 2028?
[3:01:05] It would delay the cut until 2028.
[3:01:09] Right now that cut will take effect at the end of this month.
[3:01:13] That bill did, this was part of the Appropriations Bill for the Federal HHS.
[3:01:20] That bill did pass the House of Representatives, it's pending in the Senate.
[3:01:23] The bills are all stuck in the Senate right now, because of very, very legitimate concerns
[3:01:29] around the separate funding bill for the Department of Homeland Security and for ICE.
[3:01:36] So it remains to be seen what will happen, the current appropriations for all those departments
[3:01:41] expires at the end of this month.
[3:01:43] So we could see another shutdown for those agencies
[3:01:45] including HHS because the Democrats in the Senate
[3:01:51] have asked for the bills to be split up and voted on
[3:01:53] separately.
[3:01:54] There is an agreement on the HHS bill, but so far,
[3:01:58] the Senate Republicans are unwilling to split
[3:02:00] the bills apart for separate votes.
[3:02:03] So we will monitor that, but that's the current status.
[3:02:05] Awesome.
[3:02:08] Can you back to slide 23?
[3:02:12] I feel like I've asked this question before, and I'm so sorry that I need an answer again.
[3:02:18] But looking at the first line, the prohibition on new provider taxes for Medicaid expansion states,
[3:02:27] can you explain to me perhaps again why our MCO tax falls into this category,
[3:02:33] and was it perhaps because of Prop 35 did that render it a new?
[3:02:38] Yes, so the changes in the MCOTX that were approved by the voters in November of 2024 had
[3:02:43] not yet received federal regulatory approval before the passage of HR1.
[3:02:48] And we advocated for the passage of...
[3:02:50] We did, we support this board endorsed that proposition.
[3:02:54] It wasn't perfect but it had augmented funding for public hospital systems.
[3:03:00] That's the $15 million there was a set aside.
[3:03:02] It's gone entirely.
[3:03:06] The state says that they're trying to do some conversation with federal CMS.
[3:03:11] I would just say I'm much more skeptical than the governor's budget is about the success
[3:03:15] of that conversation.
[3:03:19] The question since he did not want to prop to 35 in the first place.
[3:03:23] So, we'll see what happens.
[3:03:26] But there's two things that HR1 does with regard to the MCOTACS and the directed payments
[3:03:31] that I think people have confused a little on the timeline, which is, we tried to show it
[3:03:35] in here, immediately there was a freeze, and we got caught up in the freeze. So we have
[3:03:42] impacts from the freeze. And then later, you'll see in 27 and 28, there's the ratcheting
[3:03:50] down of both the MCOTACs and the directed payments, ultimately a 50% reduction in directed
[3:03:59] payments. So we have two separate types of impacts that we're facing. Immediately, we've
[3:04:07] been frozen out with the freeze. We're not seeing the natural growth of the program,
[3:04:14] right? Because these are programs that you would normally have and if you look over the last
[3:04:18] decade, they grow year over year because costs grow year over year. So with the freeze, you're
[3:04:23] no longer getting the growth. That actually has a revenue impact on us. And then to
[3:04:29] make things much, much worse, starting in 27, you actually see the frozen amounts getting chopped
[3:04:36] down.
[3:04:37] Ultimately, in the case of those directed payments that Paul mentioned, are about $750 million
[3:04:43] a year in revenue to our system, ultimately seeing those payments chopped down in half.
[3:04:49] So, it's a layering impact, and that's why when you see on that chart on slide, I think,
[3:04:53] it was 26, those ongoing impacts stacking up over time.
[3:04:58] So we've got ones immediately, some of which are due to the freeze, and then we have these other ones hitting, and that
[3:05:04] that 260 million bucket that comes 2728 is largely attributable to those
[3:05:13] ratcheting down of the supplemental payments, and MCOTax, while part of it is attributable to enrollment loss,
[3:05:22] a big chunk of the middle orange block 160 is due to enrollment loss.
[3:05:28] So there's a multitude of ways in which we're getting hit.
[3:05:31] So why we're on this slide is the 300 million counted in each of those...
[3:05:37] Each here, these are annual amounts, so the 200, these are ongoing.
[3:05:43] So another way to think about this is this is the ongoing annual impact in 28.
[3:05:50] And you see how we get from here to there year over year over year so that 200 million for this current year?
[3:05:56] That's 200 million a year.
[3:05:58] So we're dealing with 200 million in ongoing solutions.
[3:06:02] Otherwise we have the 200 million last this year.
[3:06:04] Next year the year after that the year after that.
[3:06:06] Got it.
[3:06:08] I think.
[3:06:09] Okay.
[3:06:12] Thank you.
[3:06:13] I apparently might need a second round but I'll come back to.
[3:06:17] I'll think about that.
[3:06:19] On slide 24, the UIS population is discussed.
[3:06:24] Can you say a little bit just about the refugee care, which is an incorporated here, and
[3:06:31] those are folks with protected legal status that have not been impacted by the federal government,
[3:06:37] but the governor's proposal does propose to cut their care as well?
[3:06:42] Yes, you're going to get me worked up on this point.
[3:06:44] There's about 200,000 Californians.
[3:06:47] It's a relatively modest number of people.
[3:06:50] But these are folks who in this federal administrations
[3:06:55] infinite wisdom have been kicked off of Medicaid coverage.
[3:07:01] These are refugees, folks here who are on a asylum.
[3:07:06] You visa holders, TVs or holders.
[3:07:08] These are verified victims of human trafficking
[3:07:12] and domestic violence, all of whom are here legally, in other words, they have lawful status
[3:07:20] to be in the United States.
[3:07:23] The federal government has chosen to toss them off of Medicaid, and the governor's budget
[3:07:30] is proposing to just roll forward and implement that.
[3:07:33] In other words, not to place these individuals onto the state-only program, so they be left
[3:07:40] with worse coverage than the state-only medical program.
[3:07:47] So from a moral standpoint, even though the population numbers
[3:07:51] are modest, the specific fiscal impact is more modest,
[3:07:55] but from a moral standpoint, this is really just
[3:08:01] a horrific proposal.
[3:08:02] And it's quite stunning to me to see the state
[3:08:06] choose to just roll forward and implement that federal policy direction.
[3:08:14] Thank you.
[3:08:14] I think more people need to be talking about that.
[3:08:19] It's a line item of a line item.
[3:08:23] And really, I think,
[3:08:27] is as you said, really just a horrific proposal.
[3:08:32] Let me ask about the FQHC rate strapping.
[3:08:40] What are we thinking about the clinics that we currently have contracts with, especially
[3:08:47] the smaller ones, is it realistic that they stay in business, losing 60% of their revenue
[3:08:53] with each patient?
[3:08:54] Well, it would vary by clinic, depending on how many of the state-only recipients are accessing care at their clinic site.
[3:09:09] So as an example, in my conversations with one clinic, close to 12% of the patient population fall into this category.
[3:09:20] So, if they're losing 60, 70% of the revenue for that time, 10% of the time, that's the impact.
[3:09:30] And so, we are having conversations, supervisors, you well know around, as I mentioned, the revision, the remodeling of the PCAP program,
[3:09:41] to ensure that these individuals can maintain their medical home and continue their own going care.
[3:09:49] So that is one of the proposals that we'll be being back to your board, probably in October, November
[3:09:54] time, right?
[3:09:55] Thanks.
[3:09:56] Obviously, it doesn't do us any good and harms us if the clinics aren't providing care, because
[3:10:01] wherever those patients go, they'll come to the county.
[3:10:04] So one way or another, we're paying for that care.
[3:10:07] I do have three more questions that I'll be happy to take in the second round.
[3:10:10] Thank you.
[3:10:13] Yes, thank you.
[3:10:15] Thank you for this presentation.
[3:10:17] 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.
[3:10:40] 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,
[3:10:46] but you're always on call for all of us to help us understand exactly what's happening with our care systems.
[3:10:53] James, that was very, you know, you talk about getting riled up.
[3:10:56] It's very hard not to get emotional, especially since we have such a deep immigrant history here.
[3:11:03] And it
[3:11:11] is. I'll just say, you know, healthcare is personal but healthcare is also a statement of community values.
[3:11:17] 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.
[3:11:30] And we will remain absolutely steadfast in that commitment.
[3:11:35] That's in part why you're seeing all of the things in front of you that you are is because
[3:11:41] people are working night and day to try to ensure that we can honor that commitment in this community.
[3:11:47] And so even those individuals, for example, who if the state just implements that proposal,
[3:11:53] our doors will remain open to refugees.
[3:11:56] Our doors will remain open to you, Visa, and TV's the holders, and we will come up with a primary
[3:12:02] care access program that's modified to help address that.
[3:12:07] Now that will mean impacts across our county organization, that will mean we will be doing
[3:12:14] things that other counties and other systems won't who will instead turn around and close
[3:12:21] some of those doors and what you see for example in us accounting for enrollment loss is not
[3:12:36] just looking at the revenue loss associated with that but the reality that we expect to
[3:12:41] continue to deliver services to those residents in our community. Instead of making a forecast
[3:12:50] that expects to shut doors and turn people away.
[3:12:53] And that is a choice that this organization has made historically and continues to make consistent
[3:13:00] with the leadership of this board and the values of our county.
[3:13:03] And so I want to acknowledge that because there are different policy choices.
[3:13:09] We could make policy choices the way you see at the state or other places where we closed
[3:13:13] doors and we record that on our books as a budget savings.
[3:13:19] And we are not doing that in what we have brought forward to this board.
[3:13:24] Thank you, James.
[3:13:39] It's okay.
[3:13:42] I'm all I'm feeling that I'm okay.
[3:13:44] I'm in all my fields today, so my audience, to our audience, our public, please don't
[3:13:47] be alarmed.
[3:13:50] Just
[3:13:55] thank you, James.
[3:13:55] We're going to, I know we're going to lean into that continuously through our intergovernmental
[3:14:00] 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
[3:14:07] 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
[3:14:15] Immigrants themselves and I'm the pro I was made by refugees
[3:14:18] who relied on this counties open door policy and the Medicaid that was afforded to them in the 70s
[3:14:31] these policies are inhumane, and I'm glad that we are part of the county that's going
[3:14:36] to be the last dance if we have to be, to protecting the health care of everyone in our county.
[3:14:44] The uninsured access program on slide 35, I wanted to like mean into that a little bit more
[3:14:49] and try to understand is that, is that part of the P-CAT program is, is, is,
[3:14:57] Thank you so much.
[3:15:00] I didn't call a peak cap because I think it's going to be much different than it is today.
[3:15:06] And what a lot of people don't appreciate is that under peak cap, we have a tremendous partnership with our community health clinics,
[3:15:16] where they provide the medical home beyond just our primary care clinics.
[3:15:21] But those individuals have access also to our specialty clinics, our hospital and other services.
[3:15:31] So in essence, it is a coverage program that focuses on ensuring that individuals have a medical home.
[3:15:38] And that is a model that we have to continue to develop.
[3:15:43] It's kind of, and I've talked to James kind of an entree into universal coverage
[3:15:48] because at the health care system, as a comprehensive health system, we're able to provide care
[3:15:54] and a managed and a value-based way, right?
[3:15:57] Making sure that people are receiving care at the right time, at the right place.
[3:16:05] So that is what we're focused on.
[3:16:07] And as Paul mentioned, we are working on options of rethinking.
[3:16:11] We obviously have the program.
[3:16:12] It's just chunk in size over the last several years for very good reasons, which is over
[3:16:17] last decade, people have been able to get healthcare coverage through a medical, through
[3:16:22] cover California.
[3:16:24] So we will be bringing forward in the fall, as Paul mentioned, options for the boards
[3:16:29] consideration on a reimagined program.
[3:16:32] But I just want to say this is an example, and if you look also at, I think it was slide
[3:16:45] slide seven, these are examples of services and programs that are supported by county
[3:16:55] general fund, because they're not revenue backed.
[3:17:00] And when we talk about the general fund investment in the health system, it's absolutely
[3:17:06] pivotal to keep in the back of our minds that there are a litany of very important services
[3:17:12] and programs including programs for specific populations that other county health systems, even
[3:17:21] though they do incredible work, just don't provide. And we're only able to provide them because
[3:17:26] of the use of local discretionary resources to do so. This is just an example of some of those
[3:17:33] services and the board will be very familiar with many of these, because many of these have come
[3:17:38] over the years from advocacy in these chambers.
[3:17:42] And P.C.A.P.A. is a piece of that as well.
[3:17:45] But those are only services that really can be supported
[3:17:48] with significant general fund resources.
[3:17:51] That's all part of that ongoing annual general fund
[3:17:56] investment in the system.
[3:17:59] And sometimes I think is forgotten about when people talk
[3:18:01] about the system, just as an enterprise system.
[3:18:04] It's a public health care delivery system
[3:18:06] that also is delivering a whole set of services that we have directed them to provide in
[3:18:15] addition to the regular work that a county health care system would otherwise do.
[3:18:22] And that systems otherwise do and the rest of the state.
[3:18:25] Thank you, James.
[3:18:27] And I guess we'll be hearing more about it in October.
[3:18:30] And it's going to be something that I personally would like to be
[3:18:34] kept a price of what the redesigning of this program entails,
[3:18:38] especially because of its and complete dependency on the general fund.
[3:18:42] And now my time is running up on the next run.
[3:18:44] I'm going to be asking about the proposed 47 FTE position
[3:18:49] elimination that's going to be coming up during the mid-year discussion
[3:18:52] and just really understanding what the impact to service will look like.
[3:18:56] In that case where there were shifting positions,
[3:18:58] 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.
[3:19:08] Thank you.
[3:19:09] Well, there's still a minute. So Paul, you have the answer.
[3:19:11] Can we do that in a minute?
[3:19:14] I'll say one thing on turn over to Paul.
[3:19:19] So I know that there's frustration in the parts of the organization around the county hiring freeze.
[3:19:29] I'm well aware of that.
[3:19:31] 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.
[3:19:41] And so we can yet again say, and we may not always be able to say this.
[3:19:46] But we can yet again say that for all of the items coming in front of the board for mid-year,
[3:19:52] that we have positions for every single one of our staff to move into,
[3:19:57] most of those positions, the overwhelming number,
[3:20:02] same classification, meaning no change in classification or pay.
[3:20:09] And that is a direct result of the steps that the health system is taken,
[3:20:15] but also across the rest of the county organization,
[3:20:18] of maintaining and managing vacancies in a way that minimizes those
[3:20:27] detail, but I do want to assure the board that for the 47 filled positions that the overwhelming
[3:20:36] majority have same classification transfers and all of them have positions available in the
[3:20:44] county organization.
[3:20:47] But the other thing I'll just say and then I'll have Paul speak a little more and obviously
[3:20:50] we'll be talking about the specific proposals at mid year at the next board meeting is that
[3:20:57] 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.
[3:21:10] The Board has seen the staggering numbers as they stack up in the out-years.
[3:21:15] But we continue to be able to say that because we've worked very hard on revenue and other solutions.
[3:21:22] the staff positions reflected here represent roughly about 20% of that 200 million and only
[3:21:31] about 21-22% of the positions are filled impacts. So you can kind of see if you apply those
[3:21:40] percentages just how hard folks have been working to try to minimize any impacts on County staff.
[3:21:46] then we'll call them like you add.
[3:21:52] So the way that I would describe the initiative that we're bringing forward is really a real
[3:21:58] alignment of resources where they're most needed or we'll be able to ensure that we're
[3:22:05] balancing the needs of patient care.
[3:22:08] As an example, when we look at a particular service line, and we may feel as though that
[3:22:23] the reassignment of a nurse or a program assistant or an analyst would be better served
[3:22:30] in another program, what we're doing is basically cutting the position from that program and
[3:22:39] and getting them a position elsewhere within the organization.
[3:22:45] In a lot of respect, what we're looking at for that program
[3:22:49] with a position with move from to be more efficient
[3:22:52] with the resources that they do have or what they're left with.
[3:22:56] And so they are going to have to look at different ways
[3:22:58] of managing their priorities, making sure
[3:23:02] that we continue to maintain the same level
[3:23:05] of patient care and patient access.
[3:23:07] So, it is a re-environment of resources, it's probably a better way of saying it.
[3:23:14] There are known as layoffs because, clearly, we're cutting a position from a program.
[3:23:20] But, as since James has described, we've been very careful to make sure we do not fill positions
[3:23:26] for which we know there may be an in-placement.
[3:23:31] So, that's what you see going on to a large degree throughout the health system.
[3:23:35] I would say that there will be disagreement or are different perspectives of whether or not the
[3:23:45] deletion of a position in a particular program to move that resource to another program was the right decision.
[3:23:53] 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
[3:24:03] where we would get the most benefit.
[3:24:07] A perfect example is on that slide,
[3:24:11] you see the reallocation of 86.6 FTEs.
[3:24:16] So these are vacant positions,
[3:24:19] which we've been over the past year,
[3:24:22] trying to work to identify that we can actually re-purpose
[3:24:25] for the activation of the child in adolescent behavioral or civilian.
[3:24:31] So, we are doing some administrative ad deletes in order to get the right classifications
[3:24:38] in order to activate this new service.
[3:24:42] Individuals that may have been identified to lose a position in one program will have the
[3:24:49] opportunity for example to help us fill these vacancies.
[3:24:53] And as you well know, we need staff to operate this new service line.
[3:24:58] And it's the critical service that Nali will provide critical care to our patients, but
[3:25:06] also allow us to generate revenue based on the pair mix, because the child adolescent,
[3:25:13] there's a favorable pair relative to both commercial coverage, that will allow us to
[3:25:20] not only sustain the service line, but also continue to do what we're here to do, which provide
[3:25:26] essential services. So that's why you see, that's why I'm calling the real
[3:25:30] alignment of where positions are used and allocated more. So then we're at the
[3:25:36] point of layoffs. I cannot tell you because we're still working on the $160
[3:25:41] million for next year where we're going to end up, whether or not it's James has
[3:25:47] mentioned, we're going to have to actually potentially close service lines, which
[3:25:53] Obviously, we're impacting additional positions.
[3:25:55] We're trying to avoid that through these strategies that I've
[3:25:59] walks through.
[3:26:00] We get to 28, and we have no state support,
[3:26:06] then you can see how the problem becomes much more
[3:26:10] difficult to solve.
[3:26:14] So we're trying every trick in the book if you want
[3:26:17] to make sure that we do not impact services
[3:26:20] to the full extent possible, and that we maintain our workforce to the full extent possible
[3:26:28] and not have layoffs.
[3:26:31] But I can't make any promises sitting here, given the magnitude of what we're looking
[3:26:34] at.
[3:26:35] But I will say one thing, which is, this is where Measure A is so powerful, and we have been
[3:26:41] able to, because of the support of the community here, plug in to the budget that Measure
[3:26:50] revenue and that is making a world of difference and we would be having a very different
[3:26:56] conversation right now, but for the passage of measure A, there's no doubt in my mind we
[3:27:01] would be stirring down of service line and facility impacts right now.
[3:27:07] Yeah, every single measure A dollar matters in this context and it's going to continue to do so.
[3:27:12] Thank you so much for the responses for your work and as a last last my last contribution to
[3:27:19] the time that's been, extra time has been allocated to me.
[3:27:23] Thank you for that, President, is that my office is receiving numerous responses
[3:27:29] and just overwhelming support and gratitude for regional medical center.
[3:27:35] A lot of our e-ciders, no regional medical center, by other names, have had experiences
[3:27:39] throughout their past iterations and engaging with the hospital system there under
[3:27:43] different ownership.
[3:27:44] And what we've been hearing is overwhelming hands down.
[3:27:47] This is the best it's ever been.
[3:27:48] So thank you so much for. I want to make sure I give that shout-out and appreciation to our leadership
[3:27:53] and to your staff please relay my appreciation that my residents over on the east side is feeling
[3:27:59] honored. They feel seen and they feel a huge, marked difference in the care and the quality of
[3:28:05] that receiving at Regional Medical Center. Thank you. Thank you. So before the second round of questions
[3:28:11] I understand Paul, you actually have to go immediately after discussion to Sacramento,
[3:28:16] So, the test file before the legislation on behalf of a county, to let them know, allow
[3:28:20] them clear how those proposed cuts are inhumane, right?
[3:28:24] So, I don't want to delay a trip.
[3:28:26] So, I just want to say if you could bring this presentation also to our February HXC meeting,
[3:28:32] for the budget study, so that I would like to discuss come items like AI, healthcare,
[3:28:38] revenue, cycle, enhancement, some of the service line restructuring, and the market
[3:28:42] to create strategies, so we could take a little deeper on, but other social components we
[3:28:47] can look more on this budget process. That's okay with people.
[3:28:51] Yeah, we're certainly happy to come to the February HHC. We did activate our backup plan
[3:28:57] for the Sacramento Test of Moni, but we were very fortunate, and we'll talk more about this
[3:29:03] under the Intergovernmental Relations Report, but to be the only county that was invited
[3:29:08] to participate in the Assembly Health Committee hearing on this.
[3:29:13] Thank you.
[3:29:15] Thank you.
[3:29:15] He should go.
[3:29:16] You've got a good team here that you continue to answer questions.
[3:29:19] I'd love to go, but I'm not sure I'm going to make it by 130.
[3:29:23] But.
[3:29:23] I'd love to go.
[3:29:24] I'd love to go.
[3:29:25] We activated our backup option for that.
[3:29:29] We have a good backup option.
[3:29:31] But to James's point, I have to say to this board that.
[3:29:37] the level of interest in what's happening here in Santa Clara County by our state legislature,
[3:29:45] but also from official that DHCS and others is probably at its optimal level because many of the strategies that we have.
[3:30:02] Thank you.
[3:30:04] Did you have that?
[3:30:06] Oh no, that's all I have. So if there's things you can see for the HXC because we're here in February.
[3:30:11] Since you're a HXC, we could ask those questions to us.
[3:30:14] Just a couple questions for James.
[3:30:19] Thank you.
[3:30:20] And then I had to really,
[3:30:25] I've been really watching this and, you know, really grateful to see,
[3:30:31] and I appreciate that I think our way to solvency
[3:30:35] is frankly expansion.
[3:30:38] But in light of that, I have been concerned about,
[3:30:42] there's only so much one person can do,
[3:30:47] or in the leadership team.
[3:30:51] So I understand that a few years ago, there was a COO position
[3:30:57] that was created for the hospital system.
[3:30:59] And I was wondering what the status of that position is, and the expected time for hiring,
[3:31:07] and then along with that, just in general, the administrative bandwidth to look at, again,
[3:31:14] how we continue to leverage revenue generation and other solutions, because I do think leadership,
[3:31:22] and this is about, you know, right, the strategic thinking into the future, we do need the right
[3:31:28] leadership to be able to drive this effort forward, so.
[3:31:33] Now, I really appreciate the question supervisor.
[3:31:37] A couple years ago, I think it was in the first budget
[3:31:42] proposal, and my tenure is kind of executive.
[3:31:45] We did add a COO position in recognition
[3:31:48] of how the system has grown.
[3:31:50] We have struggled to fill that position.
[3:31:51] We've had several rounds of recruitment.
[3:31:54] We are in active recruitment.
[3:31:56] I think we have some interviews coming up.
[3:31:58] So we're hopeful that that will be successful, but we absolutely agree that given that we're now
[3:32:04] a four hospital system that we need to not just have the right people and right team and we've
[3:32:12] got some excellent excellent folks, as I mentioned earlier, but that we also have the right structure
[3:32:18] on size to sustain the operation and move all of these initiatives forward because, you know,
[3:32:23] some of the things that we haven't gotten into, you know, all of this specific details, but when you're
[3:32:27] talking about, for example, you know, negotiations that we might be having with
[3:32:31] medical managed care plans, or you're talking about restructuring contract
[3:32:37] relationships, or restructuring service lines, and service line delivery,
[3:32:41] or many of the other initiatives that we've been focused on.
