govermend.
Board of Supervisors — Regular Meeting
February 24, 2026 · 8h 49m · 6 speakers
0:00 / 0:00
Otto Lee 14:30

Well, good morning, everybody.

UNKNOWN 14:31

Today

Otto Lee 14:32

is Tuesday, February 10th, and let's call this meeting to order.

UNKNOWN 14:38

And

Otto Lee 14:38

if I could please have our clerk, Rhonda, good morning, to call the roll.

UNKNOWN 14:43

Good

Otto Lee 14:44

morning, Supervisor Abacoga.

UNKNOWN 14:46

Here.

Otto Lee 14:47

Supervisor Young.

UNKNOWN 14:48

Here.

Otto Lee 14:49

Supervisor Ellenberg.

UNKNOWN 14:50

I'm

Otto Lee 14:51

here.

UNKNOWN 14:51

Vice

Otto Lee 14:52

President Aranis.

UNKNOWN 14:53

Here.

Otto Lee 14:53

President Lee. Good morning, President. Please have a quorum.

UNKNOWN 14:56

Great,

Otto Lee 14:57

thank you. And Rhonda, would you please read the interpretation announcement, please? Certainly.

UNKNOWN 15:07

Set

Otto Lee 15:07

the current item here. If we could please have our interpreters translate the following into Spanish and then Vietnamese. If you are in chambers and require Spanish or Vietnamese translation, translation devices are available at the back of chambers.

UNKNOWN 15:24

The

Otto Lee 15:25

clerk can assist you with setup. Translation is also available in Zoom using the interpretation button. Additionally, as a gentle reminder for public commenters, staff, and those of us on the dais, please speak clearly and at a measured pace directly into the microphone to ensure accurate translation.

Otto Lee 15:51

All right, thank you, Rhonda. And may I please have Supervisor Ellenberg please lead us in the Pledge of Allegiance, please. Excuse me, we do need the interpreters to do the translation. Translation first. Okay, sorry. My apologies.

Public Comment 16:04

Here

Public Comment 16:11

I go, the Spanish interpreter.

UNKNOWN 16:13

Yes,

Public Comment 16:16

good afternoon to the people who are going to use simultaneous interpretation. In the back of the chamber you will find the devices and the staff can help you to use them. There will be simultaneous interpretation in Vietnamese and in Spanish. All people who speak into the microphone are asked to do so in a paused and understandable way so that you can have a good simultaneous interpretation service. Thank you very much. Thank you, Beatrice.

Public Comment 16:43

Thank

Public Comment 16:51

you.

Public Comment 16:52

To

UNKNOWN 17:08

our

Otto Lee 17:08

Vietnamese interpreter, we seem to have lost you.

Public Comment 17:20

To our Vietnamese interpreter, we seem to have lost you.

Public Comment 17:48

Thank you. Thank you. Thank you. Yes, so now may I have Supervisor Ellenberg please lead us in the Pledge of Allegiance. Please

Susan Ellenberg 17:58

join me in standing if you're able.

Susan Ellenberg 18:02

Ready? Begin. I pledge allegiance to the flag of the United States of America and to the republic for which it stands, one nation, under God, indivisible, with liberty and justice for all.

Susan Ellenberg 18:21

Thank you.

Otto Lee 18:23

So before we move on to our next item, the invocation, I just want to make a couple of announcements. First, I'm really pleased to report that our county's year -long preparation to host the Super Bowl 60 was a huge success. I had the chance to see our county Emergencies Operations Center in action on Sunday with over 85 staff members from many departments supporting the day's activation. To our county emergency operations staff led by James Williams and Dana Reed and to so many departments, first responders, sheriff deputies, firefighters, nurses, and volunteers, many doing 12 -hour shifts, worked so hard to ensure that our county's emergency operations center was in action on Sunday. We are a safe

Otto Lee 18:58

and successful event for everyone. Let's give them a huge round of applause.

Otto Lee 19:10

And we're also very relieved that there was no ICE presence at the event. And we thank the NFL and the 49ers for contacting DHS and kept all of us informed. Many thanks as well to our rapid response partners and volunteers who promptly investigated false ICE sightings, helping dispel rumors and alleviate fear of our neighbors. Their efforts ensured that everyone could fully enjoy the game. And who can forget the incredible halftime show headlined by Superstar Bet, who

Otto Lee 19:38

called for unity, holding a football with the inscription, Together We Are America. Sometimes people forgot that everyone born in Puerto Rico is an American citizen and I have the honor to have met and served with many of them in Iraq a decade ago. That bunny's real name is Benito Antonio Martinez Ocasio, who reminded us to, quote, never stop believing in yourself. And that, quote, the only thing more powerful, than hate, is love. In these times of division and chaos, we are blessed to have such a powerful message broadcast from our county to more than 100 million viewers around the world. Muchísimas gracias, Benito. Thank you.

Otto Lee 20:27

All right, other announcements I

UNKNOWN 20:28

have.

Otto Lee 20:29

Coming on Friday the 13th, we actually have two this year. One's going to be this Friday, but that's not the one I'm talking about. On Friday the 13th in March, we will host the 2026 State of the County Address right here in the city of Puerto Rico. We will host the 2026 State of the County Board Chambers.

UNKNOWN 20:43

This

Otto Lee 20:44

free event is an opportunity to hear about our accomplishments and our goals for the year ahead.

UNKNOWN 20:47

And

Otto Lee 20:48

there will be great music and delicious food.

UNKNOWN 20:50

So

Otto Lee 20:50

please R .V .P. in advance at the link available on our District 3 website. Throughout February, we are also honored to co -sponsor the art installation, quote, honoring the children of Palestine. They deserve to play, unquote, in the County Civic Center Breezeway.

UNKNOWN 21:04

Following

Otto Lee 21:05

last November's Angels of Ukraine exhibit, which honored thousands of children who lost their lives,

UNKNOWN 21:11

this

Otto Lee 21:11

installation, now for the 2026 State of the County Board Chambers, commemorates the 64 ,000 children who have died in Gaza and the West Bank over the past 30 months.

UNKNOWN 21:17

Guests

Otto Lee 21:18

are invited to share messages and reflections, and we extend our sincere thanks to our county partners, the Palestinian Heritage Committee, the Arab American Culture Center of Silicon Valley, and the soul of my soul exhibit for bringing this powerful display to life.

UNKNOWN 21:32

All

Otto Lee 21:33

right, next we have our invocation, and I'll pass it over to Supervisor Abicoga to introduce our invocator today.

Margaret Abe-Koga 21:40

Thank you, President Lee.

UNKNOWN 21:41

Thank

Margaret Abe-Koga 21:42

you. Good morning, everyone.

Margaret Abe-Koga 21:53

Happy Lunar New Year to everyone here today. And I know there are many other languages, and I apologize.

UNKNOWN 21:58

I

Margaret Abe-Koga 21:58

don't know all of them. But this morning, President Lee and Supervisor Young will be bringing forward a proclamation to proclaim February 17th as the first day of observance of Lunar New Year in Santa Clara County. I'm proud to continue the Lunar New Year, especially as we face an administration that is actively instilling fear in so many of our communities. 2026 is the year of the fire horse,

UNKNOWN 22:22

a

Margaret Abe-Koga 22:23

Chinese

UNKNOWN 22:23

zodiac

Margaret Abe-Koga 22:24

animal symbolizing intent, energy, and bold action.

UNKNOWN 22:28

The

Margaret Abe-Koga 22:28

fire horse reminds us to move forward with conviction and quickness, and we'll need to act as such as we face challenging situations this year. Here to speak more about Lunar New Year for today's invocation is my guest, Rosa Kim, co -president of the Asian American Parents Association.

UNKNOWN 22:45

APA,

Margaret Abe-Koga 22:46

as it's known, has served Cupertino and West San Jose families for more than 30 years.

UNKNOWN 22:51

The

Margaret Abe-Koga 22:51

association brings parents and school districts together and creates the programs, leadership opportunities, and cultural support students need to succeed.

UNKNOWN 22:59

One

Margaret Abe-Koga 23:00

of APA's most significant contributions is the AAPI Multicultural Festival, which will be celebrating its fifth year this year on Saturday, May 16th, at the Cupertino Civic Center Plaza in front of the Cupertino Library in the afternoon. Last year's festival brought together 500 residents to enjoy cultural booths, performances, and art from across Asia and the Pacific Islands. It strengthens cultural understanding, builds community pride, and reinforces the welcoming, vibrant culture Santa Clara County has thanks to the diversity in cultures.

UNKNOWN 23:34

I'd

Margaret Abe-Koga 23:35

now like to introduce APA's co -president, Rosa Kim, who has earned accolades serving the AAPI community She has served our community for decades, including working as teaching history and bilingual education at the Silicon Valley Korean School,

UNKNOWN 23:50

becoming

Margaret Abe-Koga 23:51

director of the Silicon Valley Korean School Community

UNKNOWN 23:53

Center,

Margaret Abe-Koga 23:54

co -authoring Korean history textbooks, organizing annual cultural seminars on Korean history for local K -12 educators,

UNKNOWN 24:03

and

Margaret Abe-Koga 24:03

co -founding the AAPI Multicultural Festival during the pandemic as a way to uplift community spirit and combat AAPI hate.

UNKNOWN 24:12

She's

Margaret Abe-Koga 24:13

really the perfect person to lead the AAPI APA. And I forgot to mention she's also a trustee for the Fremont Union High School District.

UNKNOWN 24:24

So

Margaret Abe-Koga 24:24

welcome, Rosa, and thank you for being with us today.

UNKNOWN 24:27

Thank you

Margaret Abe-Koga 24:28

so much, Supervisor Abe -Koba.

UNKNOWN 24:29

Good

Margaret Abe-Koga 24:30

morning, honorable supervisors and community members.

UNKNOWN 24:34

Thank

Margaret Abe-Koga 24:34

you so much for this opportunity to share a few reflections as we welcome the Lunar New Year. I'm so happy to be here next week.

UNKNOWN 24:42

I

Margaret Abe-Koga 24:42

was born and raised in South Korea, and I came to the Bay Area as a young immigrant parent with my husband and our 18 -month -old daughter.

UNKNOWN 24:54

Since that

Margaret Abe-Koga 24:55

very first year and every year since, our Lunar New Year has started with tteokguk, the rice cake soup.

UNKNOWN 25:04

In

Margaret Abe-Koga 25:04

Korean culture, eating rice cake soup on New Year's Day symbolizes a fresh start, good fortune, and the gaining of another year of age and wisdom.

UNKNOWN 25:17

Later,

Margaret Abe-Koga 25:18

when I began teaching a Korean language school in Cupertino, I started making rice cake soup for my students, too.

UNKNOWN 25:25

I

Margaret Abe-Koga 25:26

believe and still believe that sharing cultural traditions helps children understand who they are and where they come from.

UNKNOWN 25:36

When

Margaret Abe-Koga 25:36

young people see their culture honored, it becomes a source of pride rather than something to hide.

UNKNOWN 25:43

The

Margaret Abe-Koga 25:44

more cultural experiences they have, the more they see their identity as an asset and a strength.

UNKNOWN 25:51

The

Margaret Abe-Koga 25:52

recent Super Bowls or half -time show reminded me that belief

UNKNOWN 25:59

is

Margaret Abe-Koga 26:01

also what led the Asian American Parents Association to begin hosting the AAPI Multicultural Festival.

UNKNOWN 26:08

The

Margaret Abe-Koga 26:09

festival planning started during the pandemic, a time when many AAPI community members felt afraid and discouraged because of rising anti -Asian hate.

UNKNOWN 26:22

For

Margaret Abe-Koga 26:22

many families, cultural identity no longer felt like a strength.

UNKNOWN 26:27

It

Margaret Abe-Koga 26:28

felt like a risk.

UNKNOWN 26:30

As

Margaret Abe-Koga 26:30

a parent organization founded in the early 1990s, AAPI has always focused on helping the next generation grow up, with confidence and pride.

UNKNOWN 26:41

So,

Margaret Abe-Koga 26:42

instead of retreating, we chose to show up.

UNKNOWN 26:46

We

Margaret Abe-Koga 26:46

partnered with high school student volunteers and AAPI SB, and launched an AAPI Multicultural Festival during AAPI Heritage Month to share our cultures,

UNKNOWN 26:57

our

Margaret Abe-Koga 26:57

stories,

UNKNOWN 26:58

and

Margaret Abe-Koga 26:58

our contribution with the broader community.

UNKNOWN 27:02

Thanks

Margaret Abe-Koga 27:03

to the foundational support from Supervisor Abe Koga and the Board President Lee, we could host our first festival in Mountain View in 2022.

UNKNOWN 27:12

Since

Margaret Abe-Koga 27:13

then, the first festival has continued every year in Cupertino.

UNKNOWN 27:18

What's

Margaret Abe-Koga 27:18

been most meaningful is seeing students lead, sharing their heritage through booths and performances, and learning about

UNKNOWN 27:27

one

Margaret Abe-Koga 27:27

another.

UNKNOWN 27:29

Again

Margaret Abe-Koga 27:29

and again, I hear students say, diversity is our strength. And I see that strength coming from our students. And that strength comes alive when we create spaces where everyone feels seen and valued.

UNKNOWN 27:44

The

Margaret Abe-Koga 27:45

Lunar New Year marks the Year of the Fire Horse, a symbol of energy, courage, and action.

UNKNOWN 27:52

To

Margaret Abe-Koga 27:53

me, it's a reminder that building belonging doesn't happen by accident.

UNKNOWN 27:58

It

Margaret Abe-Koga 27:58

requires intention, participation, and the willingness to stand together, especially during challenging times. As we welcome the new year, I hope we carry the Fire Horse energy forward, renewing our commitment to understanding one another, honoring our differences, and strengthening our shared community.

UNKNOWN 28:25

As

Margaret Abe-Koga 28:26

for me, I will be celebrating once again

UNKNOWN 28:28

with

Margaret Abe-Koga 28:29

rice cake soup, remembering where I came from, and feeling hopeful about what we can build together. For our children.

UNKNOWN 28:40

I

Margaret Abe-Koga 28:41

wish you all a healthy and meaningful, energetic Year of the Fire Horse.

UNKNOWN 28:46

Thank

Margaret Abe-Koga 28:46

you so much.

Otto Lee 28:55

Thank you very much, Rosa.

UNKNOWN 28:57

And

Otto Lee 28:57

now we're moving to item number five, which is the commendation and proclamations. Today we have a proclamation from

UNKNOWN 29:06

Supervisor Young

Otto Lee 29:07

and myself, an observance of the Lunar New Year.

UNKNOWN 29:10

And

Otto Lee 29:11

before we begin, I would like to invite our community partners to join us at the dais.

UNKNOWN 29:14

Nga

Otto Lee 29:15

Nhi Ha Nhi Tran from Basque, Tiffany Plec from Viet SSA, Brian Tamavong, Misook Oh, Cindy Huynh, and Linh Tran from APIEC, and all the members who helped make these celebrations possible. Please come forward.

UNKNOWN 30:01

Look

Otto Lee 30:02

at those beautiful dresses.

UNKNOWN 30:03

Let's

Otto Lee 30:03

give them a round of applause for this.

Otto Lee 30:10

Well, let's see.

UNKNOWN 30:12

.

Otto Lee 30:12

.

Otto Lee 30:26

Well, Happy New Year, everybody.

UNKNOWN 30:29

Well,

Otto Lee 30:29

today the County of Santa Clara proudly declares February 17th as the first day of Lunar New Year,

UNKNOWN 30:35

one

Otto Lee 30:35

of the most significant cultural celebrations across many Asian American communities. Lunar New Year marked a time of renewal, reflection, and hope.

UNKNOWN 30:44

And

Otto Lee 30:45

this year will welcome the year of the fire horse.

UNKNOWN 30:48

So

Otto Lee 30:49

Lunar New Year begins on the first day of the first month of the lunar calendar, typically in late January or early February.

UNKNOWN 30:55

The

Otto Lee 30:55

2026 celebration is on February 17th, and traditionally lasts for seven days, bringing families and communities together across Asia and around the world.

UNKNOWN 31:05

Santa

Otto Lee 31:06

Clara County is home to one of the nation's most vibrant and deeply rooted Asian American populations.

UNKNOWN 31:11

The

Otto Lee 31:12

cultural traditions, leadership, and contributions enrich every part of our social, economic, and civic life. And this past weekend, we saw that the spirit come alive with February 4th of Social Services Agency, the Asian Pacific Islander Employee Committee, hosting a wonderful Lunar New Year celebration for our county employees. Our VASC also brought the celebration to a broader community on February 7th for an event filled with culture, joy, and connection. Today's proclamation honors Lunar New Year by celebrating our cultures, uplifting Asian American traditions, which means like eating yummy foods, kids especially receiving those red pockets with many money and goodies in there, and embracing the shared hopes for prosperity, good health, and peace for the new year.

Otto Lee 31:58

And at this time, I'd like to also invite my colleague, Rosa Young, to share her thoughts. She's coming up, Betty.

Betty Duong 32:03

Good morning, everyone. Happy Lunar New Year. It officially starts on January 17th. But it's really important for us to remember that we have a lot of work ahead of us to start this meeting today as we head into budget proceedings and tough discussions at the county to acknowledge Lunar New Year and not just to recognize the employees that bring their services and talents and gifts to the county, but also the gifts of their culture. Our county employees, our healthcare workers, our staff bring their heart and soul to this job. And Lunar New Year is an opportunity to give blessings to those nearest and dearest to you. The Year of the Horse symbolizes strength, freedom, agility,

Betty Duong 32:43

endurance, and generosity. Those born during the Year of the Horse are optimistic, determined, and energetic. Values that we need now more than ever during this challenging time in our country and county.

Betty Duong 32:59

Santa Clara County welcomed my parents and thousands more just like them

UNKNOWN 33:03

in

Betty Duong 33:04

the 1970s as refugees when the world didn't want us. Santa Clara County took us.

UNKNOWN 33:09

And

Betty Duong 33:09

we still abide by those values today of being an immigrant -welcoming and belonging community

UNKNOWN 33:15

where

Betty Duong 33:16

our most vulnerable and those in most need of our services not just survive but have the opportunity to thrive.

UNKNOWN 33:24

This

Betty Duong 33:25

proclamation is a wonderful celebration of both Asian culture but also the diversity that makes our county such an amazing place to live, and place to serve, and place to work.

UNKNOWN 33:36

I

Betty Duong 33:36

am so proud of our county's workforce for the way they have not just embraced Lunar New Year

UNKNOWN 33:40

but

Betty Duong 33:40

every celebration we have all year long.

UNKNOWN 33:42

Because

Betty Duong 33:43

when our traditions and our cultures are recognized, our employees feel seen.

UNKNOWN 33:47

It's

Betty Duong 33:48

how we express our values as a county standing with all of our communities.

UNKNOWN 33:52

I

Betty Duong 33:53

particularly want to recognize the staff at the VAST, the Vietnamese American Service Center, the Social Services Agency, Asian Pacific Island Employee Committee, and the Vietnamese Social Services Administration team for their work year round but also all the extra time spent to throw grand Lunar New Year celebrations inviting every single employee and colleague in the county to join them. Representatives of these groups are here today with me on their own time away from work and then they're going to go back to work and then work extra to make sure that they cover all their work.

UNKNOWN 34:25

That's

Betty Duong 34:25

what we do.

UNKNOWN 34:25

We

Betty Duong 34:26

work.

UNKNOWN 34:27

We

Betty Duong 34:27

work every day to solve problems we didn't create. And that is the county way. Lunar New Year has many traditions. A few enduring traditions stand out for me. That on the first days of the Lunar New Year, November, no sorry, November, what's that? January 17th, 18th, and 19th, the first days of the Lunar New Year, we only speak with kindness and good intention because whatever you give, you receive tenfold throughout the year. It is when your words have the greatest intention. Another tradition is that no soul or human shall experience loneliness, hence the altars to welcome our ancestors home for dinner and the rule that everyone is welcome at my table.

Betty Duong 35:05

These traditions have been in practice for 4 ,000 years, so no matter how foreign they are to some, I believe they are rooted in principles recognizable to anyone. Oh, and for those who observe Lunar New Year traditions, we have until midnight tonight to deliver the kitchen god.

Betty Duong 35:21

But no matter what, I wish you at this moment, as we usher in the year of the fire horse, on behalf of myself, my family, and my office, I wish you good health, good prosperity, great wealth, abundance, time with loved ones, to my colleagues and to the administrator that serve us, I wish you good health, great rest, clarity in your judgment,

Betty Duong 35:46

collectiveness in our intentions, and for us to work together, as we have always done at this county, to weather through bad storms and tough times. I know we'll get it done. Happy Lunar New Year.

Betty Duong 36:04

At this time, I'd like to introduce our colleague, Supervisor Margaret Abacoga, who has also a Lunar New Year wishes of her own.

Betty Duong 36:24

Good morning

Margaret Abe-Koga 36:24

again. I just want to first of all thank Rosa again for opening today's meeting with our Lunar New Year invocation and then to continue that celebration with the presentation of this proclamation by my colleagues. Lunar New Year, as mentioned, is really a deeply meaningful time for so many of our residents, and I hope everyone will have a chance to attend a festival or a community celebration happening across the county for quite a few weeks, which is so great about this holiday. One of the best things about living in Santa Clara County is that we don't just observe diversity, we learn from it,

UNKNOWN 37:01

we

Margaret Abe-Koga 37:02

enhance it, and we make it a part of our culture that makes people want to move and live here. Lunar New Year gives us a chance to understand how different cultures honor time,

UNKNOWN 37:12

family,

Margaret Abe-Koga 37:12

and renewal. And in a county as diverse as ours, we shouldn't or can we afford to be ignorant of our neighbors' traditions. In a place like Santa Clara County, New Year comes a few times a year. So, for instance, my Japanese culture, we actually celebrate it on January 1st. We're the outlier, frankly. But with each culture, we get multiple opportunities to celebrate with a sense of renewal. When we lean into each other's celebrations, we strengthen the fabric of our shared community. And as county leaders, I'm really grateful to be a part of this county where we are proud to bring people together and put a spotlight on the many cultures, histories, and experiences that make

Margaret Abe-Koga 37:52

our community so rich. So, I wish you all luck, prosperity, and good health in the year of the Fire Horse, and let's make 2026 a year where our community grows even stronger together. Thank you so

Otto Lee 38:04

much.

Otto Lee 38:08

So, I'd like to also invite Hany Tran to say a few words, followed by Brian Temelval.

UNKNOWN 38:13

Good

Public Comment 38:13

morning,

Public Comment 38:19

everyone. My name is Hany Tran. I'm the director of our county's Vietnamese American Service Center. First, I'd like to thank President Lee as well as Supervisor Yung for inviting the VAS to participate in today's proclamation. Lunar New Year is very meaningful for the community that the VAS serves. We've hosted a celebration every year since we opened in 2022 to allow our community to honor the traditions as well as to engage in the county services offered at the VAS. And this year was no different, as you heard from President Lee and Supervisor Yung. VAS hosted our Lunar New Year celebration just this last Saturday on February 7th. The theme was that across the three regions of

Public Comment 39:01

Vietnam, and we had amazing multi -generational performance from youth groups, our local elementary schools, as well as high schools. We had hundreds of community members attending our event, and 24 county departments and community organizations tabling, and I'll highlight just a few of them. Our county Department of Employment and Benefit Services tabled to share with the community changes to the Medi -Cal program. Our county's Public Health Department tabled to share information about tuberculosis prevention. And Second Harvest of Silicon Valley tabled as well to share information about the free groceries program. I'm very grateful for the support of our Board of Supervisors, elected leaders, our county departments, community partners at our Lunar New Year event, but just

Public Comment 39:49

every day as we work together to serve

Public Comment 39:52

our community. Thank you very much.

Public Comment 40:00

Good morning, everyone. My name is Brian Tamavong. I'm the Secretary of the Asian Pacific Islander Employee Committee at our Social Services Agency. First, I'd like to thank our supervisors for the honor of inviting us to this proclamation. And just to say a little bit about the work that we do, as an employee committee, we are totally volunteer -based. All of our officers are actually from different cultures, ethnicities, so none of us speak the same languages at home.

UNKNOWN 40:27

Aside

Public Comment 40:27

from being a model UN, we are always exchanging culture, exchanging food. Our meetings are the best meetings to attend because we've got food from everywhere and we don't speak the same language at all other than, you know, county productivity. But the reason that that's important, though, is that

UNKNOWN 40:43

that

Public Comment 40:44

situation is a microcosm of what life is in Santa Clara County. Cultures, ideas, people, ethnicities. We are a globalized city for a globalized society. We can bring that down to the employee level through our employee committees. And so one of the most important things that we do is we reach out to one another in terms of, um, employees. We reach out and we share our culture. We extend the invitation. On Wednesday of last week, we were lucky enough to host a Lunar New Year celebration for the employees of the social service agency. And Supervisor Jung said something very, very profound that I felt was profound in that she said, you know, when you grow up

Public Comment 41:28

in the Bay Area, Lunar New Year is for everyone. And it really is. Even if you're not participating in the language or the culture, you know the lion dance, you hear the noise, you hear the firecrackers, you eat the food. Like, you know, it's not your culture, but it is. You've been invited. And if you want to know the power of that invitation, two days ago, we had one of the most important and amazing cultural invitations in the NFL halftime

UNKNOWN 41:54

show.

Public Comment 41:55

I'd be lying if I said I'm not singing Bad Bunny

UNKNOWN 41:58

in

Public Comment 41:58

my car. Right? It's improved my Spanish just a little bit. You know? Okay.