[3:32:44] They all take a significant amount of bandwidth.
[3:32:48] So, you know, we will continue to take a look at that.
[3:32:52] And I think we also recognize that we don't want to be a Pennywise and Pound Foolish.
[3:33:02] And, you know, one of the stories of what happened at Regional is HCA started cutting
[3:33:08] service lines in a way that led to such a decline in census at the hospital.
[3:33:13] And you need volume in order to deal with overhead, to deal with the equipment,
[3:33:17] for example, the Dr. Wang mentioned, to ensure that you have staff or competent trance,
[3:33:22] you can maintain a level of excellence.
[3:33:25] And so being cognizant of all those pieces, that we will need to continue to make strategic
[3:33:31] investments in facilities, in equipment, in staff, including bringing some of our physician
[3:33:40] staff in house and that also means in the administrative infrastructure and positions that are
[3:33:48] necessary to be best and most effectively positioned to fight for every penny that we deserve
[3:33:56] as a system, especially when we're talking about commercial payers and managed care plans.
[3:34:03] So we'll keep our eye on that.
[3:34:05] We may need to bring some additional recommendations to the board as part of these strategies
[3:34:09] because they are part of driving revenue and saving services and positions for the system overall.
[3:34:16] Great, thank you. Yes, I think it's important to have, you know, the right positions and the right personnel
[3:34:22] 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.
[3:34:31] So I look forward to that.
[3:34:33] And then the last thing is, there was a lot about AI,
[3:34:37] which I'm very excited to see.
[3:34:39] I don't know that as a sport, at least,
[3:34:42] has had a chance to talk about AI and policy.
[3:34:46] And there's been, obviously, there's a lot of concerns, too.
[3:34:51] But at some point, maybe hopefully soon,
[3:34:55] I would like to request that we have a steady session, perhaps,
[3:35:00] on what our AI policy is and should be.
[3:35:04] Sure, we have an active AI-related administrative policy that's
[3:35:09] in the meeting confer process with SEMA and SCIU.
[3:35:13] We have implemented, as you can see from this slide, especially
[3:35:17] the health system, but even in other parts of the organization,
[3:35:20] a number of AI initiatives.
[3:35:22] But I agree that we haven't done as good a job as some other places
[3:35:27] in talking is publicly about some of the things that we're doing in this space.
[3:35:32] So.
[3:35:32] Okay.
[3:35:32] Thank you very much.
[3:35:33] Thank you, President.
[3:35:35] Thank you.
[3:35:35] And this is an information item.
[3:35:37] There's no motion.
[3:35:38] Need a thank you Paul.
[3:35:39] Have a safe trip up there and call the sheriff and my bar is helicopter.
[3:35:45] All right, let's see.
[3:35:47] I know it's $12.50 and we still have another item on item 9, which is the public here in environmental
[3:35:55] health fees.
[3:35:56] 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.
[3:36:02] So do you think we could do this before lunch or no? Well, I had additional questions.
[3:36:06] Oh, I'm sorry. I thought you were done. Oh, I'm so sorry. I thought you'd say go.
[3:36:10] I'd be up for the questions. I'll have a seat.
[3:36:12] I'm so sorry. I'm so sorry.
[3:36:20] I definitely don't need ten. I will be I will be quick, but didn't want to miss the opportunities.
[3:36:26] is also wanted to not to further aggravate James around the state hitting harder than the federal
[3:36:35] government but I couldn't help thinking of the irony this morning that you honored oral
[3:36:40] health months and one of the governor's proposed cuts in service is eliminating dental coverage
[3:36:47] for the state only medical population and that I think will almost assuredly have major medical
[3:36:55] consequences that we will see in emergency rooms and for a whopping savings in the state budget
[3:37:02] of $134 million out of $222 billion medical budget. So clearly we have a lot of advocacy
[3:37:11] work to do.
[3:37:15] What I wanted and I don't even know that it's easy to give an answer now so maybe
[3:37:20] something to think about is, with all of the changes, particularly around increasing revenue,
[3:37:28] that you mentioned,
[3:37:31] how do we assess or how are you assessing the likelihood? Are the things
[3:37:37] that you've mentioned, 100% going to happen, crazy, maybe only 5% if we're lucky, it's really
[3:37:44] 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?
[3:38:04] Yes, yes. So that's in the 90 million dollars.
[3:38:06] that's in both the 90s and the 70s, so there are some positions due to restructuring
[3:38:13] the alignment of services and there are some positions that are deleted.
[3:38:19] So that's we have pretty good control over because we're making those decisions.
[3:38:24] So can I assume that the 70 and the 90 are highly likely to be successful?
[3:38:30] Not all of that is position reductions.
[3:38:32] the cumulative amount associated with positions is about 50 out of the two-year-old.
[3:38:38] Okay, but operational efficiencies, I would still think we have some good degree of control.
[3:38:46] We do, in fact, the finance team is working very hard to track each of these initiatives
[3:38:52] to ensure that we actually incur the ongoing savings and improvements that we've identified
[3:38:58] because these have to be on-go-way.
[3:39:01] Right.
[3:39:02] Going forward.
[3:39:03] And the revenue improvements.
[3:39:04] Yes.
[3:39:05] Four million.
[3:39:07] Is that a moon shot or is that easy?
[3:39:10] No.
[3:39:11] In fact, I would say that the 104 million total that I had mentioned earlier from year over year
[3:39:18] improvement, some of that we had already budgeted or anticipated.
[3:39:23] But a lot of the revenue improvements are directly tied to specific initiatives for which we
[3:39:28] in track, including improvements in revenue cycle,
[3:39:32] whether has to do with denial, management,
[3:39:35] and improvement in charge capture.
[3:39:38] I would just add, this is something
[3:39:40] that we look at very closely centrally.
[3:39:45] And so this is a part of the push and pull tension
[3:39:48] between OBA and the health system finance.
[3:39:52] I see some notes smiling, you know what I'm talking about,
[3:39:54] which is we have tremendous confidence in this team,
[3:39:58] deliver what they say but we also monitor it very closely and we will be continuing
[3:40:06] to monitor it because the reality is if we see over months gaps opening up we're
[3:40:11] going to have to take further actions to keep the budget in balance so it's something
[3:40:16] that we have to monitor and have been having to monitor that's not a new thing it's
[3:40:21] just a magnitude that's newer given what's happening to us from HR1 so we will be
[3:40:28] continuing to track at every single month.
[3:40:32] And we meet across the finance and budget teams
[3:40:35] every single month to track all of that.
[3:40:38] I appreciate that.
[3:40:39] You feel confident about the revenue?
[3:40:42] We feel confident about the revenues.
[3:40:45] If you go to slide number 42,
[3:40:48] because this 40 million is only out of the 200.
[3:40:53] But if you go to slide number 42,
[3:40:55] where the revenue cycle has shown seven and a half percent improvements, where we are seeing
[3:41:01] that our per patient, visit and per patient per DM rate or per is increasing significantly.
[3:41:11] That is about 104 million dollars growth in this year.
[3:41:16] Those are monitored regularly and finance is actually partnering with all the departments
[3:41:24] And working closely with them to monitor these things because if they fall, the chances
[3:41:31] are next year would be even more difficult.
[3:41:34] Thank you.
[3:41:35] I appreciate the confidence I also just want to extend again, appreciation to the physicians
[3:41:40] and the nurses who I know are working closely with you there, the one performing the
[3:41:46] and their efficiencies and increases, obviously, without compromising care, are going to be a really significant part of our success.
[3:41:56] So, sorry for the false alarm.
[3:41:58] I really am finished and I appreciate all of you.
[3:42:00] Go eat lunch.
[3:42:02] Okay.
[3:42:02] Thank you.
[3:42:03] All right, thank you.
[3:42:04] So, moving on, I'm just going to pull my colleagues.
[3:42:07] Item number nine is regarding the environmental health fees.
[3:42:10] Do you think we can break, but we should do this first before a break for lunch?
[3:42:15] Or do you want a big flood first?
[3:42:19] You can do it.
[3:42:19] All right.
[3:42:20] Let's go.
[3:42:21] I don't mind.
[3:42:21] Let's see if we can do this one quickly.
[3:42:28] I will speak things along by beginning their presentation for them as Dr.
[3:42:34] Redmond.
[3:42:34] Dr. Underwood.
[3:42:35] Make their way forward as public health departments.
[3:42:38] Environmental health branch.
[3:42:39] This is a return of the item.
[3:42:40] Those in front of the board in December.
[3:42:43] With the additional information requested by the board.
[3:42:46] included in attachments that look at specifically the food facility and body art fees, as
[3:42:52] they relate to other counties, as well as looking at impacts on smaller entities and
[3:43:00] noting that there's a number of fee decreases, actually, for smaller facility kitchens.
[3:43:05] The board has in front of it the specific recommendations that are being brought forward by
[3:43:09] administration.
[3:43:11] There was additional outreach conducted.
[3:43:12] 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.
[3:43:20] Thank you.
[3:43:20] I think Mr. Williams covered everything.
[3:43:23] I hope to bring to you today as well as to introduce Dr. Underwood Director of Environmental Health.
[3:43:28] And we do have our Division Director of Consumer Protection here with us for additional questions.
[3:43:35] 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.
[3:43:42] of these proposed fee changes to engage with us through website outreach via post and email.
[3:43:52] And to be absolutely certain that these fee increases not only were justified based on the complex
[3:43:58] fee study we presented, but we're in line with the surrounding counties.
[3:44:02] And so you'll see additional counties provided for you today in the attachment that indicates
[3:44:07] that the fees that we bring you today are in line with what our neighbors are requesting
[3:44:11] 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.
[3:44:31] With that we're happy to support any of your questions.
[3:44:33] Dr. Rodman, I forgot to mention the good news regarding the Mikos program, so if you want
[3:44:40] to just add that real quick.
[3:44:42] I appreciate you leaving the good news for us, so we were very pleased to speak with the leadership
[3:44:46] of the health trust after hearing from you several months ago about how important it is,
[3:44:51] especially with our Mikos program.
[3:44:53] Support some of our newest business arch patures in.
[3:45:00] Food Services, that they are willing to both fund and operate a system that will offer fee relief
[3:45:08] for low-income applicants. And so, we're working closely with Dr.
[3:45:12] Iton and his team to help get that off the ground. They may be bringing in community-based organizations
[3:45:16] on their end as well. And so, extremely grateful to the Health Trust for that partnership.
[3:45:22] Wonderful. Thank you. We like good news for need-good news. All right. Let's see how many
[3:45:28] and public would like to speak, have you run it?
[3:45:32] I currently have 10 speakers in chambers and one online.
[3:45:38] Okay, can we do a melody?
[3:45:40] All right, we'll start with our speakers in chambers.
[3:45:44] We're going to go ahead and close our cue.
[3:45:48] I'll call you up and you can speak in any order.
[3:45:50] Sean Dollard, Zowilder, Zeru Vasquez, Lopez, Surya Tajoba, Suitsa Del Rio.
[3:46:04] And just to appreciate this as the opening of the panel here.
[3:46:08] Thank you. Good afternoon.
[3:46:14] I'm honored to be here today on behalf of our CEO Dr. Tony Eighton.
[3:46:18] At the health trust, we fully support agenda item nine,
[3:46:21] and then propose recommendations related to the Mikos program.
[3:46:24] 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.
[3:46:36] The opportunity before us today is a resolute pathway to health equity.
[3:46:39] Poyce to catalyze a flourishing, culturally rooted food entrepreneurship ecosystem that reduces
[3:46:45] barriers to opportunity and prosperity that our neighbors justly deserve.
[3:46:49] Food entrepreneurs living on lower incomes have the vision, the tenacity and the brilliance
[3:46:53] to bring their business to life, yet their greatest hurdle can be the cost and regulatory
[3:46:57] burden to get started.
[3:46:59] Today we have a chance to remedy a challenge that disproportionately impacts our community members
[3:47:03] and small business owners living with less economic power and resources than they justly deserve.
[3:47:09] Thank you very much.
[3:47:11] Thank you.
[3:47:18] Good afternoon, my name is Surayah Jovell.
[3:47:22] Dear Supervisor of the Condado Santa Clara.
[3:47:26] I am a good friend from the University of Mexico.
[3:47:28] In the rest of the year, I want to thank the condado
[3:47:32] for everything that has happened especially
[3:47:34] for being able to collect more data
[3:47:37] on the micro operators.
[3:47:39] I consider the resolution to modify the tasks
[3:47:43] and to be more happy, that helps us a lot to continue and especially with the changes in
[3:47:52] the laws and the costs, thanks for supporting the small businesses and for their
[3:47:58] commitment with our community.
[3:48:01] Thank you, and I translate it, please.
[3:48:04] Yes, this is a honor of the rest of my friends.
[3:48:09] And I just want to thank the county for collecting data about the Microsoft Providers and
[3:48:16] We could change into these to be more just for everyone and help us move
[3:48:20] a form work and support the support small business
[3:48:26] Thank you. Please. Oh, hello. Good afternoon. This is Pervator. It's the condado. My name is Soraia Vasquez
[3:48:32] And my pequeño negocio, I am a Soraia's co-fian Bakerie
[3:48:34] a few months ago, we were going to the same
[3:48:38] supplicating them so that they could not attend
[3:48:40] to reduce the costs of food
[3:48:43] that we will buy from home.
[3:48:46] And fortunately, we have been listening
[3:48:48] for so many reasons.
[3:48:51] In my name, I am a small business
[3:48:54] and the organization of Begyllusio,
[3:48:56] who is attending our university
[3:48:57] of the services.
[3:48:59] And we can also come closer to the market
[3:49:04] Thank you very much very much for supporting the community.
[3:49:08] And we hope that you will not miss it.
[3:49:10] We will be in some time, more adelante, in the future,
[3:49:14] sharing the best of our business, in my case,
[3:49:17] in my business that is called Soria Escoffian Bakerie.
[3:49:20] Because there are many delicious and delicious
[3:49:22] and delicious dishes that share with all of you.
[3:49:24] Thank you very much.
[3:49:34] 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.
[3:49:48] 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.
[3:50:03] Good afternoon, Supervisal is the condado. My name is Sojita Del Real. I am a part of the
[3:50:10] evolution and member of the community force.
[3:50:14] It is a commitment to entrepreneurs
[3:50:16] small business business in the area of the San Jose, as before, we have already been here. I want
[3:50:22] to thank you all for having considered the recopulation of data, the model of business
[3:50:31] And I consider to modify the tasks and establish a more fair manner for everyone.
[3:50:39] This means a lot for everyone and each of us,
[3:50:43] because there would be a great way to obtain the permission of each one of the employees of the Panamico business.
[3:50:52] Thank you for all your support and for your commitment to the small businesses.
[3:50:57] Thank you.
[3:51:03] I'm a member of the entrepreneurial business in the San Jose area and I just came to
[3:51:10] with Deep Heart to thank you for all the because of data model for data collection
[3:51:17] and how you have helped us to obtain the permits and reduce the costs.
[3:51:23] And we just want to thank you again for all of your continuous support.
[3:51:27] I'm going to go ahead and call forward the rest of the speakers in Chambers, Miguel Gonzalez,
[3:51:34] Katherine McClillan, Michael Orlando, and Nathan.
[3:51:44] My name is Zoe Wilder and I'm a body art practitioner and constituent of district 2.
[3:51:51] Thank you to the board for taking the time to listen and protect small businesses in Santa Clara County.
[3:51:56] We urge the board to not pass these updated fees for the body art program.
[3:52:01] Body art is defined in the safe body art act as body piercing, tattooing, or application of permanent cosmetics.
[3:52:10] Many of these services do include reconstruction for misectemies and cancer-related traumas, or decorative pieces that celebrate the survival of that journey.
[3:52:20] While many clients do not utilize all of the body art services,
[3:52:24] most Santa Clara County residents have used at least one of these services that are available to the public.
[3:52:29] 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.
[3:52:41] Thank you.
[3:52:52] My name is Michael and I'm going to continue on.
[3:52:56] 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.
[3:53:09] nearly every phone call made to the DEH and to update our contact information, change shop names, etc.
[3:53:19] is met with someone who isn't trained to deal with any of our inquiries related to body art programming.
[3:53:26] 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.
[3:53:35] And our shop rosters have not been updated.
[3:53:39] So we're to people who are no longer working
[3:53:44] at the facilities and into inactive artists.
[3:53:48] And they will continue on.
[3:53:57] Hello.
[3:53:59] My name is Nathan.
[3:54:00] And I am a tattoo artist based in Campbell, California.
[3:54:02] I'm here to continue the thoughts of my colleagues.
[3:54:06] The lack of roster updates leads
[3:54:08] to clients not knowing who is registered
[3:54:09] and who to book with potentially beating to artists losing a fair amount of money.
[3:54:15] This opens up to possible lawsuits as well because clients, he clients, does not know
[3:54:20] who is responsible in a personal lawsuit case or if the artist is permitted to work.
[3:54:25] This holds the facility liable for employing unlicensed practitioners.
[3:54:29] It will be the facility's responsibility to answer to any lawsuit.
[3:54:33] Updating the roster is one service that is provided for by the county.
[3:54:39] Diverting precious hours of time looking into complaints submitted without any evidence or
[3:54:43] verifying who's submitted to be abused with zero repercussions on and both parties being
[3:54:48] responsible for a loss of income for numerous artists who need to halt their work during this
[3:54:52] inspection. Now that the body arts program is under the consumer protection division of the DEH should be
[3:54:59] charging they will continue.
[3:55:07] So my name is Katie McLean and I am a cosmetic doctor to artist. So the
[3:55:12] EH has provided no plan as how the fees increases would increase the support in the body
[3:55:18] art program as they've been promising.
[3:55:20] There is no accountability, there needs to be a tangible plan provided publicly as well
[3:55:25] as a schedule for the DEH to adhere to in order to demonstrate that the DEH is being held
[3:55:29] accountable and efficiency and using funds appropriately.
[3:55:33] Hours build for certain services are unrealistic if not intentionally skewed.
[3:55:37] 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.
[3:55:48] 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.
[3:56:03] State of Clear County is on track to being one of the most if not most expensive and worse to serve as body communities.
[3:56:19] Good morning.
[3:56:20] My name is Omega Gonzalez and I am a body art facility owner.
[3:56:26] Public comment regarding Proposition 26 and body art program fees.
[3:56:30] Good morning.
[3:56:32] I like to address the ongoing impacts of Proposition 26 proposed by the body art program fee increases.
[3:56:38] Proposition 26 was passed approximately 15 years ago, and resulted in the removal of the scale system fee system.
[3:56:46] 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.
[3:56:58] The absence of a scale fee structure disproportionately benefits large businesses while placing small studios and independent artists as an added disadvantage.
[3:57:07] It removes the ability to fairly account for what businesses can reasonably afford while still maintaining cost recovery.
[3:57:14] Our business has already been impacted by the county's actions.
[3:57:17] Some of these artists have not yet received their health permits in a timely manner,
[3:57:21] which directly restricted our ability to operate fully and generate income.
[3:57:25] Proposing this fee increases under those conditions for other strengths,
[3:57:29] small businesses that have already been struggling due to administrative delays beyond their control.
[3:57:34] I also want to address that.
[3:57:38] Thank you and our final speaker is Chase Wedgland.
[3:57:42] We've asked you to unmute.
[3:57:49] Hi, my name is Chase Wedgland.
[3:57:50] I'm a tattoo shop owner in Campbell, California.
[3:57:53] A majority of body art practitioners are registered as independent
[3:57:56] contractors, not employees who receive hourly pay,
[3:57:58] health benefits, paid time off, et cetera.
[3:58:01] Every single dollar that the body art practitioner earns is crucial
[3:58:03] to their survival.
[3:58:05] Increasing body art program, these places the FD financial burden
[3:58:08] on practitioner that can mean the difference of purchasing higher quality
[3:58:11] applies for the adequate groceries, saving for retirement or for the living costs, etc.
[3:58:16] In addition, the DEA does not mean any consideration for a large number of body
[3:58:19] practitioners and facility owners who are a part of protected classes,
[3:58:23] the saving by the DEA to survey its not been yet conducted to determine the
[3:58:27] percentage of body art businesses owned by members of protected classes, such as
[3:58:31] survey could be valuable to better understand impacts to explore potential
[3:58:35] mitigation strategies including alternative funding sources.
[3:58:39] As Supervisor Betty Duong mentioned in the meeting in December 9, the current society pressures
[3:58:43] and economy, disproportionately impacting immigrant families and those of protected classes.
[3:58:51] And this concludes our public speakers.
[3:58:54] Thank you, Ronda.
[3:58:55] And we'll go ahead and close the public hearing portion.
[3:59:00] There's really, yes, change.
[3:59:02] I just wanted to make one very, very brief comment of appreciation for our last in-person
[3:59:06] speakers at something really powerful by Prop 26 that I feel like is very, very, very
[3:59:12] misunderstood by the general public, which is the way in which it ties our hands, not
[3:59:18] just the county, but cities and all governments, by eliminating the ability to do sliding
[3:59:23] scale fees, has actually really harmed across the state. And I'm not just talking about
[3:59:30] this kind of fee. I'm talking about water rates. I'm talking about all sorts of other
[3:59:35] permitting structures has really harmed small businesses all over California.
[3:59:40] And I say that because that's not how those measures are sold to the public when they're put on the ballot.
[3:59:46] They're sold to the public as if they're going to provide relief to small businesses.
[3:59:51] But in fact, they tie our hands in creating fee structures in ways that make more sense.
[4:00:00] And that can allocate the costs of a regulatory program to those entities who have disproportionately higher revenue.
[4:00:09] And so I just wanted to note that it's something that comes up over and over again every time we look at fees.
[4:00:15] 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.
[4:00:23] 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.
[4:00:32] Thank you, James, so so far as young.
[4:00:36] Thank you.
[4:00:37] Thank you, Dr. Redmond, Dr. Underwood.
[4:00:39] I know that today is a continuation of a previous hearing that we had.
[4:00:44] And with the following up on their quest for information for their comparative studies,
[4:00:48] as is for his request. I want to appreciate you for that. I'm encouraged by the updates
[4:00:52] for some of a few questions. And also thank you for the clarification. I'll have to remember
[4:00:57] to refer to the department as EHB now or the environment to the health branch moving forward.
[4:01:02] That's going to have to undo a decades worth of calling you. So breaking down the EHB funding and
[4:01:10] why really just wanting to understand why it took so long to take until now to update these fees.
[4:01:17] The Environment Health Branch is almost fully funded by these fees, yes.
[4:01:22] And can you elaborate on the departments like totality of funding sources to provide
[4:01:27] further context?
[4:01:29] I'll let Dr. Underwood jump in first.
[4:01:32] Let's see if I can do that.
[4:01:34] Good morning.
[4:01:35] Good morning.
[4:01:35] Supervisor Young and Board.
[4:01:37] Primarily, I think it's about 94% of our budget is covered by fees and we do have small
[4:01:43] member grants that make up the other 6% and then less than 1% of a couple of general funds
[4:01:51] that fund our healthy nails as well as our noise ordinance.
[4:01:55] Primarily it is fees that cover our costs.
[4:01:59] And the report, the update report says that fees for food and body art facilities had not been
[4:02:04] updated since 2013 and the department has focused on cost containment versus full cost recovery.
[4:02:11] can you explain this further and why did the Department wait or what was preventing us from making
[4:02:17] movements since 2013? Sure, the program was within the solid and medical waste group and within
[4:02:25] that group, they also do solid waste inspections. That needed basically revamping the entire program
[4:02:33] which you guys approved back in December to be in line with Prop 26 Prop 13 where the landfills
[4:02:41] and the transfer stations that we were doing actually took their full cost of what it took to inspect them.
[4:02:49] Because the solid waste and medical waste team had been doing the body art inspections,
[4:02:54] and we hadn't really restructured the entire program and their cost.
[4:03:00] We had not actually looked at the body art in time.
[4:03:03] It took to do this work and restructured their cost.
[4:03:08] So, we did move the body art program.
[4:03:11] It is a consumer protection program into the consumer protection division a couple of years ago.
[4:03:17] And with this fee study, we were able to not only look at the solid waste, but also put
[4:03:22] an alignment the body art fees as well.
[4:03:26] Thank you.
[4:03:26] And then there are two new fees are listed at Identify as a new in the attachment for
[4:03:32] a body art practitioners.
[4:03:34] Can you tell me if these fees are brand brand new or if they were under a different category when
[4:03:39] body art was under solid and medical waste?
[4:03:43] So one of the things that we want to do is just in pointing out not only in this program,
[4:03:47] but in other programs where we have annual operating costs was to take out one time cost,
[4:03:53] like a new food facility, our new body art facility, our new practitioner.
[4:03:57] So that's not only in this program, but we're over the last few years we've been adding
[4:04:01] the application fees to these different programs so that we're pulling that time out and making sure
[4:04:07] that the annual operating people are not paying for a new application. So it is brand new for the
[4:04:13] body art but we have also been over the last few years with bringing it to the board. The last
[4:04:18] time we bought feed changes to the board. We introduced application fees for other programs as well.
[4:04:24] So prior to the introduction to application fees, we just processed applications without any fees.
[4:04:30] Well, it was part of the annual operating permit, eventually, that they would be paying for.
[4:04:35] So, the cost was already embedded in the annual operating permit, and now this cost has been moved out of the operating permit
[4:04:42] into this application fee to rent.
[4:04:46] So, I just want to make sure I'm getting this.
[4:04:47] So, it's technically kneel on ordinance on paper,
[4:04:52] but it's a movement of a portion of the fees from one category where it was typically charged to another separate
[4:04:59] 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.
[4:05:09] So then, hypothetically speaking that if I were to open a new body art facility, which I wouldn't because I can't draw.
[4:05:19] I would pay a one-time application fee and that fee used to live in the annual operating permit.
[4:05:36] So then the annual operating permit has been reduced by that amount.
[4:05:41] Well again, the time has been taken out of the calculation for the annual operating permit.
[4:05:45] 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.
[4:05:56] 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.
[4:06:07] Thank you. Thank you for that clarification.
[4:06:11] 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.
[4:06:26] I had a chance to support Supervisors in the Chavez on that program.
[4:06:30] as her former staffer Paul Murphy was here earlier, I don't know where he is now, but helped
[4:06:34] develop that with her. Really encouraged that it's been converted to transition to a permanent
[4:06:40] program and that we found a way to be able to support that program through this partnership.
[4:06:48] Another aspect of the health-interest partnership that not only are they taking on the cost of the
[4:07:00] permits, right, which results in few deductions.
[4:07:02] But they're also taking on the task of identifying
[4:07:05] qualified mecos participants for that fee reduction,
[4:07:09] which is something that I know that EHB is not typically
[4:07:14] tasked with or has been outfitted for in terms of identifying
[4:07:19] who is eligible for a lesser for reduced rates
[4:07:26] And accordance with Proposition 26, because we could provide a discount of fee when you are a client of our social services benefits programs.
[4:07:42] And so, did I get that right, James is leaning in? I didn't get that right.
[4:07:45] 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.
[4:07:56] 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.
[4:08:07] So we're going to cost our cover $3 million, but we're going to have a sliding scale and
[4:08:12] we're going to charge more to certain entities based on their gross revenue and we're
[4:08:17] going to charge less to other entities.
[4:08:20] Now what we have to do under Prop 26 is we can't charge more to any entity beyond the time
[4:08:27] that it takes to do the work associated with that entities program.
[4:08:33] And so, as a result, if we still need to cost recover for the program,
[4:08:40] then we, essentially, are forced into more across the board type structures.
[4:08:45] 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.
[4:08:54] But in general, we're much more limited in how we can do that.
[4:08:58] 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,
[4:09:17] are not factors that we're allowed to incorporate into a Prop 26 fee structure.
[4:09:27] 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.
[4:09:50] 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.
[4:10:03] Including EHB fees.
[4:10:04] That's right.
[4:10:05] 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?
[4:10:18] We don't have a direct mechanism, it's really incumbent on those individuals to bring forward
[4:10:28] that information because the databases aren't set up with, you know, they don't, for
[4:10:36] very obvious reasons were very, and subject to a lot of state laws, we can't share benefits
[4:10:44] information all across the rest of the organization, that information is considered relatively
[4:10:50] sensitive and especially in this time with everything going on at the federal level, it
[4:10:55] kind of heightens that issue. And so we actually need people to themselves identify the other
[4:11:01] departments aren't allowed to pull from social services records. Yeah, folks need to self-identify
[4:11:08] so that not creates an illness on us and to make sure that we provide clear communication that this
[4:11:13] is a benefit or an augmentations that's available to folks who qualify.
[4:11:18] And this also reminds me of the conversation that we had with CEPA and our new garbage
[4:11:23] contract, being able to do a data sharing pilot with Debbs.
[4:11:28] So I know I'm fully aware of the challenges, the difficulties, the red tape and also the
[4:11:33] height and sense of concern with a hostile federal administration right now.
[4:11:37] But I also know that this is a county that has to figure out to do things when no one else
[4:11:41] has. And so I would hope that, well, I would like to request that for the thought be given
[4:11:48] into this, whether it be a communication and outreach plan to be able to inform folks
[4:11:53] that if you self-identify, that you may be able to avail yourselves of reduced fees. But also
[4:11:59] at the same time, administratively, how do we create a mechanism of self-identifying mechanism
[4:12:04] that doesn't put people in a situation where their data may be insecure and safe. I know
[4:12:10] asking for all things in the world that it's not a direction to request for information and for
[4:12:15] the discussion around this topic. I do want to circle back to some of the public comment
[4:12:21] that I heard today. I'm not very familiar with body art inspections and that was referenced
[4:12:27] earlier today. Can you shed some more light about what that entails? The fees associated with the
[4:12:33] time that's associated with that? You want to know a little bit more about what a body art inspection
[4:12:39] about personnel, to staff, body, our inspection.
[4:12:42] So like, how many staff do we have to do something like that?
[4:12:46] Like, what is the time that's afforded?
[4:12:48] How, yeah, it really, I really appreciate some context.
[4:12:53] Right, so some of our smaller programs are assigned
[4:12:55] to a senior registered environmental health specialist,
[4:12:59] because their small enough they can be handled by a single person.
[4:13:04] They do all, we also always have backup people
[4:13:06] trained for those as well.
[4:13:08] So yes, this particular program is small enough, the body art program that it is headed up by one senior inspector.
[4:13:16] And he does handle most all the inspections, the new facility evaluations, working with the practitioners as well.
[4:13:24] 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.
[4:13:38] 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.
[4:13:52] 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
[4:14:02] recoup our costs to do things like higher certain vacancies we haven't been able to hire in the past
[4:14:06] in general, as well as improved systems that we use for things like our computer systems,
[4:14:12] our data tracking. And so I especially appreciated the public comment, noting how helpful it would
[4:14:16] be to understand more about the clients we serve and make sure we're serving them as well as possible.
[4:14:21] And I'm hopeful that this proposal will help enhance how quickly and how well we can do that.
[4:14:26] I hope so too. And I fully appreciate that that's the North Star that are a department or a staff
[4:14:31] your leadership is driving towards does greater efficiencies and faster service
[4:14:36] times result and less staff time therefore lower fees or portioned fees.
[4:14:43] Yeah I just wanted to say we will also we have to have our software system
[4:14:47] replace we will be doing that this year and one of the nice advantages of the
[4:14:52] new system will be that our clients will have a portal and my hope is like one of
[4:14:57] issues I was hearing about how a facility.
[4:15:00] 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.
[4:15:09] That that actually will be something they can do themselves in the portal, and that they won't necessarily need our interface.
[4:15:15] So I'm hoping that some of the efficiencies will be helped by our software system change.
[4:15:20] Thank you, Dr. Underwood. I appreciate that. I can't remember. I just stress my appreciation,
[4:15:25] but it's worth bearing again that thank you for extending the number of comparable counties in this report.
[4:15:32] I know that was like the big last time that this discussion came up.
[4:15:36] And when I looked at attachment three and saw how the new proposed rates stacked up against the same
[4:15:41] or mostly similar fees from other counties. And it appears that we are not the most expensive county.
[4:15:48] 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.
[4:15:59] 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.
[4:16:08] So Dr. Underwood, I know that we are very familiar with each other across various programs from food programs
[4:16:16] to nail salons and I think we're going to be adding body art to our continued partnership
[4:16:21] together to better understand this industry and how we could support them. But with that,
[4:16:26] I make a motion to approve the recommended actions today with request for further information
[4:16:32] how we can engage our fee customers so that they're able to avail themselves of discounted rates.
[4:16:39] And also to further understand how we can be more efficient in terms of particularly around
[4:16:45] the body art industry, which is something that I think is a new area for many of the board members.
[4:16:51] I could say that because of our conversation last time.
[4:16:55] I'll go ahead and second that.
[4:16:57] Actually, I want to say that first, I want to thank staff for returning this report.
[4:17:02] Incorporating those additional information with requested regarding mecos,
[4:17:06] the body are also the facility fees.
[4:17:08] I want to say huge thank you to the health trust for stepping out to help out
[4:17:12] because for businesses that's huge and I'd only appreciate the outrageous deficit conduct of
[4:17:17] the CBOs community based organizations and identifying a potential funding partner to help
[4:17:22] also the application and your fees for the low income and micro enterprise home kitchen operators.
[4:17:29] We are in a very challenging budget environment and the county continues to seek ways to support
[4:17:34] some of our most impacted community members and I'm glad to see that the commitment has to
[4:17:42] health-grange fees, some small businesses will see feed reductions, and that's only great.
[4:17:49] However, some businesses, as we mentioned, like piercers, food truck operators will actually
[4:17:54] experience feed increases. Some are small, but some are not. But the thing is these are
[4:18:00] many of them are small independently owned operations. And that being said, we are facing fiscal
[4:18:07] constraints driven in part by somewhat funding cuts that we see by federal government. And to
[4:18:12] maintain the public health services. We certainly need to have full cost recovery. Also,
[4:18:17] we need to do the proposition 26. We do not generate profit in this work. It really is just
[4:18:23] to make sure that we are just covering the cost spent. So as much as I'll be supporting this
[4:18:29] proposal today, I do want to end this important point. So making sure that we really need to
[4:18:34] bring these fee updates to a board in a more regular basis and not wait so long for the delta
[4:18:39] be so much so that these adjustments will be gradual and less disruptive.
[4:18:44] That being said, I would like to ask the maker motion if she might accept to request
[4:18:50] a report six months back into the Mecos program and any additional challenges and cost
[4:18:54] it might arise, such requirements or restrictions from landlord for operators who are renters.
[4:19:02] I am happy to accept the friendly amendment for a six month report back on the Mecos program
[4:19:08] is that what you're asking?
[4:19:09] Yeah, and I also, if this is a correct, okay, with the rules, I want to clarify my motion
[4:19:16] to realize that I was not so clear, Tony's nodding his head.
[4:19:21] Thank you.
[4:19:23] So my original motion is to approve the recommended action today.
[4:19:28] What they request for further information, I'm going to ask for in the form of an
[4:19:33] agenda and the fall, about engagement opportunities and possibilities on how to make our
[4:19:41] fee customers aware of the benefits of reduced potential reduced fees and how to avail themselves
[4:19:50] of such benefits. Am I allowed to call it benefits? Reduce fees. I'll just say that. And how
[4:19:57] to avail themselves is such reduced fees. And I'm trying to make the motion broad enough so
[4:20:03] that you have this space you need to explore all avenues.
[4:20:06] So that's why I'm struggling a little bit with the language here.
[4:20:08] So let me know if I'm not going to give you that space.
[4:20:12] And then secondly, I would like to report as part of the Office of Gender Report back.
[4:20:18] A status, a check-in with our body art industry to see how the new fees have worked out.
[4:20:24] If new efficiencies have been able to be rolled out, and just to see the better understand
[4:20:29] the impact of how these fees have landed.
[4:20:31] in addition to the six-month report back on the status of Mikos?
[4:20:37] No, thank you. You'll be me too, and I really do think that I know so little about
[4:20:42] the body of our program, and I think we do need to help sunshine the staffing issue,
[4:20:47] just been mentioned by many of the speakers. First, I do want to thank the speakers that
[4:20:53] came up and be so organized on your presentation of piggybacking each other in every
[4:20:58] eating the same thing and that's really helpful for us
[4:21:00] understand the situations. But clearly, there is a challenge.
[4:21:05] And it's not clear because when the answer is being given,
[4:21:08] I can see you shaking your head.
[4:21:10] No, I don't see this what's going on in terms of
[4:21:12] staffing. We're seeing that there are multiple people doing it.
[4:21:14] But your experiences is barely one person is doing it.
[4:21:18] So let's see, we could get that sunshine so that they can
[4:21:20] understand how we could really help them to do better
[4:21:24] in terms of out staffing and to make sure that they don't
[4:21:27] have to wait a long time to get their permits or their answers necessary for, for continuing
[4:21:34] their work and our community.
[4:21:36] Thank you.
[4:21:38] All right.
[4:21:39] We got motion.
[4:21:39] We got seconds.
[4:21:41] And if no further comments, let's go take a vote.
[4:21:45] Thank you.
[4:21:46] Motion of Supervisor Yoon, seconded by President Lee, supervisor of a code.
[4:21:53] Aye.
[4:21:53] Supervisor Yoon?
[4:21:55] Supervisor Ellenberg?
[4:21:57] President Lee.
[4:21:57] I as well. Motion carries four to zero. Thank you very much for coming today. Thank you for
[4:22:02] the board. All right. We are very close to lunch, but the county
[4:22:07] exact trying to tell me that he could do it really fast. So, James.
[4:22:11] Just have two very quick items for the county executives report this afternoon. One is that
[4:22:16] our office of emergency management and partners have been diligently preparing for the upcoming
[4:22:21] Super Bowl. We will be fully activated in our emergency operations center throughout the entire
[4:22:27] week and over the weekend as well. We are coordinating across jurisdictions regarding emergency
[4:22:34] alerts. Folks who would like to receive Santa Clara County's emergency alerts related to
[4:22:40] the Super Bowl should text SBLX to 888777. And that's a simple way. You can make sure that you've
[4:22:49] got any public safety or other updates and stay informed in real time. My other update was related
[4:22:55] federal appropriations, and we can talk more about that during the IGR report later today,
[4:23:01] but like I said earlier, we're closely tracking whether there will be a shutdown, affecting
[4:23:06] a number of federal departments, and we are also very closely tracking in specifically the
[4:23:12] federal HHS appropriations bill that could have a tiny bit of good news for us here if it passes
[4:23:20] as currently drafted. That concludes my report. Thank you. I'll note for the question, Tony.
[4:23:30] At the January 26th, 2026 closed session by unanimous vote with all members present.
[4:23:35] The board authorized the county to initiate litigation or file are joined in a
[4:23:39] Mika's brief in one matter. The name of the action and the parties as well as the substance
[4:23:42] of the litigation shall be disclosed once the brief is filed. It's any person upon inquiry.
[4:23:48] And I should say once the brief for lawsuit is filed, that concludes my report.
[4:23:54] Thank you, Tony. I've got 138. How about we break till 2015 with that work? Do my colleague?
[4:24:03] Yes. All right, let's pick one for 2015. Thank you.
[5:03:36] 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.
[5:03:51] Thank you. Yes, that is. That is my third supervisor. What can you have?
[5:03:56] So let's go take a roll, please. Look.
[5:03:59] Supervisor Abik Hoga.
[5:04:02] It's absent.
[5:04:04] Supervisor Yunk.
[5:04:05] Here.
[5:04:06] Supervisor Alvinberg.
[5:04:07] I'm here.
[5:04:08] Supervisor Anasas absent.
[5:04:09] And presently.
[5:04:11] Good afternoon, President.
[5:04:12] So let's go start with our item number 12.
[5:04:14] The Valley Homeless Healthcare Program Report.
[5:04:17] Good afternoon.
[5:04:18] Hi.
[5:04:18] Good afternoon.
[5:04:19] President Lee and members of the board.
[5:04:21] My name is Kristi Raus, assistant nurse manager with Valley Homeless Healthcare Program.
[5:04:25] And I'm here with Sergeant Yvonne G.
[5:04:27] Medical Director and Selling Hode Director of Primary Care.
[5:04:32] Today, in your board packet, we have a response to Vice President Renez's requested information
[5:04:36] regarding our behavioral health services and the connections we have with the behavioral health
[5:04:40] service department.
[5:04:42] And then we have some qualitative information regarding patients that were diagnosed with colorectal
[5:04:46] cancer.
[5:04:48] We also have included our annual QI, the Quality Improvement Project that includes our health
[5:04:53] for that in House population and as you know we do report on a few of those metrics quarterly.
[5:04:58] So with that we're happy to answer any questions you may have.
[5:05:02] Great. Thank you. Let's see. Any public would like to speak on the side of today?
[5:05:07] We have no requests to speak.
[5:05:08] Okay, close the public speaking portion just as well as I learned.
[5:05:12] Thank you so much for the report. I was glad to see the 2026 homeless quality improvement
[5:05:19] plan building on the success of the UDS metrics in 2025? I'm interested in learning a little
[5:05:26] bit more about the HIV linkage to care metric. Can you explain just what that how you're
[5:05:33] measuring that metric, maybe who some of the partners are that are involved?
[5:05:50] Thank you, Supervisor Allen, I'm happy to answer that question. So I think for HIV linkage
[5:05:55] to care we just always are looking at individuals who are newly diagnosed or have been living
[5:06:02] with HIV and if they are connected to care which would really be if they've seen a provider
[5:06:08] in the last 12 months. And so specifically for us, we're looking at the house population
[5:06:14] that we interface with. We do see a lot of individuals. We are encountering a lot of individuals
[5:06:21] where we are diagnosing HIV, and we are also able to provide their care. One of our new providers
[5:06:28] is actually certified in HIV medicine as well. And so we can look at if they are following up with
[5:06:35] us and continuing their medications or connected with the pace clinic. For linkage to care, we can
[5:06:40] the partners are really primarily the pace clinic in terms of working together. We have a close
[5:06:47] collaboration with their team and their outreach staff.
[5:06:53] That's good.
[5:06:54] That's clear.
[5:06:54] I appreciate it.
[5:06:57] Great.
[5:06:57] That's the only question I had today.
[5:06:59] Thanks so much for the report.
[5:06:59] I'm happy to move a receipt of the report.
[5:07:04] Second.
[5:07:05] A motion.
[5:07:06] Second.
[5:07:06] I do have one quick question.
[5:07:08] Just before we move on.
[5:07:09] Presently.
[5:07:11] Just wanted to clarify as the motion.
[5:07:14] The recommended action or just the receipt of the report.
[5:07:16] Oh, the recommended action.
[5:07:20] Thank you.
[5:07:22] OK, to second.
[5:07:24] So my brief question is, when you go out there and figure out
[5:07:30] that there might be that it's through your detection, you find out
[5:07:33] that the visual has depression.
[5:07:36] And we'll need to meet with a psychiatrist.
[5:07:40] Whether it's a person's health visit.
[5:07:43] Can you estimate what the weight time is?
[5:07:46] Usually the same day.
[5:07:47] Wow, that's great. Thank you. That's wonderful. Thank you. All right, let's go take a look.
[5:07:53] We have a motion by Super Ezrealmberg, a second by Super Ezrealm.
[5:07:58] Super Ezrealm.
[5:07:58] Hi, Super Ezrealm. Yes, Super Ezrealmberg. Yes, I'm presently. I as well.
[5:08:03] The motion carries for us here. Thank you very much.
[5:08:07] And next we have our monthly legislative report from the office of intergovernmental relations.
[5:08:18] Good afternoon
[5:08:19] President Lee and supervisors, this is David Kompos here from the Sacramento Office and with you and
[5:08:30] chambers are Monica Tong and Elaine Trin who are going to help with the presentation.
[5:08:40] And if you can hear me okay, we'll begin with our presentation but I do want to ask if the
[5:08:46] any executive if you want to say any remarks before we can get?
[5:08:53] Yeah, I'll just share two things. One is David, I don't know if you were on earlier,
[5:08:58] but we've already talked a little bit about the pending federal appropriations bills.
[5:09:04] And just wanted to add that we are very focused on our state-related advocacy.
[5:09:09] You're going to hear a tiny bit about that, but maybe we can explore that a little further in questions.
[5:09:16] And just in recognition that the governor's budget proposal is really an opening position.
[5:09:23] It's not the last word.
[5:09:25] In fact, the governor's budget proposal pretty expressly differs a lot of things to the may revise.
[5:09:33] And so we, while disappointed with the way that initial proposal addresses,
[5:09:39] because HR-1-related impacts are not surprised and will be fully focused in the coming months
[5:09:47] on addressing those impacts as part of the final product that the legislature ultimately
[5:09:53] proves in June.
[5:09:55] And just want to express a lot of appreciation for our IGR team, we're keeping them very busy.
[5:10:00] And know that David and others are in Sacramento participating in that assembly health
[5:10:06] We're one of the only counties invited to participate on the panel regarding the healthcare
[5:10:13] effects.
[5:10:17] Thank you, James, and if it's okay with the President and the Board will receive this.
[5:10:22] Thank you very much.
[5:10:25] We can go to the next slide, just as you know, the role that the Intergovernmental Relations
[5:10:31] Office plays is to represent the interests of the county and both Sacramento and Washington
[5:10:36] DC and given that we have a Trump president and a Republican Congress, our ability to influence
[5:10:45] what happens in DC is limited, nevertheless we are still focused on doing everything we
[5:10:51] can on that front that you're going to hear from Elaine Trent about some of the activity
[5:10:56] in Washington DC and we actually will be going to DC in the near future and I believe that
[5:11:04] as it only might be there as well.
[5:11:07] So because of that, the focus really is on what we can do in Sacramento.
[5:11:14] And before I turn it over to Monica, who's going to give you a more detail report on what's
[5:11:21] happening in Sacramento, I want to note two things.
[5:11:23] First, what James noted, the Assembly Committee on Health is doing a hearing right now.
[5:11:31] And we are, in fact, the only county that has been invited to be a participant to present on that hearing.
[5:11:39] And we are grateful to Dr. Dolly Goel, who is the chief clinical officer for population health and managed care for the county.
[5:11:49] We're about the health care, who will be testifying shortly.
[5:11:53] 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,
[5:12:22] are not entirely known to many of the members, and we have a lot of members who are relative
[5:12:29] new to the role and who may not fully understand how public hospitals work, the role
[5:12:35] of the play and healthcare in the state. And so a big part of our effort is really to educate
[5:12:40] those members to make sure that they understand the challenges faced by Santa Clara and other
[5:12:46] counties and especially counties that one public hospital. So with that, I'll turn it over
[5:12:52] to Monica, and we'll proceed with the presentation.
[5:12:57] Thanks so much, David.
[5:12:58] The state legislature did return to Sacramento on January 5th, and they have definitely
[5:13:03] hit the ground running.
[5:13:04] In November, the Senate experienced a leadership change in Senator Lamone to
[5:13:09] official oath of office as President Pro Tem on January 5th.
[5:13:13] As you're aware, the governor released his fiscal year 2627 budget
[5:13:17] proposal on January 9th and we'll talk a little bit about that in a bit, and last week
[5:13:23] was the legislative council deadline, meaning that general requests to the legislatures
[5:13:27] attorneys were made for potential bills. Many of these are spot bills, meaning language
[5:13:32] has not been finalized. A few upcoming deadlines to put on your radar in the second year
[5:13:37] of the two year cycle, January is extremely busy, and two year bills must pass their
[5:13:44] house of origin so assembly bills out of the assembly and Senate bills out of the Senate by this week.