Public Comment 42:05

So, anyway, the point of this is that when we hold these celebrations and we extend these invitations, we strip away difference. Santa Clara goes from the county you live in to the community you live in. From the community, it goes to the neighbors. And from the neighbors, it goes to your friends. And when your friends are in trouble, when your friends experience adversity, you've got someone to stand up for and you've got someone to stand up for you. And that's some of the most important work that we do in our employee committees. And again, the celebration of the Lunar New Year is more than just the Lunar New Year. It's, again, a cultural invitation for

Public Comment 42:42

everyone, a way for the county to come together. And when we come together, we look out for one another. And that's, again, some of the most important work that I think we can do. So, in closing this, I would just like to share my intention for the Lunar New Year with all of you. It's a way that I close most of our events with the APIEC. And that's to say that when you look in the mirror,

Public Comment 43:02

it's my wish that you find hope. And when you look in the mirror, and you look to the community, may you always find friends and allies. Happy

Public Comment 43:09

Lunar New Year, everyone. Thank you. Good

Public Comment 43:17

morning. My name is Tiffany Plek. I'm an employee at Social Services Agency, Department of Employment Benefits. I would like to extend, say, Happy New Year to all of you. It's not just

UNKNOWN 43:32

the

Public Comment 43:32

Asian that we celebrate New Year. We invite all communities to celebrate with us. And, like, for example, Mamie Rocha, she's not born Vietnamese, but every event of the date celebration, Lunar New Year celebration, she's the main person that drive us to organize all the celebration that

Otto Lee 43:57

we have. Well,

Otto Lee 44:05

so, thank you so much. Thank you so much. And we'll go ahead and go present this. Feliz Año Nuevo de Luna. Happy New Year. Let's turn over, and let's take a picture for the proclamation. All

Otto Lee 45:45

right.

Otto Lee 45:48

This festive start to our meeting today, so today will be a good meeting, right, everybody? Okay. Now, next, we have our public comments. This item is reserved for members of the public to address the board on any items not on this agenda, and any public who wish to speak on items not on the agenda should request to speak at this time. Please fill out a speaker card and return to a clerk. We will call up to 30 names now, then the remainder names, if any more, will then be called at the end of the agenda.

UNKNOWN 46:16

In

Otto Lee 46:17

-person speakers will be called first, followed by the Zoom speakers.

UNKNOWN 46:21

No

Otto Lee 46:22

further requests to speak will be accepted under the continued public comment in the afternoon. Reminder for the public on Zoom, as soon as the first speaker in the Chamber starts speaking, no more speakers will be taken. During the public comments, to respect everyone's comments, we do not allow applause or boos,

UNKNOWN 46:41

but

Otto Lee 46:41

to show your support, you can raise and shake your hands quietly.

UNKNOWN 46:45

And

Otto Lee 46:46

I want to say thank you for your cooperation to keep our meeting moving orderly.

UNKNOWN 46:51

Hi,

Otto Lee 46:52

Rhonda, how many speakers were at this morning? I currently have 24 speakers in Chambers and one speaker on Zoom.

UNKNOWN 47:02

All

Otto Lee 47:03

right, let's do one minute each. All right, with that, we're going to close the public speaking queue.

UNKNOWN 47:09

I'm

Otto Lee 47:09

going to call forward several names.

UNKNOWN 47:11

You may

Otto Lee 47:12

speak in any order. Guadalupe Ruiz de Lina, Tung Vai Duong, Caterina Fernandez, Francisco Ruiz, Sangao, Natasha Walker, and Tanya York.

UNKNOWN 47:28

Please

Otto Lee 47:29

come forward.

UNKNOWN 47:38

Yes. My

Public Comment 47:39

name is Guadalupe Ruiz, and I am a provider of IHSS.

UNKNOWN 47:44

I live

Public Comment 47:45

in District 1.

UNKNOWN 47:46

This

Public Comment 47:47

message is for Sylvia Arena. I love the IHSS program because it protects the health of my community.

UNKNOWN 47:55

As

Public Comment 47:56

an immigrant, I am concerned about many things that are happening in this country.

UNKNOWN 48:00

And

Public Comment 48:01

here in Santa Clara, I am concerned about the general health of the Latino community.

UNKNOWN 48:05

The

Public Comment 48:06

evaluation of the health of the Latino community mentioned many worrying aspects in the results of the health of the Latino community.

UNKNOWN 48:13

It

Public Comment 48:14

is necessary that we address this to ensure long -term care stability in our care system. The SAU 2015 has been a strong ally in medical care in Santa Clara.

UNKNOWN 48:27

We

Public Comment 48:28

were asked to help to approve Measure A, and we gave all our support.

UNKNOWN 48:32

We

Public Comment 48:32

did our part to win this election, which means that we must be included in this triumph.

UNKNOWN 48:38

The

Public Comment 48:39

IHSS

UNKNOWN 48:40

program...

Public Comment 48:41

Thank you.

UNKNOWN 48:42

Thank

Otto Lee 48:42

you.

UNKNOWN 48:42

And

Otto Lee 48:43

the translator, please.

UNKNOWN 48:46

Good

Public Comment 48:47

morning. My name is Guadalupe Ruiz, and I am a vendor for IHSS. And I

UNKNOWN 48:52

belong to

Public Comment 48:53

District 1.

UNKNOWN 48:54

This

Public Comment 48:55

message is for Sevilla Arena, and I just want to say that I love the IHSS

Public Comment 49:03

because it is having a lot of... It is paying a lot of attention in my community.

UNKNOWN 49:09

And as

Public Comment 49:11

a member of the community, I'm very concerned of what's happening in the country, specifically in what's happening in Santa Clara. We were... We were...

Public Comment 49:24

In the community, I'm very concerned about the Latin American health, Latin American community health. And we were supporting the SAU 2015 because we were told this was going to be a big ally, so they have our full support, specifically for item 8. So we gave full support, and now it's our turn that our voices are heard.

UNKNOWN 49:48

Thank

Public Comment 49:49

you.

UNKNOWN 49:49

Buenos

Public Comment 49:55

dias.

UNKNOWN 49:55

Mi

Public Comment 49:56

nombre es Eferina Fernandez, y soy proveedora del programa de IHSS. Vivo en San Jose, California.

UNKNOWN 50:04

Me

Public Comment 50:05

encanta el programa de IHSS porque representa nuestros valores.

UNKNOWN 50:09

Aquí

Public Comment 50:09

en Santa Clara nos preocupamos por nuestras familias y cuidamos de la comunidad de personas inmigrantes, pero claramente a la administración de Trump no le importa el bienestar de las personas inmigrantes.

UNKNOWN 50:23

Y

Public Comment 50:23

al liderazgo republicano, claramente no le importa la salud y la seguridad de las familias trabajadoras.

UNKNOWN 50:29

El

Public Comment 50:29

proyecto de ley del presupuesto federal HR1 fue un ataque directo a nuestra comunidad.

UNKNOWN 50:38

Quitaron

Public Comment 50:38

miles de millones de dólares en fondos de medical y entregaron miles de millones de dólares a ICE.

UNKNOWN 50:44

Esta

Public Comment 50:45

es una situación que parte el corazón, pero nuestra comunidad no se da por vencida.

UNKNOWN 50:51

Señor

Public Comment 50:52

Ottoli, olvido decir que este mensaje era para usted.

UNKNOWN 50:55

Usted

Public Comment 50:56

puede asegurar que el programa de IHSS pueda seguir adelante.

UNKNOWN 50:59

Gracias.

Public Comment 51:00

Good

Public Comment 51:04

morning.

UNKNOWN 51:04

My

Public Comment 51:05

name is Eferina Fernandez, and I am a vendor of IHSS also, and I live in San Jose.

UNKNOWN 51:11

I

Public Comment 51:12

love IHSS, and we are, because it is representing, it is taking care of our community, it's also taking care of our family, and it's also taking care of our immigrant community. Mr. Trump doesn't care about that, doesn't care

UNKNOWN 51:36

about

Public Comment 51:36

the health and life of immigrants, and Republican leaders are not taking care of health and families also.

UNKNOWN 51:44

The

Public Comment 51:44

HR1 was a direct attack, because they took millions of dollars out of medical and they put it into ICE. And this is really heartbreaking.

UNKNOWN 51:55

But

Public Comment 51:56

our community is here for support, and I forgot to say, President Ottoli, this message is for you.

UNKNOWN 52:04

Thank

Public Comment 52:05

you.

Public Comment 52:10

Hello, everyone. My name is Tuong Vy Duong. I am in charge of the IHSS program. I live in District 2, and I would like to call on Patty Duong. I really love this program, because through this program, I can connect with my relatives and acquaintances in the community, especially for me to fulfill my duties for my children and family. In particular, in my union, we often talk about the strength of the members. We know that everyone here is with each other on this journey.

UNKNOWN 52:47

One

Public Comment 52:47

tree grows to the top, three trees grow to the top.

UNKNOWN 52:50

As

Public Comment 52:51

long as we are united, we can make positive changes and improve each other's lives.

UNKNOWN 52:57

The

Public Comment 52:58

organization has put a lot of effort to get through Measure A, and I know that we have to contribute to support our community even more. We are committed to improving the quality of care in the Santa Clara district for a long time.

UNKNOWN 53:38

So I would like to thank them for that. Of course, we have our responsibility for the parents, for the family members, and this helped me to finish or complete that responsibility. And the work of the union is great, and we need to work together

Public Comment 54:02

in order to achieve our work and to be a success. One tree cannot make up a jungle. Several trees make up a big jungle and mountain.

UNKNOWN 54:15

Unified

Public Comment 54:16

unification is the palliative objective. So with this, I would like to thank them, and we will be united. We will come together to complete this

UNKNOWN 54:34

further.

Public Comment 54:35

Thank you.

Public Comment 54:39

My name is Song Gao, and I'm an IHS care provider. I live in District 5, and that message is for Margaret A .B. Koga. I love IHS because they ensure the safety and the dignity of our elders. Our elders are essential of our communities. We owe it to them to provide support in their time of need. The IHS program is a safety net for those who have already made a major impact on our life and should receive care and comfort. Giving IHS providers a fair wage is a long -term investment in this program. The demand for care is only going to get bigger as our population ages. More and more elders will need assistance as

Public Comment 55:24

time goes on. And we have to get more caregivers to enter our industry. Right now, the county has many and fulfilled care hours. We are falling short in our duty to provide for those who need support. We should not be single and go without the care of the need. Thank you.

Otto Lee 55:45

If you have any comments that you cannot finish, you could also give the comments. To our clerk, and we will include it in our record. Thank you. My

Otto Lee 56:00

name

Public Comment 56:00

is Natasha Walker, and I'm an IHSS provider. This message is actually for the county CEO, James Williams. Our county leadership should be receiving regular information about tax revenues in order to make informed decisions. My team at SEIU 2015 is certain there are budget solutions to the issues we are presenting at the bargaining table. But the board needs to receive regular updates of necessary information they ask for so they can do their own evaluations. The board should be managing the CEO, not the other way around. Our union of providers worked hard to pass Measure A. They donated their time. We answered the call, and we delivered results. Why? Because we value our healthcare system. We are

Public Comment 56:48

good faith allies of this county's leadership and the county, and we are invested in this county's healthcare system for the long term. We have to work together to ensure our caregivers can pay their bills through whatever's coming. In order to do that, we need creative solutions, not flat wages.

Public Comment 57:35

Both physically and emotionally. Sometimes it's very difficult to manage all of my responsibilities. But my love helps me to move forward. We want to be their caregivers because we know we are the best people to do so. We don't want them to be a cost

UNKNOWN 57:52

center.

Public Comment 57:53

The IHSS program makes this possible, and I'm grateful for that.

Public Comment 58:00

The IHSS program...

Public Comment 58:03

I'm sorry. But we want to have the opportunity to stay in Santa Clara. My family needs economic stability. Children with disabilities in Santa Clara need a solid IHSS program. And we can only do that by using... Thank

Public Comment 58:23

you. Thank you.

Public Comment 58:25

Good morning. My name is Francisco Ruiz, and I am an IHSS provider. And this message is for Susan Ellenberg. I love the IHSS program because it is taking care of my children. Also, my wife and I are taking care of Mateo and Daniel, who are our sons. And they are really needing this program. It is difficult throughout the day, mainly both physically and emotionally, and it's different to manage all my responsibilities.

UNKNOWN 59:01

However,

Public Comment 59:02

my wife and I want to take care of our children, and we don't want to go to an expensive center. And I think that the IHSS program is making this possible, so we are really grateful for that.

UNKNOWN 59:13

We

Public Comment 59:13

really want to stay in Santa Clara because we need stability for our family and our kids are disabled. Thank you.

Otto Lee 59:22

If I can call the next several speakers forward. Jack McGovern, Raymond Goyne, Jesse Weitz, Justin Ruffner, Mark Trout,

UNKNOWN 59:34

Monica

Otto Lee 59:35

Simon, Andre Oliveira, Desiree Nuzzi. Thank you. Please go ahead.

UNKNOWN 59:44

Good

Public Comment 59:44

morning. My name is Tanya York, and I'm an IHSS provider. Since the rules for public comment were changed last year, it has been difficult for our members to have their voices heard. Our members have important stories that are hard to share in just under a minute. We have immigrant members with language barriers who need time to express why they are concerned about their family's future. We have family providers that have left their jobs to take care of their children with their loved ones and are struggling to keep up with their bills. We have older members who sacrifice their time and travel long distances just to speak to the board for a few seconds about how

Public Comment 1:00:23

badly they need a raise. IHSS providers are a lifeline for immigrants, children, and families in Santa Clara.

UNKNOWN 1:00:31

We

Public Comment 1:00:31

love IHSS and want to ensure the program is ready to meet the needs of our community for years to come. We did our part to pass Measure A and win crucial funding for the county. We are committed to improving health care in Santa Clara.

UNKNOWN 1:00:46

We

Public Comment 1:00:46

need your support.

Public Comment 1:00:54

Good morning, Board. My name is

Public Comment 1:00:56

Jack McGovern. I'm here on behalf of the South Bay Labor Council to strongly support

UNKNOWN 1:01:00

my SEIU 2015 brothers

Public Comment 1:01:03

and sisters. SEIU 2015 members provide essential care that keeps thousands of Santa Clara County residents safe.

UNKNOWN 1:01:10

You've

Public Comment 1:01:11

heard it here today. They stepped up big time to pass Measure A. I know, and we all know, how difficult this upcoming budget season is. We know difficult decisions need to be made.

UNKNOWN 1:01:22

But

Public Comment 1:01:23

our 2015 workers are taking care of some of the highest need populations in our county. We must do what is right. So we are calling on the county administration to bargain in good faith and ensure that home care workers receive livable wages and affordable health care. Please support your 2015 members and ensure that Santa Clara County lives up to its values Thank you.

Public Comment 1:01:53

Good morning. My name is Raymond Goins. I'm here in my individual capacity. I'm here to call the branch of the county's attention to events that happened in one of the county cities in San Jose, California. On January 21st, 2026, San Jose Police Department executed a man in broad daylight. I'm here to ask you to not allow criminality to replace humanity. The man was fleeing away. He was shot when he was shot. The man, when he ran over, he wasn't a threat. And when he was shot approximately 26 times, while he laid down there in the city streets, he wasn't a threat.

UNKNOWN 1:02:25

Now,

Public Comment 1:02:26

we all recall that Donald Trump enforced his immigration policy to go after criminals. And that enforcement has expanded to go after everybody. Alex Pratt was killed, and Rene Gould was killed, and Keith Porter was killed by, on the premises of criminality. I ask the county to stand by us as we fight, as I fight for justice for Muhammad Hussein. I understand that criminality was attached but he wasn't a threat when he was murdered on

Public Comment 1:02:53

our county streets.

Public Comment 1:03:01

Hello. My name is Jessie Wise, and I'm a senior at Live Oak High School, part of the Morgan Hill FFA chapter. This year, I'm going to be going to the Santa Clara County Fair with my steer hank that I purchased at the end of October. Mid -December, the fairground officials released a statement about expected date changes. Instead of the last week of July falling into the first week of August, the dates have been changed to the third week of August. The fairgrounds released this date change and then released the press release that failing to acknowledge the graduating seniors who would be starting their first week of college. Every single college that I applied to, I

Public Comment 1:03:34

would either be moving in the weekend of auction or beginning classes. This brought me to a hard decision of either taking a major loss of money or sacrificing my first semester of college to be at the fairgrounds. I worked extremely hard for the past four years to get to this point and now I might have to sacrifice it all due to the fair board's mistakes. The leaders in charge should be taking accountability for this and making a change as they should have for us as we make this fair the fair. Thank you for your time.

UNKNOWN 1:04:07

Hi,

Public Comment 1:04:07

my name is Justin Ruffner. I'm a senior at Live Oak High School and a part of the Morgan Hill FFA chapter. I'm here because of the Santa Clara County Fair date change has a very real and personal impact on my life. This is my senior year, my final opportunity to show after years of early mornings, late nights, and hard work. And it's honestly heartbreaking to think that it might not happen.

UNKNOWN 1:04:29

My

Public Comment 1:04:29

family is scheduled to move to Miami, Florida from my dad's house to my dad's job. We already adjusted our plans once so I could stay through the summer and complete my final fair. Now I may be forced to choose between being with my family during a major life transition or staying behind just to finish the project that I've already committed so much time, effort, and money toward. That is not a choice that any student should have to make. There are also serious animal welfare concerns because my steer was purchased months ago. Based on the traditional timeline, pushing the fair later means I would have to hold his weight longer than what is considered healthy, potentially

Public Comment 1:05:05

leading to overweight animals or forcing unhealthy feeding adjustments. Thank you for your time.

UNKNOWN 1:05:18

I

Public Comment 1:05:18

think everyone who's going to be a nurse and goes to Unitec College or any college to become a

UNKNOWN 1:05:26

nurse should

Public Comment 1:05:26

be required to read Brian Artis' book Moving Beyond the COVID -19 Lies and

UNKNOWN 1:05:33

taught. There's

Public Comment 1:05:35

a documentary I've offered mostly to people to watch. It's so powerful by Del Bigtree

UNKNOWN 1:05:42

and

Public Comment 1:05:43

it's called an inconvenience study dot com and it'll rip your heart out.

UNKNOWN 1:05:50

Now,

Public Comment 1:05:51

the Nightingale Pledge says, I solemnly pledge myself before God and in the presence of this assembly to pass my life in purity and to practice my profession faithfully. I will abstain from what is deleterious and in the presence and mischievous and will not take or knowingly administer any harmful drug. And in this documentary,

UNKNOWN 1:06:17

Monica

Public Comment 1:06:28

Simon. Good morning, supervisors, and thank you for listening

UNKNOWN 1:06:31

to

Public Comment 1:06:32

our concerns last month regarding the 2026 Santa Clara County Fair.

UNKNOWN 1:06:36

I'm here today because

Public Comment 1:06:38

the situation surrounding the fair has only grown more concerning. The sudden date change announced long after animals were purchased or bred for the original late July schedule has created serious challenges for youth exhibitors. Many of these animals were selected in September based on the fair's original timeline. Now, with the fair pushed to mid -August, exhibitors are being told their animals may be overweight or that they should hold them, meaning withholding feed and water just to make weight. This is not acceptable and it places young people in an impossible position created entirely by poor planning. The fair's future is uncertain and without transparent communication and responsible management, we risk losing the long -standing community tradition that

Public Comment 1:07:25

has shaped

UNKNOWN 1:07:26

generations

Public Comment 1:07:26

of youth.

Public Comment 1:07:36

Hello Board, my name is Andre Oliveira. I'm a Vice President of SEIU

UNKNOWN 1:07:41

521

Public Comment 1:07:42

in the Santa Clara County and more importantly I'm a healthcare worker.

UNKNOWN 1:07:46

I

Public Comment 1:07:46

am here because I'm concerned about the almost 200 positions that the county wants to delete,

UNKNOWN 1:07:52

some

Public Comment 1:07:53

of those being filled. Yesterday, I read that one of the core values of Santa Clara County

UNKNOWN 1:08:00

is

Public Comment 1:08:01

commit to efficient, effective, quality service. How should the people,

UNKNOWN 1:08:08

the

Public Comment 1:08:09

population that we serve expect that when we are cutting the hands of the people who are providing such services? I'm here to ask you to listen to healthcare workers like myself

UNKNOWN 1:08:23

because

Public Comment 1:08:24

this decision can and will become a dark moment for the future healthcare of every family in our community. Please do not forget the duty that we have and that we owe them. Thank you so

Otto Lee 1:08:38

much.

Otto Lee 1:08:40

I'd like to call forward the rest of our speakers. We have Tressa Hillman, Tommy Deveninces, Jessen Fox, Carlos Murillo,

Otto Lee 1:08:54

Kendra I think Medina, Apisa Wan,

Otto Lee 1:09:02

Gavin Martinez, Marin Quares, and Sean. Please go ahead.

UNKNOWN 1:09:11

Good

Public Comment 1:09:12

morning. My name is Desiree Nuzzi and I'm a rehabilitation counselor with the integrated care team with the health and hospital system. Our team is up for deletion and we have not been told where we are going.

UNKNOWN 1:09:23

This

Public Comment 1:09:23

board approved our program as a pilot to address system gaps affecting the most vulnerable patients. These individuals have executive functioning impairments often alongside serious mental illness, substance use disorders and complex medical needs. They do not fail services due to lack of motivation. They fail because our systems are fragmented and broken. Our team provides continuity across hospitals, custody, courts and the community ensuring care plans actually happen.

UNKNOWN 1:09:52

The

Public Comment 1:09:53

pilot revealed persistent gaps and predictable crisis when support is withdrawn. We chose continuity over disengagement. Today we asked the board to preserve the integrated care team and its positions while funding alignment is explored. Dismantling this team would recreate the very cycles it was designed to interrupt.

Public Comment 1:10:14

First of all, I just want to say thank you

Otto Lee 1:10:17

for the comments and one thing is that this portion for the procedure purposes, this is really only talking about items not on the agenda today. While you talk about the budget, it's actually item number 13 which we will be hearing later. Since we spoke

Otto Lee 1:10:35

everybody knows that this is actually a portion not to talk about the budget but talk about anything not on the agenda today. Thank you so much.

Otto Lee 1:10:47

Good afternoon. My name is Tressa and I'm a community outreach specialist with the integrated care team and I work directly with patients experiencing homelessness,

UNKNOWN 1:10:56

justice

Otto Lee 1:10:57

involvement and complex medical and behavioral health needs. Many are already connected to mental health services yet continue to struggle, not due to the lack of effort but because their needs extend beyond mental health alone. Our team does not replace these existing programs. We support them by providing an added layer of coordination. Because we are internal to the county health and hospital systems, we can access medical records and discharge plans that others

UNKNOWN 1:11:25

cannot, allowing

Otto Lee 1:11:27

providers to focus on treatment while we stabilize the foundation. This coordination is a critical stopgap. Without it, people will cycle back into the emergency rooms or custody. I respectfully ask the board to preserve this team so we can continue to support both clients

UNKNOWN 1:11:55

My

Public Comment 1:11:56

name is Tammy DeVincentis. I am the nurse practitioner with the ICT team. Patients on our caseload are medically fragile, terminally ill and all require a level of coordination that cannot be replaced. Our review of high utilizer patients showed a significant reduction in emergency visits, custody stays, EPS visits representing

Public Comment 1:12:28

patients

Public Comment 1:12:33

in the We are asking the board to preserve the integrated care team intact and relocate us to a clinic where we can continue to take care of the patients entrusted to us while responsible solutions are explored. A medical home will allow us to build generate revenue.

UNKNOWN 1:12:56

Thank

Public Comment 1:12:56

you. Thank you.

Public Comment 1:13:01

Hi, my name is Kiana. I'm a healthcare worker and this is the only time I have to

UNKNOWN 1:13:04

speak. I'm an LVN employee

Public Comment 1:13:06

health. I want to speak to the financial and operational reality of this decision. If LVN's positions are eliminated, the work does not disappear. The department will either fall behind increasing risk and dissatisfaction or RNs will be required to fill LVN roles to meet demand. The outcome increases the department's budget because RN costs significantly more than LVNs to perform the same employee health services. At the same time, employee health continues to absorb high -cost decisions that were not reduced before cutting LVNs. Since November 2024, the department has continued paying

UNKNOWN 1:13:36

a

Public Comment 1:13:48

lot of cost lowest -cost licensed staff. This decision risks delayed exposure responses, lapses in compliance, increased risk to the employees and patients while potentially raising costs. This is not budget reduction. It's budget displacement and puts safety and compliance at risk. Who can I give the paper

UNKNOWN 1:14:06

to?

Otto Lee 1:14:08

I just want to make sure we are not yet talking about the budget item. If you want to do that, you really should speak at item 13. That will be coming up and we'll have time for that. For those who speak on the budget item now, during this period, you will not be able to speak again later. Hi,

Otto Lee 1:14:31

everyone. I'm a healthcare worker and this is the only time I get to speak.

Otto Lee 1:14:38

Eliminating all LVN positions is being

UNKNOWN 1:14:40

presented

Otto Lee 1:14:41

as a budget decision, but it directly affects county employees and patient safety. Employee Health supports four county hospitals and we ensure new hires, travelers, volunteers, staff are immunized, TB tested, MassFit compliant and receive timely follow -up after communicable disease exposures. Cutting frontline staff delays exposure response, increased risk to missed prophylaxis and testing and raises the risk of workplace

Otto Lee 1:15:13

and medical center resulting in slower response times and reduced access. Further cuts will worsen these delays. We're not asking for RN positions to be removed. We respect our RN colleagues. We're just questioning how removing LVNs, the most cost -effective licensed staff, improves the budget when the workload remains. Thank you.

UNKNOWN 1:15:31

Hi,

Public Comment 1:15:38

good morning. My name is Maria Quiroz. I work at Regional Medical Center San Jose. I am a monitor technician and I'm here to read a statement on behalf of Courtney. And so before the integrative care team came into my life, I had been living on the streets for several years and I thought that that's where I belong. I had been giving up. I was hopeless. I lost everything in 2021 including my apartment. Since then, the team has been in my life. Everything has changed for me. I have a different outlook on life.

Public Comment 1:16:15

I'm getting over everything I lost and I want to live. I have never had a team like this. I talk to my family now. My dad and I are best friends. I was able to walk through the death of my grandma being sober and with the support of this team. This team saved my life. The program works and please reconsider. Courtney. Thank you.

Public Comment 1:16:38

Good

Public Comment 1:16:44

morning board. I'm Carlos Murillo, Vice Chair of SEAU 521 Blue Collar. As representatives of our community, you hold the crucial responsibility of managing taxpayers' money. This trust in government is at all time high and your decisions have direct impact on working families. It is vital that you engage with us and communicate openly about the choices being made. Transparency is not an option. It's essential to rebuilding

Public Comment 1:17:21

our and the impact of your decisions on our lives. Again, we are here to make sure voices are heard and that you prioritize accountability as a key part of your leadership. Thank you.

Public Comment 1:17:41

All right.

Otto Lee 1:17:42

Last call for Jessen Fox, Gavin Martinez and Sean.