[5:13:52] Related to bills this year's 2026 bill introduction deadline is February 20.
[5:14:02] On to the budget, the governor announced a 348.9 billion dollar budget proposal in January
[5:14:09] that addresses an estimated 2.9 billion projected shortfall, which we've discussed is much
[5:14:16] smaller than the LAOs, 17.6 billion projected shortfall.
[5:14:21] To be clear, this is the governor's proposed budget,
[5:14:25] and his Department of Finance, as our county executive noted,
[5:14:29] acknowledged a few things that the state is eagerly awaiting
[5:14:32] the upcoming tax season, and additional guidance
[5:14:35] from the federal government regarding HR1 implementation.
[5:14:39] Department of Finance, Director Joe Stephenshal, described this
[5:14:42] as a workload budget with no new significant funding
[5:14:46] or Governor initiatives, while the state is still waiting for that HR1 guidance, the governor
[5:14:51] did not include any mitigation to prevent disenrollment of safety net services.
[5:14:57] IGR's focus remains on our three main state.
[5:15:00] Meditation request with preserving enrollment in programs, providing state support for public hospitals, and allocating significant new resources for indigent care.
[5:15:10] I'll turn it back over to David.
[5:15:14] Thank you, Monica, and I want to highlight that the biggest challenge and priority for us is the budget.
[5:15:24] And the three items that Monica noted are the things that not only are we pushing as a county,
[5:15:33] but I think a number of other counties embrace as big issues.
[5:15:38] And once again, the has to do with preserving enrollment in Medicare and Cal Fresh.
[5:15:44] Making sure that there's support for public hospitals and making sure that there are resources provided to counties.
[5:15:52] because there will be a need to provide additional
[5:15:57] in-design care.
[5:15:58] With that in mind, I do want to note that we,
[5:16:03] to the leadership of the board, put together a legislative platform,
[5:16:07] which support approved November 4th of this past year.
[5:16:13] My job along with Aaron Evans,
[5:16:16] Puedum, who is here in the Sacramento office,
[5:16:20] is to shop around a lot of the field concepts and ideas that were approved by the board and
[5:16:27] we're in the process of doing that.
[5:16:30] There are fewer bills that folks can actually put forward and so it's a more challenging
[5:16:37] time to get members to embrace some of the ideas that we have put forward or working hard
[5:16:43] to make sure that happens, we will be providing additional reporting on sort of the progress
[5:16:50] on those ideas as this work proceed to the next few days.
[5:16:56] There has been some interest on some bill concepts and we have drafted a language that we have
[5:17:03] provided to let council in their essentially language that is not final, but these are
[5:17:11] stock bills that allow us to continue to pursue some of those ideas as pieces of legislation.
[5:17:19] But again, you know, that's still a work in progress.
[5:17:22] And many members are trying to figure out what they can agree to move forward, given everything
[5:17:28] that's happening with the budget, challenges being, of course, at the top of the list,
[5:17:33] terms of priorities for every member, and so we will continue to, you know, keep the
[5:17:40] board updated on that. I think that the big issue is the uncertainty around that only
[5:17:49] what happens at the federal level but also around tax season and what actually the budget
[5:18:03] by the governor or is it closer to the $80 billion deficit that the legislative analyst's office
[5:18:10] had previously indicated was the actual reality. So that's where we are in Sacramento with
[5:18:18] the new leadership change in the state Senate. There are some things that are different. One of
[5:18:24] things that we will say, and we welcome is the fact that Senator John Lair, who, for a
[5:18:33] long time, represented a piece of part of Santa Clara County, is now a lot of care
[5:18:37] budget, and we welcome that appointment, and, you know, I know that some folks have already
[5:18:44] spoken to chair Lair, and we are in the process of setting up a more detailed conversation
[5:18:49] with them. So with that, I'm going to turn it over to Elaine to just give you a very brief
[5:18:54] overview of what's happening in Boston to DC today. Elaine? Thanks, David. As a county executive
[5:19:00] mentioned earlier, we are following the federal appropriations process very closely. Just wanted
[5:19:05] to note a few highlights in the appropriations bill. Late last week, the President signed the
[5:19:10] Commerce Justice and Science bill that included 175,000 for our sexual assaults for
[5:19:15] to exam program in the financial services and government spending bill that is pending
[5:19:20] Senate action.
[5:19:21] There is a million dollar in Congressually direct spending, included by Senators Padilla
[5:19:26] and Shift for a small business center at BASC.
[5:19:28] In the Labor HHS education bill also pending Senate action, it includes a elimination of the
[5:19:34] Medicaid disproportionate share hospital cuts that was mentioned earlier during the study
[5:19:38] session, as well as an extension of the telehealth flexibility through December 20, 27.
[5:19:43] in the Transportation HUD bill, also pending Senate action.
[5:19:47] There's three community project funding for the Santa Clara County,
[5:19:50] including $3 million for 10 Kirk,
[5:19:52] included by Representative Kana,
[5:19:55] $850,000 for Agraver, Culture Resource Center,
[5:19:58] included by Representative Lofgren,
[5:20:00] and $250,000 for Marshall Cottle Park,
[5:20:03] included by Representative Penetta.
[5:20:05] Additionally, Agra is watching HR-1834,
[5:20:08] which would have extended the enhanced premium tax credits
[5:20:11] for their Affordable Care Act,
[5:20:12] which passed the House earlier this month,
[5:20:15] it is still pending action in Senate as well.
[5:20:18] And with that, the answer of presentation.
[5:20:21] I will just add one more note,
[5:20:24] I propose what the County Executive indicated.
[5:20:28] When you look at what's happening in Sacramento
[5:20:30] because of the changes,
[5:20:33] because of the decisions that the federal government
[5:20:35] you have a situation where just about everyone
[5:20:37] in California is coming to Sacramento to ask for money.
[5:20:41] And so as we think about how we can influence what happens in Sacramento in this landscape,
[5:20:48] it is important for us to work in partnership and coalition with a lot of other players,
[5:20:55] not only other counties, other cities, but also associations like C-SAC and others.
[5:21:01] And so that is how we are approaching this work. And in many respects, you have to not only do
[5:21:08] your typical lobbying but you really have to take steps to influence the decisions of key
[5:21:14] players and that requires the better understanding of what their respective districts are
[5:21:20] dealing with and working with those jurisdictions to make sure that we are approaching the
[5:21:26] right individuals with the right information about what's happening that only statewide but in
[5:21:31] the respective districts and that really is the strategy that we are, you know, are they're taking
[5:21:37] And it requires for us to work very closely with other players and spend more time developing
[5:21:46] those relationships.
[5:21:48] And so the county executive is very involved in that process and just to give you a context
[5:21:54] for where we are in Sacramento.
[5:21:57] It's a very interesting time, very challenging time, but also an opportunity for accounting
[5:22:02] like us to lead on issues that are really critical to all of us.
[5:22:09] That concludes our presentation.
[5:22:13] Thank you, David.
[5:22:14] Do we have any public like to speak on the side?
[5:22:17] We have no requests to speak.
[5:22:19] Thank you.
[5:22:20] Any questions from my board members?
[5:22:26] Do you have questions from my board members?
[5:22:27] Thank you, President Lee.
[5:22:28] Thank you so much for the presentation.
[5:22:31] Just question and guarding the bills that we are looking for sponsorships on.
[5:22:36] What is expected, how's going, you know, there's a deadline coming up.
[5:22:43] Could you just elaborate on that process?
[5:22:47] Yes.
[5:22:48] We have a number of bills.
[5:22:51] If I made sure the chair is supervised traffic code,
[5:22:53] we have a number of fill ideas that were adopted by the board
[5:22:58] that we are shopping around to different members.
[5:23:03] 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.
[5:23:18] 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
[5:23:33] to enter into some contracts, the authority that was previously given to us, which actually
[5:23:40] is Assemblymember Caldra, carried for us that bill is sunsetting, so we are the process of
[5:23:46] trying to extend the sunset and we are working with them on that issue.
[5:23:54] There are other ideas around, for instance, information on the use of place of birth in
[5:24:01] enforcement where in conversations with not only members of our delegation would also
[5:24:06] sit at a dean who is looking to do a piece of legislation and involvement involving
[5:24:13] immigration and access to certain information by federal agencies and so we are, you know, working
[5:24:20] with him to see if that's something that he would carry for us. We are also working with assembly
[5:24:27] member-pellerin on transitional shelter care facilities, there's an interest on potential legislation.
[5:24:36] We're also working on a bill involving our medical examiner and we're in conversations
[5:24:43] with a couple of different offices on that piece of legislation.
[5:24:48] 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.
[5:25:15] 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.
[5:25:38] I was reading my own number of Congresses report out that this might be an area of bipartisan partnership.
[5:25:48] I didn't notice that for Representative Lakarta, we hadn't made any requests.
[5:25:54] I thought at some point I had mentioned our homestead, Fiddil Expressway,
[5:26:00] safe routes to school project, we're in need of some funding there, but was that request made?
[5:26:08] And if not, I guess, can we put that on for this table?
[5:26:12] Sorry, sorry.
[5:26:13] I got it all.
[5:26:14] Yes, please.
[5:26:16] Hi, Supervisor.
[5:26:17] Thank you for the question.
[5:26:18] Yes, we did submit the request for the homestead, safe routes to school,
[5:26:25] project to representative Lakarto. Unfortunately, it was not selected to move forward. It is
[5:26:31] something that it's on our radar and I believe we do regular reports to you let. So definitely
[5:26:36] something we can continue looking at. Great. Thank you. And then regarding this small business
[5:26:42] center, the vast, which is a great concept. I know there's some of the programs are online and
[5:26:50] And, you know, being a former small business owner myself,
[5:26:54] I definitely put priority on how we can help small businesses.
[5:26:59] So my hope or request is that can we advertise the center
[5:27:05] throughout the county, because I think there are businesses
[5:27:08] throughout the county that can benefit from the resources
[5:27:11] that will be in place there.
[5:27:14] That's why my supervisor will work with the team on that.
[5:27:17] Great.
[5:27:17] Thank you.
[5:27:18] And I may add the supervisor on the federal piece, you know, because I know for instance that San Jose, I think Spotlight,
[5:27:25] we have had something on what Congressman Ricardo had been sort of working on.
[5:27:35] We have made every single request that has been asked of us to make, you know,
[5:27:40] unfortunately we don't have the final say on what an individual office adopts, you know,
[5:27:48] 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.
[5:27:59] the board to prove we're pursuing issues around housing in Rina and we are exploring a
[5:28:08] potential legislation on that. There's also issues involving the medical integration
[5:28:15] and we're working closely with County Council on that. I mentioned the medical examiner.
[5:28:22] I mentioned the contract change that sounds sitting that Assembly Member Collar is working with us.
[5:28:28] 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.
[5:28:39] So a lot of balls in the air, if you want more detail, happy to provide it.
[5:28:44] All right, thank you. Thank you so much.
[5:28:48] Do you need a motion to receive the report?
[5:28:53] There doesn't need to be a motion. No, it's just information.
[5:28:56] Thank you.
[5:28:59] Okay.
[5:29:02] No question by colleagues.
[5:29:04] Thank you.
[5:29:05] First of all, yeah.
[5:29:06] Thank you so much for the comprehensive report.
[5:29:08] A lot of things happening.
[5:29:09] It's great to see that many of our local member of our legislators, near bias, taking these
[5:29:15] very important positions at the Senate, the committee chair level.
[5:29:19] So I think that certainly gives a little more emphasis of asking for some of these requests
[5:29:23] in the future.
[5:29:24] Thank you.
[5:29:25] On the federal side, I do see the various community projects being put in. Is there any idea
[5:29:32] when we may find out what a this would be a propany type of potential timeline would give in
[5:29:38] Guestment at this point?
[5:29:42] Elaine, do you have any thoughts?
[5:29:45] Thank you, sir. Advisor for the question. Yes, it is quite a process, supervisor. Each
[5:29:51] federal agency that is responsible for overseeing that funding has our own process in timeline,
[5:29:55] where they issue their agreement and work directly with the department to, uh, kind of roof.
[5:30:00] We'll find this scope. So for best guests, I would say at least another several months at a minimum.
[5:30:08] 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.
[5:30:25] Great. Thank you.
[5:30:28] And let's see, there's one bill that I just saw was being voted on yesterday.
[5:30:34] 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,
[5:30:41] I'll just just let me know, I appreciate it, relaying to the claim shorts issue for veterans.
[5:30:49] Happy to do that.
[5:30:50] Thank you.
[5:30:51] All right.
[5:30:51] Thank you.
[5:30:53] And that's all I have.
[5:30:55] All right.
[5:30:55] No further questions. Let's move on to our next item. Thank you so much.
[5:30:59] I appreciate it. Thank you.
[5:31:13] All right, moving. I just want to let everybody know that because my statement
[5:31:16] talks about SPX-694, my AI and my phone immediately wanted to tell me what SP694 does.
[5:31:24] It's kind of scary. What they're listening and now something we want to respond to you.
[5:31:27] All right, good. Yes, they're moving to item number 14.
[5:31:33] Well, if I may have been Dr. Sarah Redman, I'll talk to Sarah and I'm joined by my colleagues
[5:31:37] when you can hear and Heidi, everyone from SSA, to respond to a request, I think, from Supervisor
[5:31:45] Allen Berg in the entirety of the board, now several months ago to understand the current
[5:31:50] state of home visitation programs, many of which are operated either by the Public Health
[5:31:55] Department or partners in the community and often with the fierce collaboration and support
[5:32:01] of our partners in DFCS, specifically in response to a study conducted with collaboration with
[5:32:09] first five, to see how we can sustain and in places and hands access to these important
[5:32:15] services that reach into families' homes to give the best understanding of what they're
[5:32:21] experiencing and what they need at a time, especially for new parents and infants when families
[5:32:26] can be vulnerable and have an opportunity to be set on a healthier, more wholesome path to thriving.
[5:32:35] Now, what we bring to you at this today, looks at the work that is still happening across
[5:32:41] the county, including in collaboration with non-county partners to do this work.
[5:32:47] But at the opportunity area at a moment where due to both budgetary constraints and the policy
[5:32:56] to invest in expansion is extremely limited and so really the priority of both our departments
[5:33:03] at this time is focusing on sustaining the efforts we do have while ensuring we are as prepared
[5:33:09] as we possibly could be to expand when new resources do become available and so you see
[5:33:15] before you the report that goes into great detail on these elements and we're prepared to take
[5:33:21] your questions today. I'll see if my colleagues have anything you want to add. Okay, thank you.
[5:33:27] Thank you. May I check to any public or like to speak in this item?
[5:33:31] No, request to speak.
[5:33:32] Okay, close that. Yes, would I.
[5:33:38] Let's like their lives. Let me verify that.
[5:33:41] Okay, let's pause for a second while we go through the court submission for item number 14.
[5:33:48] and
[5:33:56] we do have some cards apologies, and some hands have also raised at this time, so let
[5:34:02] me just count.
[5:34:08] Looks like I have 10 in chambers and two hands raised in Zoom.
[5:34:12] Okay, let's try to do one minute each. Sure. Our first five speakers are Jennifer Lloyd,
[5:34:19] Yelisa Donno, Liz Salis, Angelica Lehano.
[5:34:28] I'm sorry about that, yes.
[5:34:29] That's okay.
[5:34:30] We gotta be lined up.
[5:34:33] Oh, yes.
[5:34:33] So the mic is right there on the podium.
[5:34:35] And as soon as you start speaking, the time would start counting.
[5:34:38] Thank you.
[5:34:39] Good afternoon.
[5:34:40] I'm Jennifer Keller, her Lloyd.
[5:34:41] I'm the Executive Directorate for S5.
[5:34:44] And our program was the author of the feasibility study that you are reviewing today.
[5:34:48] I think I have to start by acknowledging the critical importance of a service like home visiting in a time
[5:34:55] like we are living in now where the environment and the climate of fear is substantial.
[5:35:01] So having trust of messengers who are able to connect with families in their homes are critical.
[5:35:08] I understand the report talks about implementation of Calam and medical reimbursement as being challenging and it absolutely is.
[5:35:15] However, it's not an overnight solution, and if we don't invest in building the infrastructure
[5:35:22] around medical now to reimburse some of these services, we may lose the opportunity to access
[5:35:28] those benefits later.
[5:35:30] Also, I want to just identify, home visiting.
[5:35:32] If one program goes down, it will place heavy stress on many of our other systems, including
[5:35:38] our health system.
[5:35:39] So, we need to consider that as we look at the overall context.
[5:35:42] Thank you.
[5:35:43] Good
[5:35:49] afternoon, supervisors, my name is Angelica Lujano, the director of Somos, Mayfer.
[5:35:56] I want to thank the world and especially supervisors, Suzan, Ellen Bird.
[5:36:02] For her leadership in advocacy for home visiting and early childhood system in Santa Clara County.
[5:36:08] Through the Santa Clara County, home visiting, home visiting programs currently served over 6,900 families each year.
[5:36:16] So, most may-for is perhaps to be part of this ecosystem tool or part-in-child-plus partnership
[5:36:23] with first five Santa Clara County and part-in-child-plus national.
[5:36:28] At this time, in the political climate, many families are fearful to leave their homes and
[5:36:34] stay support.
[5:36:36] Home-based-in-vuralist-made families, they are providing trust, relationship-based care when
[5:36:43] is needed most.
[5:36:45] Thank you for recognizing the importance of this work and for your continuous partnership.
[5:36:51] Thank you.
[5:36:57] Thank you.
[5:36:57] Okay, good afternoon.
[5:36:58] My name is Lisa Aless and I serve as a Parential Plasso Visiting.
[5:37:02] I'm a supervisor.
[5:37:03] I want to thank the board and like my director mentioned, especially
[5:37:07] Supervisors and Ellen Burke for all her leadership and advocacy in the home visiting systems.
[5:37:13] Our Parential Plasso program is delivered by a home grown promotor as who come from the
[5:37:18] communities and families they support and serve. They share the same language, culture and
[5:37:23] live experiences, which helps build trust in a very real and meaningful way. This
[5:37:29] connection allows our families to feel seen, understood, and respected, not as clients,
[5:37:35] but as partners. So for many families, their home visitors become a steady source of guidance
[5:37:41] and encouragement and connection to resources. We see our caregivers gaining confidence in
[5:37:47] raising their role as first and best teachers.
[5:37:51] Their children strengthening their development and families feeling less alone.
[5:37:56] So when we invest in this workforce, we're not only supporting our promotoras, but we're
[5:38:00] lifting women, men and strengthening families in creating long-termist ability for our children
[5:38:07] across our county.
[5:38:08] So this is the human impact that our home visitation families receive, and they just, it's
[5:38:15] I just support the thrive, so thank you for your time.
[5:38:20] Thank you before we go to the next speaker.
[5:38:22] I want to note that I feel the timer was set for two minutes on that one, and I want to
[5:38:27] make sure that we are right.
[5:38:29] It was set for one minute, but there was an issue in the back that it didn't start at
[5:38:33] the appropriate time.
[5:38:34] It's about it.
[5:38:34] I apologize.
[5:38:36] And before you make sure everyone gets the same time, thank you.
[5:38:40] I'll call a few more speakers.
[5:38:42] Victor Vesquez, Arlene Mora, Liliana Strada, Irma Beltran, Leslie Serrano, and Sunnyly.
[5:38:52] Thank you.
[5:38:53] You may proceed.
[5:38:58] Yes.
[5:38:59] Just speak to them.
[5:39:00] Awesome.
[5:39:01] I always have to put the mic down.
[5:39:02] I'm like, oh, this is nice.
[5:39:04] Good afternoon.
[5:39:05] Board of Supervisors.
[5:39:06] My name is Naili Sedano.
[5:39:07] And I'm a manager at Somos May Fair.
[5:39:10] And I'm here to talk about an advocate for the home visiting programs and expansion throughout the county.
[5:39:16] The families who benefit most from home visiting are the same families who would be most impacted by the HR1 cuts,
[5:39:24] low income families, medical patients, and households that quickly fall into crisis without consistent support.
[5:39:30] The county Latino Health Assessment continues to show persistent disparities impacting Latino children and families.
[5:39:38] Home visiting is a proven strategy to address these inequities early and prevent deeper systems involvement later.
[5:39:43] We cannot go backwards.
[5:39:45] Family should not be told to seek funding elsewhere for essential services as a county.
[5:39:49] We have the responsibility to invest in women and children and in prevention and in
[5:39:53] systems that work.
[5:39:54] Home visiting should be funded, sustained, and prioritized across the county level.
[5:39:58] Thank you.
[5:40:04] Dear supervisors in the board, as the parent child plus program supervisor at Catholic
[5:40:08] Church of Santa Clara County, I'm here in support of sustaining county investments in home visiting
[5:40:12] programs.
[5:40:13] Home visiting programs are especially critical in today's political and economic uncertainty.
[5:40:17] Home visitors provide more than guidance, they are consistent, trusted partners who bring stability and connection during stressful times.
[5:40:24] By showing up week after week, listening without judgment and supporting parents in everyday routines.
[5:40:29] Recently, I support a family by connecting them to immigration services and securing early intervention for their toddler who has speech delay.
[5:40:36] These connections can be like changing for families who might otherwise be experienced navigating complex systems.
[5:40:42] Programs like parent child plus are essential.
[5:40:45] They give children and families the tools, support, and stability they need to
[5:40:48] thrive even in uncertain times.
[5:40:50] Thank you.
[5:41:19] I confirm that these programs are a key to support and stability for the
[5:41:24] families vulnerable.
[5:41:26] Our team, which reflects the diversity of communities, offers a
[5:41:31] powerful and expert support.
[5:41:33] Programming programs, such as Parangio Plas,
[5:41:35] Fortalecena, the parents, such as Primero, seducadores, and
[5:41:39] Proportionate children, the base for the school, and a
[5:41:43] adoptive development.
[5:41:44] Protégere, these inversions, is an imperative,
[5:41:47] strategic, to garantize an opportunity,
[5:41:50] equitable, for all the children of the condado,
[5:41:53] of Santa Clara.
[5:41:54] Gracias.
[5:41:56] I sense, and translate it first.
[5:42:00] Yes, grazine, as a professional,
[5:42:03] and as a re-education.
[5:42:05] I would like to continue asking for your support.
[5:42:08] Since, in my experience,
[5:42:11] it's very important to continue the home visits
[5:42:14] to confirm these programs that gave stability to the community and help the parents and the
[5:42:22] children and for the children to have a very successful experience at school.
[5:42:48] to maintain their children.
[5:42:49] These expressions affect all the family and the small children
[5:42:52] also feel.
[5:42:54] The impact is evident.
[5:42:56] A peer benefit from Calwork with special needs.
[5:42:58] In front of our physical and physical properties,
[5:43:01] despite their conditions of health,
[5:43:03] there will be a chance to visit them and always be present.
[5:43:07] Participating in the interactive and interactive
[5:43:10] during visits.
[5:43:11] Suija is receiving the therapy of Able,
[5:43:13] and she has observed her great progress
[5:43:15] with the support of the therapist and the Specialist Education Infantile.
[5:43:19] Thank you so much for the service that you have now
[5:43:21] visited my son for his son,
[5:43:23] as well as the requirements.
[5:43:25] This is possible thanks to the team of professionals
[5:43:28] with the community that proposed to support
[5:43:32] culturally the families.
[5:43:33] That was very impressive.
[5:43:35] How much you put in there?
[5:43:38] That's a good translation, please.
[5:43:41] Thank you for continuing the investment
[5:43:44] in school programs, because especially for Latino communities that undergo stress and economic
[5:43:53] uncertainty. And especially I've seen a parent who is part of their health conditions,
[5:44:00] they actually benefit from the visit they never miss the opportunity to attend the program,
[5:44:07] they acted participate in it and they have a daughter involved in speech language and with
[5:44:12] help of professionals and experts. They can give it a daughter more opportunity. So we would
[5:44:21] like to continue to invest in this program and also in home business.
[5:44:29] Dear board members, I'm here to support a suggestion of the county investment in home visiting
[5:44:36] program. As an early learning specialist with cadre attorneys of Santa Clara County, I work
[5:44:42] with families who juggle, work, school and everyday challenge. I am working with the Spanish
[5:44:47] speaking mother of her three-year-old who's navigating challenges with sleeping and ongoing health
[5:44:52] concerns. Through all our visits we have successful establish a constantly daily routine
[5:44:57] engage in an early learning activity.
[5:45:00] And connecting her with valuable, community resources for additional support. She truly, she truly
[5:45:07] values the value, the assistantship, her CV and managed and effectively to manage the stress
[5:45:14] and financial unable. On certain surrounding her child's medical needs and has expressively
[5:45:19] a appreciation and relieved in support receiving support and also expressed how heartwarming
[5:45:25] to see her child has grown during her visits and smiley and connecting.
[5:45:30] Thank you.
[5:45:37] This supervisor and the board, my name is Sunnyly.
[5:45:40] I am an early learning measure lead with Catholic charity.
[5:45:43] And I walk slowly with the family who often fail at
[5:45:45] economy, dress, while raising young children.
[5:45:48] Program my parents, travelers.
[5:45:50] Provide more than early learning support.
[5:45:52] We build just connection and hope.
[5:45:55] This month, I have honor, raturizing a cow or family from the program.
[5:45:58] This model, who raised in two children with autism,
[5:46:02] worked in relatively hard to support her children's development.
[5:46:05] Together, we have said early intervention survey and
[5:46:07] directed strategy that has helped her feel more confident in a parent.
[5:46:11] Today, the family feel empowered and better
[5:46:14] rebelled to navigate available resources.
[5:46:16] She has also laid her second daughter on our home
[5:46:19] business in wireless, so in her continued commitment
[5:46:22] to her children's growth.
[5:46:23] Moments like this remind me why did work mother,
[5:46:25] because parents of their trained and family support
[5:46:28] parents and give children a strong
[5:46:29] foundation for the future.
[5:46:31] Thank you for listening.
[5:46:38] Good afternoon, Victor,
[5:46:39] at Somos.
[5:46:40] I want to thank the Board,
[5:46:41] especially the supervisor,
[5:46:42] Ellenberg, for protecting children,
[5:46:44] youth and families.
[5:46:45] I'm here today as a new parent.
[5:46:47] I urge you to sustain these critical programs
[5:46:49] in a kind of national tax.
[5:46:51] Brown families are primary target.
[5:46:53] We're living in fear,
[5:46:54] due to immigration enforcement,
[5:46:56] and anti-immigrant sentiment,
[5:46:58] leading to family separations,
[5:47:00] traumatized children,
[5:47:01] and public executions. Communities are in fear of accessing resources and these programs
[5:47:07] are spaces where people will find trust, support and hope.
[5:47:11] Our Board needs to name racial justice as a core value again and send our brown families
[5:47:16] and protect these critical services and them. It is time to collectively refuse to balance
[5:47:21] the budget of the back of brown children, women and families. Also urge the county to
[5:47:26] Center Latino Health Assessment, so funding decisions align with documented community needs,
[5:47:31] services, and resources, protecting brown children and families must remain a county priority.
[5:47:37] Thank you for your partnership.
[5:47:41] Moving to our Zoom speakers, our next speaker is Saul Ramos. You will have one minute.
[5:47:49] Good afternoon, Supervisors. This is Saul Ramos,
[5:47:52] Quadietz, almost May 3. We're very supportive of sustaining and enhancing the home
[5:47:55] the institution strategy.
[5:47:57] I'm speaking from East San Jose,
[5:47:59] alongside families with young children
[5:48:00] who are navigating fierce risks to my solution.
[5:48:03] And the county's own public health data shows
[5:48:05] that many of our families face higher barriers
[5:48:09] to be under care, greater economic strain,
[5:48:11] and worsening mental health outcomes,
[5:48:13] and those conditions begin early in a child's life.
[5:48:16] Home visiting works because they meet families
[5:48:18] where they are.
[5:48:19] It builds trust and intervenes before crisis.
[5:48:22] Our home visitors connect families to food,
[5:48:24] housing stability, healthcare, early learning assessments, strengthening parent confidence
[5:48:29] and child development, all of that at the same time.
[5:48:32] And sustaining this work is not only the right thing to do it is physically responsible.
[5:48:37] Home visiting is an investment that protects families now and will save us public dollars down the road.
[5:48:43] So I want to thank you for your efforts and I think the leadership of Supervisor Elberg in this effort.
[5:48:47] Thank you.
[5:48:49] Our next speaker is General Garcia. You'll have one minute.
[5:48:54] Hello, my name is Janelle. I'm a home visitor within the program, a parent shop plus with
[5:48:59] Somel's May Fair. I would like to ask for the continuous support working for the home
[5:49:04] visitation programs and working directly with the families for the past four years has allowed
[5:49:08] me to get an insight look of what our community needs or wants. It allows me to support and guide
[5:49:12] the families to the resources they search for. I see their strengths and growth within the
[5:49:17] two years I spend with them. Programs like home visitation allows these families to become their
[5:49:21] leaders and advocates for their family and community. It allows children to be
[5:49:25] school ready by the time the program completion, and it strengthens the connection
[5:49:29] between child and caregiver. I believe it is important to keep these programs
[5:49:32] active for our community as it gives equal opportunities from the start. Thank you.
[5:49:38] We had one additional speaker that raised our hand before the key was closed. Our next speaker
[5:49:42] is Cam Nguyen. Cam you will have one minute?
[5:50:02] Yeah.
[5:50:58] Hello. Yes, we can hear you, Greg.
[5:51:04] Good afternoon.
[5:51:05] Thank you for the board.
[5:51:07] I'm just support.
[5:51:10] I'm just.
[5:51:12] Our cabin.
[5:51:13] And I'm just going to talk to the
[5:51:16] Um,
[5:51:17] When I get to start start over your.
[5:51:20] Um,
[5:51:21] Audio quality is very hard to hear.
[5:51:23] So maybe you can get a little closer to the speaker and try again.
[5:51:27] Thank you.
[5:51:30] What moment did
[5:51:34] you get in this career?
[5:51:35] Oh, much better, yes.
[5:51:36] Go ahead.
[5:51:41] Can you do it better?
[5:51:44] Just now was good.
[5:51:45] Go ahead, go ahead, go ahead, go ahead.
[5:51:52] Good, well, provide so many tools.
[5:51:54] And I'm
[5:51:58] talking, and then I'm talking,
[5:52:01] with a Catholic support group who come to the home
[5:52:07] of my family, and have a support
[5:52:12] having with the parents, children's programs, they have to support the children with the
[5:52:21] program, the land development for the language field,
[5:52:28] and support what they have as
[5:52:31] a police example development in the home. They have to connect the parents to the children
[5:52:37] and be confident through the children so that it can be ready for the reading and studying
[5:52:45] program.
[5:52:47] And, nicely, I hope that we can have further support.
[5:52:54] Our families are about to register for our second drive into the program and we do hope
[5:53:03] that repairing this will help my children to develop better
[5:53:08] and I look forward to further support
[5:53:10] so that the program can continue and support
[5:53:14] to our families and their level and to see the child
[5:53:18] for less a few years.
[5:53:20] Thank you very much.
[5:53:24] That concludes public comment.
[5:53:25] Great, okay, we'll close the public speaking portion.
[5:53:28] Yes, supervisor, Amber.
[5:53:29] Thank you.
[5:53:31] I want to begin by thanking all of the partners
[5:53:34] In this work, first five public health, social services agency, the CBOs of the Home Visiting
[5:53:42] Collaborative, and thank you as well to the folks who came as public speakers, whether
[5:53:46] providers of or recipients of home visiting services, hearing about your experiences is really
[5:53:53] vital.
[5:53:54] I want to just emphasize to everyone, the gravity of the work being done here.
[5:54:00] Time and again, we hear our leaders, including myself, say that we need to meet people where they are.
[5:54:07] 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.
[5:54:16] 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.
[5:54:29] low-income medical eligible patients and other folks who could easily fall into crisis without
[5:54:36] proper support and services. Currently, home visiting programs throughout the County Home
[5:54:42] Visiting Collaborative serve more than 6,900 families annually. A significant goal of this work
[5:54:52] is to ensure and support a safe home environment and develop support the development of a
[5:54:59] healthy, loving, and supportive relationship between a child and their parent or caregiver.
[5:55:05] This work is not insignificant.
[5:55:08] It reflects a baseline of preventative care that can force all adverse childhood experiences
[5:55:14] which ample research has shown to be factors in everything from poor educational outcomes
[5:55:20] to housing instability to criminogenic behavior.
[5:55:24] It is a deeply vulnerable thing for a young family to welcome a stranger into their home,
[5:55:31] even briefly, who is there to watch them engage with their child.
[5:55:36] Building trust quickly is critical to the success of these visits as is demonstrating
[5:55:43] the many additional supports that may be available to that young family if they would
[5:55:49] benefit from them.
[5:55:50] Removing this benefit could be directly responsible for perpetuating another generation of trauma, poverty, and instability.
[5:56:01] We know that home visiting is cost effective.
[5:56:03] The return on investment for such programs ranges between $1.75 and $5.70 for every dollar spent.
[5:56:12] Home visiting can improve healthy development, education, economic wellbeing, and overall health,
[5:56:17] further yielding economic savings to the county.
[5:56:21] When healthy children become healthy adults,
[5:56:24] the county spends fewer dollars on costly and high
[5:56:28] intensity services.
[5:56:31] I am encouraged to see the partnership with first five
[5:56:34] moving forward.
[5:56:35] The extraordinary circumstances related to our budget
[5:56:38] will not last forever.
[5:56:41] And we need to remain positioned to expand
[5:56:44] as soon as dollars are available.
[5:56:46] So, with this in mind, I have a few clarifying questions and then we'll make a motion.
[5:56:55] First, to Dr. Redmond, could you say a little bit about how public health
[5:57:00] has engaged with first five thus far on the areas of partnership that are identified in the report?
[5:57:07] I'm happy to, and please, that are first five partners.
[5:57:10] I'm happy to share your information as well.
[5:57:13] Yeah, she'll probably poke me later if I forget anything.
[5:57:15] because let me just make clear, Jennifer, if you want to add you are absolutely welcome.
[5:57:19] Go ahead.
[5:57:20] I will say part of the reason I joke about that is that we do work so closely with first
[5:57:24] drive as do our partners in SSA.
[5:57:27] I think I'll start by thanking first five for their leadership for the fact of this report,
[5:57:33] which has been so helpful in highlighting exactly as you described the deep importance of
[5:57:37] home visitation.
[5:57:38] And I think one of the things we've grappled with in bringing this item back has been how
[5:57:43] visitation in and of itself is often carried out through a series of different types of programs,
[5:57:49] some of which by nurses, some by community health workers, some by mental health experts,
[5:57:54] their child development experts, all of whom bring slightly different lenses and ways to make sure
[5:57:59] we're reaching people with the services they need. And so in terms of public health collaboration with
[5:58:04] first five, I know that they take a leadership role and our network, in fact, you know, I'm going
[5:58:11] let the experts speak, let me stop.
[5:58:14] So both Heidi also knowing where she comes from,
[5:58:16] but Jennifer, please take it away.
[5:58:18] Is it because that really, thank you.
[5:58:20] Thank you, Supervisor.
[5:58:22] So first five collaborates regularly with public health
[5:58:25] on both the Home Visiting Collaborative
[5:58:28] as they are active participants.
[5:58:30] And also on implementing our CalWorks Home Visiting Program,
[5:58:34] those dollars fund both public health,
[5:58:37] nurse operated home visiting programs as well as it is a personal funding source for the
[5:58:45] parent child plus program. First five actually utilizes four funding sources, which, by the
[5:58:51] way, is typical for almost every home visiting program that we stand up in this county and also
[5:58:56] statewide because none of the funding sources often can cover the cost as a whole. But so we do
[5:59:05] operate together on implementation, I think where we have not yet really collaborated and was going
[5:59:13] to be one of my requests that I did not get to in my one minute is, you know, meeting together
[5:59:19] with the managed care plans to really talk through the barriers.
[5:59:23] There's literally my next question.
[5:59:25] Oh, there you go.
[5:59:26] I think they have met with the managed care plans.
[5:59:29] We have met with the managed care plans.
[5:59:31] We have met with public health.
[5:59:33] 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.
[5:59:45] 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.
[6:00:00] Local government meeting, level sources, as well as how caloric funding is going to be implemented.
[6:00:05] 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.
[6:00:15] And that was a consideration that we almost had happened this last year.
[6:00:20] Thank you. Is there anything you want to add, Sarah, about the managed care plan involvement?
[6:00:25] No, I mean, I think exactly, as Jennifer was saying, we need to close that loop, but there
[6:00:31] have been some productive conversations happening.
[6:00:33] I think exactly to your point of, we have not given up on Calame, but there are major barriers
[6:00:39] to overcome and making sure that it actually fills the gap we need, and who should the board
[6:00:44] be interested?
[6:00:45] We can talk about some other work that public health does to help get us to that point.
[6:00:52] 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.
[6:01:17] We have to connect the dots outside of the county.
[6:01:21] Thank you.
[6:01:22] The goal should always be get the care where it's needed.
[6:01:26] And I'm agnostic, whether we're delivering it
[6:01:28] or first five or a CBL.
[6:01:33] I heard you, Jen, reference the four different funding streams.
[6:01:38] Thankfully, I know you have a brilliant finance director
[6:01:41] in Maureen, but thinking about the state funding
[6:01:47] streams, any federal that's left, I'll turn back to Dr. Redman, what kind of creative
[6:01:56] strategies are you thinking about so that public health can help sustain these home-visiting
[6:02:04] programs given the budget situation post HR1 and realizing that the general fund dollars are
[6:02:13] not going to play a significant role.
[6:02:15] Well, I will say, so some of that work does predate even this particular referral in which
[6:02:21] public health is still able to draw down Title 19 dollars for a huge number of our programs
[6:02:27] that serve families and homes, especially new parents and infants. And so we have maximize
[6:02:34] making sure that we are qualifying for every dollar we possibly can, some of which including
[6:02:40] even in the supportive services that train the same nurses or support workers who facilitate
[6:02:46] those programs so that every federal dollar that we are possibly eligible for is coming into the county.
[6:02:53] 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.
[6:03:00] 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,
[6:03:09] will be when we bring back our community health worker information that is coming both as a referral
[6:03:16] from the Latino Health Assessment on what would it look like if we had a truly comprehensive
[6:03:20] community health worker system and network that covered our in particular Latino community
[6:03:27] members but because we had a similar program serving our Asian Pacific Islanders that we lost or the
[6:03:34] funding sunset for. We know that the findings of that Latino Health Assessment study will also help us
[6:03:41] solve problems to sustain that work for other communities, other SNPs. What we are finding
[6:03:47] is there are problems everything from what the actual Calam reimbursement is, what qualifies for it,
[6:03:53] and who qualifies for it, including the certification of community health workers in order to
[6:04:04] grassroots on the ground home visitation services, especially with community members, often
[6:04:09] don't have the back office ability to do things like become medic health billers. And so we're
[6:04:15] seeing whether it is specific to programs that do home visitation or not in that community health
[6:04:20] worker work, helping organizations that are nearly ready to build, CalAIM, bill medical to do so,
[6:04:26] helping folks who are not yet certified as community health workers to get certified and helping
[6:04:31] organizations often with support of other CBOs to have the ability to become
[6:04:36] medical billing eligible. So I think that is sort of the next big promising
[6:04:40] funding source. The problem is it still may not be enough and it's not a switch
[6:04:45] we can turn on overnight. It's something we're taking continuous steps toward.
[6:04:49] Absolutely. Thank you. None of this will be enough.
[6:04:53] And speaking of funds, sun setting, Wendy, maybe I'll look to you for this. The
[6:04:58] 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.
[6:05:15] 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.
[6:05:30] 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.
[6:05:42] We are using state block allocated grant dollars that is that allocation that doesn't expire until 2028.
[6:05:50] 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
[6:05:59] so that then it would make us eligible to pull down federal funding in the future.
[6:06:04] So we are just like Sarah had talked to Redmond and talked about items and sort of preparation.
[6:06:08] This is our preparation work to prepare us for possibly other revenues later to get at federal
[6:06:14] prevention dollars, so it's an investment for us in the parent child plus.
[6:06:19] Thank you so much.
[6:06:21] That's really just exactly what I had hoped to hear that we're going to keep the infrastructure
[6:06:28] moving forward.
[6:06:29] We're going to remain ready.
[6:06:32] We're sort of the understudies that can go on at any second where you're not leaving.
[6:06:37] I don't know where I'm going with that.
[6:06:38] not leaving the theater.
[6:06:40] Let me move to a motion.
[6:06:42] My motion is to receive the report and direct administration
[6:06:47] to return to this board in six months
[6:06:50] with an update on the partnership between county and first five
[6:06:55] regarding efforts to expand home visiting,
[6:06:59] including convening a meeting with first five
[6:07:01] and managed care plan partners.
[6:07:04] The update should include the feasibility
[6:07:06] and meaningful progress of any and all of the four areas of partnership identified in the report.
[6:07:14] In addition, the Motion Direct Administration to return no later to the board,
[6:07:21] no later than the second meeting in January of 2027,
[6:07:26] with formal strategies or a work plan to provide support and assistance to community-based organizations,
[6:07:32] looking to bill either the CHW or Collean benefits for home visiting. I chose this date
[6:07:40] because by January 2027 the state will have entered its next 1115 medical
[6:07:48] weaver cycle and let I think we'll have a better knowledge of the long-term
[6:07:52] sustainable strategies that community-based organizations can use to fund home
[6:07:57] visiting programs and if all of that is clear to you, I will look for a second.
[6:08:04] Happy to second the very comprehensive motion and I believe all my questions I was going
[6:08:09] to ask has been already discussed so thank you so much to everyone for your leadership on
[6:08:14] this.
[6:08:14] Thank you staff to our partners and talk community members here today for making sure that we understand
[6:08:21] the benefits of this program, the gains of it with clarity and what it means to our families
[6:08:25] rely on it.
[6:08:26] So thank you so much. Happy second.
[6:08:28] Thank you for the support.
[6:08:30] We take care of babies, literally, everything is better.
[6:08:34] Thank you very much.
[6:08:35] There's only one to support this strongly.
[6:08:37] And thank you so much for the speaker that came out
[6:08:39] to talk about how important this program is.
[6:08:42] I'd have a question of a timeline here,
[6:08:45] which is when do you think this,
[6:08:46] you might come back to the board with the strategies
[6:08:49] to partner with first five,
[6:08:51] to the Clara Family Health Plan and all the agencies,
[6:08:53] I think
[6:08:58] if it was the direction to come back in six months, I think the public health side
[6:09:03] can meet that.
[6:09:05] Okay, good.
[6:09:06] Thank you.
[6:09:07] Thank you.
[6:09:08] Perfect.
[6:09:09] Thank you.
[6:09:09] And that's all I have.
[6:09:11] And no further comments.
[6:09:12] Please take a look.
[6:09:13] We have a motion by Supervisor Elinberg and a second by Supervisor Jung.
[6:09:17] Supervisor Abacoga?
[6:09:18] I.
[6:09:19] Supervisor Jung?
[6:09:20] Yes.
[6:09:20] Supervisor Elinberg?
[6:09:22] Yes.
[6:09:22] And presently?
[6:09:23] I as well.
[6:09:23] Motion carries for us now. Thank you so much.
[6:09:31] All right moving to item 15 which is
[6:09:33] recommendations from the Office for the Housing and the Behavior Health Services Department
[6:09:38] on the efforts to strengthen the county's partnership with cities and homelessness.
[6:09:47] And I see
[6:09:47] we have a director of Ash, KJ Cumminski and also from our Behavior Health Service Department
[6:09:55] Dr. Sherry Terrell. Good afternoon.
[6:09:59] Good afternoon, President Lee.
[6:10:01] Members of the Board, KJ Kaminski.
[6:10:04] Director of the Office of Support of Housing.
[6:10:07] Join by Sherry Terrell, Director of Behavioral Services Department.
[6:10:11] I'm going to provide a brief verbal report and share some highlights
[6:10:14] of the work that we included in the report today
[6:10:18] and will also be available for questions.
[6:10:20] This report response to two referrals approved by the Board in September and October that include
[6:10:26] eight areas of work and it's related to the coordination of services with the City
[6:10:31] San Jose as well as other cities across our county.
[6:10:35] In the report we numbered the items one through eight we provided an update on the status
[6:10:42] of each of those referrals as well as the departments that are responsible for working
[6:10:47] on those efforts and there is a narrative report on each of them.
[6:10:53] Just wanted to start with a very brief background on the county's role as it relates to
[6:10:59] our supportive housing system.
[6:11:01] As the continuum of care lead agency OSH plays a coordinating role for our supportive
[6:11:06] housing system county wide, that includes sort of tracking the capacity and outcomes
[6:11:12] of our housing programs overseeing our shelter hotline, developing and updating our quality assurance
[6:11:19] standards for how programs are operated.
[6:11:21] But the county is also the largest funder of services for unhoused folks in our community
[6:11:27] with investments of nearly 450 million across the departments, the behavioral health services
[6:11:35] department, OSH and the Valley Homeless Health Care Program.
[6:11:40] Additionally, the county has made significant investments in shelter in temporary housing.
[6:11:45] We currently support over 2,000 beds across 20 sites, countywide, and that represents $45 million
[6:11:52] in funding for those services.
[6:11:55] Many of these investments have been ongoing for more than a decade, but the county has worked
[6:12:00] hard to expand our temporary housing option since 2020, which is aligned with our community
[6:12:05] plan to end homelessness goal to double temporary housing capacity.
[6:12:11] We have added 899 temporary housing bed since we set that goal in 2020.
[6:12:19] I mentioned these two roles as a coordinator but also a funder because some of the work
[6:12:24] reported on in this in the report are related to either the county as an operator but some
[6:12:33] the county as a coordinator. In addition to shelter operations funded through OSH, our
[6:12:41] valley homeless health care program partners and behavioral health services department
[6:12:45] have been working closely with OSH and our partners across our support of housing
[6:12:50] system to provide services to shelter residents, to permanent support of housing
[6:12:54] residents across the county for many years. As you see in this report we're currently
[6:13:01] building on this partnership, and I'm going to share just a couple of highlights. First,
[6:13:07] related to item number one, this is to expand direct medical and behavioral health services
[6:13:13] to city funded shelters in the city of San Jose.
[6:13:19] Behavior health and OSH and BHHP have been
[6:13:22] working on expanding services to city funded shelters and building on work that exists in other
[6:13:28] shelters across the county.
[6:13:31] We've been providing the county has been providing these services
[6:13:35] to shelters such as the Sunnyvale family shelter,
[6:13:40] the shelters in Mountain View, the Mountain View Home Keys site,
[6:13:45] other shelters in San Jose, like the Ricardo Reception
[6:13:48] Center, JSI, MSI, and in South County
[6:13:51] at the Gilroy Armory.
[6:13:54] So the work to expand to the city's emergency
[6:13:57] interim housing site is building on those established practices across shelters throughout
[6:14:03] the county. As with our work at county funded shelters, the goal is to connect shelter residents
[6:14:11] to medical care, whether provided on site or at another location. The first phase of this work
[6:14:18] is piloting this partnership at the Bernal emergency interim housing site as well as the Ru for
[6:14:26] 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.