Otto Lee 1:18:13

Jessen Fox, I believe you are in INS. If you would please come over to board chambers to give your public

Otto Lee 1:18:23

testimony. Is that you?

Otto Lee 1:19:15

Yes, for the speakers, if you actually have a statement that you would like to present, you can give it to our clerk and we'll add it to our record. Thank you so

Public Comment 1:19:21

much. I

Public Comment 1:19:27

think the T -shirt speaks

Otto Lee 1:19:28

for

Public Comment 1:19:36

itself.

Public Comment 1:19:39

I totally support the ICT program. And one of the biggest reasons is because getting people sober while they're housed. There's no point in getting people sober and returning them to the streets. That's just useless. I wanted

Public Comment 1:19:55

to say action. There are camps in San Jose right now being repeatedly swept and swept and swept.

Public Comment 1:20:02

Taking these people to jail over and over, exposing people who may be undocumented to jail is pointless. Making senior citizens like convicted criminals is pointless. You can say no. We're not going to keep allowing people in jail for stupid tickets like trespass or loitering or anything like that. Say no. These are homeless crimes and these are just vindictive prosecution by an idiot mayor who wants to be governor. This is not somebody we reward. Please say no and say we are not going to keep letting people in jail for trespass. And if you need a whistle, I got them.

Public Comment 1:20:38

Thank

Otto Lee 1:20:39

you. And now we'll move to our online public speakers. Parent, we've asked you to

Public Comment 1:21:00

give us a few

Public Comment 1:21:06

We're going to take a few minutes of your time. We are going to take a minutes your time. We

Public Comment 1:21:28

going to

Public Comment 1:21:35

take a moment to give you

UNKNOWN 1:21:41

a

Public Comment 1:21:42

moment silence say thank you for your time.

Public Comment 1:21:49

Thank you.

Otto Lee 1:21:50

We

UNKNOWN 1:21:54

will

Otto Lee 1:21:55

move to the consent calendar to consider

Otto Lee 1:22:10

items number 13, 14, and 15 concurrently. Item number 13 is to consider recommendations relating to the fiscal year FY 2025, 2026 mid -year budget review.

UNKNOWN 1:22:25

Item

Otto Lee 1:22:26

number 14 is adoption of salary ordinance number NS -20 .25 .04, deleting various positions in the Department of Tax and Collections, the Office of the Assessor, Valley Health Plan, Facilities and Fleet Department, and Santa Clara Valley

Otto Lee 1:22:57

Association.

UNKNOWN 1:22:58

Item

Otto Lee 1:22:58

number 15, adoption of salary ordinance number NS -5 .26 .42, deleting and adding various positions as part of the fiscal year 2025, 2026 mid -year budget review. There's a request from

Otto Lee 1:23:27

the Article 2, Section 2 .5 and 2 .6 of the Memorandum of Agreement with CEMA dated June 24, 2024 through December 19, 2027, adding nurse longevity pay for the nurse manager infection control NMIC classification and aligning the NMIC classification salary and step system with other nurse manager classifications represented by CEMA.

UNKNOWN 1:24:00

Item

Otto Lee 1:24:01

number 26 is adoption of salary ordinance number NS -5 .26 .41, retitling the infection control nurse manager classification to nurse manager infection control and aligning to the same salary and step system as all other nurse manager classification.

UNKNOWN 1:24:21

There's

Otto Lee 1:24:22

a corrections to item number 52J.

UNKNOWN 1:24:25

The

Otto Lee 1:24:25

item should read as follows.

UNKNOWN 1:24:27

Item

Otto Lee 1:24:28

number 52J, adopt commendation recognizing STEAM at Stipe Elementary School for its commitment to cultural education, community engagement and promoting appreciation of Asian traditions on the occasion

Otto Lee 1:24:52

to February 24th, 2026.

UNKNOWN 1:24:55

Item

Otto Lee 1:24:55

number 57 is to consider recommendations relating to a cost -sharing agreement with the City of San Jose regarding pavement maintenance.

UNKNOWN 1:25:05

And

Otto Lee 1:25:06

this concludes our consent calendar update.

UNKNOWN 1:25:11

Thank

Otto Lee 1:25:12

you very much, Rhonda. Just want to check my colleague to see if there's any more further changes to the consent. Any questions on those?

Otto Lee 1:25:19

Oh, yes,

UNKNOWN 1:25:20

Vice

Otto Lee 1:25:20

Ellenberg first.

UNKNOWN 1:25:21

Thank

Susan Ellenberg 1:25:22

you.

UNKNOWN 1:25:22

I

Susan Ellenberg 1:25:22

don't have changes but want to make a comment on item 38. I want to thank staff for collaborating with the City of Campbell, the Santa Clara County Housing Authority and Charities Housing to bring another affordable housing development to my district. As staff mentions, our contribution will help facilitate the creation of 91 new affordable housing units for county residents. That breaks down to 10 units for individuals with intellectual and or developmental disabilities and their families, 30 units for unhoused veterans and 51 units for households across the area medium income spectrum. I'm really always so pleased to see the

Susan Ellenberg 1:26:18

number happy to move approval of the consent calendar. I

Betty Duong 1:26:21

don't

Betty Duong 1:26:25

have any changes. Brief comments on item 33.

Betty Duong 1:26:32

Regarding

Betty Duong 1:26:36

our budget

Betty Duong 1:27:03

and our

Betty Duong 1:27:17

budget we have that We have a number issues that we need address. We have

Betty Duong 1:27:25

a number we address. We have a number of that we need to We a number

Betty Duong 1:27:35

of issues that we need to address. Thank you. Thank

Otto Lee 1:27:45

you. Thank you. Vice President Arenas. This

Sylvia Arenas 1:27:47

is comment on item 47. Excuse me.

Sylvia Arenas 1:27:55

This is an item that was that is a grant from

Sylvia Arenas 1:28:02

the district attorney. I'm sorry. Let me

Sylvia Arenas 1:28:12

I'm sorry. I was just second guessing myself for a minute there. Okay. So this is the burn state crisis intervention grant program. And I think it's very admirable for our DA to begin to use grants to pay for some of the positions that may be at peril that we are going to lose because we're just reducing where we have a reduction we have a deficit and so we must reduce.

Sylvia Arenas 1:28:58

Implement state gun crisis interventions in court proceedings and related programs or initiatives. But it sounds like the DA is also going to use this to maybe process more Prop 36 clients. And so I just wanted to make that

Sylvia Arenas 1:29:27

clear

Sylvia Arenas 1:29:33

that we are going to continue to do what we doing doing and we are going to

Sylvia Arenas 1:29:56

process more Prop 36 clients. And so I disagree with that purpose. I wanted to just put it in public comment and make sure that I have that statement. As well as asking our county executive to continue to use utilize external grants to fulfill some of the

Sylvia Arenas 1:30:26

needs

Otto Lee 1:30:28

that Thank you. I see no more lights. Let's see. Let's open up to public comment. Any public comment regarding the consent items? I currently have no public comment in chambers and no hands raised on Zoom. Okay. Let's go and close the queue on that. And we've got a motion. We've got a second. Let's go take the roll. On motion of Supervisor Ellenberg, seconded by Supervisor Young. Supervisor Abacoga. Aye.

Otto Lee 1:31:11

We relating to mental health and substance use as a public health crisis.

Otto Lee 1:31:18

I'll pass this to you, James.

James Williams 1:31:24

Good morning, members of the board. We have our team from behavioral health coming forward for this presentation. As requested by the board, the main focus of this month's quarterly report is a budget study session related to BHSD and its funding streams. It's kind of going with the theme of today, a very sobering report that outlines how we are being hit with a litany of negative funding changes across every single one of behavioral health's critical funding streams with very unfortunate timing of state -directed changes piling on top of federal changes. So you will hear about that in the slides to come, but just wanted to preface the conversation with that, and I will turn it over

James Williams 1:32:16

to Sherry to kick things off.

James Williams 1:32:22

Great. Good

Sylvia Arenas 1:32:23

morning, Board of Supervisor

Sylvia Arenas 1:32:33

Sherry . Today's focus will be a budget overview study session, and we're pleased to be able to provide information to all of you. Next slide, please.

Sylvia Arenas 1:32:44

This is a list of our most recent reports that we've provided since our last quarterly report in

Sylvia Arenas 1:33:05

the last two We have some information that will help inform all of us around our current budget and our

UNKNOWN 1:33:17

fiscal

Sylvia Arenas 1:33:18

planning for fiscal year 27. Next slide, please.

Sylvia Arenas 1:33:23

As an introduction to our budget presentation, we thought it would be helpful to have a shared understanding of the role of counties as the behavioral health plan for Medi -Cal beneficiaries.

UNKNOWN 1:33:34

I'm

Sylvia Arenas 1:33:34

pleased to introduce Jill Donnelly from Arara Health Group. Jill serves as the managing principal for Medicaid programs.

UNKNOWN 1:33:42

And

Sylvia Arenas 1:33:42

BHSD has been contracting with Arara Health Group for several years and we're grateful for their guidance and expertise in the areas of California behavioral health funding streams, regulations and requirements. And so with that, I'm going to go ahead and turn it over to Jill.

Public Comment 1:34:04

There we go. All right. Hi. I'm Jill Donnelly, managing principal at Arara Health Group.

UNKNOWN 1:34:11

Our

Public Comment 1:34:11

firm is a small consultancy based in Sacramento. We do a lot of work with the Department of Health Care Services and a lot of work with counties throughout the state, helping them interpret federal and state obligations and how those are operationalized on the ground.

UNKNOWN 1:34:27

So

Public Comment 1:34:28

the purpose of my presentation today is to really set a foundation both for the board and for the public about how county behavioral health operates within California's Medicaid program, Medi -Cal. Behavioral health

Public Comment 1:34:56

plans are people with serious mental illness and substance use disorders.

UNKNOWN 1:35:02

These

Public Comment 1:35:03

are individuals whose needs are often the most complex and require the most sustained and coordinated care. Santa Clara behavioral health is the safety net for these folks.

UNKNOWN 1:35:17

So

Public Comment 1:35:17

when managed care plans, when commercial insurance, when

UNKNOWN 1:35:21

community

Public Comment 1:35:22

informal supports aren't sufficient, the county is there to catch them. We can go to the next slide. So I want to start just with a 10 ,000 foot

UNKNOWN 1:35:36

view

Public Comment 1:35:36

of what we're talking about. That behavioral health plan has two primary components and you can see them at the bottom of the screen there. The first is the mental health plan and this is the health plan that covers folks with those serious

UNKNOWN 1:35:50

specialty

Public Comment 1:35:52

mental health needs. The second is called the drug medical organized delivery system or DMCODS

UNKNOWN 1:36:00

which

Public Comment 1:36:01

provides

Public Comment 1:36:10

the California Department of Health Care Services to operate both programs on behalf of the state and this is part of the state's medical program.

UNKNOWN 1:36:19

Under

Public Comment 1:36:19

those contracts, counties are required to arrange for and ensure access to services when a medical member presents with a serious mental illness or substance use disorder and that obligation to serve that member is foundational. It means that counties aren't just responsible for funding those services but for ensuring that a functional system even exists. So are there beds? Are there providers? Is there a crisis response team? Is care coordination available? Whatever that

Public Comment 1:36:58

is available for these services, we can go to the next slide.

Public Comment 1:37:02

So in California, Medi -Cal behavioral health services are intentionally divided based on the severity and complexity of a member's needs. So for members with less intense mental health needs, these are often referred to

Public Comment 1:37:28

like group therapy, like psychological testing, other outpatient mental health services. For members that require more significant specialty mental health services or substance use disorder services, the responsibility shifts to the county. And this division is designed to ensure that the most complex and high acuity needs are really met in the community with specialized and local expertise. At the same time, this means that the county cannot simply step in to fill gaps that belong to a managed care plan without creating financial and compliance risk. We can go to the next slide.

Public Comment 1:38:14

So let's talk a little bit more about what these services look like. When someone qualifies through the county mental health plan, they can receive services such as residential treatment, intensive care coordination, or therapeutic foster care. And these services are really designed

Public Comment 1:38:40

to help DMC -ODS, again, that's the drug medical organized delivery system, individuals with substance use disorders might receive crisis intervention, residential treatment, they can get help with withdrawal management, and they can get medication for addiction treatment, or MAT. This is just a sampling. And these are among the most resource -intensive services in health care. Counties are required to ensure access to them for eligible members. This means maintaining the infrastructure needed to do that.

Public Comment 1:39:22

So, we're going to go to the next slide. Talking a little bit more about how these services are funded. I could keep you here all day talking about the complexity of how county behavioral health is funded. But I won't do that. I just want to highlight a few funding sources that really shape the county's role. The first is the 1991 and 2011 realignments. These really shifted responsibility for behavioral health services to the counties. And along with that came a whole handful of long -term fiscal and operational obligations.

Public Comment 1:40:10

So,

Public Comment 1:40:16

we're going talk these services are funded. going talk a little bit more how these services are funded. So,

Public Comment 1:40:28

we're going to a little bit about these services are funded. So, we're going to talk a little

Public Comment 1:40:42

bit about how these services are funded.

Public Comment 1:40:46

we're

Public Comment 1:40:55

going to talk a little those with most serious mental health and SUD needs.

Public Comment 1:41:02

Okay, we can go to the next slide. Let's talk a little bit about where

UNKNOWN 1:41:07

these

Public Comment 1:41:07

requirements originate and how they flow down to the county. We can go to the next slide. So, county behavioral health plans are subject to requirements that really originate at the federal government, flow down to the state of California, and finally passed on to the counties to operationalize those requirements. So, I just want to say that again. The federal government is really the one establishing all of those financial compliance quality requirements. They are passed down to the states. The states do have some agency in negotiating their waivers with CMS and determining who's eligible, things like that. But once that's in place, the state is contracting with counties who have very little say in those obligations and

Public Comment 1:41:57

requirements but who are obligated to implement

Public Comment 1:42:09

those matters because counties are held accountable even when they don't control the underlying policy choices. And counties cannot easily opt out. We can go to the next slide. These are some examples

Public Comment 1:42:39

of some of The first thing that I like

Public Comment 1:42:46

to talk about is the fact

Public Comment 1:43:08

that we have to take now and they're really shaping how counties are operating and reorganizing. We can go to the next slide. I'm going to talk just a little bit more about these fiscal and compliance risks. We can go to the next slide. So first I want to say all of this is happening in a period of political and fiscal uncertainty particularly for Medicaid. Counties are navigating state budget pressures at the same time that federal oversight of the Medicaid program is increasing. This combination of that state budget pressure and federal pressure means that counties have less margin for error than they have in the past.

Public Comment 1:43:52

We can go to the next slide. I'm going to highlight just a couple of examples of some of the financial sanctions in recent history. The first is that in 2025 DHCS, this is the Department of Healthcare Services, sanctioned managed care plans $1 .6 million. In 2022 they find LA care health plan $55 million for failing to meet

Public Comment 1:44:27

the requirement to move into functioning as fully operational health plans. This is a real paradigm shift for county behavioral health plans. It's very likely this level of scrutiny and use of financial sanctions will increasingly apply to counties as well. In fact, in 2025 DHCS issued corrective action plans to behavioral health plans and they've indicated that fiscal enforcement will begin in upcoming years.

Public Comment 1:45:13

We will continue to work state level to ensure continue

Public Comment 1:45:21

to provider networks, crisis response capacity, quality and

Public Comment 1:45:43

safety. even as funding shifts obligations do not. All of this is happening at a time of significant uncertainty for the Medicaid program and counties are navigating intense state budget pressures. This combination means counties have little room for error. In this environment staying tightly aligned with those core mandated services is not just a programmatic choice, it is a risk management strategy for the county. It also means that the county is able to preserve essential services and their role as the safety net for residents with the most serious mental health and substance use needs who have nowhere else to go. Thank you so much.

Otto Lee 1:46:27

Thank you. Go

Sylvia Arenas 1:46:28

ahead. Thank you so much, Jill. We appreciate you providing that foundational setting for us as we move through our presentation. And we will go ahead and go through the entire presentation and then open up for questions at the end.

Sylvia Arenas 1:46:44

So this slide represents the wide array of programming that the Behavioral Health Services Department provides. The table represents both mandated and non -mandated program categories. Failure to provide the mandated programs listed here on the left -hand side of the table would result in state fines, sanctions, and corrective action plans, as Jill just mentioned. And as you can see, the list of mandated programs offered is very robust with programs including, for example, our outpatient services, intensive services such as full service partnership, crisis stabilization, residential, our substance use treatment services including withdrawal management, residential treatment, and acute inpatient hospital services. The non -mandated programs listed on the right also support our system. Some of the programs listed

Sylvia Arenas 1:47:36

here are grant -funded and there are also some parts of these programs within the program category that are mandated. Next slide, please.

Sylvia Arenas 1:47:46

While BHSD is always working to enhance and improve our efforts, it is important to share some of the highlights we are most proud of. Over the past three and a half years with your support, BHSD has added a total of 263 treatment beds including acute, subacute, mental health community residential, substance use residential, and withdrawal management, and the addition of these 263 beds serve an additional 2 ,850 clients per year. Behavioral Health Services Department has exceeded our state targets during Fiscal Year 24 in the areas of follow -up after hospitalization for children and after emergency department visits. This is an important metric as we know that immediate follow -up post -hospital discharge has a strong relationship

Sylvia Arenas 1:48:31

with a reduction in hospital readmissions. In Fiscal Year 25, BHSD and its network have served 33 ,000 clients with 76 % of our clients receiving treatment for substance use disorder meeting their treatment goals and 67 % for mental health clients. Approximately 56 % of our clients served by our BHSD network are Latino with our network outperforming the statewide average in creating access for this population and Latinos are equally likely to have successful treatment outcomes when compared with other racial and ethnic groups receiving treatment. Next slide, please.

Sylvia Arenas 1:49:11

With the support of the Board of Supervisors, BHSD has expanded access to specialty mental health and substance use treatment services since Fiscal Year 22 and you can also see the increase in overall number of clients served since the launch of CalAIM in Fiscal Year 24. Next slide, please. As a Board, you have continued to support increasing access to subacute beds by 24 % since 2022.

Sylvia Arenas 1:49:38

Next slide, please. And since Fiscal Year 22, we have seen a sharp increase in acute admissions in line with inpatient bed expansion. Next slide, please.

Sylvia Arenas 1:49:51

I think it's safe to say that there is no other system or possibly any other county department that has experienced as much change as behavioral health. You'll see here a listing of the many behavioral health state reforms impacting county behavioral health between 2022 and 2025. And, you know, our department has really been tasked with a dizzying amount of state wide health reforms impacting behavioral health. So we wanted to note that on this slide just to bring some awareness and observation to the many initiatives that we've been required to do.

James Williams 1:50:27

I just want to pause on the slide for a moment because if there's one message to send the state, which, as was explained earlier in the presentation, really plays a key role in setting the policy and funding streams associated with behavioral health, this slide, to me, really in one picture demonstrates the broader statewide challenge in behavioral health, which is when you try to change funding structures and funding streams layer on program after program, make numerous additional changes in mechanisms and structures for treatment all at the same time. This is all just since 2022.

James Williams 1:51:10

Without opportunities for assessment and evaluation, a lot of these without accurate actual funding or certainly adequate funding for implementation, and then keep layering them on over and over again on top of each other, you create extraordinary challenges for the actual delivery of service, and each of these in one way or the other represents mandates and obligations imposed on counties across the state by the state government. So it's worth pausing for a second. Some of these are very substantial shifts and changes, including complete reform of how payment is structured across the behavioral health delivery network, which affects each and every provider of these services. And now, as we'll get to later in this presentation, to see

James Williams 1:52:03

the shifts in major state funding streams layered on top of that poses just extraordinary challenges for counties across the state and certainly for our county, which, as you'll see, has historically made different choices with flexible funding locally than what the state is now directing counties to do.

Sylvia Arenas 1:52:28

Great. Thank you so much, James. We can move ahead to the next slide, please. This next section is going to be a transition into discussion regarding our behavioral health budget. This slide illustrates our behavioral health fiscal year 26 expenditures by service and program category. As you'll see, our spending is highly concentrated in outpatient, acute, and crisis services. We also wanted to illustrate where our local funding is concentrated. In some cases, you will see the bright blue bar covering the majority of a service line, for example, in housing or subacute or outreach and prevention. In other areas, such as outpatient, you will see that there are options to create efficiencies through expanding and scaling the service

Sylvia Arenas 1:53:14

by enabling Medi -Cal to preserve local resources for programs with limited Medi -Cal coverage. Next slide, please.

Sylvia Arenas 1:53:22

Both market conditions and increasing needs and expenditures have contributed to our current fiscal challenges. Increasing costs for behavioral health services, increasing reliance on county behavioral health systems even by those with private insurance, culminating with a growing demand for behavioral health services, increased expenditures, and the use of one -time fund balances and MHSA allocations have led to those being nearly depleted. Next slide, please.

Sylvia Arenas 1:53:52

In addition, there are also key pressures contributing to our fiscal environment. Federal HR1 changes create uncertainty around funding, future funding levels, and increasing administrative workloads. As James mentioned, state BHSA changes ushered in by voters require specific allocation percentages of funding across distinct service categories, the proposed change to the mobile crisis benefit in the governor's budget would shift responsibility for the non -federal share of the benefit from the state to the county, and we wanted to note the importance of our mobile crisis programs and how critical they are to our community. We are committed to continuing to improve our efforts, strengthen the coordination across our continuum of crisis response programs, and continue our focus on making

Sylvia Arenas 1:54:41

these programs sustainable. Next slide, please. This

Sylvia Arenas 1:54:47

pie chart represents our total anticipated funding availability for fiscal year 26. Our total fiscal year 2026 anticipated expenditures of $959 million exceed available funding of $893 million, indicating a structural funding gap of approximately $66 million that must be closed. Next slide, please.

Sylvia Arenas 1:55:12

This chart illustrates a historical overview of our behavioral health services department budget. You will notice growth in costs increasing rapidly since the declaration of the public health crisis. Some of the key drivers impacting our current financial position includes implementation of CalAIM payment reform, service expansion, and annual rate structure increases have significantly increased payments, contributing to substantial and ongoing growth in provider -related costs across the system. As we've noted, temporary increases in revenue in fiscal year 24 and 25 were driven by delayed Mental Health Services Act payments that were due to COVID, and as a result of the factors noted, BHSD will require new funding sources or cost reductions to help sustain our system moving forward.

Sylvia Arenas 1:56:04

Next slide, please.

Sylvia Arenas 1:56:08

These charts illustrate spend trending for behavioral health services departments' two major funding sources, 2011 realignment and MHSA. 2011 realignment allocation has been roughly flat because sales tax and fees have also been flat. If the current spending and allocation trend continues, BHSD will run out of fund balance in the current fiscal year. And as we have noted in past presentations, the Mental Health Services Act funding is extremely volatile. Our spending increased in fiscal year 24 and 25 because of increased revenues and goals set under the declaration of the public health crisis, and we also, as I noted, received those two increases in revenue due to COVID. It's important to note that since publishing this presentation, we

Sylvia Arenas 1:56:56

have been provided additional guidance from a financial consultant that the state's projections around BHSD may paint a more rosy picture than may actually materialize for fiscal year 27.

Sylvia Arenas 1:57:08

Next slide, please.

James Williams 1:57:11

I just want to remind folks when we're talking about MHSA, this is something that is extraordinarily volatile tax that's heavily dependent on capital gains. And because of that, there's big swings that can occur and great variation year over year. So it is not a stable funding stream in that sense that makes it hard when you're talking about funding ongoing programs and operations with what is a very volatile funding stream.

Sylvia Arenas 1:57:43

Great. Thank you, James. This slide represents our fiscal year 26 -27 deficit projection. We anticipate a $100 million projected deficit in fiscal year 27. And this is due to some of the factors I've described in previous slides, but I will call a couple of, call your attention to a couple of comments. One, the reduced funding due to the transition of BHSD, as I've noted previously, some of the uncertainty around HR1 impacts and our continued interest to increase expenditures for new programs under Medi -Cal. Next slide, please.

Sylvia Arenas 1:58:24

We wanted to provide a reminder about just some of the changes associated with the transition from the Mental Health Services Act to the Behavioral Health Services Act. 90 % of funding is dedicated to our county allocation, while 10 % is withheld by the state for state -directed activities. Some of these activities include 4 % for population -based prevention activities that will be administered by the California Department of Public Health, with 51 % of the funding used to serve individuals aged 25 and younger. The California Department of Public Health has developed two program guides, and we are working closely with our local county public health department as we work together towards supporting these population -based prevention

Sylvia Arenas 1:59:07

activities. 3 % is administered toward behavioral health workforce administered by HCAI, and 3 % is administered to state administration. Next slide.

Sylvia Arenas 1:59:22

This chart represents the shifts in funding from current spending in BHSA categories translated into our new requirements. As noted previously, this transition requires specific percentages of funding allocated by category. Under BHSA, you will notice the state will require the county to increase spending to increase access to full -service partnership, associated with assertive community treatment and forensic assertive community treatment. This requirement is intended to create greater access for our most vulnerable populations, requiring more intensive services. Next

James Williams 1:59:59

slide, please. I'll stop on this slide for just one second. I just want to point out here,

James Williams 2:00:05

the board will notice there's a couple categories where the shift is really profound for our county organization. And if you look at the blue, the 49 % of the current allocation that's in the BHSS, behavioral health support services category, that under the new state requirements imposed on us, has to shift down to 17%. So there's two different dynamics going on with this critical funding stream. One is, what's the overall amount of funding from this volatile tax? But almost as significant, if not more significant, for our county in particular, is the shift in what the funding can be spent on, and what that means for programming here locally, where historically, we have steered more funding towards

James Williams 2:00:59

prevention, intervention type services, and the state is directing treatment, directing much substantial increases in funding go towards deep end services. And that's what's reflected in the gray and blue on the left hand side, shifting over to the gray and blue on the right hand side of that chart, which reflect the new state mandates on spending categories. Thank

Sylvia Arenas 2:01:30

you, James. Next slide, please.

Sylvia Arenas 2:01:34

In anticipation of fiscal year 27, beginning in the past fall, BHSD has been actively involved in communications with both our county staff and contract providers to gather their input on anticipated budget reductions. And this slide lists several activities and meetings and efforts that we've been engaged in since the fall in anticipation of some of our fiscal challenges facing us in fiscal year 27.