[6:14:39] 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.
[6:14:49] but also training staff to help shelter residents engage in their benefits and health care while they're staying at the shelter.
[6:15:00] 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.
[6:15:10] The other item I want to highlight is our work related to item number 7.
[6:15:16] This is our ongoing work with all cities across the county to preserve and expand temporary housing opportunities.
[6:15:23] The approved referral was to consider options for expanding temporary housing capacity,
[6:15:29] beginning with the top three homelessness impacted cities.
[6:15:32] The cities with the highest number of unhoused people are San Jose Gilroy and Mountain View.
[6:15:43] And as it relates to our work with the city of Gilroy,
[6:15:48] we are currently working to sustain operations at the Gilroy Armory,
[6:15:52] which we understand the city intends to sell.
[6:15:55] We are also working with the City of Mountain View to sustain our safe parking programs and the Mountain View Home Keysight.
[6:16:06] We are, we've met with those cities, both county administration and the OSH team has met with both of those cities,
[6:16:13] but we also are meeting with cities across the county as part of our planning for the updated community plan to end homelessness.
[6:16:23] And I want to note that we do that work, whether it was the Mount View site, our work with the
[6:16:31] Palo Alto Home Key site, some of the expansions that have happened over the last several
[6:16:36] years have been in close partnership with City staff. And with the update to the community plan,
[6:16:42] we are working with the cities to identify regional priorities, regional goals, that will be
[6:16:50] presented as regional plans that are aligned with the community-wide goals that are identified
[6:16:58] through our process. So we're seeking to build upon the successes that we have seen,
[6:17:06] and also are looking always looking for additional funding opportunities, but those are,
[6:17:12] that's the primary challenge that we face right now in terms of expansion and really focused
[6:17:17] on sustaining our investments as across the committee.
[6:17:23] With that, we're happy to answer questions.
[6:17:28] Oh, sorry. Any questions we have here?
[6:17:31] Well, I don't see a bit. How will this do to public first?
[6:17:35] Just a moment. And confirming no requests to speak.
[6:17:39] Okay, close the public speaking portion. Yes.
[6:17:42] So Vice-Young.
[6:17:43] Thank you.
[6:17:44] K.J. Sherry. Thank you so much.
[6:17:46] I'm so pleased to see that progress is being made on addressing
[6:17:50] homelessness but the City of San Jose and through this partnership as a city with the largest
[6:17:54] unhoused population in the county. We clearly have a need to see this done quickly and done
[6:17:58] right. I do have some questions as it relates to the areas of work that you've outlined. Mainly
[6:18:03] timing issues and some of the where the shared responsibilities are. I really, as some of this
[6:18:10] work just got underway and the initial reporting from the medical mobile van and BHP at the
[6:18:20] that. And I was also equally happy to read that behavior health is working on a training plan
[6:18:24] for case managers as city owned size. I think this level of cross training is going to do
[6:18:29] as a great deal of good and serving our clients and our most vulnerable. Are the dedicated liaison
[6:18:36] noted in the Lechva existing staff who are having this added to their portfolio of work are
[6:18:41] these new rules?
[6:18:47] Sorry, this related the behavioral health dedicated liaison.
[6:18:53] Yeah.
[6:18:53] 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.
[6:19:05] Were there any budgetary or staff impacts or staffing changes?
[6:19:09] The need to facilitate this.
[6:19:12] Not at this time, we've been able to utilize our existing resources to help support this initiative.
[6:19:16] I appreciate that, music to my ears.
[6:19:18] 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
[6:19:26] I understand that will take some time
[6:19:28] 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
[6:19:38] Our our residents and clients in need of our services know that there's only one hotline to call in the future
[6:19:42] Yes, that would be part of the plan
[6:19:44] And as when we are ready to make that transition, we OSH has a outreach, plays an outreach
[6:19:53] coordination role brings together all outreach providers across the county, both city
[6:19:58] funded, county funded advocates, non-profit advocates and community-based organizations.
[6:20:04] And we will be utilizing that infrastructure in our coordination role to make sure that the messaging
[6:20:11] is clear to our residents, the whole intent here is to make access easier and to reduce the
[6:20:18] number of places that people have to call or show up to get a referral to shelter so we'll
[6:20:23] be doing some, be doing a lot of outreach to make sure that message gets to the people who are
[6:20:30] experiencing homelessness. Yeah, thank you, KJ. And I know that the, the, a lot of the works,
[6:20:35] the benchmarks are in progress right now because this is a recent undertaking. So thank you so much
[6:20:40] for preparing this so quickly and being able to come back
[6:20:43] to the board with the very timely update.
[6:20:47] I have some more questions about the other parts of the referral,
[6:20:50] but one of the requests I'll be making along with my motion today
[6:20:53] is that you, the KJU and your team and Sherry,
[6:20:59] your respective team members or yourself.
[6:21:02] If we could have a report back on the status of the progress
[6:21:05] before the end of the fiscal year,
[6:21:07] and also one more time before the end of the calendar year.
[6:21:12] And then I'm going to move on to some questions about the 19 million dollars delegation of
[6:21:20] authority that's being recommended, that's one of the recommended actions.
[6:21:24] How do we intend to use it if we come to an agreement on this approach with the city?
[6:21:28] Do we have plans for it yet?
[6:21:32] I know it's homelessness prevention.
[6:21:34] Any specifics you could provide on that?
[6:21:37] Yes, the funding would be used 100% to augment the county's existing homelessness prevention program,
[6:21:43] which can very much use the additional funds this program as the board is aware was
[6:21:49] the subject of a rigorous controlled study and has shown incredible efficacy in preventing
[6:21:57] and avoiding homelessness and so the intention would be the 19 million would be an additional
[6:22:02] augmentation to that program.
[6:22:05] Thank you, James.
[6:22:07] I just appreciate that this work that we're doing today is something that our staff, our
[6:22:15] line staff, have been wanting to see and making recommendations for a number of years.
[6:22:21] So I know that as makers of referrals and motions, we sometimes get credit as elected
[6:22:26] for this.
[6:22:27] I really want to make sure for the record that this latest phase of partnership and collaboration
[6:22:33] really came from our staff.
[6:22:34] Both on the county side and the city side seeing where the gaps were in our integration so I'll give that shout out
[6:22:41] I'd like to make a motion to receive the report and approve the delegation of authority with the report back
[6:22:47] On the status of implementation or progress of our collaboration with the city
[6:22:52] Before the end of the fiscal year and one more time before the end of the calendar year
[6:22:58] Happy to second the mission if I can make a few comments. Thank you
[6:23:02] Thank you to Professor Young, and thank you to staff, KJ, and staff for bringing this
[6:23:09] forward.
[6:23:10] I'm just very, obviously, supportive, I think, that this growing sense of cooperation
[6:23:16] with the, in partnership with the CEO of San Jose is really important to give in
[6:23:20] that San Jose.
[6:23:21] It is the largest city, and it does have the largest number of unhoused according to the
[6:23:32] And as administrators of the coordinated entry system
[6:23:35] and provider of major, the majority of wrap around services
[6:23:39] and case work management, it makes perfect sense
[6:23:42] that we prioritize coordination with the city of San Jose.
[6:23:46] I do, though, hadn't given that I represent nine, eight other cities
[6:23:51] in my district really appreciate that the county
[6:23:55] is working with all of our cities.
[6:23:58] And when I've discovered in my conversations
[6:24:01] and on this issue, working on this issue for a number of years is that in more and more
[6:24:07] I am seeing is that each city has their special circumstances and so we really need to look
[6:24:14] at each city, city by city, and come up with solutions that are tailored to those respective
[6:24:20] issues.
[6:24:22] For instance, in Mountain View, we have a high vehicle-dwelling population, and part of that
[6:24:27] due to a lawsuit settlement that required the city to produce a map of where the
[6:24:32] vehicle dwellers can park. South County City's, we talked about it at our last
[6:24:37] humid, humid meeting, meeting has a high agricultural worker population. I
[6:24:42] didn't appreciate staff bringing that up to. And then what I just recently had a
[6:24:49] conversation with the service provider at one of our safe parking lot programs and
[6:24:57] He had shared the challenges specifically mainly seniors are having in transitioning into
[6:25:05] permanent affordable housing solutions.
[6:25:09] I think part of that maybe because of their restricted incomes.
[6:25:14] So I'm hoping that we can look at that more carefully as we work on this upcoming plan
[6:25:23] to end homelessness cycle.
[6:25:25] So, as a regional issue, I'm glad that we're trying to work closely together rather than
[6:25:33] pointing figures or leaning, laying, laying, laying at any when jurisdiction, and I appreciate
[6:25:41] that we're looking again at all solutions, safe parking, emergency, interim housing, as well
[6:25:46] as permanent supportive housing, and looking at where the people are and who they are, and I
[6:25:52] that I'll give a, I don't have significant impact.
[6:25:58] So, and then, of course, for the health care providers, I appreciate the work that you're doing
[6:26:02] at coordinate with our shelters in support of housing programs.
[6:26:08] So, with that, thank you and happy to second-the-motion.
[6:26:12] Thank you.
[6:26:17] I am frankly very surprised to see how big this issue is, and to have no public comment.
[6:26:25] being given today on this very specific issue. Given how many people have been talking about
[6:26:33] on shelter homelessness or on the different cities and counties because this is exactly the
[6:26:39] good news we want to tell the world that the counties and cities are absolutely working together
[6:26:45] to solve these issues. I guess sometimes as the bad news is when they get to get out there,
[6:26:51] Good news in how this doesn't get published, so I just want to make sure that people understand
[6:26:55] how hard different jurisdictions are working together to get to where we are of these proposals
[6:27:00] and we're looking for even better outcome as we move forward.
[6:27:06] The term homelessness has been so misunderstood or been abused by certain individuals politically
[6:27:12] otherwise to put certain image what homelessness means and as we know this is a far more
[6:27:17] complicated and complex issues.
[6:27:20] As my colleague has stated, and like the supervisor,
[6:27:23] I'd be curious that, you know, different cities,
[6:27:25] different locations, a different type of homeless,
[6:27:28] less issue, right, what it is vehicles.
[6:27:31] And even some of those vehicles, like the RVs, for example,
[6:27:34] not necessarily, they don't have home.
[6:27:35] They might have home some way off.
[6:27:36] They just don't want to have to rent another place,
[6:27:39] which is very expensive while they're working here,
[6:27:41] and they go home for the weekend.
[6:27:42] Things like that, right?
[6:27:43] So everybody has a very different issue.
[6:27:45] And so that's why I think it's important to have
[6:27:47] different solutions. I'm working to tailor these solutions on the need and I just want to really
[6:27:53] give a huge thanks to our office support housing, our behavior, health services and your team for
[6:27:59] coming of these solutions and how we're going to tackle them one by one and this is not an easy lift.
[6:28:06] This doesn't mean you would end homelessness by doing what we're doing here but it would certainly
[6:28:10] make a huge dent onto this issue and that we are coordinating with not just one city. In this case
[6:28:16] Sounds as we stayed here, but we are going to be working with all the other cities as well
[6:28:20] to make sure that our service will be given to our residents that need it and making those
[6:28:26] accessible to all.
[6:28:27] Thank you very much.
[6:28:28] And what further do you want us to take a vote?
[6:28:31] We have a motion by Super-Zone and a second by Super-Rezer Abacoga, Super-Rezer Abacoga.
[6:28:35] I, Super-Rezer Yung, yes, Super-Rezer Ellenberg, yes, and President Lee.
[6:28:39] I as well.
[6:28:40] Thank you.
[6:28:41] The motion carries 4-Zone.
[6:28:47] Okay, moving on to item number 16, which is report from the Office of CountExec,
[6:28:53] relating to the services, is a place budget for budget and contract management system.
[6:28:58] And this is actually an informational item only, and no actions needed.
[6:29:03] Go ahead, James.
[6:29:04] This is a report back to referral from Supervisors, Elmberg, and Abhay Koga, related to information
[6:29:12] And regarding Object 2, we've laid out several categories of information that we will be providing
[6:29:20] as part of this year's recommended budget process regarding Object 2 spending from the past.
[6:29:27] Also included is an update on the county's budget management system and timeline related
[6:29:32] to that as well as an update on the county's contract management system implementation and
[6:29:38] timeline. Just to be clear, given competing resources and prioritization, administration is
[6:29:46] prioritizing the implementation of the budget system ahead of the contract system, not because
[6:29:52] both aren't important. They both are important, but realistically, the budget system is an essential
[6:29:58] system that we have to have.
[6:30:00] Up and running in place, as soon as possible. We're happy to answer questions that the Board may have.
[6:30:09] Thank you. First, any public lift to speak on this item?
[6:30:11] We do have one request to speak on Zoom.
[6:30:15] Pardon us to two minutes.
[6:30:17] Okay.
[6:30:18] Parent, you will have two minutes to speak.
[6:30:21] Yes, thank you.
[6:30:22] I really hope that we can address in our budget this time around all the waste,
[6:30:29] especially what's coming out of the just attorneys office I mentioned before about Daniel
[6:30:35] Chung that he was just trying to protect my children and me and now we're paying him
[6:30:42] we paid him over four years we paid him over 800,000 dollars plus we're fighting the litigation
[6:30:47] over what because he wrote an op-ed and he forgot to put that he was writing in his personal capacity
[6:30:54] I mean that's just crazy to me that
[6:30:57] 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.
[6:31:06] So that's the first thing.
[6:31:08] 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.
[6:31:23] And I mean, when he was confronted about it, I saw the video, you know, he said, I ordered
[6:31:32] this to happen.
[6:31:35] And then he retaliated against James Sibley for blowing the whistle on the skin.
[6:31:42] So we don't know.
[6:31:43] He's still doing it.
[6:31:44] We don't know.
[6:31:45] He retaliates against whistleblowers.
[6:31:47] He makes everybody scared, he even James Siddley said he has a culture of fear in that
[6:31:55] office, so we don't know what he's doing, so we really need to look closely because we
[6:32:02] can't have all this waste when we're having a deficit now, so thank you so much for your
[6:32:10] time.
[6:32:12] That concludes public comment.
[6:32:16] Thank you.
[6:32:17] So that's on, Burke.
[6:32:18] Yes.
[6:32:18] Thank you.
[6:32:20] Thank you, James, for walking us through the high levels of the report.
[6:32:25] And thank you to Supervisor Abba Koga for your partnership and for all of our colleagues for supporting this referral.
[6:32:33] 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.
[6:32:45] I appreciate administrations willingness to implement meaningful system changes, which will support our internal decision making process and increase public transparency.
[6:32:56] 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,
[6:33:07] which were to implement first short term improvements, which will enable greater transparency during the upcoming budget cycle.
[6:33:14] And second, long-term system-based solutions which will enable more detailed budgeting and contract reporting.
[6:33:22] So I'll share my understanding of how the actions in this report move us closer to those outcomes.
[6:33:29] My bigger concern right now is regarding the short term improvements.
[6:33:34] This report indicates that administration will provide a breakdown of FY2425 object to spending.
[6:33:41] The original request, contrary to the original request, which specified providing that information in advance of the recommended budget,
[6:33:51] this report proposes providing that information to the board on May 1st in conjunction with the recommended budget.
[6:34:00] And while spending actual spending information from the most recent completed fiscal year provides a snapshot of what department budgets generally look like,
[6:34:09] 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.
[6:34:27] So I still maintain that we need the actual spending figures for 2425 information sooner.
[6:34:33] And we also need comparable information, even if it's only estimates, for the current fiscal year.
[6:34:40] 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,
[6:34:50] to contextualize the scale and impact of any reductions.
[6:34:54] 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.
[6:35:06] 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.
[6:35:23] I also think it would make sense to separate utility costs into a standalone category.
[6:35:29] I do look forward to hearing from my partner on this referral and the rest of our colleagues.
[6:35:35] So I'll end by offering a motion and then look for a second.
[6:35:40] I'll move receipt of the report with the following direction to administration.
[6:35:44] 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.
[6:35:59] Second, provide an approximate or estimated breakdown of FY2526, Object 2 spending, no later than May 1st, 2026.
[6:36:11] 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.
[6:36:30] And we'll look for a second.
[6:36:32] Thank you.
[6:36:35] Yes, I'm happy to second that motion.
[6:36:38] Thank you so much.
[6:36:39] Supervisor Elemberg for your leadership on this item.
[6:36:43] I do have a couple of other items.
[6:36:45] I would like for the consideration to add to the motion.
[6:36:49] But just again, thanks to staff for your work on this.
[6:36:54] I know it's not the most exciting topic,
[6:36:56] 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.
[6:37:15] I, you know, who said it many times, I take my few-to-share, I response very very seriously.
[6:37:21] And I really do want to understand the nuances of our budget, and I also want our community to be able to understand it.
[6:37:29] 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,
[6:37:36] 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.
[6:37:47] 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.
[6:38:02] I also want to request administration to create a, well, actually, I think I will hold off on the other requests.
[6:38:12] 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,
[6:38:25] So that they can communicate desire reporting capability to administration before it comes back in August and again
[6:38:33] That's we've received requests from community leaders that they're interested in it
[6:38:38] So if we could get that
[6:38:40] Do our offices sooner
[6:38:42] We can also get some community feedback on that
[6:38:46] Before sorry just before I accept that it sounds it sounds fine. I just want to check that the timing will does that
[6:38:55] work to do it before August?
[6:38:59] I'll look to key about whether you can
[6:39:03] think you can demonstrate the contracting system
[6:39:07] in the August timeframe.
[6:39:17] Thank you.
[6:39:18] We can certainly provide to the Board offices
[6:39:21] the report templates
[6:39:24] and how to utilize the dashboards,
[6:39:27] which are publicly available.
[6:39:30] And then through those conversations,
[6:39:31] as we can, if there are additional requests
[6:39:34] that we can sort of take that under advisement.
[6:39:37] I might suggest, I think, the most productive approach
[6:39:41] might be to have procurement staff meet individually
[6:39:44] with each board office, and walk through it.
[6:39:47] Instead of trying to do some demonstration here
[6:39:49] and chambers, which I just think, well, take a lot of time
[6:39:52] and not be as productive.
[6:39:54] Yes, you did mean individually, right?
[6:39:56] Yes, so we're off for the each of our offices to have that.
[6:40:00] 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.
[6:40:14] 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.
[6:40:25] This is all set.
[6:40:26] Yes.
[6:40:29] Yeah.
[6:40:30] Understood.
[6:40:31] Okay.
[6:40:31] Thank you.
[6:40:33] And the last item was, if we could receive the department budget proposals in early
[6:40:39] March, so that we can be better prepared for the committee discussions that will
[6:40:44] be happening in April.
[6:40:46] And I know that might move up the county executive timeline.
[6:40:50] Yeah.
[6:40:51] That poses some really serious challenges for us.
[6:40:54] So, as you can imagine, we have, there's lots of departments,
[6:41:03] we receive, we're supposed
[6:41:04] to receive their proposals at the beginning of February, and we spend the month of February,
[6:41:10] and it consumes a huge portion of the month, meeting with departments to go through
[6:41:16] those, and then they come to the committees in April.
[6:41:22] We can endeavor to get those two board offices as early as possible,
[6:41:30] but I do need an opportunity
[6:41:33] to actually be able to review those proposals before they just show up on a public forum.
[6:41:40] So we will work to get them out early, but I don't think early marches likely feasible,
[6:41:48] but hear the requests to get them get them out as soon as possible.
[6:41:52] Would two weeks prior to the committee meetings be reasonable?
[6:41:59] Probably for several of the committees.
[6:42:02] I don't have in front of me the committee schedule for April,
[6:42:06] but we'll endeavor to do that.
[6:42:09] Okay. We just need time too, as well, to look at the information.
[6:42:16] Absolutely. And just to add something, this is something we say, no matter how many times
[6:42:20] I say this and how many employee forums, I 100% guarantee not every departmental proposal will
[6:42:29] make it in the recommended budget. And there will be proposals in the recommended budget that
[6:42:33] we're not made by departments. And so I will keep repeating that caveat too because sometimes
[6:42:40] people get extremely worked up about departmental proposals that may or may not.
[6:42:45] in their certainly in their full form or even in a modified form and making sense.
[6:42:51] And we also have to look at how departmental proposals interact with each other, sometimes
[6:42:56] departments propose things that affect other departments as well.
[6:43:01] So we'll continue to reiterate all those caveats, but yes, we will endeavor very hard
[6:43:09] to have them two weeks in advance of the committee rights.
[6:43:14] I appreciate that and I hope you understand it. Again, it's our attempt to understand
[6:43:22] as much of that detail too. I know that's your job counting executives, but I do think
[6:43:28] it's important for us as supervisors to also understand what the requests are, what
[6:43:34] the trade-offs are, making sure that they're aligned with the board's priorities. We just
[6:43:41] as much time as we can have as long as it goes through the voluminous budget that we have.
[6:43:48] So, yes, if you can endeavor to do two-weeks prior to our committee meeting, so I'll be great.
[6:43:53] Absolutely. So, this is where the two items have been announced.
[6:43:56] It sounds like the second one isn't a friendly amendment unless we describe it as best efforts.
[6:44:04] That's right. That's right. Happy to do that, the great. Thank you.
[6:44:07] Okay, motions, I can get the question.
[6:44:10] Spadium, and I think, yeah, yeah.
[6:44:12] Thank you, spoiler, I will be supporting support of the motion.
[6:44:17] But I do have some questions, well, really.
[6:44:21] James, and key, thank you.
[6:44:23] Thank you for the report.
[6:44:25] I remember in prior years as middle management,
[6:44:28] that staff was able to had some autonomy
[6:44:32] making decisions about their overall object to budget
[6:44:35] to prioritize reductions.
[6:44:36] I remember being asked to do that when I ran my own program, where would I need object 2 funds,
[6:44:42] how much of it, or what balance of object 1 and object 2 I was able to give up.
[6:44:46] So, but essentially, do you foresee any changes to that approach given the new reporting capabilities
[6:44:51] by these four subcategories?
[6:44:53] Will staff still have some autonomy or program managers have a autonomy to be able to declare
[6:44:58] where an object 2.
[6:45:00] 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.
[6:45:11] So departments have discretion on allocation within the object and that will remain the case. That's the legal level of appropriations.
[6:45:24] The information that's being requested is as I understand it and effort to understand how
[6:45:30] departments are intending to utilize those budgets, but there will be no legal change in
[6:45:35] the appropriation.
[6:45:36] So object 2 is one big category.
[6:45:39] Object 1 is as well, and as are the other objects, we don't talk about there's several other
[6:45:45] objects as well.
[6:45:45] We don't talk about them because they're not as relevant to the day-to-day operation
[6:45:49] and programming, but there's fixed assets and debt service and so forth, but Object One is
[6:45:58] staff costs and Object Two services and supplies, and the board's formal approval of the
[6:46:04] budget specifies for each budget unit and each fund, the appropriation at the object level and
[6:46:11] for other than that.
[6:46:14] Thank you, James, for that assurance, and to key, I just want to say I'm really looking
[6:46:20] forward to the budget software rollout.
[6:46:22] We often do ribbon cuttings for new buildings and new new parks and things.
[6:46:28] I don't think I've ever written a ribbon cutting for a new software rollout, but just don't
[6:46:32] say that's how monumental this is to be able to give us, I mean, I'm especially looking
[6:46:36] for these systems of grades for contracting and I'm especially looking forward to being
[6:46:40] able to the, the quote, run real time reports with apples to apples comparisons of spending
[6:46:45] by category and contract across all parts of the organization. I think Cindy used to call
[6:46:50] that the book of business. And I know Joe had always made similar requests for that level
[6:46:56] of analysis and understanding of our budget. So thank you, Tiki. Thank you for your efforts
[6:47:01] on this.
[6:47:03] We're very excited about that.
[6:47:05] The procurement piece of it is something that I've been wanting for many, many, many years
[6:47:11] going back to when I was first at Deputy Kenny Council in the county and had to work on
[6:47:18] a little discovery related project from the Attorney General's Office wanting a Norse spending
[6:47:23] on certain categories of equipment and I had to go from department to department to
[6:47:29] Manually gather that information so this is long time coming. Oh, yeah, maybe we you know what with that
[6:47:36] 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
[6:47:44] Transparent right transparency
[6:47:47] Can you are looking in that direction am I thinking the wrong person
[6:47:55] Thank you, Azika, Peytoni, thank you, all right, so all my shoutouts to you and appreciation.
[6:48:04] 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.
[6:48:10] Thank you.
[6:48:13] Yes, I think I'm just missing.
[6:48:14] This is motion by Syvizer, Alan Burke, and seconded by Syvizer Abbey Koga.
[6:48:20] Syvizer, I thought you said you will not be supporting this motion.
[6:48:23] Is that what you said? Oh no, sorry.
[6:48:24] I said spoiler alert. I will support this motion by just had questions.
[6:48:28] Okay.
[6:48:28] One of you put everybody at ease.
[6:48:30] Okay.
[6:48:31] I'll be more clear next time.
[6:48:33] President, thank you.
[6:48:35] Thank you.
[6:48:36] Let's leave the day.
[6:48:37] So, all right.
[6:48:38] No, thank you so much again for bringing up this referral.
[6:48:41] I think this will help, I guess, transparency
[6:48:43] and getting the public, you know what we do every day.
[6:48:46] Sometimes it's hard to read up much it,
[6:48:48] but I just want to thank staff for the additional
[6:48:50] air fresher put in to make this clearer for everybody.
[6:48:53] So, not for you to do less tick to vote.
[6:48:55] We have a motion by Supervisor Elmber.
[6:48:57] You're in a second by Supervisor Abacoga.
[6:48:59] Supervisor Abacoga?
[6:49:00] I, Supervisor You.
[6:49:02] Yes.
[6:49:03] Supervisor Elmber?
[6:49:04] And presently.
[6:49:05] I as well.
[6:49:05] Thank you.
[6:49:06] Thank you.
[6:49:08] All right.
[6:49:09] And next, we are moving to item 17,
[6:49:13] relating to the 2025 measure A in the penance
[6:49:16] citizens, oversight committee,
[6:49:19] James, that's your lights on to hit.
[6:49:22] Yes, so good afternoon.
[6:49:23] This item is part of us fulfilling our promises
[6:49:28] associated with the successful passage of 2025 measure A.
[6:49:34] Building on this county's incredibly successful model,
[6:49:38] working off of the 2016 housing bond, the 2025 measure A ordinance,
[6:49:47] included similar language, that there would be an oversight
[6:49:51] to process to audit the spending of the proceeds from 2025 measure A.
[6:50:00] I want to be really clear about what this isn't.
[6:50:03] It is not an advisory committee regarding spending plans.
[6:50:08] It's not to determine how the funding is allocated.
[6:50:13] Those are decisions consistent with the discussion we just had in the last item.
[6:50:17] Those are decisions that are lawfully made by the Board of Supervisors as part of the annual budget process.
[6:50:25] The purpose of this committee consistent with the 2016 housing bond oversight committee
[6:50:31] 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.
[6:50:48] Administration is recommending using the Successful 2016 Measure A over-site committee structure.
[6:50:55] That structure has been praised in numerous forums, including by the civil grand jury and many others.
[6:51:02] For its success in auditing and verifying the spending of those 2016 housing bond proceeds,
[6:51:09] our recommendation is to basically adapt to that same structure and format for the purpose of this 2020
[6:51:17] And with that, we're happy to answer questions.
[6:51:22] Thank you, James.
[6:51:23] Yes, anybody in public would like to speak on this item?
[6:51:26] We do have speakers for this item.
[6:51:28] I have one speaker in chambers, and it appears to be one moment
[6:51:34] about five speakers on Zoom.
[6:51:37] One, two, five in Sims.
[6:51:38] Okay.
[6:51:38] There's six in top.
[6:51:40] Okay, there's the one in each.
[6:51:42] Okay.
[6:51:42] Our first speaker in chambers is Emily Korin.
[6:51:45] And Apology said, one minute or two minutes?
[6:51:53] Please.
[6:51:54] Oh, actually, please go to the podium because there's a building
[6:51:57] Mike, yes, exactly.
[6:51:59] And we'll start talking.
[6:52:02] Hi.
[6:52:03] I'm Emily Korin, the Director of Governance and Advocacy at the Santa Clara County Medical Association.
[6:52:09] We represent over 4,800 physicians in Santa Clara County.
[6:52:13] The Association recommends that you include Dr. Carol Somersel in the Measure A Citizens
[6:52:19] Oversight Committee.
[6:52:20] She is an OBGYN and SCCMA Council member and was recently re-elected as a member of the
[6:52:26] El Camino Health Care District Board of Directors.
[6:52:29] Thank you for your consideration.
[6:52:30] Thank you.
[6:52:33] Moving on to our Zoom speakers.
[6:52:34] Our first speaker is Parent.
[6:52:36] Parent.
[6:52:37] You will have one minute.
[6:52:46] Parent.
[6:52:46] Your mic is open?
[6:52:51] Yes.
[6:52:52] I just wanted to make sure that we didn't give any measure A funds to this attorney Jeff Rosen.
[6:52:57] I know you guys say you guys determined that, but I want to make sure that we relay that to this oversight committee.
[6:53:05] I know he's been asking for measure A funds and he turned to investigate you guys.
[6:53:11] 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.
[6:53:22] and by incentivizing assaults against parents who don't want their kids rape.
[6:53:30] Measure A funds should go to hospitals and to healthcare, not the sex trafficking children.
[6:53:37] I posted an information online. If you guys want to see it, if you Google D.A.
[6:53:40] Jeff Rosen petitioned sex trafficking, all those terms together within the top three results.
[6:53:46] You'll see exactly what I'm talking about. Please like, share this committee.
[6:53:49] It doesn't give any money to Jeff Rose, thank you so much for your time.
[6:53:53] Our next speaker is Joe Caffaro, Joe you'll have one minute.
[6:54:00] Good afternoon, Joe Caffaro, the hospital council.
[6:54:04] I would like to thank you for a leadership in establishing an independent citizen over
[6:54:08] psych committee and for your continued commitment to transparency and accountability.
[6:54:13] Measure A was placed on the ballot and direct response to a fiscal emergency created by
[6:54:18] term one. Those approved this measure with a clear expectation of these funds would assist in mitigating
[6:54:24] the reduction of healthcare access and safety net services. We respectfully ask the Board to
[6:54:30] consider adding a designated hospital council seat to the proposed OPEC committee membership for
[6:54:36] from an executive to chosen by the hospital council objectives Santa Clara County. Thank you.
[6:54:46] Our next speaker is Vaughan Villeverde. Vaughan, you will have one minute.
[6:54:52] Good afternoon, members of the Board. My name is Vaughan Villeverde, director of advocacy and
[6:54:56] co-chair of the health equity work group of the real coalition. I'm speaking today in support
[6:55:01] of the administration's recommendation to establish a independent oversight committee for the 2025
[6:55:07] measure a sales tax measure and we agree that an oversight body is key to ensure accountability
[6:55:11] and that revenue is that legally and it weighs that aligned with the promise made to voters during the campaign.
[6:55:18] 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.
[6:55:31] 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
[6:55:41] 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
[6:55:51] Our next speaker is Carmen Martinez, Carmen you have one minute
[6:55:57] Good afternoon, Board of Directors, my name is Garmin and I'm the Director of Organizing
[6:56:02] with Leadinghouse Contraganet.
[6:56:03] Thank you for your leadership throughout Measure A campaign for the commitment of safeguarding
[6:56:07] the life-serving services provided by our county health and hospital system.
[6:56:11] Measure A pass because Boarders understood the industry of protecting such a care, particularly
[6:56:16] for us to serve the under-resource communities for our already bearing the front of shifting
[6:56:20] federal and safe funding.
[6:56:21] As we move into the implementation, I hope that you continue and that this spirit of partnership
[6:56:26] transparency and community engagement. First, the committee should reflect the values and
[6:56:30] the test that guided the measure a campaign and the line with voter expectations.
[6:56:34] Rather, as keeping it as a narrow legal compliance body, we urge the board to empower
[6:56:38] the committee as a recommended bottom body. One capable of advising how funds should most
[6:56:43] effectively meet the community's health needs. Second, the committee must reflect a full diversity
[6:56:49] of our county, especially those impacted by health inequities. I encourage you to include representation
[6:56:54] to every community, community clinics,
[6:56:56] and on-profit organizations,
[6:56:57] but I'm a bodice to hear her help, experts.
[6:57:00] And that concludes public comment.
[6:57:03] All right, thank you very much.
[6:57:06] I do want to add just one other comment I meant to make earlier,
[6:57:11] which is of course the,
[6:57:13] the item in front of the board just now is the structure.
[6:57:16] Who is specifically nominated to the different seats
[6:57:19] would be up to individual board members.
[6:57:21] there's wide, wide discretion associated with many, many of the seats with representation
[6:57:28] from broad swaths of the community and so some of the comments that have been received
[6:57:34] both in writing and made today during public comment can easily be accounted for as individual
[6:57:40] board members bring forward specific nominees for different seats. I just wanted to distinguish
[6:57:45] that it is not in front of the board today to determine individuals who may sit in any seat.
[6:57:54] Thank you.
[6:57:55] I feel like I'd like to serve as you.
[6:57:58] Yes, thank you.
[6:58:00] So, James, I'm just going to repeat what I just heard you say.
[6:58:04] So, for clarification, today's vote does not appoint anyone to the oversight committee.
[6:58:10] That's correct.
[6:58:10] We're seeking input on the structure, and then once the committee is actually formed,
[6:58:14] If the board adapts these recommendations consistent with the 2016 structure, then individual board members will bring forward nominations to the different seats.
[6:58:24] Just as you normally do for all of the other bodies that the board appoints individuals to.
[6:58:32] 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.
[6:58:44] 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.
[6:58:58] 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.
[6:59:07] 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
[6:59:19] Strenuous and Dave and Cindy continued forward on words with that model, which has since then received
[6:59:26] praise them, silver grandjuries, awards from other auditors, for out-odding themselves, like
[6:59:32] just simply has set a new standard.
[6:59:34] Yes, it's been really successful, and it's worked well, and we have high confidence in
[6:59:41] that structure.
[6:59:42] Yeah, and what I remember about this structure, too, is that the allocation or the decision-making
[6:59:46] process of how the funds will be used, risk with the body on this day is, and that the
[6:59:52] that can make sure that then the operational steps that follows, that the money is allocated.
[7:00:00] 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.
[7:00:07] 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,
[7:00:26] my.
[7:00:29] answers you have my full commitment that I will be informed by your feedback to make sure that
[7:00:36] I pass a vote that is in line with our needs and our desires and hopes and wishes for
[7:00:41] securing medical access and quality care for everyone and that the oversight committee
[7:00:45] based on this composition will watch us like a hop to make sure that every dollar is spent exactly the way this board
[7:00:52] has voted.
[7:00:52] That's correct.
[7:00:54] Great.
[7:00:54] And then one specific question,
[7:01:00] could you tell me, I'm curious to the specific, the level
[7:01:06] of specificity in terms of the recommendation for a dedicated seat to a current or former
[7:01:14] physician, some would say that that's a narrow take on healthcare expertise, also considering
[7:01:21] the conversations we've had today about community health workers, culture competency, and the
[7:01:27] broad range of care that can show up in community. And you know what we found, what I
[7:01:33] found as a board member when it comes to appointing commissioners, sometimes narrow, narrowly
[7:01:38] tailored qualifications can make it challenging to find candidates. I would just love to hear
[7:01:44] more about your rationale behind that category.
[7:01:46] We swapped out the seat that was on the 2016 committee, the reserve for an attorney.
[7:01:53] How many specifics do we swap, we swapped the attorney for physician like I said we just
[7:01:58] tried to adapt the 2016 structure. Obviously opened any input from the board but that was what we did
[7:02:05] as we swapped the attorney with physician. And then other seats on this board would be able to reflect
[7:02:10] to broaden our definitions of health and community health.
[7:02:13] Absolutely, civic organization, labor, business, general public, of course, could be anybody.
[7:02:21] And healthcare advocate would encompass, I think anyone interested in advocacy related to healthcare very broadly.
[7:02:29] 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
[7:02:39] on the 2016 bond measure committee, and then, like I said, the attorney was replaced with
[7:02:46] physician.
[7:02:47] Yeah, well, that's by the auditor's love us for those vaccinations.
[7:02:51] So I made to receive through port and direct statutory port back with an ordinance to establish
[7:02:56] the 2025 measure aid independence that is in oversight committee, as I recommend the staff
[7:03:01] and them accompanying the SIGGenda item, and I just want to say I love, I know this is a
[7:03:07] different measure A, but still loving that 2016 measure A has some some presence and influence
[7:03:13] in in this application.
[7:03:16] Yes, President.
[7:03:17] Thank you.
[7:03:18] I'm happy to second the motion.
[7:03:20] I just had one very more specific question, so we will each of us supervisor will point
[7:03:27] when will we be assigned these categories to set?
[7:03:30] Yes, so the way of the process works is the clerk of the board will believe it's a random
[7:03:35] assignment.
[7:03:36] to the individual offices to bring forward nominees and of course the board has to as a whole
[7:03:41] approve those nominations for appointment but they do have a random I think it's a randomized
[7:03:46] process and then it moves from office to office in rotation order. Is it a yearly rotation or will there be
[7:04:06] 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.
[7:04:19] It will all be spelled out in the ordinance that before the board.
[7:04:24] 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.
[7:04:34] Okay, great.
[7:04:35] Thank you.
[7:04:38] So that's the little number.
[7:04:40] Thank you.
[7:04:41] Supervisor Yang, I really was hearing your comment about the first category and while
[7:04:49] really only lawyers or lawyers, I do feel that this category first one could be broadened
[7:04:57] to include a professional health care provider.
[7:05:03] Does that defeat the purpose?
[7:05:06] of objections, that would include nurses and not sure who else would fall into that category
[7:05:12] of professional healthcare provider.
[7:05:14] But regulations assistance, yeah, yeah, peace.
[7:05:17] Yeah, I think that would be totally fine.
[7:05:19] Okay.
[7:05:20] Then I would like to add that friendly amendment to be a broader healthcare provider category.
[7:05:27] Oh, I think that's a great amendment to the motion.
[7:05:30] We have to have that.
[7:05:31] Oh, I'm sorry to interrupt.
[7:05:32] What the, yeah. So, branding the physicians or the doctor, medical doctor, physician
[7:05:38] category, to be healthcare provider, professional provider. I'm distinguishing it still from
[7:05:44] number three, which is a healthcare advocate, which of course could also be a provider, but
[7:05:48] doesn't need to be. I think that gives us the flexibility that I think we'll do good. That
[7:05:54] will do this over-set committee good. So, I'm happy to accept that friendly amendment. I look
[7:05:58] to my seconder?
[7:06:00] Could I just clarify, do you mean to import current or retired?
[7:06:05] Yes, please.
[7:06:06] Okay.
[7:06:06] Sure.
[7:06:07] Thank you.
[7:06:08] Keep it broad.
[7:06:11] Okay.
[7:06:12] So first of all, thank you so much for this report and I really think this is why so
[7:06:16] we've built on the success from the previous measure A and experience and many counties
[7:06:21] are really following what we're doing.
[7:06:23] I do a one potential comment or friendly amendment to consider for the maker.
[7:06:32] As we were looking at how this funds is being used in this oversight,
[7:06:36] I only want to make sure that our custody healthcare system is being put in mind.
[7:06:41] The healthcare teams now jails are so integral part of our community,
[7:06:46] and will not be immune to these budget cuts, and we need to ensure that they are not undervaluing
[7:06:50] to make these budgetary decisions. So for these reasons, I'm trying to see if there's
[7:06:55] any way we could incorporate one of the recommendations to look for folks who have
[7:07:01] expertise in Stessie Health on the self-alpsi committee to make sure that the spending
[7:07:05] on this area is also a review of appropriate context on understanding.
[7:07:10] I'm sorry, what was the last part of the project?
[7:07:11] Oh, trying to find somebody that has some expertise in custody health on this
[7:07:16] I also like committee to ensure that the spending of the area is reviewed with appropriate
[7:07:21] context, understanding.
[7:07:24] President Lee, I really appreciate the focus on our Encussive Health Care Services.
[7:07:31] That's something that's often overlooked in the Grand Landscape of Policy Decision Making.
[7:07:35] I do feel that at this point where we've landed with the structure of the committee will
[7:07:41] allow us the board flexibility in being able to
[7:07:44] to appoint someone with that expertise.
[7:07:47] At the end of the day, we're going to appoint,
[7:07:48] and I feel like the categories give us that space.
[7:07:51] I want flexibility, but I certainly want to keep that in mind.
[7:07:54] And it's important consideration for us and look at this all.
[7:07:57] Thank you, President.
[7:07:58] I really appreciate your thoughtfulness.
[7:07:59] Thank you.
[7:08:00] Certainly falls into the category of a professional health care provider.
[7:08:03] Thank you.
[7:08:03] And I have a good idea.
[7:08:05] Thank you.
[7:08:07] All right.
[7:08:08] Okay, do you think I'll change? No. Okay, and we have spoken by the public. We have our motion.
[7:08:15] We have a second. There's no further comments. Let's take a look.
[7:08:19] Um, we have a motion by super as a young. And a second by super as a ribocoke.
[7:08:23] Um, super as a ribocoke? I, super as a young? Yes.
[7:08:27] Super as a limber? Yes. And presently. I as well. Thank you. That's four and a message.
[7:08:33] Thank you. Now we move to consider items previously removed from the
[7:08:38] and down there I believe we only have one item today, which is item 56 considered recommendations
[7:08:45] really leading to the surveillance use policy for the automated license plate readers,
[7:08:52] ALPR for the City of Sertoga, the City of Cortino and the town of Los Alto's Hills.
[7:08:58] And we have Sheriff Shonson. Good afternoon. Thanks for being so patient with us.
[7:09:04] 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.
[7:09:13] 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.
[7:09:22] We all have to report.
[7:09:25] It looks like now and this consensus that now needs a presentation.
[7:09:30] I think we're great.
[7:09:31] So let's see.
[7:09:32] Should we check to see how many in the public would like to speak on the sidemps?
[7:09:36] We currently have four speakers in chambers and one moment for the zoom.
[7:09:41] We have two speakers on zoom.
[7:09:44] So for a total of six.
[7:09:45] Six.
[7:09:46] List of two minutes each.
[7:09:48] Our first speakers are Victor Vasquez.
[7:09:52] J.P. Connolly, Missairu, Mendoza, and Jeremy Burroughs.
[7:10:00] Please make your way to the podium.
[7:10:08] Hello President of the Board and Supervisors of the Commission.
[7:10:11] The Clara Minimum is measuring, and I'm here with Amigos de Guadalupe,
[7:10:14] and I tend to urge the Board of Supervisors to reject the P,
[7:10:20] which is the approval of surveillance policy for our environmental license plates.
[7:10:24] License plate readers raise a massive privacy concerns regarding our data Jews store and share
[7:10:30] These databases give a governmental agencies more control and tools to surveil are
[7:10:37] In harm our immigrant communities and our communities of colors
[7:10:41] This has been documented instances in which the data collected by license place had been shared with federal agencies like ice and
[7:10:50] violation of a state law and policies.
[7:10:53] Flag cells, the I-Cloud connected cameras to police departments
[7:10:57] and private customers across the nation's put license plates,
[7:11:02] readings that they collect into their own servers
[7:11:05] and allow police to do nationwide searches
[7:11:09] for a resultant from the database.
[7:11:12] Sorry, records revealed that many of the searches
[7:11:16] What carry out by local officers and behalf of ICE for immigration purposes, including the notorious
[7:11:23] enforcement and removal operation division. I urge you to take a stand today and reject
[7:11:30] number B and item 56. Thank you for your attention.
[7:11:39] Thank you, Vaskas. Overall, automated license plate readers track where people drive,
[7:11:45] when they travel, who and who they associate, this surveillance happens continuously,
[7:11:49] would I individual suspicion and would ought to warrant?
[7:11:52] This is a concern for privacy and or civil liberties for amendments.
[7:11:56] Specifically, the user-floc safety makes these concerns even more
[7:12:00] students since there's documented history of them working with in-supportive
[7:12:04] eyes operations despite local and state-century policies that are put in place.
[7:12:09] Public records request including in Colorado and California,
[7:12:13] show these instances happening in their activity and working closely with eyes.
[7:12:16] This is not hypothetical. It's already happening. So our cities and counties can pass
[7:12:21] century policies, but those policies are meaningless unless we cut ties with companies,
[7:12:27] systems, and contracts that are used against us and work for ICE. In practice, when we don't cut
[7:12:35] these ties, we are in fact working with them and going against our policies, our values, and what
[7:12:41] we say, and what we value in terms of public safety for our undocumented community, but all of
[7:12:46] as who are being recorded.
[7:12:49] This kind of data collection definitely impacts immigrant communities,
[7:12:54] but it does not stop there.
[7:12:56] Once mass surveillance systems are normalized,
[7:12:58] everyone is subject to tracking, profiling, and misuse.
[7:13:02] I urge this board to cut the ties with any flawed system
[7:13:05] or affiliate system with them and establish a stronger,
[7:13:09] more enforceable protections that prohibit data sharing
[7:13:11] with federal immigration authorities.
[7:13:14] Senate clear, County must take, again, real actions to protect civil rights, public safety, and community trust.
[7:13:22] Thank you.
[7:13:27] Good afternoon.
[7:13:28] President Lee and rest of the Board of Supervisors, Jeremy Bruce, with Amigos De Guadalupe,
[7:13:33] Center for Justice and Empowerment, and we're a part of I-PIN.
[7:13:36] For decades, Senate clear, County has been a beacon for immigrant rights, and especially
[7:13:41] in today's political climate at a time where immigrants are under relentless attack.
[7:13:45] We need bold and courageous leaders to stand up and reject policies that prove harmful or for our most vulnerable neighbors.
[7:13:54] License plate readers raise huge privacy issues regarding how our data is used and shared.
[7:14:01] These databases give our governmental agencies more opportunities to surveil and harm our immigrant communities.
[7:14:08] There have been documented instances in which the data collected by license plates have been shared with federal agencies.
[7:14:15] like ICE, in violation of state laws and policies.
[7:14:19] Our communities should be able to drive and walk along our streets without worrying how their
[7:14:24] information will be used or shared.
[7:14:27] So we asked the Board to take a stand today and say no to flop or automated license plate
[7:14:33] free to civilians in our county.
[7:14:36] Thank you.
[7:14:40] Good afternoon.
[7:14:41] Supervisors.
[7:14:42] My name is Ronald Paolo with Silicon Valley Rising and I think as other speakers have already
[7:14:47] spoken today. I'd like to urge you before adopting any license by reader policy to take
[7:14:54] a careful look at the implications of this vote.
[7:14:57] Flock the company that powers
[7:15:00] This automated license plate readers is not neutral technology. This is technology that makes information
[7:15:06] about the lives and activities of Santa Clara County residents directly available, not only to the federal
[7:15:13] agencies that have shown such a profound lawlessness of late and a disregard for local community,
[7:15:18] but also this information is potentially available to a range of private actors. Look carefully
[7:15:25] at the fine print, who owns the data, who can access the data, who can sell the data,
[7:15:31] how long is that data stored, where does that data live?
[7:15:35] Because the failed to do this level of due diligence is to hand surveillance machine directly
[7:15:40] into the hands of ice and other private actors.