Sylvia Arenas 2:02:01

With that, I'm pleased to turn the next part of the presentation over to our partners, Elisa Koff -Ginsburg, representing the Behavioral Health Community Association, and Rachel Montoya from Community Solutions.

Public Comment 2:02:16

Thank you, and good morning. I'm Elisa Koff -Ginsburg, with the Behavioral Health Community Association, which is comprised of nonprofit providers delivering mental health, substance use, and supportive housing service. Many of the leaders are here today. Thank you to the county administration for inviting us to partner in this presentation, and more importantly, for partnering with us in addressing the serious challenges facing our county behavioral health system. You've heard a great deal of data and many numbers this morning. The magnitude and complexity can be difficult to fully absorb. I know that when I focus intently on understanding numbers, I sometimes find myself disconnected from what they truly represent. BHCA members spend every day focused on the residents

Public Comment 2:03:09

who receive vital services because of the funding we are discussing today. To help ground this conversation, we emailed you each a compendium of client stories that reflects the diversity of the people we serve and the range of services made possible by this funding that supports individualized, client -centered care. My colleague, Rachel Montoya, President and CEO of Community Solutions and Chair of the BHCA Finance Committee, and I will share a few excerpts from these stories. We cannot do them justice in a short presentation, and we hope you will take time to read the full document. A

Public Comment 2:03:53

12 -year -old girl struggling with epilepsy, developmental delays, and unstable housing received biweekly therapy, connection to primary care, and help securing stable housing through ACKI's Intensive Services Program. Her mother called ACKI a lifesaver.

Public Comment 2:04:27

Diego,

Public Comment 2:04:28

a 14 -year -old, was referred to Community Solutions for skipping classes due to anxiety, sleep issues, and avoidance. After the program, he showed increased self -awareness and motivation, saying he is implementing everything he learned into his life. After

Public Comment 2:04:45

a divorce, 60 -year -old Steven, living with both mental health and developmental disabilities, felt isolated and unsure of his future. With support from a Hope Services counselor, he rediscovered his sense of self and found purpose volunteering in a special education classroom. An

Public Comment 2:05:04

adult refugee from Afghanistan came to ACKI after surviving life -threatening events that led to severe anxiety and depression. After receiving care, she shared that she found new roots again after losing all hope.

Public Comment 2:05:19

Robert, age 50, struggled with behavioral issues, medication challenges, and homelessness. At Community Solutions, he said he learned to enjoy a moment and feel peace and a clear mind.

Public Comment 2:05:32

Josh, 14 -year -old, 43, grew up around gang activity, was first locked up in just fifth grade and spent years cycling in and out of incarceration and substance use. Referred to Kaminar after release from prison, he credits the staff for supporting his new path, clean for over three years, reconnected with family, working steadily, and training to become a truck driver.

Public Comment 2:05:56

Christina, who lives in New York, called NAMI's helpline concerned about her brother, who has mental and physical health conditions, and was in Santa Clara County Jail. Helpline staff connected her with medical staff at the jail to discuss the health issues and let her know how to send her brother's health history. They also referred Christina to the county's Office of Family Affairs, which contacted her so she could attend her brother's court appearance.

Public Comment 2:06:24

Cassandra was in elementary school when she was referred to Pacific Clinics for anxiety, trauma, and frequent absences. Through care, she began attending school more consistently, and grew more confident and engaged. At

Public Comment 2:06:38

age 16, Uma nervously visited Kaminar's LGBTQ youth space. He later became a peer intern and was eventually hired as an outreach coordinator, helping students in the way he once needed. After

Public Comment 2:06:53

a suicide attempt, Belle felt hopeless. At Momentum's residential program, she learned coping strategies and shared she had never felt

Public Comment 2:07:03

before. Taylor, who struggled with bipolar disorder, ADHD, and insomnia affecting her employment, received career support through Momentum. She explored new opportunities and was promoted to operations supervisor.

Public Comment 2:07:20

Roxanne, age 18, faced severe alcohol and cannabis use, mental health challenges, and an eating disorder. After receiving services at Health Right 360, she significantly reduced

Public Comment 2:07:33

her alcohol intake. She also shared she is learning to give herself the compassion she offers others.

Public Comment 2:07:38

Jenna, 17, struggled with truancy, depression, unhealthy relationships, and was involved in the juvenile justice system. Through Seneca's wraparound program, individual family and group therapy, she engaged with school and strengthened her relationships.

Public Comment 2:07:55

Betty was 30 weeks pregnant when she entered Momentum's Parisi House on the Hill. There, she focused on recovery and her health. Today, she is raising her child in a safe and stable environment.

Public Comment 2:08:07

JH was being involuntarily held at El Camino Hospital. The Patients' Rights Advocates team at Law Foundation's Health Program argued for her discharge, allowing her to return home and safely recover with her mother.

Public Comment 2:08:23

A medical social worker currently working at a county hospital shared that she had been sober for 15 years. As a client in Pathways Mariposa program, she rebuilt her life and established the foundation for long -term recovery that she still depends on today.

Public Comment 2:08:39

A 6 -year -old enrolled in Gardner Health Services Home Visitation program due to aggressive behavior towards his mother. Through the program, he improved in following directions, both at home and in school.

Public Comment 2:08:53

Jordan, a 19 -year -old non -binary young adult, was able to connect with his mother After two years at Pacific Clinics, they are now grounded, confident, and able to advocate for themselves and their community.

Public Comment 2:09:08

Ashley contacted the Trust program about her sister, who has bipolar disorder and had become manic, exhibiting risky behaviors, including trespassing on a neighbor's property. They called her to urgent care. They helped her get to urgent care.

Public Comment 2:09:28

She had multiple times where staff provided information on sharing vital background information, conservatorship, and AOT. Three months later, Ashley called back to share that her sister was doing well. These are the stories of just a few of the clients that are served by the funding that you're hearing about today. They are our neighbors in our community. They are the people that you receive phone calls about

Public Comment 2:09:58

from those in the community. And now we want to work together to ensure that our county behavioral health safety net continues to be strong. Next slide, please.

Public Comment 2:10:12

BHCA members developed recommendations that we shared with BHSD, and I'm pleased we're in the process of identifying ways to collaborate with them on them. We will now share a few specifics on this list. In regard to clients moving through the COVID -19 pandemic, to promote intensive services to lower levels of community -based care. Providers work with county staff on individual cases. We recommend building on this and reestablishing a cross -system step -down workgroup that focuses on systemic issues impacting timely step -down, addresses bottlenecks in real time, and ensures we're maximizing federal financial participation.

Public Comment 2:11:00

Next slide, please. our community -based billing workgroup to develop a coordinated system -wide approach to building the infrastructure workflows and compliance mechanisms necessary to bill commercial insurance. I want to highlight that providers are partnering with the county as they roll out the structure necessary for increasing billable services and bring online new reimbursable roles such as community health workers. Next, we recognize that unsponsored funds are limited and should be reserved for situations where no other payer exists. Improved tracking and contracts will help ensure these dollars are used appropriately and consistently. Currently, all providers where clinically and operationally appropriate are moving programs from cost -based reimbursement to fee -for -service, which will help improve fiscal sustainability.

Public Comment 2:11:54

Historically, the timing of complex payment systems make accurate tracking of clients and billing data challenging. We need to work together to ensure that contracts reflect the actual service delivery so that we are not carrying unearned dollars during a time of significant budget constraint. And the final three recommendations concentrate on ensuring we are spending precious funding on direct services. First, eliminating staffing requirements

Public Comment 2:12:23

by state or federal regulators. This creates flexibility for providers and avoids adding costs that do not directly improve access. Second, providers are spending too much time on duplicative administrative tasks. We're asking BHSD to prioritize changes that will streamline data entry and reporting and free up staff time for direct billable services. Finally, county documentation standards that exceed state requirements create administrative burden. Simplifying these requirements will increase provider capacity and help preserve services during this fiscal crisis. And I pass it to Rachel.

Public Comment 2:13:10

Good

Public Comment 2:13:10

morning. Again, I'm Rachel Montoya, President and CEO of Community Solutions. Community Solutions is one of many community -based organizations delivering the vital services we're talking about today. Community -based organizations provide 85 % of behavioral health services in this county. I want to acknowledge that most of us, including myself, my colleagues in chambers, my colleagues at this table, and likely many of you, don't see this work as a job. It is a calling. And I want to express my appreciation in allowing us to be part of the conversation today.

Public Comment 2:13:52

I am here to highlight the need for continued clear and collaborative communication in the key assumptions and data underlying the projections we just looked at. Those projections that result in the $100 million structural deficit shown in the department slides. You may notice that the funding streams in my slide here overlaps significantly with the slide that Jill put up from Aurora. And I want to acknowledge what Jill said as well. Behavioral funding is complex.

Public Comment 2:14:29

BHSD has been leaning into transparency and has been working collaboratively with us as providers, especially around the revenue and expense information that was just presented. The area we are currently working on and need to continue to work on is understanding the underlying assumptions used to calculate those projections. As we are looking at potential cuts in vital, life -saving services, it is crucial that we are clear on the best picture of what these cuts need to be. It would be devastating to dismantle or reduce services that may not have had to have been cut when we look in the rearview mirror. One example of an area that needs further understanding is the assumptions that are being

Public Comment 2:15:16

used in the FY 26 -27 HR1 impacts.

Public Comment 2:15:22

While we know the impact of HR1 has the potential to devastate Medi -Cal recipients, and county funding in many ways, HR1 has to devastate Medi -Cal recipients and county funding. In many ways, HR1 has a reduced impact to our clients that we serve. This is seen most clearly in the work requirements that are included in HR1. Individuals with disabilities, including a substance use diagnosis, are likely to be exempt from these work requirements. Understanding the assumptions being used in the impact of HR1 can allow us to work together to ensure we are operating off the same information, and it will also allow us as providers to actively work with our clients to mitigate any loss of

Public Comment 2:16:16

coverage, support and certification of their disability, and maintain the much needed funding from federal funding participation.

Public Comment 2:16:26

Go ahead and move to the next slide.

Public Comment 2:16:29

As we move into this next slide, and I pass it back to Sherry with the department, you will see BHSD guiding principles on the left hand side. I want to emphasize that providers share these same principles, and that alignment matters, because partnership has consistently been our greatest strength. We saw this clearly during COVID. We weathered the crisis as a community with very few layoffs and preserving a work force that is both vital and incredibly difficult to retain. We also saw this during behavioral health payment reform where our shared efforts resulted in recognition by the state of the success of Santa Clara County in the pivot including maximizing revenue.

Public Comment 2:17:19

A pivot not all counties were able to do with such success. While we are entering the time of making difficult decisions, I am confident that we are better together.

Sylvia Arenas 2:17:30

Thank you.

Sylvia Arenas 2:17:36

Great. Thank you so much, Alisa and Rachel.

Sylvia Arenas 2:17:40

I'm going to stay on this slide for just a minute. As we prepared for what we knew would be a challenging budget for fiscal year 27, consistent with the direction of the Board of Supervisors, behavioral health developed a set of guiding principles and key strategies and priorities. Ensuring access and preservation of services are key guiding principles. Our decisions must be made through an equity lens, incorporate stakeholder

Sylvia Arenas 2:18:06

equity and data -driven decisions. And in order to achieve a financially stable path and ensure stability of our network, we must maximize Medi -Cal leveraging wherever possible, ensure our compliance with our regulatory requirements, protect access, maintain quality, and serve our most vulnerable beneficiaries. Next slide, please.

Sylvia Arenas 2:18:28

Our structural deficit mitigation strategies include both revenue expansion and cost reduction strategies. As we shared during our November presentation on BH Connect, we are opting into all BH Connect revenue opportunities. We are ramping up our efforts around Medi -Cal administrative activities claiming, referred to as MAW. We are implementing enhanced care management at our county operated clinics and working to increase productivity across all network outpatient providers, as well as a focus on accountability for managed care and commercial payers. On the cost reduction strategies, we're proposing to restructure all levels of care to improve efficiency of our operations, transitioning cost -based programs to fee -for -service, focusing on billing efficiencies within our county operated clinics, including implementation

Sylvia Arenas 2:19:18

of AI software to improve productivity and accuracy of billing, realigning contract payment rates with funding availability across all contracts types, and ensuring compliance with our regulatory requirements to avoid corrective action plans and potential monetary sanctions. Next slide, please.

Sylvia Arenas 2:19:39

So, in summary, BHSD has a large structural deficit in two of its largest funding sources, both 2011 realignment and BHSA. BHSD has been impacted, as we've stated, by many new statewide initiatives that did not come with new or adequate funding. We will need to make reductions in a way that preserves the greatest degree of access to mandated services for Medi -Cal beneficiaries that we are contracted to serve. We will need to increase funding in certain categories. As we've noted, the shift from MHSA to BHSA does not come with new funding, and we will be required to increase spending in certain categories. And BHSD is a noted leader amongst large California counties, and we will continue

Sylvia Arenas 2:20:26

to strive to maintain our level of excellence and exceeding our state performance targets. So, with that, we conclude our presentation, and we're open to questions. Thank you.

Sylvia Arenas 2:20:39

Thank you.

Otto Lee 2:20:40

Thank you, Dr. Terrell, and thank you for the team. Anything else, James, to add before we open up the public? I

James Williams 2:20:46

don't know if you want to do public comment first, and then I might have a brief thing to

Otto Lee 2:20:49

add. I'll ask public comments first. How many in public would like to speak on this item?

Otto Lee 2:20:56

I currently have five speakers in chambers and six on Zoom. Okay, let's do one minute each. All right. Thank you. We are now closing the public comment. We will call forward the people in chambers. Andrew Sigler, Allison George, Laurie Katcher, Sandra Asher, and Sean. Good

Otto Lee 2:21:36

morning.

Public Comment 2:21:36

My name is Andrew Sigler. I am a member of Search Santa Clara County. I'm also on the Trust Community Advisory Board. I also suffer from a mental health disability. I'm crazy. So, we on the CAB got a presentation back in January that showed that trust was going to be downgraded to a mobile outreach team, and not a crisis response. It showed marketing materials that don't say that it's a crisis response. And the problem with this is that if it's downgraded from a crisis response to an outreach team, it will no longer be billable by Medi -Cal. So, with the report saying that, you know, trust is going to continue to be funded by Medi -Cal,

Public Comment 2:22:24

we in the community are going to continue reimbursement. That's not going to be possible if it's a mobile outreach team. So, I don't know. I have things to look into. Thanks a lot.

Otto Lee 2:22:42

Actually, the mic is on the podium. So, just stand at the podium. Yes, there you go.

Public Comment 2:22:48

Sandra Asher, District 5 resident, member of the Trust Community Advisory Board. And today was intended to be a study session and not just a budget overview. So, that's why we are

Public Comment 2:23:03

going to spend about the changes that were communicated to us in our last meeting, shifting trust away from a Medi -Cal reimbursable mobile crisis team and towards a community outreach program. And although we appreciate some assurances we've received from county staff, there's a lack of, sorry for the pun, trust between the CAB and the county based on the communication that we've been receiving. So, we ask that staff communicate early and well before any decisions are made, either this budget year or next budget year, and really return to the spirit and intent of a collaboration between the community, the providers, and the county. Thank you. Thank

Otto Lee 2:23:46

you.

Otto Lee 2:23:50

Hi,

Public Comment 2:23:51

good morning, Board. My name is Lori Katcher. I'm a 23 -year resident and voter in District 2, proudly, and a member of SURGE. I'm grateful for the collaboration of impacted families who lost loved ones to police violence, who gave their heart and soul to work with the county and community partners in collaboration to create the Trust Program several years ago. And as a mom of three young adults and as a neighbor to some of our most marginalized residents here in Santa Clara County, Trust provides desperately needed non -police crisis response. Of all our mobile crisis teams, Trust receives the highest volume of calls, and unlike MCRT, Trust is our only completely non -police crisis response

Public Comment 2:24:37

program, which is what our community called for and continues to stand behind. So I just want to call to action concerns of the CAB members and ask our Board to slow down, to listen to, please, and integrate concerns from CAB members. Thank you. Hi,

Public Comment 2:25:00

my

Public Comment 2:25:00

name's Allison George, and I live in District 5 and I'm a member of SURGE. I think maintaining trust as a peer -based, non -police crisis response is critical. As a parent of an adult with a history of significant substance abuse and mental health issues,

Public Comment 2:25:21

I am particularly concerned about maintaining trust. Gratefully, my son is stable now, but has had experiences in the past of psychoses with significant delusions and hallucinations, and these were particularly related to fear of the police and experiences that I think founded in aggressive behavior that he'd experienced. I would not call 911 if my son were to experience an exacerbation again for fear of escalation and potential risk to his health and life. I urge you not to receive the report. Thank you.

Otto Lee 2:26:01

Thank you. If you have any more comments that you would not be able to read out, please give the statement to Rhonda and she will put it onto the record. What's that? Yeah, if you could not finish your statement and you have it written out, please give it to Rhonda and she could add it to the record. Thank you so much.

Public Comment 2:26:17

I agree with what everybody said before me. Trust is the only one that people trust. When somebody's in crisis and you say, hey, is it okay if we call trust? People say yes. If you say, hey, is it okay if we call anything else, 911? No, no. Nobody will accept when we're offering help anything that involves the cops, and that says a lot. So when you say, hey, is it okay if we call trust? And they're like, I don't know, what is that? And then you explain it, and they're like, does it have cops? And you're like, no. They're like, okay. And so every experience that I've ever had with trust has been great. Even

Public Comment 2:26:57

if the person doesn't leave with them, it's just that when we're standing there talking to trust and when they're talking to trust, it is still a great experience. And, you know, I normally never have anything good to say about, you know, anything. So trust

UNKNOWN 2:27:10

is great.

UNKNOWN 2:27:18

Thank

Otto Lee 2:27:18

you. With that, we'll move to our Zoom speakers. Our first speaker is Catherine Hedges. We've asked you to unmute.

Public Comment 2:27:27

Thank you. My name is Catherine Hedges, and I'm a member of SURGE and a former member of the Trust Cab. And I want to amplify everything people have said before me. It's critical that we keep trust as a peer -based crisis team. They were the only ones who could get through to some of my neighbors at Donner Lofts when they were in crisis. 988 would just hang up on them if they were rambling. Nobody wanted police around. We had a police shooting in our building.

Public Comment 2:28:01

People do not want the police when they're in crisis. The police are not going to know how to cope with somebody who is pulling the wiring out of their apartment because they think it's a spy system. Okay, that's not what police do. We need trust. It's required by the state. We'll get fined if it doesn't meet the requirements.

Public Comment 2:28:21

And it works. Keep it. Don't accept the report. Listen to the Trust Cab. Thank you very much.

Public Comment 2:28:31

Thank

Otto Lee 2:28:32

you. Our next speaker is Karen Mitsuda.

Public Comment 2:28:36

Hi,

Public Comment 2:28:39

my name's Karen. I live in District 2 and I'm a member of SURGE. And I echo what everyone has already said. Please listen to the Cab members. Don't receive this report as it's been given. I'm the sister of a man with severe mental illness. So I know firsthand the response a person in crisis receives can mean the difference between life and death. The right response still looks like trust. Mental health professionals, EMTs, and peers with lived experience working together with care and skill without law enforcement. And this just isn't my family's experience. It's backed by data and it helps explain why trust receives more calls than any other crisis response program in the county. People

Public Comment 2:29:21

call trust because they trust trust. And trust's ability to save lives depends on its designation as a non -police crisis response team so that it's eligible for Medi -Cal reimbursement. Please

UNKNOWN 2:29:33

listen to the Cab

Public Comment 2:29:34

and let's help our neighbors. Thank you.

Otto Lee 2:29:39

Thank you. Our next speaker is Emma Hartung.

Public Comment 2:29:45

Hi, my name's Emma Hartung. I'm a member of Showing Up for Racial Justice and a constituent in District 4. Just echoing what everyone else has shared, people trust trust and it's so crucial to maintain that trust by maintaining it as a genuinely non -police crisis response both for everyone's safety and for community trust and also for budgetary Medi -Cal reimbursement purposes. And I wish trust had existed when I most needed it as a young adult and my friends most needed it. We've just seen in my hometown of New York City, we've just seen another police shooting of a young man who's currently handcuffed to his hospital bed because the police shot him during a mental

Public Comment 2:30:25

health crisis when his family called for help and so just really hoping that we can maintain this beautiful program that families have built with their love and support and input. So yeah, please don't receive the report as written. Ask for an off -agenda report and really listen to the CAB and the community that worked with you to build this program. Thank you. And also shout out to the in -home support workers and RIP Muhammad Hussein. Thank

Otto Lee 2:30:48

you. Our next speaker is Lori Valdez.

Public Comment 2:30:51

Hi,

Public Comment 2:30:55

my name is Lori Valdez and I'm one of the 13 families who envisioned trust, who worked with the Behavioral Health to get this program to be in our communities to save lives and it's important that I'm also a CAB member and want to express that me as an impacted family who actually envisioned how trust would operate in our county has been disrespected by some of the county people that work with trust. When I express my opinion, they attack me and it's hard to stay. I want to stay on the CAB because this is our vision. I'm one of the 13 families. There's three of us on it and we need to keep trust as a

Public Comment 2:31:43

non -police crisis to get funding but also because Antonio Guzman Lopez, within 50 seconds he was killed by a CIT trained officers. Thank

Public Comment 2:31:58

you.

Otto Lee 2:31:58

Our next speaker is Jenna Kress.

Public Comment 2:32:00

Hi,

Public Comment 2:32:04

my name is Jenna Kress from District 6 and I'm also here with Surge Santa Clara County and I grew up in a home with a loved one navigating severe mental health challenges that required crisis response on multiple occasions and then I developed my own mental health challenges and it's deeply important to me that me, my loved ones, and the community that I care so much about are able to call a peer -based, non -law enforcement crisis response when we need it most. I'm asking the board to listen to and integrate the feedback from concerned CAB members before any material changes to trust are made. Trust was created by family members like Lori who lost loved

Public Comment 2:32:44

ones to police violence during mental health crises as a peer -based non -law enforcement crisis response program and it needs to remain that so that more people in our community aren't harmed or even killed during the moments that they need the most help.

Public Comment 2:33:02

Thank

Otto Lee 2:33:03

you. Our next speaker is Kim Guptill.

Public Comment 2:33:08

Yes, good morning. Kim Guptill, D4, member of Surge Santa Clara County. And we are showing up for racial justice and public safety in solidarity with our SVD bug partners. I have a nephew who has serious mental health challenges and the thought of him being approached by police while in crisis makes me shudder. This is about living up to our community values of racial justice and public safety. I'll remind you that nearly three -quarters of people seriously injured or killed by San Jose police between 2014 and 2021 were believed to be experiencing a mental health or substance use crisis. Say no more. Do not receive the report as written, please, and ask for an off -agenda

Public Comment 2:33:51

report. We want you to listen and integrate the feedback from the concerned CAB members, many of whom just spoke, and before any material changes are made to trust. It needs to remain a peer -based non -law enforcement crisis response program so that more people in our community don't

Otto Lee 2:34:09

get hurt. And this concludes our public speakers for this item.

James Williams 2:34:15

I just wanted to make a brief comment and invite the department to make a brief comment regarding the issue of trust, which as the board is aware, was not an item where there's any proposal or recommendation included in this report. As the board's also aware, and I've mentioned on a number of occasions, the trust program is funded under innovation funding under the MHSA. That innovation funding is going away under the MHSA as part of the broader state shifts that have been discussed, and that project ends in November of 2026. And so, consistent with a lot of the comments that the speakers have shared regarding trust, we do want to figure out a way to ensure

James Williams 2:35:02

the program continues, continues as a non -law enforcement response, and continues in a way that it can qualify as a Medi -Cal mobile crisis benefit, given that we are losing innovation funding. So I'll invite the department to add anything to that, but based on some of the written comments that were submitted, there appears to be a little confusion around that. There's no proposal here. Instead, there's continued ongoing conversations, and of course something would come in front of the board well in advance of anything, but the reality is, as it stands today, absent changes before November of 2026, the current funding for trust is going away, and again that is a state loss of innovation funding,

James Williams 2:35:51

and just one example of many of what happens when the state makes some of these policy changes. But we very much are committed to figuring out ways for the trust program to continue. Sherry, I don't know if you want to add anything to

Sylvia Arenas 2:36:05

what I just shared. Thank you, James. I just wanted to acknowledge and thank you for your public comments today. The county is really a great community. We are committed to hearing your concerns and better understand some of your comments. Megan and I will be attending the next CAB meeting, and we really look forward to having a reboot, restart, really understanding what some of your concerns are, and being engaged in that dialogue. So we look forward to seeing you at the next meeting. Thank you so much.

Sylvia Arenas 2:36:41

Thank

Otto Lee 2:36:42

you. I see the lights on the Suvai Zalimber. Thank

Susan Ellenberg 2:36:45

you very much. I really appreciate first the public commenters who came out to speak on this item and the presenters for the formal DAC. Jill, I wish every state legislator would be required to hear your presentation. So many just don't understand the chasm that exists between their mandates, often unfunded, and what is needed to actually implement and operationalize those jobs. Thank you for the directives here, and I just thought you did a remarkably clear

Susan Ellenberg 2:37:23

job that I think is applicable across the state. Also, really want to appreciate that the presenters included both county staff and community partners. To me, this is also a very encouraging sign. Doesn't mean we are exactly where we need to be, but I'm hearing from a lot of

Susan Ellenberg 2:37:48

I realize that this year's budget is truly, truly unprecedented for the Behavioral Health Services Department. As you so eloquently laid out, we are simultaneously implementing the transition from MHSA to BSHA, which could result in an estimated loss between $6 and $12 million in revenue next year, while we're also preparing for the significant.