[7:15:43] To fail to ask these questions and get very clear on the front end, it's to continue with
[7:15:47] the policy that potentially undermines the substance of our sanctuary policies.
[7:15:51] In Texas, Flock cameras were used to track and surveil women who were seeking reproductive
[7:15:55] health care.
[7:15:56] Flock has a long track record of this kind of collaboration.
[7:16:00] Major investors in Flock include Peter Teal and Mark Anderson, two outspoken opponents
[7:16:05] of many of the humanistic and democratic values of this county espouses.
[7:16:10] Flock, along with Palantir, another Peter Teal company, are part of a surveillance ecosystem
[7:16:15] that is gathering and centralizing ever more information to all Americans.
[7:16:19] This is concerning stuff, and so I urge this board to take this vote very seriously before
[7:16:24] moving forward and consider the implications of our community.
[7:16:27] Thank you so much.
[7:16:30] Moving to our Zoom speakers.
[7:16:31] Our first speaker is Kimberly Wu.
[7:16:34] Kimberly, you'll have two minutes.
[7:16:40] This is for advisors.
[7:16:42] I'm Kimberly Wu, and I'm a community organizer from Cypher.
[7:16:45] I'm also a number five.
[7:16:47] On behalf of Cypher, I strongly oppose Sanitano County Sheriff's
[7:16:50] new contract plot, and I urge to end our county's contract
[7:16:54] of plot through a post of dangerous surveillance tools
[7:16:56] that can be accessed by ICE to terrorize communities
[7:16:59] and separate our families.
[7:17:01] The power plots, ALPRs, to plot the retain and analyze
[7:17:06] location data for every driver on the road,
[7:17:09] violates a fourth amendment, might try to see.
[7:17:12] By centrally enabling masks, we're less tracking
[7:17:15] that stocks and individual movements
[7:17:16] in a twisted form of persistent judgment to them.
[7:17:19] And that's the technology creates such massive data privacy constitutional violations
[7:17:24] that sign a world with care health on you, ACLU, a newly found community, electronic
[7:17:30] funding, financial fund nation, see what the city of San Jose was in stream in basings.
[7:17:36] San Jose's unweighed cameras automatically retain the locations of drivers to find tire
[7:17:41] of you.
[7:17:41] And they were in the San Jose police to instantly, we could shut up places where we would
[7:17:45] throughout the city do not tire a time.
[7:17:47] There is no evidence that licensed plate readers
[7:17:50] meaningfully reduced crime.
[7:17:52] In fact, they actually create a dangerous, unsafe accident,
[7:17:56] because harms the privacy of well-documented women.
[7:17:59] The records will be all that many data searches
[7:18:01] will carry it out by local officers
[7:18:03] on behalf of ICE for immigration purposes,
[7:18:06] including in the choice enforcement
[7:18:08] and removal operations decisions
[7:18:10] to separate our families and debilitate our community.
[7:18:14] Our communities, our people should be able to drive
[7:18:16] to drop this kids off school,
[7:18:19] drive to a ton of medical appointments and drive to work,
[7:18:21] that worrying how the information will be used,
[7:18:24] stored, and shared.
[7:18:26] But that's an increased immigration force
[7:18:28] that comes to Super Bowl, and a very unsanified county.
[7:18:30] We're calling unsanified county leadership
[7:18:32] to stop these influx families and show no county data
[7:18:36] as shared directly or into actual supplies.
[7:18:38] This is how it's attached to our immigrant communities.
[7:18:41] Thank you.
[7:18:42] Our next speaker is who you trim,
[7:18:44] who you have two minutes?
[7:18:45] Good afternoon, Supervisors, this is Sweet Tran, Con from Siren.
[7:18:53] I'll make my comments focused and brief here.
[7:18:57] I'll disclose to you right off the bat.
[7:18:58] We currently actually do have a lawsuit,
[7:19:01] where we're represented by EFF and ACLU to challenge
[7:19:05] the open access to data collected by block systems
[7:19:09] through law enforcement.
[7:19:12] A reason for doing that is because we recognize that
[7:19:15] everybody wants public safety and people want traffic, you know, road safety and all of that.
[7:19:21] But this is a very dangerous tool to create. What we're doing is creating a system where
[7:19:26] everybody's movements can be tracked 24 hours a day, seven days a week in this data stays in place.
[7:19:32] And the thing is what we call in the here about our concerns about flock is, hey, you know,
[7:19:37] we have rules in place, we have a voter pause in place to make sure that this doesn't get into the
[7:19:45] surveillance tool is that faith in that and trust in that deep ends on who is in power
[7:19:50] and whether or not that system is going to stay strong or stay firm in protecting residents
[7:19:57] when those kind of power dynamics change. We're seeing that at the federal level. So a lot of
[7:20:03] here in concerns exist with mass data systems because all of this information is being put into place
[7:20:09] 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,
[7:20:21] we have to be incredibly careful about any expanded use of a mass data gathering system.
[7:20:27] So we do encourage you to oppose this.
[7:20:30] The demand that we have in our lawsuit is to ensure that any access to data gathered by cloth,
[7:20:36] require that law enforcement get a warrant first that is that one additional
[7:20:41] step to get it and of course I don't want to put that as a reason to support this
[7:20:45] but it is an additional concern that we have to make sure we'll be further
[7:20:50] berserker and that concludes public comment thank you very much for the speakers yes
[7:20:57] supervisor Alanberg I have things to say but you pulled it so I'm happy to refer to you
[7:21:05] All right. Thank you. Thank you.
[7:21:07] We were trying to be polite. Like you go first.
[7:21:10] Now you go first.
[7:21:11] We all have things to say.
[7:21:14] Chair of Chonson. Can I ask?
[7:21:15] Do we currently the county or I guess this question is both for you and for our administration?
[7:21:20] Does the county of Santa Clara currently have any contracts with flock?
[7:21:24] We do not.
[7:21:25] Do not.
[7:21:26] And today's recommended action is to approve a surveillance use policy for
[7:21:30] the cities of Saratoga, Cupertino, and TenoLas Altas for their automated license plate
[7:21:35] reader.
[7:21:35] That is correct.
[7:21:36] Are those?
[7:21:37] Or will this result and then having a contract with lock?
[7:21:41] Well, each of them do have a contract with lock.
[7:21:44] They are the purchasers of this equipment, so they contract independently with lock.
[7:21:50] We, because we provide law enforcement services to those cities, we are the overseer of
[7:21:56] that automated license plate reader and the data and how it's used.
[7:22:02] Thank you, Sheriff.
[7:22:03] And the reason I ask, I just want to, I know this is a weird, like administrative
[7:22:09] bureaucratic path, windy road here, and just to clarify that no member of this administration
[7:22:16] has entered into a contract of flock or approved a contract of flock directly.
[7:22:21] That's true.
[7:22:22] And I just also, I want to thank all of our members of community who came up for public comment.
[7:22:29] Thank you for tracking our agendas and our consent items so carefully and thoroughly to be able to raise your concerns for us.
[7:22:37] And what the concerns I heard today are about this specific vendor that has been proven to be problematic
[7:22:42] in the National Landscape during a very tumultuous time.
[7:22:46] Presently, I'm just remembering, you know, back to once upon a time at the beginning of this meeting,
[7:22:52] that we opened with a moment of silence for the victims of ice violence,
[7:22:59] and what we're closing today with as concerns,
[7:23:02] more community members of continued exposure and harm coming from ice.
[7:23:08] vis-à-vis this flock vendor,
[7:23:13] so I of the three cities I also know that the town of Los
[7:23:16] Alto Cills used to have a contract with flock and they've since suspended that contract.
[7:23:23] And then I was also recently informed to that the city of Santa Cruz has also canceled
[7:23:30] their contract with flock.
[7:23:34] So I would like to make a motion today to defer this vote, but I understand that the
[7:23:43] policies in place is that was approved two years ago is sunsetting, right?
[7:23:48] That's correct.
[7:23:49] So I would make a motion for a one-month extension of the existing policy that was originally
[7:23:57] scheduled to send set for the City of Saratok and the Tana-Los Alto Hills into deferred
[7:24:03] today's recommended action, this vote to continue this conversation at the second meeting
[7:24:08] of February. The reason I'm asking for this deferred, is that during that time, my request is
[7:24:13] that the County Council's office and the administration work together to evaluate the issues
[7:24:19] with flock and give us an overview of the investigation and an overview of the basis for the contract
[7:24:26] cancellations that have occurred in Los Alta Cills, with Santa Cruz, and potentially any other
[7:24:33] jurisdictions that have recently canceled their contract with Flock.
[7:24:38] What I'm hearing from public comment and feedback, community feedback is that this cancellation
[7:24:43] is happening in response to a number of concerns over egregious data sharing contrary to policies.
[7:24:51] In other words, my request is so that my request is for, I understand what's going on with
[7:24:56] and so that we can have a more informed discussion when this comes back.
[7:25:01] And Tony, from your, from this analysis, please make public what you can for the portions of your analysis,
[7:25:10] that cannot be made public, please send those pieces to the full board and a confidential memo.
[7:25:16] Make sure that gives you more room to have this, the level of transparency that our community is requesting.
[7:25:22] Happy to do that, Supervisor.
[7:25:24] Okay.
[7:25:25] Second, your motion with an additional request for the report, and I will be transparent as
[7:25:32] well that I was prepared to abstain on this consistent with my past votes aside from the
[7:25:39] flock issue.
[7:25:41] So, I want to be clear that I wasn't looking for a different angle here, but what I would
[7:25:50] the report to include, whether it has to be confidential or not, is whether if the majority
[7:25:56] of the board were to vote to approve these contracts with the cities in the future, is
[7:26:05] it appropriate and enforceable for us to limit or prescribe what companies they can contract with?
[7:26:15] And I really want us to be cognizant here, that even if we are not the ones contracting,
[7:26:25] we're complicit.
[7:26:25] This is one degree of separation.
[7:26:29] And while I understand that these cities have, you know,
[7:26:32] I'm sure admirable intentions of this is how they believe they can increase traffic
[7:26:40] safety or other public safety, the methodology is problematic and particularly today, given
[7:26:49] what we are seeing and understanding how information is being used to weaponize and hunt
[7:26:56] people. I don't think this county should have any part of this kind of work, whether it's one,
[7:27:05] three degrees separated. So, supporting your motion today, but clear that my underlying vote
[7:27:11] would have been to abstain from up. Is that a second? That was a second in there. Yes.
[7:27:17] Okay. I just want to clarify the motion. You mentioned two of the three cities. I didn't
[7:27:21] mark here is a Cupertino. Well, the existing surveillance use policy with Cupertino
[7:27:28] Um, is uh, is not sunsetting is that right?
[7:27:34] Yes, that's correct.
[7:27:35] If you, um, uh, the vote to extend the sunset for Seratoga and Mosaltos Hills would allow for the
[7:27:44] Sheriff's Office to continue operating those systems during the extension.
[7:27:48] You don't need to make a similar extension as to Cooper China because that does not sunset until June
[7:27:54] 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
[7:28:04] Following more information about what's happening with flock. Does that sound okay? I mean date. Did that is that clear?
[7:28:11] 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
[7:28:17] Yeah, Sheriff Johnson is that clear?
[7:28:19] Yeah, that is clear and I would just like to say
[7:28:22] 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.
[7:28:42] But what I will say to this county is we are very good in making sure guardrails are in place.
[7:28:47] 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
[7:28:59] In fact, I would say we probably have one of the most restrictive policies regarding license plate readers
[7:29:06] definitely in the region if not the state, and I do think it's important that we may
[7:29:12] be informed the community of exactly what those policies are, as mentioned by one of
[7:29:18] the speakers, how long the data is stored, who we share the data with, because we don't
[7:29:23] share it, it's just that simple. The Santa Clara Sheriff's Office does not share data with
[7:29:28] any federal agencies, and we really don't share it with anybody other than ourselves. I think
[7:29:32] That's really important for the community to understand
[7:29:35] is how we're utilizing this data.
[7:29:37] It is not ever used for hunting individuals.
[7:29:41] It is not ever used for immigration purposes,
[7:29:45] because that's truly something very, very important
[7:29:48] to this community.
[7:29:49] And I understand that and I take that very seriously
[7:29:51] and I take responsibility for that.
[7:29:55] So again, I think this is something that needs to be looked at.
[7:29:59] So I appreciate that.
[7:30:00] 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.
[7:30:25] We're talking about community safety so again whether we agree with the vendor or not
[7:30:31] 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
[7:30:37] We can look at other options
[7:30:39] so
[7:30:40] Thank you
[7:30:42] Chef Johnson, thank you for for your words here. I I would go out on a limmer
[7:30:46] I know you said that we may have one of the most strictest use policies
[7:30:50] I'm gonna say we do have the strictest use policy. We have very intense guardrails
[7:30:55] Thanks to former supervisor Symedian, who really dedicated much of his career to ensuring the protection of data and safety.
[7:31:03] I think with all that, we're on the same page.
[7:31:06] I think what I'm hearing today is the concerns is that we may have a vendor that doesn't follow policy.
[7:31:12] 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.
[7:31:22] 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
[7:31:30] But my my intention today is not to
[7:31:36] It's it's not to chastise our surveillance use policy
[7:31:40] Like I said I think it's one of the strictest ones. No you said was one of the strict ones
[7:31:45] I think it's a strictest one period and protecting our residents privacy and data in in
[7:31:51] I would never want the use of public funds to go towards corporation that would
[7:31:58] 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
[7:32:06] Or information has been shared to see if their
[7:32:10] Policies were as strict as ours because again the only way that data can be shared is by the organization that holds a data
[7:32:17] which is us so
[7:32:19] The vendor can't even share the data unless we give them permission to share the data.
[7:32:24] Could I get clarification, Sheriff?
[7:32:26] Did the cities that have the contract not access the,
[7:32:30] not have access to the data?
[7:32:31] I trust our organization.
[7:32:33] Yeah, no.
[7:32:33] We are the ones that have access to it for investigations.
[7:32:37] So the cities don't have access for any purpose.
[7:32:41] No, I mean, I could clarify that, but I'm all 100%.
[7:32:43] 100% and I was just confirmed.
[7:32:45] But were the only ones that have access to the data?
[7:32:47] No reason to keep bringing this up. I think it's really important that the community understands it.
[7:32:52] Yes, there are things that may happen in other parts of this country, even in this state.
[7:32:57] But when it comes to Santa Clara Sheriff's Shents, Santa Clara County,
[7:33:00] we are not communicating or sharing our data period.
[7:33:04] Thank you for the clarification, Sheriff.
[7:33:07] I haven't ever had concerns about our operation or organization.
[7:33:11] And I know that you've stood with our immigrant communities since day one of a mutaking office.
[7:33:16] I would like to add a further request to my motion today that if Sheriff and your engagement with the
[7:33:24] cities of Cupertino in Sunnyvale, if you could prevent them with provide them with other options for other vendors.
[7:33:30] Yeah, you mentioned Sunnyvale just for record clarification.
[7:33:33] Oh, I'm sorry. Yes, sorry. Sunnyvale and Los Altos. Oh, but Los Altos has already canceled their contract with Flock.
[7:33:39] Yeah, but, and again, for fairness, I do think, you know, without having represented from Los Altos here.
[7:33:45] There were other reasons, I don't know if it was just because it was flocked.
[7:33:50] They had purchased numerous cameras over the years at a cost.
[7:33:55] And I think the budgetary constraints may have been a factor for that.
[7:33:58] But again, I'm not going to speak on their behalf.
[7:34:00] And I'm not trying to speak on their behalf either.
[7:34:02] Hence, my request for further investigation in analysis of actually what went down with
[7:34:07] these contracts, contract cancellations, and that are there other vendors besides flock out
[7:34:13] in the market?
[7:34:18] So during this one-monthing section, extension, as we're doing more research and providing more information to the board for an informed discussion,
[7:34:26] Sheriff, can I ask you to also share, provide with Los Altoes and Saratoga?
[7:34:34] Am I make up cities now?
[7:34:36] It's Saratoga, Los Altoes.
[7:34:38] I got it.
[7:34:43] I was just there last night and lost health to lost health.
[7:34:52] It's I'm spoiled by getting to be the only district inside one city.
[7:34:57] So if I could ask Sheriff that you provide them with other options for vendors as well.
[7:35:02] Yeah, I mean I think those conversations already happened.
[7:35:06] So but yes, to answer your question we can.
[7:35:08] Okay, thank you.
[7:35:09] And that's it for me, and President, turn it back to you.
[7:35:15] Oh, good.
[7:35:15] I'm glad you mentioned the difference between Los Altoes and
[7:35:18] Altoes Hills because they are two separate cities.
[7:35:21] And I've heard that a resident from Los Altoes Hills,
[7:35:24] when you live in Los Altoes, she was very upset about it.
[7:35:28] So, this is separate.
[7:35:29] In any case, just this, but no.
[7:35:31] First, I just want to thank my colleague for very thoughtful discussion
[7:35:36] on this very important topics, for those of us who have been on the board a little longer
[7:35:43] be in Surveys, I remember, have always been very familiar with all former colleagues who
[7:35:48] buys us medium, who truly has been the strongest protector regarding these privacy issues
[7:35:56] on cameras, LPR, license plate readers, and then that's the reason why this county really
[7:36:04] as strong as laws or policies on these specific institutions.
[7:36:09] So I just want to say thank you for these thoughtful discussion.
[7:36:12] I look forward to every part coming back to us in a month.
[7:36:15] He's makes face, doesn't it, Russia?
[7:36:16] And make sure we do the right things.
[7:36:18] Thank you very much for all the input.
[7:36:21] And I think we have a public come up.
[7:36:23] Do you have some more to say?
[7:36:24] I have a proposal.
[7:36:25] I have a proposal.
[7:36:26] Before we continue to clarify the record,
[7:36:28] I just wanted to confirm that the secondary degrees
[7:36:31] with that amendment to the motion regarding direction to approach the cities with the alternate
[7:36:38] vendors.
[7:36:42] Okay.
[7:36:42] Motion seconded.
[7:36:43] And yes.
[7:36:44] So I was on the Coga.
[7:36:44] Yes.
[7:36:45] Thank you.
[7:36:46] I will actually not be supporting the alternate motion.
[7:36:51] I read it as the sheriff mentioned.
[7:36:54] This is really about the surveillance policy and I think it's important to have the strongest
[7:37:00] policy that we can, and this wouldn't enable that.
[7:37:03] It would also consolidate the three cities into one, which I think helps in streamlining
[7:37:09] and making it easier to enforce the policy, and I, you know, very much appreciate the
[7:37:18] many concerns, and I share a lot of them, and it seems like the issue is that this
[7:37:25] In vendor, my understanding is the policy actually mentions this vendor, but it would allow
[7:37:32] it to by changing it to ALPRs to enable a different vendor to be under this policy.
[7:37:41] So to me, I was looking at it as a policy that would strengthen our position and maybe enable
[7:37:48] us to even move away from this specific vendor if we needed to do so. I will say I voted for
[7:37:59] these cameras and Mountain View as a city council member after much deliberation and extensive research
[7:38:08] and information. Yes and we always have to be mindful and careful of how the data is shared and
[7:38:16] make sure that it's not shared and used in correct ways.
[7:38:21] But I have to say that we use cameras for our fast track
[7:38:26] transponders in our expressways.
[7:38:30] I visited a country in Asia that uses cameras all
[7:38:35] around their city.
[7:38:36] There means city, and it provides emergency response,
[7:38:41] safety running buses on time, monitoring the number of, you know, taxi, it's a transportation tool, a transit tool.
[7:38:52] So there's definitely, you know, beneficial uses to these cameras.
[7:38:58] And I, you know, and I asked and about this, you know, there's going to be trade-offs.
[7:39:04] 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.
[7:39:20] And I think it is worthwhile to have that full conversation and discussions, so I very much support everything else.
[7:39:27] 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.
[7:39:39] And I will say in terms of Los Santos Hills, which is in my district, as is Saratoga and Cupertino,
[7:39:46] I have heard from many members of the community who support the cameras.
[7:39:52] There's a neighborhood in Los Santos Hills that were the residents got together and purchased
[7:39:57] them themselves. So, again, and I'll say, and we got 8 to 1 support for the cameras in this community.
[7:40:06] So, I think there's a lot of information and a lot of discussion to be had, but I believe
[7:40:14] a policy is important to have in place, so I will not support the notion.
[7:40:19] Thank you.
[7:40:24] So, there's some additional information I'd like to debate based on the exchange, Tony,
[7:40:31] and with your agreement, can you include in the memo confirmation of who gets access
[7:40:39] to the information I'm understanding from the sheriff that it's just their office, that's great.
[7:40:43] I just want us to have the full picture, does CLEATS get it? Is there any leakage in this
[7:40:54] in this system? Can that analysis be included, please?
[7:40:57] Yeah, absolutely. Thank you.
[7:40:59] Is that all right? Yeah, absolutely. More information is always going to be better. Thank you.
[7:41:02] And we'll certainly confer with the sheriff's office on it.
[7:41:05] Supervisor Abicaga, I appreciate your comments.
[7:41:09] I want to clarify that my motion today doesn't end the existing use policy.
[7:41:14] It actually is intended to allow for further information and conversation to happen without
[7:41:20] any disruption to the existing usage of cameras.
[7:41:25] I think the alternative is that I cannot support moving forward with the recommendation that's
[7:41:31] on the, that's, that's, on the ledge file today.
[7:41:36] So I'm asking for an extension, extension, the existing use permit,
[7:41:40] so that it doesn't sense it, so that there's no description to service.
[7:41:44] Well, we do our due diligence for further information about this very controversial vendor.
[7:41:49] So of course, you are free to vote, however you want.
[7:41:53] I just want to add that layer of clarification,
[7:41:54] that I'm trying to avoid any disturbance in service.
[7:41:57] Yeah, I appreciate that.
[7:41:59] I guess, again, I look at this as we were taking the specific vendor out and expanding it,
[7:42:05] so that allows for us to continue to die a log and then to explore other vendors.
[7:42:11] And I'll say, I think, when I voted for this as a city council member, I don't know that we,
[7:42:16] there were other vendors, every city in this county, because we were the last ones,
[7:42:21] I believe in Mountain View to adopt it has flock.
[7:42:24] I imagine every city now is having this discussion.
[7:42:28] And so it's important to be a part of that conversation.
[7:42:32] But in the meantime, to be able to expand out
[7:42:35] and look at other alternatives is, I think, worthwhile.
[7:42:39] Thank you.
[7:42:44] OK.
[7:42:45] If there's no further comments for a go take the vote?
[7:42:47] Sure.
[7:42:49] We have a motion by Supervisor Young,
[7:42:50] and a second by Supervisor Ellen Berg.
[7:42:53] Supervisor Abacoka?
[7:42:55] Yes.
[7:42:57] Yes.
[7:42:58] Presently?
[7:42:59] Yes.
[7:42:59] Yes.
[7:42:59] As well.
[7:43:01] The motion carries 3-1.
[7:43:04] Thank you.
[7:43:05] Well, now is moving to the end of our agenda.
[7:43:14] With that, we will be able to adjourn our meeting.
[7:43:16] Our next meeting will be held on Tuesday, February 10th at 9.30 a.m.
[7:43:21] Right here is the inflation channel.
[7:43:23] So again, thank you to our clerks of security staff on administration.
[7:43:27] Before you all go, I just want to give another familiar reminder that we have a state of the county,
[7:43:32] 2026 coming up soon.
[7:43:35] We have two Friday the 13th this year, and we'll be holding our state of county on the second one,
[7:43:40] March 13th, 2026, and I'll honor to host the event right here also,
[7:43:45] beginning at 545 PM.
[7:43:47] We hope that you'll be able to join us and make sure to RCP to our on our web page on district three.
[7:43:52] Thank you so much for being here.
[7:43:54] Thank you.
[7:43:56] Have a nice day.