Susan Ellenberg 2:38:17

The federal administration and the Medi -Cal cuts proposed by the state, and of course these pressures are also coming on top of rising service and staffing costs driven by both new mandated programs and non -mandated programs that we have added to meet community needs and comply with state and federal requirements. So, given these combined challenges and the fact that the department is facing a nearly $100 million budget hole for the upcoming fiscal year, it is going to be so essential that we are fully, truly transparent about how decisions are made, what services are impacted, and who is the population. I thought, Elisa and Rachel, you did a really lovely job connecting the numbers to the

Susan Ellenberg 2:39:17

individual there are so many more of them, but when we say the words of cut programs or cut services

Susan Ellenberg 2:39:25

we are we are being able to we are offering less to all of the individuals that you talked about and so many more. I do understand that the first draft of the BHSA three year plan will be submitted to the state at the end of March. I initially requested a detailed breakdown of programmatic funding changes in this report, but I recognize that the department is waiting for state feedback before finalizing those allocations so that is fine. Sherry and Megan, as part of this year's budget reporting to committees in April, I want to make sure that we have a clear understanding of BHSD budget changes including changes resulting from the transition from MHSA to BHSA. I'll

Susan Ellenberg 2:40:12

make a motion outlining what I'm looking for at the end of my comments, but essentially what I want is to ensure that our county again has full transparency about the reasons for making specific budget recommendations and that our providers and community stakeholders have sufficient time to provide meaningful input on the BHSA plan and the broader behavioral health budget well before the May budget study sessions. Second. Thank you very much. I'll make the motion a little bit clearer at the end, but I appreciate the early support. Thank you. I want to acknowledge the concerns that we've heard both from before today and this morning from community members around the trust program and our broader crisis response

Susan Ellenberg 2:41:01

team. And just to shine a spotlight on our leaders in this work, Greta, Key, Megan, and Sherry, I want to just continue to emphasize how critical it is that our mental health response health crisis response delivers high quality, reliable services. And I know that you don't disagree with me, but I also think that we need stronger collaboration across the entire crisis response network than we currently have specifically between the trust community advisory board, county staff, and our mobile crisis response system providers. The original vision for trust as articulated by community partners was a non law enforcement based in the field mental health crisis response, not simply an outreach model. And that includes, so that would

Susan Ellenberg 2:41:56

include in my view, responding to individuals experiencing suicidal ideation who are not necessarily posing an immediate safety risk. What I've been hearing from community stakeholders about trust is that they would like the CAB meetings to be more collaborative. Sherry, I heard you say that you are already moving on this path, so I am reiterating what I believe is already in motion. And CAB certainly has legitimate questions about the trust program's scope, the direction, long term stability. James, thank you very much for your comments indicating that we really are aligned on turning over every possible stone to find sustainable funding.

Susan Ellenberg 2:42:43

And again, all of this in light of the fact that the county has to make significant budget cuts in this upcoming fiscal year. So I would direct administration to work with CAB members and the trust providers to develop a better structure for the Trust Community Advisory Board. One that promotes genuine collaboration and ensures that everyone at the table feels heard and respected. And where reasonable information requests from CAB are appropriately tracked and responded to. As an initial step, I would recommend,

Susan Ellenberg 2:43:17

I'm not directing CAB, I'm recommending that the CAB members select a chair who can partner with county staff and trust providers to help set agendas and facilitate meetings. I know that everyone involved in the Trust Community Advisory Board truly deeply cares about behavioral health access and supporting our community so let's take full advantage of this precious I'm not using that word lightly, this truly precious opportunity and climate where so many important voices can come together. Finally I want to thank BHCA for including system improvement recommendations on page 36 of the updated slide deck and behavioral health for the deficit mitigation strategies on page 39. I would appreciate an update on these recommendations their feasibility or

Susan Ellenberg 2:44:11

a progress update as an off agenda report by the first meeting in October. So with all of that I will make what I hope is a clear and somewhat concise motion. So my motion is to receive the report with directions to number one, include information on the transition from MHSA to BHSA in behavioral health's budget proposal to HHC in April including what I had originally requested for this report which was information on the programs and so what programs and services are continuing and being recategorized under a new or existing BHSA funding bucket what programs are being added or expanded to meet new state requirements and what programs are scaling back or being completely eliminated due

Susan Ellenberg 2:45:06

to budget limitations. For reference this was the earlier request, I'm just restating it here. The second piece of direction is to work with the Trust Community Advisory Board members county staff and trust providers to develop a more collaborative structure for the Trust Community Advisory Board and in recognition of a number of the thoughtful ideas that were shared through public comment and communications with my office I would request that behavioral health collaborate with my office and the Trust Community Advisory Board to explore potential refinements to the mobile crisis response systems reporting metrics. Third, the third piece of direction is an off agenda report by the first board meeting in October on the feasibility and our progress

Susan Ellenberg 2:45:56

toward structural deficit mitigation strategies that were included on page 39 and the recommendations outlined by BHCA on page 36 of the updated presentation. I'm hoping you are still in for a second on that. Second.

Sylvia Arenas 2:46:13

I just have a question about the structural deficit improvements. You were asking for those to happen after the budget is approved. You said October.

Sylvia Arenas 2:46:24

Okay.

Susan Ellenberg 2:46:24

Yes, because those are the ongoing pieces, not necessarily

Susan Ellenberg 2:46:31

the absolute urgent needed for this fiscal year. Okay. Thank you.

Susan Ellenberg 2:46:43

She's

Sylvia Arenas 2:46:43

done. Oh, me? Okay. I think, I think Well,

Otto Lee 2:46:49

you second it. So I figure if you want anything to say out of my office, I could.

Sylvia Arenas 2:46:52

Okay. Sure. I just don't want to skip anybody. But thank you. Okay. So I am going to pick up a little bit where you left off Supervisor Ellenberg

Sylvia Arenas 2:47:07

only because I think it makes sense. And then I'll go back to some of the points that I wanted to make. So some of the improvements based on

Sylvia Arenas 2:47:19

one of your slides, you have strategies that you're going to take in order to increase or to decrease the

Sylvia Arenas 2:47:31

structural deficit strategies.

Sylvia Arenas 2:47:37

One of which is on the cost reduction strategies in this one, two, three, four, five. The fifth one down is adapting the countywide mobile crisis response system to align with the anticipated state benefit changes while ensuring sustainability. So translate that for me. What does that mean? What did you mean by that? That's a very fair question. So since the inception of trust and also PERT was another innovation program, the mobile crisis benefit has been adopted by Medi -Cal, which is a great opportunity for us to sustain programs like trust, like our county operated MCRT. So we are actively have been actively working with our contractors to make sure that we are fully maximizing that benefit.

Sylvia Arenas 2:48:27

Even as there are contemplated changes at the state level that would net reduce funding, it is still an ongoing funding stream that we can tap into to maintain our robust system.

James Williams 2:48:39

I do want to just take this opportunity to point out one of the many things we are not pleased with in the governor's budget proposal, which is specifically to shift the mobile crisis response benefit from being mandated to optional, which on the one hand you may think, okay, well that gives flexibility. Actually what it does is it takes away the state funding associated with that and makes it so that if a county chooses to do it, the county has to cover 100 % of the non -federal share. So what it actually is, is a proposal by the state to cost shift to counties like ours that they know will be committed to trying to continue

James Williams 2:49:20

the benefit. Of course, in other parts of the state different things might happen that are even more problematic. So that's one very concrete item in the governor's budget that we strongly oppose, along with several others, and is a piece of our state -related budget advocacy. So that's related to the same item, so I want to just point that out so it's on people's radar.

Sylvia Arenas 2:49:44

I appreciate that. I just want to make sure that, and I want to thank Supervisor Ellenberg for making it clear that we would like to know what those programs and services are that are being discontinued, scaled back, that are being added, all of that, because I think that allows for us to continue to support the direction that BHSD is making, or not making, and not to have any surprises,

Sylvia Arenas 2:50:13

especially the last time that we had a surprise was with PERT. PERT was never in full development and never really was enacted on the part of the county, so we never even gave it a chance. And these are folks who are interacting with the law enforcement agencies, the local law enforcement agencies, that couldn't result in death, I mean, or severe injury. So I want to make sure that that doesn't continue to happen, and while I'm on that topic, what is, I'd like to add to the motion to figure out what from those crisis responses that you've had either with the trust or the MCRT, probably MCRT at a different level, how many of those involved

Sylvia Arenas 2:51:00

law enforcement or included law enforcement incidents?

Sylvia Arenas 2:51:07

You shook your head yes. We have that data. I don't know off the top of my head, but if you want to make a request for a time period, we can certainly provide that. I'll ask for it in the same, actually, did you ask Supervisor Ellenberg, your request for additional information for the reduction, addition, all of that, that's before the budget, correct? So I'll follow, I'll go ahead and follow the same timeline that Supervisor Ellenberg recommended in her, I think her off -agenda report. I have

Susan Ellenberg 2:51:42

a note that the, that information is in the report.

Sylvia Arenas 2:51:46

Yeah, sorry, it's on page 53 of the report. You can see percentages that involve law enforcement or 5150, it's broken down. Great, since you found

Susan Ellenberg 2:51:57

the page, could you share that what it says about the percentages for Vice President Arenas? Thank you. Just

Sylvia Arenas 2:52:11

want to make sure I'm interpreting it correctly. So

Sylvia Arenas 2:52:16

I'm looking at the line for trust, we have law enforcement agency arrest less than 1 % of the calls. For MRSS we have 0 % of the calls.

Sylvia Arenas 2:52:31

For MCRT, law enforcement arrest is 1 % of the calls. And per district, we have law enforcement arrest at 2 % of the calls. So overall, fairly

Sylvia Arenas 2:52:44

low percentages. Is that consistent from previous years? You have it in front of you, so I don't know what the timeframe is. I'm just wondering, did that increase? Did that decrease? Did our relationship building with the law enforcement agencies in this county grow and so then they call us more often? Or is that pretty stagnant? The timeframe is from October 2025 to December 2025, so it's not sort of a comparative over time. But we certainly have the data to be able to do that. Wonderful. I'd love to learn more about that. One of the things that I want to make sure that we don't

Sylvia Arenas 2:53:24

some of the preventable deaths that unfortunately happen with

Sylvia Arenas 2:53:32

because our law enforcement agency uses different kinds of tools, and obviously you all do, and so those tools may be utilized with folks and some of our law enforcement agencies may feel threatened, right? And so I'm not excusing anybody, and I'm certainly not going to be on one side or the other, but I understand there's interactions there that could be preventable, and we also had a death in our jail system of a gentleman who

Sylvia Arenas 2:54:07

shouldn't have interacted with our police department in that way and shouldn't have been in jail and should have been

Sylvia Arenas 2:54:18

in a different unit, should have, should have, should have, but he's not here with us anymore. That's at the beginning of last year, right? So this is almost an anniversary for that gentleman in terms of his death, and I keep that in the back of my mind because those are the folks who will continue to interact with our police, our different law enforcement agencies. Okay, so I'm going to move on to the revenue expansion strategies.

Sylvia Arenas 2:54:50

I'm glad you had this in here, but there were some other strategies that your partners mentioned, one of which was reducing duplicative input of information, simplifying requirements as needed, and I forget, I think there were some assumptions that were made that were integrated. How are you taking those, that feedback and applying it, integrating it, responding to it? What is, Sherry, what is it that you all are doing?

Sylvia Arenas 2:55:24

Sure, thank you for the question, Supervisor. We are continuing to work with our contract providers. As Jill mentioned in her part of her presentation, there are many regulatory requirements and directives and obligations that we are required to do with respect to data collection, representing the network, the information that we are required to share with the state. And, you know, those do trickle down to the county and then to the providers. We continue to work together to attempt to mitigate, you know, administrative burdens to the extent possible. However, you know, there are going to always be specific requirements that we are requiring our providers to provide just that are part of the regulatory requirements. So, to

Sylvia Arenas 2:56:11

your question, we are continuing to always look at options for reducing administrative burden, but there, you know, certainly are certain circumstances for which we are just required to get information that we need to have as part of those requirements. No, that's completely understandable, but what is substantial or could take away from the provision of a service is somebody who is a therapist who is just inputting something that they've already input, and they're looking to, I don't have the answer to this, but I know that between you and the stakeholders, there is an answer. And there's always improvement for, if you are not looking to internally improve, and this is what's missing here for me, you

Sylvia Arenas 2:56:58

have a structural deficit mitigation strategy in order to expand your revenue and to decrease your revenue, but what you're missing is a real analysis of your department and where you're doing really well, and I know that there's a lot of really great places that you're doing well, and I'll mention some of those in a minute, but there are also areas where there's gaps, and I think this is an opportunity for us to take a look at those gaps and improve those, and I did not hear that in this presentation. So tell me, what are you concretely going to do? I see James light on.

James Williams 2:57:38

Yeah, I would just know super visor, there's a tremendous amount of work happening on the department as a whole. If you look at bullet number one under cost reduction strategies, restructuring at all levels of the department to prove efficiency of operations,

James Williams 2:57:56

and I think you should expect to see coming forward and this department's budget proposals pretty significant

James Williams 2:58:08

reductions associated with the department. We've also raised for some time now the issue of our own clinics. They're the minority of the broader network, but we do have county -run behavioral health clinics, and the need for those clinics to also be achieving productivity and successful transition to fee -for -service, just like providers do as well. There's some unique things about some of those clinics because of the population served or locations served that make them a little different than the community providers in terms of access or populations, but that is another big piece of things, and the board will recall actually in the last budget that there were a number of restructurings associated with the behavioral

James Williams 2:59:01

health service department's own clinical operations as well. So, I can assure the board that that is a significant piece of things as well, even though that is only about 10 to 15 percent of the network. Okay,

Sylvia Arenas 2:59:17

so I'm going to add that to the motion. I want a really thorough breakdown of what that restructuring is going to be and the improved efficiencies of operation because I think it starts in -house. It starts with you making sure that you take a look at what your analysis that you give us an analysis of the department so that we can clearly see what are some of the structural deficiencies, and then we can also, as policymakers, be able to support you or not, or be able to guide with policy a different direction. But if we don't have the information, we're not going to be able to do that.

Sylvia Arenas 3:00:00

There are some really wonderful

Sylvia Arenas 3:00:05

performance and equity outcomes that I do want to mention before I continue on. And the reason I well, let me just start by saying that I know that behavioral health exceeded the state targets in multiple quality measures, and that includes follow -ups with hospitalization, emergency department visits, medication adherence for schizophrenia specifically.

Sylvia Arenas 3:00:32

There is also I think treatment outcomes for Latino clients are comparable to other racial and other ethnic groups. As you know from the Latino Health Assessment and Latinos over -representing clients in behavioral health department, it's important to me and it's important for us to continue to look at those who are underserved. They represent, Latinos represent 58 % of the clients served. So I want to make sure that when you make those cuts or you

Sylvia Arenas 3:01:05

reduce anything, I want to understand how that's going to impact the Latino community, how that's going to impact South County specifically.

Sylvia Arenas 3:01:17

But then I'm going to also bring it back to reality because when our children aren't met with the kind of support services that they need, there's very serious consequences to that. And we might take a look at well, we need to create efficiencies internally so that we can run a better program.

Sylvia Arenas 3:01:45

And in the end, what we're hoping to do is support our youth. And our youth have lived through a pandemic. I know personally, my daughter was in kinder. And in kinder you know that you socialize in order to learn. That's the phase that you're in. And that was absent for her. So there's consequences in terms of development for that. And every age and every, whether it's elementary or high school, we've had those consequences, right? And as a system, I haven't seen it clearly respond to the pandemic, the necessities of our children and our youth in a way that I think is directly connected. And I'll give you an example in terms of how I haven't

Sylvia Arenas 3:02:35

seen that. Because in the SDRTPs and the scattered homes that we had, there was some really difficult things that were happening there. And it was, it made only sense to me to have behavioral health and DFCS working together in order to better support our children and our youth. And then there was foster care

Sylvia Arenas 3:02:59

now adults who stepped up and participated in terms of giving some feedback.

Sylvia Arenas 3:03:06

That didn't happen organically. That came from the board. That came from a referral for me. And so those kinds of improvements, those are the kinds of improvements, those are the kinds of cross -departmental work that I really would like to continue to see, especially as DFCS is doing an overhaul in terms of their, the way that they're providing services and improving their services.

Sylvia Arenas 3:03:33

And the reason I say this is because when I looked at the child death review report, I don't know if you had a chance to look at this, we've had between

Sylvia Arenas 3:03:48

2021, 2022, and 2023, we had 13 cases of hanging.

Sylvia Arenas 3:03:58

The youngest of them being a 12 -year -old. Another one being a 13 -year -old with a transgender, it was a male transgender youth that was being bullied.

Sylvia Arenas 3:04:15

Another one was another hanging, but also fentanyl toxicity involved.

Sylvia Arenas 3:04:24

And some of the recommendations that are coming from the committee that reviews all of these deaths are that many of these deaths are preventable. And these deaths with our children,

Sylvia Arenas 3:04:43

it doesn't end there, there's also a lethal ingestion poisoning of six cases, one jumping, firearms that involve three additional. It really can bring you into a place where you may feel, at least that's what I felt after reading some of these cases, was that how can we help our children and our youth more directly? And how can we use this report to respond to our youth in a more direct way? And so my question to you is, how do you do this? How do you, on an ongoing basis,

Sylvia Arenas 3:05:26

do this? Because in the last eight years, I think it was eight years, there were two suicides and in these last three years that the death review report was reviewed, oh my gosh, I think it was 52. So there's a huge difference. And I'm wondering, what is the behavioral health department? How do they respond? How do you respond?

Sylvia Arenas 3:05:56

Yes, thank you for raising those very alarming stats, Supervisor. The behavioral health department, like many of our county departments, are committed to the well -being of children in this community. For many decades, the board has supported many initiatives and supported services, behavioral health services, to really help reinforce the importance of the well -being of children to be able to thrive in our community. We have committed over the years efforts around suicide prevention, prevention and early intervention in education across the community and have developed a really robust continuum of supports around behavioral health for children, youth, and families. I think some of the things that we're excited to be able to point to are some of

Sylvia Arenas 3:06:47

the statewide efforts around the California Youth Behavioral Health Initiative, which is going to be able to bring services to young people up to age 25 in schools and in colleges. And so that will clearly expand the opportunity for individuals at whatever level of behavioral health need they have to receive screening, assessment, and treatment opportunities. And so we're really looking to expand and partner with the state along these initiatives while bringing and continuing to provide those supports at the local level. So, while that may not address your question specifically, I will say that we do very much take the needs of the children in our community very seriously. We have committed for many years to attend

Sylvia Arenas 3:07:36

to their behavioral health needs and will continue to do so to the extent that we're able to. And let me just correct myself. I switched those numbers.

Sylvia Arenas 3:07:48

So, that two overdoses in

Sylvia Arenas 3:07:53

2010 to 2018 and it was 25 for 2019 to 2023.

Sylvia Arenas 3:08:03

It just tells me and this is just one aspect of it. It's not the whole I didn't do a comparative of all of the deaths, but it was very clear that neglect had a lot to do with some of the preventable deaths and it is very difficult for us to see neglect and DFCS to see neglect. But there were also a lot of the deaths had to do with suicides. And so, those are our children who are asking for help. Our transgender youth who is obviously in a place where they're

Sylvia Arenas 3:08:49

in a crisis and for them to have this option to me, it means we're failing them.

Sylvia Arenas 3:08:59

So, you can tell me everything about how the federal government and the state government is imposing regulations, reductions, but as a mom, what I'm going to see is our children are they're dying at their own hands because we are not supporting them and we're not being responsive and so I'm going to add to the motion on the floor to have a more direct response from the recommendations that were made by the committee by the number of deaths that were committed either through suicide and some preventable deaths. I'd like to see a direct response from you and maybe later what I'll do is a referral directly on that so we can have an ongoing and structural

Sylvia Arenas 3:09:54

that behavioral health and DFCS has a response on an annual basis, but for the moment, I'd just like to use this motion to ask for that.

Sylvia Arenas 3:10:06

That's fine. Perfect.

Sylvia Arenas 3:10:14

You know, I'm going to end there. I do have a lot more points I wanted to make, but I'm going to rest there because I think that the

Sylvia Arenas 3:10:25

children that passed away that are in this report, I think is their statement about how we are doing is stronger than anything else that I can add in terms of comments. So

Otto Lee 3:10:43

I'll end there.

Otto Lee 3:10:47

Supervisor Abacuga.

Margaret Abe-Koga 3:10:48

Thank you, and thank you for this presentation. I think it's a good start to this conversation, but I agree with my colleagues who have already spoken that I think this is really the tip of the iceberg and we really do need to delve further into some of these issues. I'll start off in saying that there's definitely a lot of positive work being done. I'm glad that the county is continuing to add behavioral health beds which are critical to meeting the needs of our community, but I guess I'll pick up where Vice President Arrena has left off. My focus or interest was on the youth mental health services. As some of you may know, within my

Margaret Abe-Koga 3:11:33

district we faced another tragedy last week with another student who died by suicide. And this is, I believe, the fourth within about a year and a half in one city, in the city of Palo Alto, which has experienced these clusters over the last ten years, and it looks like another one has begun. And so, my question was along the lines of what are we doing to respond to the needs that are clear in our community, especially around youth. I know that there's been comment or note that we as a county have the highest rate of response, but I'm looking for really more specifics on how we're dealing with the needs out there. And so, I

Margaret Abe-Koga 3:12:28

do appreciate Supervisor Ellenberg's and the motion. I really was looking for the, you know, what are our programs that we're going to be needing to scale back, add, perhaps eliminate. And in particular, my interest is that given that it looks like 85 % of the services provided are from our community partners, the real need to engage with our community partners in this conversation. And I appreciate BHCA's recommendations. I didn't, the slide wasn't in our presentation, so I hope we can get a copy of that. But I'm specifically interested in learning or seeing how we respond to those recommendations because I do value those from our partners who are out there on the front lines providing

Margaret Abe-Koga 3:13:22

these services. I just was looking at, and looking at some of the ideas or recommendations, you know, I know we focus a lot on Medi -Cal patients, and rightfully so, but understanding that that's one out of four of our county, and mental health is frankly community -wide. And there was a, I don't know if you can put up the BHCA slide, but, you know, ideas like training for private insurance billing, like these are some of the things that I hear in the community. You know, Medicare is, we have a lot of Medicare folks. So looking at, you know, what are the alternatives out there for funding sources and being better at capturing those funding sources

Margaret Abe-Koga 3:14:15

are of interest to me. I think about the programs we provide. Again, I think we need to work with our community partners to come up with, you know, good solutions. I'll be, you know, frankly, I'll just be very frank. Alcove is a youth mental health counseling center in Palo Alto, and just like PERT, it came up at one of our, I think, HHC meetings for elimination, without any conversation here, again. And, you know, in light of the fact that this community is facing these tragedies, it's just a very unopportune time to be cutting, completely eliminating a program. So our office organized a community meeting where we had 150 people show up, and I appreciate staff

Margaret Abe-Koga 3:15:14

coming, but we have been working with the community partners who have stepped up and said, you know, we're willing to try to even help fundraise to keep this program going, and so maybe we have to pare down that, you know, we can preserve it in some way. And that's what I'm looking for as we look at, you know, having to reduce

Margaret Abe-Koga 3:15:37

because of our deficit. We have to be, you know, look at what's going on in the community and respond accordingly, and to cut a program for youth when we have these suicides happening is just not the right thing to be doing, and so it's just an awareness issue, I think, and then to work with the community, and yeah, when I said, look, we need help, you know, folks are willing to step up. So I really think that, you know, I appreciate the work that's being done, but sometimes I feel like it's very internal, and we're not really focusing or facing outward enough, and I think we really need to be doing a better job of

Margaret Abe-Koga 3:16:17

that. So that's what I would like to ask. So, you know, the program -by -program specifics I think will help us in that effort,

Margaret Abe-Koga 3:16:32

and looking at ways to, you know, preserve as much as we can with, you know, community involvement, I think is really the way to move forward in these tough budgetary times. So thank you for the motion. I think it captures pretty much everything, including trust. I think there's a lot of work we can do there, too.

Margaret Abe-Koga 3:16:57

I'm wondering, like, from an administrative, just, you know, bureaucracy, are there ways to eliminate some of the bureaucracy and make it more efficient? And I think there's opportunity to do that throughout all of the programs in the department. So I very much support the motion. Thank you for the additions, and appreciate the

Otto Lee 3:17:23

conversation. Thank you.

Otto Lee 3:17:27

On this? Sure, I just wanted to add a little bit of one thought on a comment that you just made, Supervisor Abacogo, which I think is really critical in that as we look at community mental health needs writ large across the county, one huge challenge that the Behavioral Health Department faces is that they become the provider of last resort, even for folks with private insurance.

Otto Lee 3:17:57

So there's also a need for us to really press the state to hold those private insurance providers accountable, because what happens when they don't step forward and actually provide access, work with those partners, you know, the private insurance plans are who should be reaching out to our community providers, making it easy for them to become part of their networks of care and deliver services to their members. Then Behavioral Health has to take on

Otto Lee 3:18:27

and also need to be served. And so I think as I'm listening to this conversation, I'm reflecting on how we as a county can really lift up the burden that we're bearing as a public system that truly is the responsibility of private insurance companies who are making huge profits as we face major cuts. Another thing I would just share on, I think your point is completely well taken and is going to be even more well taken as we enter

Otto Lee 3:18:57

into this conversation with our core partners. I think one reality that I would just share that I think is going to be hard is that we are undoubtedly going to be proposing really significant reductions in that administrative tranche of the Behavioral Health Services Department who are the staff who also do that community outreach and engagement as they also manage these endeavors. And so we're going to try and reduce that capacity while also increasing our efficacy

Otto Lee 3:19:27

of those reductions. And I just wanted to note how challenging that becomes as we face limited resources because we really do need to make those reductions to avoid instead cuts to client -facing services. But that does make the task of managing all of the work of operating the department and deep collaboration with our partners even more taxing on the staff that remain.

Margaret Abe-Koga 3:19:53

And I very much appreciate that.

Margaret Abe-Koga 3:19:57

There's a lot of work that we need to do at the state level. Frankly, there's just so much red tape that they keep adding on. It's making it pretty hard for us to actually do the direct service. I will say that I think that what I'm trying to get at and it's going through the Elk Cove process was actually very helpful for me to see a program and see for the funding the staffing, etc. I will say as a county, yes, we are the last resort but I think in this area there's a lot of work that can be done well, in a lot of areas, frankly but upstream that we don't get to the

Margaret Abe-Koga 3:20:43

last resort and as a community as the public looks at the county as the mental health resource or the leader there's no other entity out there

Margaret Abe-Koga 3:20:57

that can come together to talk about even the policy around mental health. They look to the county and so I think that is a part of our role and so whether that comes from general fund which I know that it does I think that's really actually an expectation of the public from the county so we just have to own it and figure out how we're going to do that and continue to be the leader in this area. I will say in terms of programs I think we also just have to look at what we're good at and admit that we're not good at everything and I'll say like in the Alcove model it's like a

Margaret Abe-Koga 3:21:37

teen center slash counseling service I don't think we're actually really the best at running a teen center but there's a lot of other providers who are so that's what I'm saying and I'll be honest I looked at our staffing and it's pretty staff heavy and I think that having worked in the nonprofit world and parks and rec and whatnot there are other providers who can do it more efficiently so let's make sure that we're partnering with the right partners and then providing them with what they need to be able to administer the programs and then we can add we can definitely value add but we don't need to be running everything and that was the

Margaret Abe-Koga 3:22:19

point I was trying to make Thank you Jameson, what to add?

James Williams 3:22:23

I just wanted to emphasize a point that Greta just shared and Supervisor that you were talking about because I think this is really significant at its core the behavioral health services department is the state medical behavioral health plan that is how it's funded that's how it's mandated that is the client population that it's designated to serve and the one take away that we hope that the board would get from the presentation was to recognize the funding streams and the fact that the one flexible source of funding MHSA has now also been shifted to force funding away from the exact kinds of programs that this board has long cared about and that this county has deeply

James Williams 3:23:16

invested in and forces that funding into a different set of programs that are really focused on acute services for the adult population and I say that because the reality then is that for us to continue the kinds of programs and services that this conversation has been about will require general fund money which means pulling that general fund money from elsewhere in the organization and I think we just have to be very clear eyed about that and the reason we opened the presentation with the discussion of the Medi -Cal plan is because that is the core of the department and we could rename the department and maybe it would be clearer to the community if we

James Williams 3:24:01

did rename the department the behavioral health Medi -Cal plan department but that is really the overwhelming bulk of what the department is what it does how it's funded and what the mandates are and I share that because there's no disagreement on the part of staff and in fact it has long been the priority of this county unique in the state

James Williams 3:24:27

in prevention in early intervention in youth in very successful programs in innovative programs I think there's some incredible irony that the state has eliminated innovation funding at a time when innovation is absolutely needed in the behavioral health space across California but I just have to emphasize that point because it is

James Williams 3:24:57

a reality that programs like ALCOVE and of course there's ongoing conversation about how to continue and modify that program are not actually a part of the department's mandate not part of the mandated funding streams and have been historically funded through MHSA innovation funding that's now going away and I know none of us want that staff doesn't want that the department doesn't want that

James Williams 3:25:27

we know the members of this board don't want that but we are trying to make sure that people at least are aware of what's been foisted on us by these state directed policy changes led in particular in this space on MHSA by the current governor who was the one who advocated for and brought that measure to the voters to radically shift how counties were directed to utilize the funding

James Williams 3:25:57

and so we will bring forward our best recommendations in this space it will of course be iterative we will absolutely bring the information forward in April as requested in the motion but I don't want anyone to leave this conversation thinking that we have the ability on our own to just continue all of those programs that we love in that space when we are being forced towards other sets of programs and activities we are and we've tried to show that in a very visual way in some of these charts just how significant the magnitude is and I would just point the board back to two things slide 24 that shows all the mandates that are imposed

James Williams 3:26:49

on us and point the board to slide 33 and you'll see just how significant they are in the blue category of MHSA funding right now 49 % of our current funding is in the category of behavioral health support services and that's going to be capped at 17 that's huge that's huge so the of course we have lots of things we can do better of course we're going to be bringing forward recommendations to reduce administrative staffing in the department but we have to also be very clear eyed about what the actual impact is of this state directed funding shift on us and other counties but especially on us because this is not how the chart looks

James Williams 3:27:39

in other counties in California we have really disproportionately put money on these kinds of programs because of the leadership of the board because of the values of the county organization and that shift is being imposed on us but I don't want us to leave this conversation without acknowledging that we will continue to make improvements we'll continue to bring forward the best thinking around that but we've got to just be up front and transparent about what this MHSA to BHSA shift means for the types of services that are delivered in this space in the community okay

Otto Lee 3:28:21

thank you James yes Vice President

Sylvia Arenas 3:28:23

thank you well on that note let me just ask you on the revenue expansion strategies you have Medi -Cal Administrative Activities as something that you're going to use to expand revenue

Sylvia Arenas 3:28:37

who's doing that and are you starting to do that yeah

Sylvia Arenas 3:28:44

so Medi -Cal Administrative Activities is another kind of stream way of billing for the activities that we perform in the department it's something we've been billing for many many years but we want to expand our ability to do that and our finance team finance director Caitlin Lowe is kind of building up the infrastructure we need to expand that both within our department and also in partnership with our county contracted providers good

Public Comment 3:29:15

morning

Public Comment 3:29:19

it's one o 'clock you don't

Sylvia Arenas 3:29:20

have to worry about that

Public Comment 3:29:23

thank you for your question in terms of the Medi -Cal like Megan has stated that we have been doing that in our department but we haven't been able to expand as much so first step for us is to expand it within the county operations first where we're tapping into billable activities with reimbursements from outreach activities our administrative type of functions that have never been that we could get reimbursement for in FFP then once we have that in order and we are working with some of our contractors to kind of build that out as well to make sure everything is in alignment then we will start rolling that out with the county contracted providers so that

Public Comment 3:30:05

we can also build that and be able to expand the revenue in that area

Sylvia Arenas 3:30:10

I'm very familiar with mob billing I did that 20 years ago with FFP and when Nancy Pena was the head of mental health who facilitated that for FFP and all of its subcontractors so I'm very surprised that 20 years later we haven't implemented mob billing with our subcontractors so for 20 years we've missed mob billing with subcontractors is what you're telling me I

Sylvia Arenas 3:30:43

think it is unique across the state to extend that to contractors Caitlin's team was able to go to a conference where we heard about just a few other counties that are doing it and kind of learn from that experience what I'm saying is we did that 20 years ago with FFP with Nancy Pena's assistance who is head of mental health and we did it for FFP all of the FFPs grantees so it is not a new model that has happened before I did it myself I didn't provide any direct service I worked directly for FFP it was mob billing so I'm just surprised that we're just getting that going right now and Sherry you were

Sylvia Arenas 3:31:29

at FFP so I'm very surprised that mob billing isn't integrated as a revenue expansion strategy it should be a basic building block of revenue I'm

Sylvia Arenas 3:31:44

going to move on to something else and that is the percentage of deaths, overdoses that happen in our jails based on the last report that we had and I can't remember it was in the last couple of months and I believe last year it was around five overdoses and the total number of adults in custody that right now have documented psychiatric crisis is 1 ,637 it comes from the agency advisory form this is the resting officer that has indicated that the person has demonstrated suicidal behavior or through the acute psychiatric unit so through the agency advisory form that's 298 the acute psychiatric unit is 833 and then EPS emergency psychiatric services is 281

Sylvia Arenas 3:32:50

for the total that I just gave you and these are folks who are coming into our jail system because of psychiatric difficulties so they're engaging with our law enforcement

Sylvia Arenas 3:33:06

and my ask is if we have a captive audience in our jail system where we could provide and receive reimbursement for the services because I'm going to guess that everybody most everyone in that jail who is serving for longer periods of time is probably Medi -Cal eligible why aren't we providing services for folks that are in custody that we know have had psychiatric issues

James Williams 3:33:37

supervisor

James Williams 3:33:41

services in custody are provided by custody health

Sylvia Arenas 3:33:44

no no no custody health is not providing psychiatric support I'm asking behavioral health why they aren't integrated into our jail system not what custody health is doing separately custody

James Williams 3:34:00

health manages a contracted psychiatric services for the inpatient population in our jail the

Sylvia Arenas 3:34:08

contracted service provider is not behavioral health

Sylvia Arenas 3:34:12

why aren't we providing service internally in our own system and yet we are contracting somebody else so that to me is an indication either of inefficiency internal inefficiency so we can't provide services in a more direct efficient and effective manner than a contractor that's what it's

James Williams 3:34:39

telling me we

James Williams 3:34:43

have had some changes in that regard I think it may be beneficial to share some of that in an off agenda format with the board but we are actually in the process of trying to expand that contracted service in custody but that is not a behavioral health services department function and while folks are in custody those services are not Medi -Cal billable which

James Williams 3:35:17

is why custody health is a general fund obligation

Sylvia Arenas 3:35:21

you are telling me there is no creative way to provide services for those folks who came into our jail system who are going to be repeat offenders

Sylvia Arenas 3:35:34

some kind of support where we can creatively use our services so that we can diminish their presence in our jail system so that we don't have a death like we had last year

James Williams 3:35:52

so that we can actually do provide those services I was just noting that they are not Medi -Cal billable services

Sylvia Arenas 3:35:57

alright well it would be great to see what you can do in terms of creativity I don't think that we have completely explored that there is substance abuse there is overdoses there shouldn't be overdoses in our jail system but yet they are we have substance abuse that is integrated into behavioral health

Otto Lee 3:36:27

so I think that thank you I

Betty Duong 3:36:29

really appreciate the robust discussion today and I feel that the motion is very comprehensive so we will be voting in support of it I just want to acknowledge that having sat on FGOC for a little over a year these are reports that come to our committee and I see today that the request that has been made at committee for more information further details and breakdowns of services and more identification is really incorporated into this report so I want to acknowledge that level of work that was put into this I do appreciate the slide on package page 53 delineating between mandated and non -mandated programs that mandated well we know what mandated means this is the

Betty Duong 3:37:15

job that we are tasked with to do and even with the mandated category we don't receive the appropriate level of funding to do the job we have to do and then in the category of non -mandated we have to be a source of pride for me an additional source of pride on behalf of this county and our departments that we lean into lanes that were not meant for us we lean into lanes where people who are supposed to be provided these services have abandoned many of their patients or abandoned this portion of the industry because it wasn't profitable enough so as we head into the future James what I heard from you today is clarity

Betty Duong 3:37:52

but not any clear direction that we are going to sever on mandated programs, correct?

Betty Duong 3:38:02

I know we have a budgetary crisis but that is not the recommendation today and that is

James Williams 3:38:07

not we are not making any recommendations today we are trying to ensure that there is appropriate background information so that when recommendations come forward obviously first to committee and when they come forward in front of the board later there is background awareness and understanding of what we

UNKNOWN 3:38:25

are working with so that those recommendations

James Williams 3:38:28

can be received and processed with appropriate context because the core mandated program categories are ones that are largely dictated to us and we will continue to identify every creative effort possible to preserve not just non -mandated related programs but continued capacity expanded capacity to try to meet expanded community need but just like we had in the budget study session regarding the hospital system and the different sources and uses of funding most of the funding in the behavioral health space is directed in very particular categories of ways and of course there are always efficiencies to identify in the delivery of those categories of services but it is important to recognize what that looks like especially given

James Williams 3:39:31

the really significant shifts that are happening at the same time and I just want to say one thing about the timing piece

James Williams 3:39:39

in fairness to the state as critical as I am of all of the changes that they are making when the state brought the initiative in front of voters and the voters adopted it in November of 2024 there was not awareness that we were going to also see so many other federal and other impacts that would happen to then occur at the exact same budget cycle so there is an unfortunate compounding and stacking effect on timing it sure for example would be a great time to have additional flexibility on some of the state funding streams given some of the other changes that are happening but in fact the opposite is occurring so there's not just the

James Williams 3:40:25

general challenge but the timing challenge of these things happening to dovetail together on the exact same timeline that make it even harder

Betty Duong 3:40:36

Thank you for that James I know that we are held accountable to a binary world of mandated and non -mandated funding sources from the state and the federal government but as this discussion has exemplified and what our work has demonstrated thus far at the county is that we don't view the world in that way we go where help is needed and we do our best

Betty Duong 3:41:01

I know that Greta to your point earlier that are we responsible for behavioral health services writ large technically, legally, no but we keep leaning in that direction and I want to acknowledge that and also to acknowledge that to your point James in terms of providing context for us to be able to make the righteous decisions on behalf of the holistic wellness of our community and not being informed by mandates and non -mandated services informed by sources of funding informed but not directed by that just because that's not how we operate a very simple ask from my part I hope it's simple I don't work in OBA so maybe it's not simple but when we're deleting

Betty Duong 3:41:46

FTEs and heading into the budget process it would be really helpful for me in addition to the FTE the number of FTE that is provided the job title, the job code that's provided the program that it's linked to I think part of our sourcing up here our decision making process is going to be what impacts are we able to can we afford to suffer across the whole organization as we have to face these very challenging budgetary cuts

Betty Duong 3:42:15

that's it, thank you

Otto Lee 3:42:16

I was going to just make a related point the slide and I can't remember which slide number it is or how easy it would be to pull it back up but just would redirect folks to that slide that does have the mandated programs on the left and the non -mandated programs on the right I think to emphasize the take away that we were trying to stress with some of this information is really how painful when you look at the names of the programs on the right side of the slide that are non -mandated it is because those are the ones that as behavioral health is asked to reduce its services that they have to look

Otto Lee 3:42:54

to reduce first because they cannot reduce the ones on the left in order to continue funding the ones on the right so as James mentioned the only way to continue those programs is to cut deeper into other county programs and services and I think you could present and we will be presenting similar information for a number of other departments and this is just really the shared pain that I think we're all going to experience which is we will take every step possible to preserve those services and there's a

Otto Lee 3:43:27

you know there's only one way to do it and that requires us then shifting money from other programs and services that we also care about or not being able to because those programs and services are mandated take the probation services department their slide would look similar with mandated services that actually I think all of us would much prefer to reduce over the ones that they're funding on that non -mandated slide and so just to say again what I think we're trying to communicate

Otto Lee 3:44:00

to the board is that there's very little ability to prevent given that we would have to reduce other programs and services and those will be the choices that I think we're going to have to collectively stare down and we will I'm sure make some decisions to shift services to behavioral health from other departments in order to preserve some of these services but it is going to be that reality and we just want to make sure that we're laying a good foundation of just not acknowledging and understanding of how challenging what is going to have to come forward during the budget process is going to look for all the reasons we've been discussing Thank you

Betty Duong 3:44:38

Reda for that and that just reminds me to I really want to appreciate the Behavioral Health Contractors Association for leaning into this work with us I also see our nurses in the room here too I think now more than ever being able to lean and to share consensus learning from each other perspectives from the ground level perspectives from providers being able to help inform the least amount of harm that can be done by these cuts that are inevitable so just thank you to our partners in the room as well Thank you

Otto Lee 3:45:15

Okay see no more lights let me finally can ask my questions First of all I just want to say having been on this board for over five years I would say Sherry and your team this is by far the most clearest and most informative presentation I've seen from you guys so many quality data points and facts to highlight so I just want to say thank you so much for putting this together I've learned a lot I've been here doing this for five years but I'm still learning so many new things first my colleagues today have identified many many other gaps that we will still have to work hard to solve in the future to find

Otto Lee 3:45:51

the efficiencies especially during these tough budget moments but you know we will be moving forward one thing I want to also mention regarding trust funding first thanks James for clarifying the trust funding being coming from a state innovation fund that's being dried up now so as we stand today I want to just confirm that at this time there will be no impact on trust until the funding runs out and that's about ten months from now correct James that's correct okay so because after all two years ago our office actually proposed to establish a direct line to trust to reduce the barriers to accessing this non -law enforcement service looking at the data between October and

Otto Lee 3:46:31

December 25 trust has actually received 1 ,728 calls more than the twice of any other services and conducted over 1 ,076 field visits and with what zero average call time wait time that's amazing and an average response time of about 30 minutes more than half the responses resulted in stabilization of connections and services with fewer than 1 % let me state that fewer than 1 % led to law enforcement involvement of 50 % 50 % hold which really demonstrated strong outcomes without the unnecessary escalation trust clearly is working people are using it they like it and they don't want to lose it so I just want to also ask questions is there a plan for

Otto Lee 3:47:18

the board to get a more thorough report on this trust funding plan in the future and the strategies that we could discuss in the future James

James Williams 3:47:27

yes we're trying to work on strategies as was indicated to sustain the program and we will bring those forward given that the innovation funding is expiring in November ok

Otto Lee 3:47:41

so certainly the sooner the better if you can and would you give a guess how long do you think it will take to give us the report it

James Williams 3:47:48

will be included as part of the information that was requested to come as part ahead of the budget process thank you

Otto Lee 3:47:57

James now I also want to share some of the highlights of some of these really amazing successes on slide 20 that you look at these are really beautiful summaries of the hard work and volume of services that BHSD and many of our contracted providers has delivered I certainly say that I'm honored to be part of this behavioral health system that funded 121 mental health clinics 17 substance use treatments clinics and 10 dual clinics across our network of providers serving over 33 ,000 clients with 3 out of 4 such clients and 2 out of 3 mental health clients meeting their goals and provided over 785 ,000 mental health patient hours over 53 ,000 such outpatient hours

Otto Lee 3:48:44

looking at slide 22 there were gaps as identified in our subacute beds back at the RAND study a couple years ago so it's really great to see that this dramatic increase in the access to these subacute mental health treatment beds which are extremely difficult to establish because of all the rules from the state right Sherry she's nodding yes those are but amazing how we can get this far and through the direction on board four years ago from an amazing referral by supervisor Ellenberg jointly sponsored by us it's clear that the county staff has been responsive to the disease declaration of mental health and substance abuse as a public health crisis and I would like to

Otto Lee 3:49:22

thank our county staff and our CBO partners for the enormous efforts growing these urgent programs and I do have a few questions for staff I'll try to keep it short on slide 36 there are these guiding principles provided by the administration highlighting the need to protect our core services to ensure access and promote transparency I understand that timely access metrics are important for the department to fulfill these guiding principles so my question is can the board get some insight into BHSD's timely access metrics and future quality reports because I think this would be helpful for us to better understand the service requirements and data collected specifically for mandated programs that deserve our attention yes

Sylvia Arenas 3:50:05

we can provide that information supervisor

Otto Lee 3:50:06

great thank you so much alright and finally I also want to make sure that the BHSD office continues to work closely with our BHCA partners to address the budget concerns making adjustments to programs and ensure that our patients are protected in the midst of the very difficult budget cuts in the upcoming months I am very encouraged to see that Ms. Ginsburg along with the BHCA is here presenting with the administration and I hope to continue to see this partnership as we navigate through the tough times ahead and with no further comments and questions let's take the roll Rhonda thank you on motion of supervisor Ellenberg seconded by vice president Arenas supervisor Abacuga aye supervisor Young

Otto Lee 3:50:58

yes supervisor Ellenberg yes vice president Arenas yes president Lee aye as well motion carries five to zero thank you quick time check for folks here we only finished one item eight so far and so it's already one oh eight I see should we try to at least get a couple more items before we go to lunch is that okay like item eight which I think item eight should not take too long yes am I correct no

James Williams 3:51:26

item nine should be very quick but then probably make sense to break after item nine would

Otto Lee 3:51:32

that be okay my colleague to just get nine first just get one more item item nine which is the purchase real property on the on south first streets and south market streets does that help the hearing okay all right okay let's do it yes

Otto Lee 3:52:01

KJ go ahead

Public Comment 3:52:03

good afternoon KJ Kaminski director for the office of supportive housing I'm joined by Natalie Monk our housing and community development manager Natalie's going to share some details about this project but before she does that I just want to note that gateway tower the project before you is one of 11 that received tax credits in the past year and want to give kudos to Natalie and her team who worked really hard with developers and our other partners to secure those tax credits so the projects could move forward you're going to see a lot of ground breakings because of that work and want to note that there are two this week for other projects supported with measure

Public Comment 3:52:45

a funds including Santa Teresa apartments in San Jose and the Magnolias in Morgan Hill collectively those projects include 57 units of supportive housing and 28 ag worker units as well and with that I will pass it to Natalie to share about the next step for gateway tower which hopefully if approved today will be celebrating ground breaking soon as well thank

Betty Duong 3:53:11

you KJ item number nine is related to gateway tower the affordable housing development located at 455 to 493 south first street and 460 to 480 south market street in San Jose this 220 unit project is being developed by the core companies and includes 55 units of rapid rehousing core has secured all financing and approximately 18 .2 million of the county's 25 .5 million dollar commitment will be used to acquire the site which will then be ground leased back to the project sponsor

Betty Duong 3:53:48

if approved today we would close on the construction financing in April and construction would start shortly thereafter this is one of 64 approved multi -family rental affordable housing developments that the county is funded with the 2016 measure a affordable housing bond which will have housed over 20 ,000 people when all projects are complete that concludes our report happy to take any questions

Otto Lee 3:54:13

thank you I'll go ahead and open a public hearing and how many public would like to speak on this item Rhonda I

Otto Lee 3:54:23

currently have one public speaker in Zoom okay let's do two minutes

Otto Lee 3:54:30

thank you Cindy we've asked you to unmute

Otto Lee 3:54:37

thank

Public Comment 3:54:38

you I have a very short question and I look at your agenda

Public Comment 3:54:50

packet

Public Comment 3:54:52

page

Public Comment 3:54:56

let's see page 97 in your background and you're talking about on January 13 2026 the board approved a revised capital investment of up to 25 .5 million for the update project design to develop 218 affordable apartments

Public Comment 3:55:27

plus two unrestricted managers unit and so I try to look at your website from county website the information I got actually

Public Comment 3:55:51

let me talk about the first one the first one is also in the background the update design make a unit mix and financing plan allow court to apply approximately 125 .7 million through California housing finance agency makes income program so about this number 125 .7 million and I checked your website county website the number is not match the number I saw is 4 million only so I would like to know where this number coming from thank you

Otto Lee 3:56:36

okay I'll go and close the public hearing portion of this

Otto Lee 3:56:43

so that's all right

Betty Duong 3:56:46

public hearing has been closed yes correct so I'd like to make a motion to adopt the resolution as listed in our packets and also to approve the delegation of authority that's necessary

Otto Lee 3:56:59

seconded any further comments thank

Betty Duong 3:57:01

you just absolutely thank you to see the fruition of measure a from 2016 measure a dollars being put forward and we're we're building we're building and I know that you mentioned that that we could with the approval of this item today we get to put shovels into the ground we get to buy dirt put shovels in the ground and celebrate a ribbon cutting and sometime in the future do you have approximation what season what year I

Betty Duong 3:57:29

don't think there's a date set yet for the groundbreaking but I would expect this summer we can confirm fantastic well

Betty Duong 3:57:39

appreciation

Otto Lee 3:57:40

okay

Otto Lee 3:57:43

no further comments let's take the roll President

Otto Lee 3:57:48

Lee I'm sorry I did miss who seconded that motion thank you Supervisor Ellenberg a motion of Supervisor Young seconded by Supervisor Ellenberg Supervisor Abacoga aye Supervisor Young yes Supervisor Ellenberg yes Vice President Arenas yes President Lee aye as well motion carries five to zero thank you KJ just one last thing the caller has problem finding 125 million come from maybe you could identify what that is in the future and so doesn't the caller would know sorry

Public Comment 3:58:21

could you clarify that question there was a

Otto Lee 3:58:23

number 125 million that the caller mentioned she could not find it so you could help identify what that is that would be helpful we could answer that now okay go ahead sure so

Betty Duong 3:58:33

the 125 million is the total of both the 4 % tax credit award and the CalHFA MIP program the CalHFA MIP program is $4 million only the way it was written in the board report was a sum of the two numbers

Otto Lee 3:58:50

got it they were added together okay thank you very much thank you all right let's go break for lunch how about we reconvene back at 2 p .m sharp works everybody thank you and

Otto Lee 4:42:39

as soon as that hit 2 o 'clock I'm

Public Comment 4:42:41

starting and I'm out there you go

Public Comment 4:42:46

I

Otto Lee 4:42:46

did say 2 o 'clock sharp

Otto Lee 4:42:56

we'll be starting this meeting in a few seconds as soon as 2 o 'clock we'll get rolling

Otto Lee 4:43:19

okay good afternoon I've got 2 p .m I'm going to get started resuming our meeting Jolene would you go please take our role

Otto Lee 4:43:28

Supervisor Abacoga Supervisor Yung is out of her seat Supervisor Ellenberg I'm here Vice President Arenas here President Lee good afternoon present we

UNKNOWN 4:43:41

have a quorum all right let's do it Curtis it's yours item number

Otto Lee 4:43:45

10

Public Comment 4:43:47

good afternoon President Lee honorable board of supervisors I am Curtis Boone the clerk of the board of Supervisors with me are Melissa Melgar our assistant clerk of the board Rebecca Ross program manager for assessment appeals division Daryl administrative services manager and I have

Public Comment 4:44:07

Kathy Taylor management analyst in the audience if other questions come up we're here to talk about the proposed assessment appeal administrative processing fee I have a brief presentation I can give for you an overview brief is good thank you if

Public Comment 4:44:42

we could get that shared to the screen

Otto Lee 4:44:45

here we go all

Public Comment 4:44:46

right so the office of the clerk of the board serves as the neutral administrator of the assessment appeals program between the opposing parties of the assessor and the property owner or appellant and that is pursuant to the provisions of the revenue and taxation code the board of equalization property tax rules and of course the county of Santa Clara local rules just a brief commentary on the timeline the

Public Comment 4:45:14

each year in June the county issues a notice to property owners of their properties assessed value we are one of just 11 counties in the state that opt to send that ahead of the tax bill July 2nd through September 15th property owners may file an appeal on their property tax assessment they file that with the clerk of the board and this is what is known as the regular filing period half of all filings received each year are during this time frame and the vast majority of those who received during the filing period tend to come in towards the end of that time frame in October property taxes are of course due and it should be

Public Comment 4:45:56

noted that property taxes are fully due regardless of whether or not an appeal has been filed successful appeals result in the county refunding the amount based upon the change in value I would also like to just note that outside of the regular filing period the county does issue supplemental and escape assessments those go on around the year basis and the appeals follow a similar structure property owners receive a notice they have 60 days to file an appeal

Public Comment 4:46:27

there are multiple proactive measures that the county takes and other avenues of relief available to property owners who have concerns about the assessed value of their property many of these are measures that the assessor takes to proactively assist residents and property owners who believe their assessments are incorrect just to go through those quickly some that I wanted to highlight computer assisted mass appraisal is a technological solution that the office of the assessor utilizes to identify changes in value that affect large areas that have similar valuation standards so tract homes that are all going to largely rise and fall together so if there are impacts that would cause a reduction in those properties they are proactively

Public Comment 4:47:23

applying that as those happen

Public Comment 4:47:27

comparable sales information the office of the assessor makes it very easy for most residential property owners to just directly access comparable sales information

Public Comment 4:47:39

property owners of course can request that but they do make them available online to most property owners as a proactive measure there

Public Comment 4:47:50

is an informal review process the informal review process is really critical this is a free process by which property owners can contact the office of the assessor discuss new information the office of the assessor may not have that may affect the assessment of their property and it is really a way to quickly resolve concerns without going through the appeal process uh also want to note error corrections the assessor is mandated by state law to address factual errors factual mistakes in an assessment without requiring an appeal to be filed

Public Comment 4:48:30

so just as a quick overview of those items this is just a table showing all of those with the exception of the appeal of course which we're talking about today those are all free to the applicant some of those are proactive some of those are mandated by law

Public Comment 4:48:48

speaking to our fee calculation we did conduct a time study in our assessment appeals division to analyze our process time requirements and the frequency by appeal category we've categorized appeals into two broad categories the first consisting of single family properties condominium townhouse multi -family properties with four units or fewer agricultural land and vacant land we're calling those residential agricultural and vacant land appeals and the second category consists of commercial industrial multi -family apartments with more than four units and business personal property we're calling those commercial and business appeals it's really important to recognize that each appeal does kind of follow a unique processing path depending upon a lot of different factors such as filing method

Public Comment 4:49:35

timeliness and accuracy and there's a lot of different steps that might apply including scheduling postponements withdrawals reinstatements notices applicant correspondence all of that contributes to the overall workload of the program so our cost study showed that staff spend significantly more time on commercial and business appeals you can see from the image on the screen there the commercial and business appeals make up about 54 % of the annual filings but represent about 73 % of the processing effort residential agricultural and vacant land appeals on the flip side are about 46 % of filings but only 27 % of effort some of that comes down to commercial and business appeals requiring much more frequent postponements that can

Public Comment 4:50:23

happen up to 40 times more than residential appeals and pre -hearing conferences and things like that many single family appeals are resolved before hearings even actually happen we are currently in the minority among counties and not charging any fees you know effectively we're subsidizing the cost of appeals for all property owners but commercial and business appeals in particular when you think about the amount of processing effort that goes into handling those appeals I do want to make a note that just so that we're all clear the time study we conducted and the fees do not in any way include the time and resources expended by the office of the county council into supporting the assessment

Public Comment 4:51:12

appeals boards and hearing officers nor does it include any of the cost of the office of the assessor in defending their assessed values before the assessment appeals boards or hearing officers I

Public Comment 4:51:26

did want to talk just briefly on the unintended incentivization of assessment appeals filings by having no fee we have seen an increasing number of appeals filed by agents and we've become aware increasingly of a business model for individuals who are property tax agents where they will solicit business from property owners basically filing an appeal on their behalf essentially on contingency and then in exchange the property owner agrees to give them a percentage of any savings they receive regardless of purpose I have here just as an example of one that just says lower your property tax by $1 ,150 it's got a QR code and everything and it's just a they go out and since there

Public Comment 4:52:21

is a no friction at all there's no fee it's very low cost for the property tax agents to file them on behalf of residents what we're seeing here is a really significant increase in the amount of residential appeals filed by agents if you look at the chart on the right side of the current slide in 2019 we had about 16 % of our residential appeals filed by agents in 2025 that was 50 % and to put that really into context in 2019 we had a total of 1 ,980 residential appeals filed of which 315 were filed by agents by 2025 we had 3 ,623 residential appeals of which 1 ,820 were filed by agents which

Public Comment 4:53:15

is nearly as many as the total number of residential appeals even filed in 2019 and is also roughly equal to the increase in the number of residential appeals filed so we can almost attribute the 733 % increase in residential appeals I'm sorry that's the appeals filed by agent we can almost attribute the entire amount of the increase in residential appeals filed to appeals filed by agents the

Public Comment 4:53:50

other element that potentially incentivizes assessment appeals filings is of course the two year statute of limitations appeals must be resolved within two years of filing or extended in writing if they are left unresolved without that waiver of statute the applicant stated value becomes a taxable value even if that stated value is zero dollars it's a one year thing but in some cases that could theoretically be a very significant sum of money for that one year

Public Comment 4:54:24

we did take this through FGOC

Public Comment 4:54:29

FGOC forwarded a positive recommendation to adopt the fee as calculated and also recommended that the board ask the clerk of the board to work with county council and administration on data gathering to refine both residential and commercial fees in the future I do want to note that there was an error in the legislative file in the committee recommendations we left out the residential portion but regardless we will be looking at how to track further and we will of course implement that tracking on all types of appeals

Public Comment 4:55:03

finally after that discussion FGOC should the board adopt our recommendations we will return to the committee after we have a chance to one have a years worth of data to assess after we've implemented the fee and then had time to actually analyze that and we'll provide some more information to the committee at that point and with that I will ask for any questions thank

James Williams 4:55:31

you James I just wanted to make a couple additional comments first just a thank you to the clerk of the board's office for stewarding and bringing this item forward as Curtis mentioned we are one of the minority counties that does not have an assessment appeals fee and I wanted to just squarely address one of the items that we saw in the series of written comments related to this item which was an expression of concern that this was a a cost shift so to speak and that really speaks to how the assessment system is designed in California the this is a cost recovery fee under prop 26 in other words this would be a fee that

James Williams 4:56:16

would only seek to recover the cost that the county actually spends on the processing specifically of the appeals these are appeals that only occur as a practical matter when someone has acquired a new property or done new construction resulting in a change in assessment where there might then be a dispute in valuation and what actually is the case for the entirety of the property tax system whether that's the cost of the assessor's office in this case the clerk of the board for the assessment appeals process the county council's office the tax collector and the controller treasurer department in the distribution of proceeds is that the county bears through its general fund for almost all pieces

James Williams 4:57:03

of that process the cost of administering the system as a fiduciary on behalf of all local governments but the overwhelming majority of that property tax dollar collected actually does not come to the county so people don't realize that because they make their check out to the county but in this county about two thirds of every dollar actually goes to school districts and community colleges a slice goes to cities a slice goes to special districts but the costs associated with the administration of the entire system are almost entirely borne by the county general fund and as a result I actually think the more fair perspective although certainly people could have different perspectives is that we're essentially

James Williams 4:57:54

shifting funding away from core safety net services away from county direct obligations to then cover these kinds of categories of costs and that's why actually the statutes expressly contemplate and authorize counties to levy a cost recovery fee for this particular

James Williams 4:58:20

service so to speak for assessment appeals that's what's being proposed here I finally just want to note there was good conversation at the committee level about collecting data this was mentioned by Curtis towards the end of his presentation to try to better create gradations associated with especially the different categories of commercial appeals as was explained those do represent disproportionately more work because it's a cost recovery fee under prop 26 we have to base the calculation of the fee on data and so administrations committed to working with county council and the clerk of the board's office on more robust data gathering so that that can be examined and potentially a more granular fee schedule adopted in

James Williams 4:59:11

the future but we really need to gather that data for at least a year to be able to do that and do so in compliance with the very significant rules around a prop 26 cost recovery fee so with that I know the clerk of the board is happy to answer questions I am as well okay

Otto Lee 4:59:32

thank you James let's open up the public hearing how many people do we have speaking on this agenda I'm showing one speaker card in chambers and currently one hand in zoom so a total of two okay

Otto Lee 4:59:47

we'll go ahead and close the queue for public speakers the in chamber speaker's name is Carol Callahan please approach the podium

Otto Lee 5:00:11

good

Public Comment 5:00:11

afternoon

Public Comment 5:00:14

I'm here to speak as a homeowner and I'm really upset about the fact that they're shifting yet another bill onto taxpayers now I hear a lot of stuff talking about agents creating this problem creating extra fees so why don't you have an agent authorization fee that leaves the homeowners to have their rights that has been going on for a very long time and I don't think it's right for county to charge the homeowners a fee just to check if their assessment value is correct sometimes I used to be an appraiser sometimes they are correct they show me the comps and I would say oh you're right let me take that I will redo this assessment

Public Comment 5:01:08

so please consider to reject this proposal and ask them to rewrite it in a different way because it's not on the homeowners anymore thank you

Otto Lee 5:01:20

thank

Otto Lee 5:01:24

you our zoom speaker is Cindy please accept the unmute you may begin thank

Public Comment 5:01:33

you I strongly oppose this unfair non -refundable fee this issue stands from concern about equity accessibility and the government accountability

Public Comment 5:01:49

process is the core government function already funded by the general property taxes charging extra to challenge a potentially inaccurate assessment amount is double taxation homeowners and small business owners shouldn't have to pay just to exercise their right to fair taxation this non -refundable fee creates a real barrier especially for vulnerable groups lower value property owners middle class families and seniors it defeats accountability for assessment accuracy and efficiency potentially allowing errors to stand and worsen our house of ability crisis please reject this pay to complain policy and keep appeal free and accessible and under California law revenue and taxation call section appeals it emphasizes taxpayers rights to assessment disputes this act might violate equal protection or

Public Comment 5:03:07

due process principles since I still have time and I would like to tell you the history

Otto Lee 5:03:37

of the public hearing portion of this I see no lights do I have a motion for my colleagues

Sylvia Arenas 5:03:45

motion to approve before we vote I just wanted to

Sylvia Arenas 5:03:54

say earlier James that we could have an appeal fee that could be scaffolded

Sylvia Arenas 5:04:02

like a sliding fee scale like San Francisco

James Williams 5:04:06

has yes so what we're hoping to be able to get some data about a year after implementation and come back with is a more graduated fee specifically on the commercial side similar to what San Francisco has although I don't think it would look the same in structure San Francisco's fee is structured based on the amount of value in dispute we have to design a fee that is based on the amount of processing time basically involved in order to be a prop 26 related fee San Francisco is maybe a grandfathered fee that predates prop 26 it probably is and so we can't create one that looks exactly like that but I'm sure that the But the

James Williams 5:04:52

goal will be to have one that has a little bit more gradation. But we need to gather that data so that we can design it in that way.

Sylvia Arenas 5:05:03

Perfect. Okay. So my motion stands.

Margaret Abe-Koga 5:05:07

Thank you. I'd like to second the motion.

Otto Lee 5:05:10

I have a motion. I have a second. Do you have any questions?

Margaret Abe-Koga 5:05:13

Yes. I just wanted to confirm. I know that the issue of cost has been brought up. But from my understanding, there are alternatives like the mass appraisal adjustments, informal reviews. So you can get a review without having to actually submit a formal application. And then those who are on public benefit would be eligible for a waiver. Is that right? All

James Williams 5:05:40

those statements are correct. And I just want to give kudos to the assessor's office who does something that only a handful of counties in the state does. And it's valuable. It's voluntary, which is proactively mails notices of assessment and provides that opportunity, along with the comps that the assessor has used to come up with the valuation that allows for resolution well in advance and outside of the process of a formal assessment appeal.

Margaret Abe-Koga 5:06:07

Okay. Great. Thank you.

Otto Lee 5:06:11

Okay. I do have a couple of questions, James.

Otto Lee 5:06:18

When it comes to making the assessment, the majority of these appeals, are they successful? Is that correct? Yes, that's correct.

James Williams 5:06:26

Overwhelming majority. Right.

Otto Lee 5:06:27

So if that's the case, is it possible for us to say that if they are successful, then they get refunded the application fees or something that can be done in the future?

James Williams 5:06:35

This was extensively discussed at committee. That's

UNKNOWN 5:06:40

not one of the

James Williams 5:06:41

recommendations that we've brought forward for a number of reasons, including that it would necessitate an increase in the overall fee amount. But that was an item that was expressly and specifically discussed. It's been discussed and considered.

Otto Lee 5:06:54

Yes, go ahead. As

Susan Ellenberg 5:06:56

part of that discussion at FGOC, one of the primary drivers that we acknowledged is that whether or not the appeal is ultimately successful, the work has been done. So the costs have been expended. And if it truly is a cost recovery, then we need to account for the investigative time and the analysis that staff needs to do in every case. Okay.

Otto Lee 5:07:20

All right. Thank you. All right. I've got a motion. I have a second. No further questions. Let's take the roll. Okay. That was a motion by Supervisor Aranis, seconded by Supervisor Abacoga. Supervisor Abacoga? Aye. Supervisor Young? Yes. Supervisor Ellenberg? Yes. I'm sorry, Vice President Aranis? Yes. And President Lee? Aye as well. Motion passes. Thank you. Thank you. Thank you. So moving to item 11, which is a report from James, County Executive. Good

James Williams 5:07:49

afternoon, members of the board. A few items for the County Executive. The County Executive's report today. First, I just wanted to give the board an update on our continued work, and you'll hear again at the next meeting when we have our monthly Intergovernmental Relations report, but I was in Sacramento last Thursday as part of our efforts related to our state -related strategies to try to mitigate HR1 impacts on our county organization, including on efforts to keep folks enrolled in Medi -Cal as well as identify additional dedicated funding for public hospital systems. Really positive conversations. One of the things I would note is we are viewed as having a lot of credibility in these discussions for

James Williams 5:08:34

a couple reasons. One is the fact that we have already gone out the gate with the 2025 Measure A, which is something that everyone is very well aware of, and I'm talking about folks well beyond our delegation. And second, that we are proactive. We are proactively taking on and managing the reductions as an organization, and that will bring us to item 13 in a few minutes. But being able to share that the health system is in fact moving forward with restructuring is also a point of incredible credibility in the conversations with the state, which is looking to see that we are taking proactive and strategic steps for the things that are in our control before

James Williams 5:09:24

we're just approaching the state for what they perceive, incorrectly, but what they perceive otherwise as a request from folks as a bailout, so to speak, for the cuts from the federal level. And because we have approached it in this way and in this order, those conversations actually, I think, are going very well, and in particular feel really good about the conversations that we had with the State Department of Finance, which of course is going to be putting together the May revise. You know, I do think that it's going to continue to be a challenging picture. Tomorrow, the Senate Committee on Budget and Fiscal Review has a hearing on the impacts of H .R. 1. We're

James Williams 5:10:08

leading coalitions in bringing forward specific and concrete ideas. That includes not just the public hospitals, but also Urban Counties Caucus, working with CSAC, working with other partners in education, working with our allies, working with our labor unions and others to really help the legislature understand what's going on, understand the disproportionate impacts, and understand some of the concrete ideas that we've been able to put out there, not all of which, by the way, would cost the state money, but where the state is a pivotal and essential partner to mitigate impacts. And I'll give one just specific example that we've mentioned before, which is related to the data systems the state utilizes. We're not talking about significant

James Williams 5:10:52

dollars there, but we are talking about the ability to keep thousands and thousands of Californians enrolled. And our ability to do that turns on the state's responsiveness and capacity and ability to effectively implement those data solutions. So we'll continue with those efforts. Like I said, the board will have a more comprehensive update at the next meeting. And we have been reaching out to each of your offices to schedule specific conversations, to develop individualized strategies for assisting and pushing all of those advocacy efforts.

James Williams 5:11:30

Second, I wanted to acknowledge that our county is going to be honored tomorrow night with two challenge awards from CSAC for two outstanding programs serving youth in our community. The first is our Peer Health Education Program for Justice Involved Youth, which is a partnership between Juvenile Custody Health Services, Division of Education, SCVH, and the Probation Department. This program, which is the first of its kind in the nation, serves to empower youth who face significant health disparities with scientifically proven health information delivered by a trusted peer, and to advance leadership and communication skills among vulnerable youth. The second award we're receiving is for our Social Service Agency's Intern and Earn Program, which offers youth receiving county

James Williams 5:12:18

services paid internships through a wide variety of organizations, including the Department of Employment Partners, to help young people develop real -world skills and experience, and to help combat generational poverty. I just want to thank the county staff and departments involved in both of these programs and many other terrific programs that were put forward for these awards. We have so many dedicated public servants across our county organization making a real difference, and these are just two small examples, but important ones of all of that great work. The third item that... I'll pause there if you... Well, actually, yes. I just

Susan Ellenberg 5:12:58

wanted to make sure everyone understands what a big deal these challenge grants are. They receive... The committee receives hundreds of applications from every county. I think L .A. County itself submitted more than 50 programs, so it is a very selective and small number of winners. And the way the winning counties and programs are celebrated is through a really lovely event in Sacramento that attracts many legislators and folks from the governor's administration. The staff members that implement and lead the programs are feted in a very festive red carpet and special manner, and it really is an effort to uplift the hard work that county staff does and to be able to share best practices across the

Susan Ellenberg 5:13:55

state by highlighting what various counties do well. And I want to thank the IGR team as well for coordinating the applications.

Susan Ellenberg 5:14:05

Thank

Otto Lee 5:14:05

you. From our CSEC president, Sylvain Zelenberg. Thank you. Go ahead, James.

James Williams 5:14:10

My third and final item is an update on the continued tracking of troubling developments at the federal level. Some of you may have seen the news that the federal government's announced the withholding of $600 million in health -related funding from a handful of Democratic -led states. It's yet another example of what appears to be very blatant political targeting of funding streams in certain jurisdictions and certain states based on partisan affiliation. We're closely watching that because our public health department does receive several of those grants. We haven't yet gotten the formal termination letters that have been discussed in some of the media notices around this, but that could have a significant impact. For example, these funds

James Williams 5:15:07

include our HIV prevention programs and services that the Trump administration is saying that it is going to freeze and withhold from California and all local jurisdictions within the state of California. So we're tracking that. The board's also aware of the prior freezes on social services funding. We're continuing to track that as well. The state is fighting these in court, and we continue to be vigilant in watching what's happening with those as well as, of course, the many cases being brought by our own county council's office on federal funding. I will just say I'm quite nervous about how all of that will progress. In the months and years to come, as those cases all work their

James Williams 5:15:52

way up on appeal, and eventually one of these sets of cases will be in front of the U .S. Supreme Court at some point, and that makes me very concerned. So we will see. We'll keep monitoring. We'll keep the board updated. Like I said, for this latest tranche, we haven't yet gotten the formal termination notices, but I'm sure they are on their way, unfortunately, and I'm sure the state will file litigation to challenge them. That concludes my report. Thank you, James. And Tony.

James Williams 5:16:30

There were no reportable actions taken at the Board of Supervisors' closed session meeting on February 9, 2026, and that concludes my report.

Otto Lee 5:16:40

Thank you. All right. Moving on. We have a big item right now, item 13, which is recommendations for a midyear budget review, and we will hear this item concurrently. We'll have items 14 and 15.

Otto Lee 5:16:55

Okay.

James Williams 5:16:56

James, go ahead. I just shared my screen. I don't know if folks can see that. All right.

James Williams 5:17:13

So I'm going to give just a quick overview regarding this year's midyear budget presentation. Obviously a very comprehensive report is included in the packet.

James Williams 5:17:25

Traditionally, midyear is an opportunity to assess where we are, about halfway through the fiscal year, make budget adjustments of a corrective and true -up nature to keep the budget in alignment with the overall picture that was adopted by the Board of Supervisors in June. And that is true for the overwhelming majority of the adjustments that are proposed in midyear here are very consistent with that. But there are a couple areas where this particular midyear is a little different. The most significant, as the Board is very well aware, and as we discussed at great length at the last Board meeting with the budget study session from SCVH, is that Santa Clara Valley Healthcare, largely due to

James Williams 5:18:14

the HR1 impacts, is bringing forward almost $200 million in ongoing budget solutions. A portion of that, it's the minority portion, but a portion of that as discussed at the last Board meeting, does relate to position reductions. The other major department that's affected at midyear, and this is for a totally different reason that doesn't have anything to do with HR1, but that is also fiscal, is our Department of Tax and Collections. The Superior Court terminated its contract with the county for the collection of justice -related fines, penalties, et cetera. And so that body of work is no longer there. It's no longer work for our department to do. The Superior Court has chosen to contract that

James Williams 5:19:04

work out to a private third party. And so there's a number of position impacts in that department as a result as well.

James Williams 5:19:15

Looking to the upcoming budget, midyear is always also a time when we reassess what the base budget projections are for the upcoming fiscal year.

James Williams 5:19:29

We're fairly consistent. We're consistent with what things looked like in our report to the Board last October. The Board will recall that in October we identified a gap of about $800 million in an ongoing deficit for the upcoming fiscal year, the significant majority of which due to HR1 and related impacts. As was also described in that October report, which was before the successful passage of Measure A, but contemplated what things could look like with or without Measure A, Measure A does address a piece of that, but left a balance of $470 million to address.

James Williams 5:20:14

With the actions in front of the Board at midyear from the health system,

James Williams 5:20:21

there is approximately a $270 million gap that would need to be addressed in the recommended budget and through the budget process. I do want to emphasize a couple of things. One is this does not account for any new surprises from the federal government, and there certainly could be. It also doesn't account for any change in broader economic circumstances. So far, for example, the stock market, local housing market, et cetera, have remained relatively stable.

James Williams 5:20:57

And this doesn't account for any changes in the overall economic situation. And this doesn't account for any changes from the state level. The governor's budget does have a few proposals that would negatively impact the county, but is largely a placeholder budget, and we will have to see exactly what ends up being proposed in the May revise and what that looks like for counties, especially our county.

James Williams 5:21:24

It is going to be a challenge moving forward. We talked about what that means for the Baylor Health Department earlier on this agenda. But maintaining the legally required balanced budget is harder with each successive cycle of reductions and with the significant uncertainty that we have. And when you layer on top of that the fact that at baseline for our general fund, operating costs continue to grow faster than revenue. The mid -year report itself includes a discussion of some of those categories of broader impacts, but they significantly include the double -digit growth in health care, retiree health, and other related costs that are attributable to, frankly, what we see more broadly nationally and across California in

James Williams 5:22:15

terms of inflationary pressures in those areas. We've had now consecutive years of budget reductions going back the last several fiscal years. We've managed those as an organization quite successfully with a whole variety of strategies focused first on revenue -related, options, including things like cost recovery fees, such as the one that the Board just adopted moments ago, as well as significant reductions of vacant positions over the last several years. But as these vacancies are reduced and as these fees are updated, as these other revenue strategies are pursued, the broader flexibility for the county organization becomes narrower and narrower. That's not to say there aren't continued opportunities, but it is just important for the Board and for

James Williams 5:23:12

our broader workforce and stakeholders and community partners to recognize these layer on top of each other. And so with each successive year, it does become harder to identify those strategies.

James Williams 5:23:31

We are, of course, continuing to follow the same prioritization framework. We discussed it with the Board in October. We do look first to maximize revenues, to consolidate and redeploy resources and reorganize. We do look to shift costs onto restricted funds where possible, and obviously those funds have legal restrictions, but we continue to identify some opportunities. A lot of that work has already happened in the last few budgets, but where there are continued opportunities, we continue to pursue those. To minimize impacts on actual service delivery to county clients and, of course, with a lens prioritizing core safety net services, our most vulnerable populations, consistent with clear direction from the Board. I do just want to say

James Williams 5:24:24

one word about the subsequent fiscal year. I know it's hard to kind of, we're talking about multiple things all at the same time, but it's a continuum. And so I'd be remiss not to say a word about that. Which is we've got midyear right now, and I'll get to that in a second. We've got, you know, the budget coming in front of us with another $270 million after we account for midyear actions. But just the HR1 and related impacts for FY27 -28 layer an additional $500 million in projected revenue loss on top of what we're looking at now at midyear and at budget several months from now. And we have to keep that in the

James Williams 5:25:05

back of our mind as we strategically approach what we're tackling collectively as a community. And that 27 -28 number is really the primary target of a lot of the state related strategies because the reality is the impacts on the county organization and the critical services that we provide from that additional layering would be truly, in my view, devastating. And make it absolutely essential that we have support from the state to help mitigate those. So we have to kind of look at this on that multiyear time horizon and multiyear advocacy horizon as we put together the most strategic approaches possible.

James Williams 5:26:00

For midyear, like I said earlier. Consistent with a normal midyear, the overwhelming majority of items in the midyear are technical in nature, true ups, other adjustments. But we do have a few departments where things are a little different. There are a few departments with filled position impacts, namely SCVH and DTAC as mentioned previously. We have worked really hard. And I want to commend OBA and ESA staff for this work on an ongoing basis to try to mitigate filled position impacts by strategically managing vacancies. What that means is right now, and we can't say this is always going to be the case, but for the midyear, we can continue to say something which has been very

James Williams 5:27:00

important for me. From a value standpoint for our county organization, we can continue to say that all impacted employees can transfer to another position, but even more significantly that 90 % of those are transfers within the exact same job classification. That's not an accident. That is because there's been a lot of effort on a weekly basis to manage vacancies across the organization. This is getting harder and harder. It was certainly harder for this midyear cycle than last year's budget. But that's something that we strive to do to the greatest extent possible. All the rest of the position impacts in midyear are vacancies. Several of them are related to specific true -ups or adjustments such as

James Williams 5:27:57

expiring grants.

James Williams 5:28:00

But certainly the most significant employee -related impacts are SCVH and DTAC. We recognize that.

James Williams 5:28:10

And like I said, the SCVH -related ones were discussed. The bigger picture of what SCVH is looking at strategically at the last board meeting, we didn't want to repeat those slides here. And the DTAC one is fairly straightforward, which is it's directly related to the termination of that contract by the Superior Court.

James Williams 5:28:33

So in front of the board on items 13, 14, 15, they are linked. 14 and 15 are the salary ordinances that are aligned with the appropriation modification in 13B, which would make these adjustments. We do have staff, including from the health system, here available to answer questions that the board may have. And I'll turn it back over to you, President Lee.

Otto Lee 5:29:00

Okay. First, clerk, do we have any members of the public elect to speak on this item?

Otto Lee 5:29:05

Yes, we do. We have several cards across two items, five for number 13 and three for 15. So that's eight, plus one hand in Zoom. So a total of nine.

Otto Lee 5:29:21

Okay. Let's do two minutes each. Okay. I will begin calling the first batch of names. You can approach the podium in any order. I have Vanessa Hernandez, Netta L .A., Steven Otero, Suong Lee, Perla Flores, Lam Do, Debbie Chang. And I'll pause there. If you're in chambers, please approach.

Public Comment 5:29:58

Good afternoon. Good afternoon. My name is Steven Otero. I'm a deputy public defender here in Santa Clara County. I'm also the vice president of the Government Attorneys Association. I'm here to ask the board to delay deletion of the codes at the public defender's office. There are five attorney positions and five staff positions that are currently being placed up for deletion. The public defender has put forward a proposal to either delete those positions and provide full credit for those positions and the salary savings towards the fiscal year 26 -27. Or alternatively, delay the deletions while the codes are remaining vacant so that there can be fuller discussion of those codes, the impacts they have during the

Public Comment 5:30:48

full budget cycle. The Government Attorneys Association is concerned about the increasing caseloads for our attorneys. We are concerned that the deletions, if they are made currently without the full salary savings, being applied to the next year, would result in additional deletions of attorney positions in the next budget cycle that's coming up. Those additional deletions would further strain the resources that we already have that are very limited. And we are already concerned that we are rapidly approaching a position where our attorneys are at risk of not being able to provide the constitutionally mandated services that the county must provide and that we as attorneys are professionally obligated to provide to our indigent clients. So I would

Public Comment 5:31:35

ask the court. I'm sorry. I would ask the Board.

Public Comment 5:31:40

My colleague is actually, Ms. Ala 'i was supposed to be providing comments today too, but she had to go to court this afternoon, which is always the word that I have in my mind. I would ask the Board to delay deletion or alternatively provide the full salary savings that the public defender is requesting to be shifted towards the fiscal year 26 -27 budget reduction targets. Thank you.

Otto Lee 5:32:00

Thank you, Councillor.

Otto Lee 5:32:06

Good afternoon.

Public Comment 5:32:07

My name is Petla Flores. And I'm speaking on behalf of the Board. I'm speaking on behalf of the Santa Clara County Domestic Violence Advocacy Consortium. I just want to take this opportunity to thank the Board and the County Executive for your leadership and partnership, including the collaboration with the Silicon Valley Council of Nonprofits to host budget town halls for service providers and community members. During this challenging budget moment, we're very grateful for the thoughtful design of the town halls and the strong support from County Executive's Office, particularly Deputy County Exec. Casey Haakon, as well as Carla Collins and the Office of Gender -Based Violence. The process that you've facilitated has been thoughtful and transparent and

Public Comment 5:32:43

genuinely collaborative. And that matters deeply to our community. At a time when uncertainty can create fear and instability for survivors of gender -based violence and service providers, the County has demonstrated a clear commitment to slowing down, listening, and engaging meaningfully with those closest to the work. DVAC is especially grateful for the intentional efforts to seek input from providers and community members and to center the real, lived experiences, and experiences of survivors as decisions are being considered. This inclusive approach reflects our shared values and a recognition that sustainable solutions are built together. We're thankful for the County's continued commitment to collaboration, partnership, and centering community needs as we navigate these difficult decisions. Thank you.

Public Comment 5:33:27

Good

Public Comment 5:33:34

morning, everyone. My name is Shibley. I am at VASC, Vietnamese American Service Center Clinic. I'm sorry. I'm a little bit nervous. I have been at the county. VASC. I've been at the hospital for more than 10 years. I started as an extra help, and I get called at a full -time position at VMC. And I seen VASC clinic open in 2022. I moved to VASC. And I was the only RN at that VASC, along with Dr. Dinh and one LVN. So, since then, we are growing. We have more doctors and nurse practitioners. And our population mainly are Vietnamese speaking person. They are vulnerable in some of, many of them, it's hard for them to speak

Public Comment 5:34:25

English. So, they don't understand much. So, sometimes it's, I believe we are very helpful because I am a bilingual Vietnamese speaking. So, I know the system. I know all of the technical and medical terms. So, I explain to them. So, I believe I play a crucial role in helping our patients. So, I respectfully think that please reconsider the cutting position because right now we are only two RNs. But I just get the news that my position will be eliminated. So, I hope that the supervisor will think about it and reconsider our clinic. Thank you. Hello.

Public Comment 5:35:22

I am Dr. Lam Do from VASC, which stands for the Vietnamese American Service Center. I am a primary care physician. You actually trained me in the early 90s. Dr. Cliff Wang and I were co -chief together back then, a long time ago. Our clinic predominantly take care of Vietnamese speaking patients. But a significant amount is Spanish speaker. I would guess maybe 40 % of my patients speak Spanish in a minority or English speaker. We have just two RNs in our clinic supporting five front line providers. One full time physician. One 0 .8 FTE. Two 0 .5 FTE physicians. I am one of the 0 .5. And a full time nurse practitioner who specializes in diabetic

Public Comment 5:36:26

care. I just want to say that it will be very difficult for me to deliver excellent and culturally competent care with just one RN in clinic. What do we do if one gets sick if we have only one?

Public Comment 5:36:48

I believe that patient safety issue will be at stake if you cut our one RN position. So please reconsider. Lastly, thank you for your hard work, dedication, and the difficult work that you do. I am sure you don't get enough support for that. Thank you.

Otto Lee 5:37:15

Thank you. Thank you. Thank you. I will call the last card, Jose Limones. If you are still with us and would like to speak. All the other names have been called. Vanessa Hernandez, Nita, who I believe had to leave, and Debbie Chang if you wish to speak.

Otto Lee 5:37:37

Okay. We will move to Zoom then. We have one speaker on Zoom. Parent.

Otto Lee 5:37:46

Please accept the unmute. Yes. good

Public Comment 5:37:49

afternoon i'm really glad that we're looking for opportunities to save money and if i could draw your attention to page 31 of the report the district attorney's office is deleting one senior paralegal position and i think that it's uh unnecessary uh you know i mean it says here that we're gonna save forty two thousand dollars uh when it's i'm gonna say when daniel chung is being paid around roughly two hundred thousand dollars and to stay at home and not work we could be saving uh we could be saving one deputy this attorney position in the office and we could we could hire five senior paralegals at that savings um and i'll tell you particularly why

Public Comment 5:38:46

it's an egregious thing is that jeff rosen doesn't have just cause for him to be sitting at home and not working when daniel chung he didn't do anything wrong what he you know he forgot to put in his in an op -ed that he that he was writing it in his personal capacity that's ludicrous that uh that we're we're paying him to stay at home and in particular too because he wanted to protect my children from being sexually molested and uh and me from being uh physically assaulted uh from one of uh d .a rosen's uh political supporters i mean it's just egregious that we're allowing this to happen and uh if you want to

Public Comment 5:39:35

look at more information about this situation please google d .a jeff rosen petition sex trafficking all those terms together and within the top five results you'll see what i'm talking about thank you so much for your time

Public Comment 5:39:51

that

Otto Lee 5:39:52

concludes our public speakers for 13 14 and 15. thank you go close to q on that yes supervisor ellenberg i believe your lights on first was it oh

Susan Ellenberg 5:40:04

okay um thank you um thank you for the the report i want to just take a moment for us to acknowledge the magnitude of the of the challenges we face i referenced that a little bit in the behavioral health item but just looking much broader at the county budget two years ago balancing the budget required 270 million dollars in reductions last june we needed to trim another 80 million this past fall voters approved measure a thank you

Susan Ellenberg 5:40:43

to the state of hr -1 to avoid 300 million in reductions but another 200 million in reductions are still necessary at this mid -year looking ahead to june the impacts of hr -1 will of course be building and we'll have to confront another 270 million dollar reduction target projections for the following year show that we will likely face yet another 500 million in reductions and in total this amounts to about 1 .6 billion dollars in budget reductions or revenue solutions so while these numbers literally keep me up at night i i want to acknowledge james the prescience you had in in starting this maybe i'll call it a dial back several years ago we saw

Susan Ellenberg 5:41:41

the economy turning we saw those years of of enormous and exponential growth in property tax revenue slowing down and frankly as drastic as the as dire as the situation is right now i think without the choices we've made over the last couple of years it would be exponentially worse i know that's not very comforting

Susan Ellenberg 5:42:13

i know that's not very comforting to most folks so that as we move through this process which will still be difficult it's going to be so important that we keep all stakeholders patients clients service and program recipients community partners county employees and the public clearly and consistently informed about any changes that could affect them i acknowledge that we and i certainly am talking about myself will need to be disciplined and be responsible for those changes and i recognize opportunities for reductions that align with our guiding principles without allowing transparency to fall by the wayside and this of course on the administration side means that we need you to communicate timely factually consistently and openly not

Susan Ellenberg 5:43:03

only with the board but with all employees we say that there are trusted partners delivering important services to residents throughout the county and we have to treat them exactly that way. We can't afford to breach their trust. I do find maybe a small sliver of optimism. The federal and financial landscape we are navigating today will not remain our reality forever. While some of our priority areas will face strain, I think our task is to determine which services can be temporarily constrained, restructured, or slowed while preserving the strongest possible foundation and a clear pathway for restoration and growth when conditions approve. At our, I think at the last board meeting when we talked about the home

Susan Ellenberg 5:43:59

visiting item, I noted that where funding may be constrained now, keeping a program, just as an example, a program going at some level, makes it easier to ramp up more when there's more funding. I do have a couple of specific questions regarding the report, and James, I'll direct them to you, and you can call on other folks to answer them. Page 18 offers an overview of 13 major checkpoints in the budget process between February and June, but I didn't see a mention of when the board could expect to see Object 2 information, as was directed by the board through the referral that Supervisor Abicoga and I brought in December. I know you previously stated that

Susan Ellenberg 5:44:50

it would be done by May 1st at the latest. Are we still on track for that date?

James Williams 5:44:57

I'm trying to remember the discussion exactly, but I think we committed to having those out in April.

Susan Ellenberg 5:45:05

Even better, that's what

James Williams 5:45:07

I meant. But I can double check, but that's my memory. Nope, nope, I'll take April. But that's my memory.

Susan Ellenberg 5:45:12

Thank you, and I know that we've all made clear that the information is really critical in informing our budget decisions. I will expect and will look forward to hearing my colleagues' expectations as well. I expect the report that's produced for the board this year to be detailed to the point that we understand the specific programs and contracts that will be impacted by reductions. And certainly moving forward beyond this year, the expectations should be the same, for the same level of detail to be included in all budget conversations, mid -year review, department budget proposals, as well as the recommended budget. The timeline doesn't mention a start date for budget request for information process. Item 17 states

Susan Ellenberg 5:46:02

that it begins on May 1st, but I think you did say, James, that we can submit questions earlier.

James Williams 5:46:11

Yeah, I believe that's covered under item number 17 on the agenda, where we've laid out those dates. It

Susan Ellenberg 5:46:21

is item 17.

Susan Ellenberg 5:46:23

That says May 1st in item 17, but we had talked about having it earlier. And just for example, the item on today's agenda that foreshadows the reduction of all one -time expenses and reserves is concerning now. I don't want to... I don't want to wait until May 1st. I don't need to wait until May 1st to know that I'm going to want an explanation of which specific programs and services will be impacted. And similarly, I'll want to know which programs will be impacted by position reductions. So can you clarify that May 1st date? What

James Williams 5:47:01

is the intent? The recommended budget will come out May 1st. So it would be hard to have requests for information regarding it prior to the publication of the recommended budget. I'm not sure what you're referring to, Supervisor, regarding the elimination of all reserves and one -time funds.

Susan Ellenberg 5:47:21

I'll get the number for that. I think it's an item on consent. I'll come back to that. But you're right for specific requests, but if there's information, for example, from the mid -year or from other things that we see along the way that we are anticipating will be part of the proposed budget, I would guess there's no reason why we couldn't ask a question

James Williams 5:47:46

earlier. Certainly, and the Board has, even earlier today, made requests for information on things related to the budget. So the Board can certainly ask for those at any time. Great. But the proposals that will be brought forward in budget won't be published until May 1st. Okay,

Susan Ellenberg 5:48:03

that's fine. And I will, as I'm talking, also find that reference to one -time expenses and reserves. With regard to HHS, is Paul here? Yes,

James Williams 5:48:17

Paul's here. Hi,

Susan Ellenberg 5:48:17

Paul.

Susan Ellenberg 5:48:20

Thank you. The report indicates a $42 million operating deficit in the enterprise fund, and that that will be covered in part by $35 million from the services and supplies budget. So this is a... This is a real -life, right -now example of wanting to understand what is the nature of those services and supplies, what services are being reduced and eliminated, and how might patients be impacted. And

Susan Ellenberg 5:48:56

thank you.

Public Comment 5:48:57

Thank you, Supervisor Allenburg. Members of the Board, Paul Lorenz, CEO for Santa Clara Valley Healthcare.

Public Comment 5:49:05

So just by way of background, you're correct that in the current year budget, we are projecting a deficit of the dollar amount that you had mentioned, $47 million.

Public Comment 5:49:19

In order to end the year on budget, we are proposing, as Jane had outlined, about $200 million in budget initiatives. Right. That is ongoing savings, which will allow us to balance this year's budget by year end. Those dollars, in excess of the $47 million, the balance is going to help us achieve the ongoing challenge relative to H .R .1. Okay. So that addresses $200 million of the H .R .1 impact and allows us to year the end... end the year on... year the... end the year with the balanced budget. Excuse me. And

Susan Ellenberg 5:50:03

I would just note that the... No, so that's not... I appreciate that, but my question is really about the distinction between services and supplies, and when we're cutting $35 million and the description is services and supplies budget, I have no idea what the impact is. I don't know if it's PPE or... I can't make up an emergency thing. I'm not a doctor, but... IV machines, holders.

Public Comment 5:50:34

So what I can share with you, Supervisor, to your question about where specifically, it is in a number of different line items within our budget. It's not any one specific item. And what I'm referring to is that when you have a services and supplies budget, you can have contracted services of a variety of different areas, which would include physician contracts. It could include service contracts related to...

Public Comment 5:51:04

contract staff. It can be a variety of different areas. It can be a variety of different items.

Susan Ellenberg 5:51:08

Hence the question, which ones?

Public Comment 5:51:12

All of the above, because what we are trying to do is across the board identify specific savings to balance the budget. So

Susan Ellenberg 5:51:23

I hear that, and I'm not sure how to ask it differently. So this is, I think... It would be easy if it was supplies. You could tell me we're not buying any more paper gowns. If it's services, I want to know, and maybe the paper gowns are very important. I want to know which services, who will be impacted, and what does this look like at the delivery level?

James Williams 5:51:48

So this is, I think, one of the challenges when you're talking about budgets as large as those in the hospital system. Okay. So we have a multi -billion dollar Object 2. The board's appropriated that budget at an object level.

James Williams 5:52:05

And we don't... Now, over the course of the year, there is ongoing day -to -day management within those budgets in the acquisition of supplies and the use of contracted services in alignment with the daily census, for example, at the hospitals. So, for instance, right now, Regional Medical Center has a higher -than -expected census. Regional Medical Center is incurring higher -than -expected expenses. There's offsets against that from other parts of the health system. And, you know, in a normal operation of that magnitude and size, we expect the managers within the department to be actively managing those budgets on a daily basis. And what I think is challenging is,

James Williams 5:53:01

on a percentage basis, what we're talking about in the health system equates to very large numbers when you compare to other small departments. But the percentage amounts that we're talking about here are actually relatively modest within that overall management. But I think they have some additional information that they'd like to share on this piece specifically.

Public Comment 5:53:28

So, Supervisor, as an example, line items could include pharmacy supplies, where we're targeting a certain percentage of savings, and maybe 1 % or 0 .5 % of the total budget. But we set that up as a target because we believe it's reasonable to achieve. That's an

Susan Ellenberg 5:53:49

excellent, specific example of supplies. What might an excellent, specific example of a service be? For

Public Comment 5:53:58

example, we are renegotiating all of our physician call contracts within the healthcare system. And we believe that there's some reasonable savings that we can achieve through those renegotiations of those contracts. In our estimate, for example, we're probably looking at about $6 .5 million by year end and ongoing savings of potentially more. And

Susan Ellenberg 5:54:26

does that impact patient... Does that impact healthcare delivery to patients? No, not

Public Comment 5:54:35

at this point in time. Okay. Because we are looking for those opportunities where we are not going to impact patient care or services. It will be a restructuring of some of those service lines for physician coverage. As an example, in the budget proposal, in the mid -year budget proposal, we are adding physicians, P41 physicians, to actually employ some physicians in certain service lines, such as anesthesiology at O 'Connor Hospital, hospitalist coverage at Regional Medical Center. And through the hiring of the P41s, we can achieve savings in certain contracts. So it's a multi -pronged strategy relative to cost savings, but also identifying opportunities for potential revenue. Because in those situations, we can bill and collect for

Public Comment 5:55:28

professional fees on top of that.

Otto Lee 5:55:31

Thank you. Yeah, thank you. I was just going to say, why don't we start the 10 -minute thing? I'm

Susan Ellenberg 5:55:36

happy to do that. Which is not a round. You can even deduct eight and I'll stop. I do have a couple of questions that I'm happy to do in a second round, but I wanted to follow up, James, because I found what I was referencing about. One -time amounts budgeted for expenditures and reserves have been removed from the FY26 -27 base calculations. And this is page 11. And I'm seeing, countywide,

Susan Ellenberg 5:56:04

all FY25 -26 one -time amounts budgeted for expenditures and reserves have been removed from the FY26 -27 base calculations. Oh, that's just

James Williams 5:56:18

the definition of what it means to look at a base budget. So by definition, your base budget is ongoing expenses and ongoing revenues. Right. And you remove from consideration one -time items in order to look at whether you, what your structural surplus or your structural deficit in the case of the most recent several years is. So when we're describing in this section of the report is a description of the status of the base budget. So that's the header if you go to the page, bottom of page eight. So this is a description of the factors that lead us to the calculation of a $270 ,000 budget. $270 ,000 net structural deficit to address in the

James Williams 5:57:04

upcoming budget. You don't count one way or the other towards that calculation, one -time expenditures or one -time revenues.

Susan Ellenberg 5:57:13

So basically, all non -labor employee costs are one -time expenditures? No,

James Williams 5:57:22

no, no, no, no.

James Williams 5:57:26

I'll give you some

Susan Ellenberg 5:57:27

examples. And if this is too detailed, and everybody else understands it, I'm happy to have a tutorial.

James Williams 5:57:32

I mean, this is important. This is the definition of a base budget.

James Williams 5:57:37

Let's say we have a one -year grant that's inputted into the budget system as one -time revenue, not ongoing revenue. In other words, it's not money that we expect to get year over year over year. It's money that we expect to get once or maybe once for a period of a couple years. And there's similarly maybe one -time expenses inputted into the system and recognized as one -time.

James Williams 5:58:06

When you're looking at your base budget to see what your structural situation is, you're only looking at your ongoing revenues. So ongoing revenues would be our property tax, our sales tax, our, you know, Medicaid, all of those kinds of things. It's the overwhelming majority of our revenue and our ongoing expenses, which would include most of our positions and Object 2, but not all. So for instance, while most of our positions are funded ongoing, occasionally the board will see in salary ordinances unclassified and expiring positions with expiration dates. Those are in the budget system as one -time, not ongoing. And absent further action such as we get another grant or we get another something, those costs

James Williams 5:58:55

would then fall off. So we do have things that are budgeted one -time. The most significant set of things that are budgeted one -time are our capital projects.

Susan Ellenberg 5:59:07

Right. Though I understand that.

James Williams 5:59:09

So this doesn't include, for instance, the capital budget. But this was just a description of that. It's not, we're not, this isn't a proposal in any way with respect to what's going to happen with one -time funding or reserves. All right.

Susan Ellenberg 5:59:23

I appreciate that clarification. I'll be happy to have a second round. Thank

Otto Lee 5:59:26

you. Vice President.

Susan Ellenberg 5:59:27

Thank you.

Sylvia Arenas 5:59:30

I know that this is really difficult. What we're doing is reducing our expenses. But that also translates to services, to programs,

Sylvia Arenas 5:59:47

and much needed support that most people count on us to be. We are that last resort. And so, when there isn't anybody behind us, it's really difficult to have these conversations. And so I appreciate the patience and your willingness to have all of these conversations. I will have some questions for you, Paul, so don't go.

Sylvia Arenas 6:00:15

I know, listen, what I'd like to highlight is something that you mentioned earlier, James, and that is that this proposal comes with recommendations to delete field positions in 90 % of the 365 .6 FTEs that employees were impacted. They'll have a landing spot in another position in the same classification. Now, that to me is like gymnastics, right? To be able to find the folks the same classification and it might create some changes, but that's what we're, that is unfortunately part of this process. The remaining 10 % will be offered another position in a different classification that they qualify for. And so I think overall, the good news here is that people will have a landing

Sylvia Arenas 6:01:15

spot. And not only because we want them and we need them, but because we want to make sure that we don't destabilize our system. And so I just want to elevate that. And while I elevate that, I think I also need to make sure that we have stakeholders that are very invested in what we are doing. Obviously, some of them came and gave us their thoughts earlier in public comment, but there's also infinity groups that have a very vested interest, including our unions.

Sylvia Arenas 6:01:55

And I would encourage you to continue to have those conversations with the unions in a way that inspires collaboration. Because we created a lot of really good will with a lot of our stakeholders, including our unions, but all of the folks who are in the community who voted yes on Measure 8 that allowed for us to stabilize the system. And so I don't want to reduce any of that good will and collaboration simply because we are making cuts. I know we never said, we're not going to. We said, this is 330, we have a billion. So, you know, you were trying to borrow from your next speaking time. And that is kind of what we're

Sylvia Arenas 6:02:43

doing, too. We're kind of borrowing for the next budget process and trying to make sure that everything gets paid and the lights stay on. So that is just what I wanted to start off by saying. Go ahead, Chase. Yeah,

James Williams 6:02:57

no, Supervisor, I really appreciate you highlighting that. And I just wanted to share a couple things related to that. One is I don't usually share very many personal stories up here, but I'll just share one because I just want our employees to know how seriously I personally take impacts on staff. My wife works now for a school district, but used to as well. And when she was pregnant with our first child, she was laid off. And by laid off, I mean actually out the door laid off during that pregnancy at a time when we didn't otherwise have any health insurance coverage. This was pre -Affordable Care Act. We were on a high deductible plan. We

James Williams 6:03:38

were informed the plan deductible was going to, you know, double to be 10 ,000. That was back at a time when, you know, I was still in graduate school. And it was an extraordinary time. It was an extraordinary stress. And I just share that because

James Williams 6:03:54

we very much understand personally what it means for people to have uncertainty for themselves and their families. And you're right, it is gymnastics. And we work very, very hard. It is exactly why we have a hiring freeze, even though every department doesn't like it, even though I get lots of complaints about it. We want to do everything we possibly can to minimize impacts on our staff. And it is no accident that 90 % of filled position impacts here are moving to the same classification. That means no loss in pay. That means no change in title. And even the remaining handful continue to have a job with benefits. It's very important to us. Now, we may

James Williams 6:04:42

not always be able to say that, but we can say with certainty we will try our hardest to be able to always say that. And that's a commitment that I personally have to our staff. I know it's something shared by every member of the board, but it's something we work really hard to do. And you're also absolutely right, Supervisor, that we had incredible community support and collaboration and partnership from our unions, from our stakeholders, from our CBO providers in passing Measure A. And we tried to be as transparent as possible. I don't know how many times we said, and we are going to have cuts even with Measure A. Measure A is essential, but isn't

James Williams 6:05:30

the panacea. And this is part of what we're seeing. We said many, many, many months ago that we were going to need to bring $200 million in ongoing budget solutions related to SCVH here at Midyear. It was a front -page article in the Mercury News many, many months ago. We've been talking about it. We are committed to continuing to do employee forums. You heard a speaker reference our CBO forums. We will continue to provide the best information we can. And we will continue every effort possible to try to mitigate those impacts, because at the end of the day, it is absolutely about vital services for the community that we serve. That's exactly why we're pushing

James Williams 6:06:16

on the state to do the right thing. It's exactly why we push departments to come up with the most creative proposals they possibly can to minimize impacts on those we serve, number one, and minimize impacts on the people who deliver those services, which is both our staff, but also we recognize many of our nonprofit partners, too, who are heavily dependent on county funding. So, you know, I appreciate you recognizing that because it is very understandable that people have concerns about any specific proposal. It's understandable that staff don't relish changing roles in the organization. That makes sense. We all recognize that. And we have to balance the budget. We have to do so in as strategic

James Williams 6:07:13

a way as we can. And we will continue to bring our best thinking and recommendations in front of the board. And as you heard at the last board meeting with SCVH specifically, they have really been pushing on solutions that don't involve positions. We're fortunate that the overwhelming majority of that $200 million is actually not based on position reductions or service reductions, but unfortunately it is a piece of things.

Sylvia Arenas 6:07:43

I'm not naive to think that the trouble that we are in is not going to require some cuts, some severe cuts, cuts that I will not be happy about, cuts I will fight. But we're fighting against our own selves, really, because this is a family, right? And in a family, we have changes to our pockets. And as much as we say in advance, hey, it's going to be a really hard summer, it's going to be a really hard year, it's still just how human beings are, right? Change is difficult and change is hard to accept, including myself,

Sylvia Arenas 6:08:26

because we're all here to make sure that we are that safety and that we continue to be that. So I have a couple of questions I'm going to ask them and then I'm going to let you answer. But before I do, there are some questions for Paul. I'll ask the questions, and then I'll ask the questions more generally from James. But I think overall what I would like to see is, I don't know if this has a little bit to do with what Supervisor Ellenberg was talking about, and that is, I think in general, I'd like to know the reduction. How are you reducing your overhead in a way that that department is becoming more

Sylvia Arenas 6:09:11

efficient, more effective? And whether it's purchases of materials or it's less consultants that you're having, that is the kind of information that I would really appreciate. And I think not only for... I know we've already had a bit of a study session, but not including this budget conversation as in -depth as we're having today. So I would like to know, to understand exactly that, what are the locations and the impacts for the reassignments in your system, and that there isn't a concentration of staff in one particular district over the other, or if there is, it's because out of need. And I will continue to pipe up about South County and the need that is there.

Sylvia Arenas 6:09:59

And simply because we're far away does not mean that we are not there. My people may not come all the way over here because that is a challenge, but they typically will call. So those are the questions I have for you.

Sylvia Arenas 6:10:17

But let me just ask the questions from James, and then you all can continue on with the conversations. We said we were going to commit to a three -prong approach where we were going to ask our residents to tax themselves, for us to look for additional grants, and then for us to create efficiencies. And so with that three -prong approach, I'd like to also, when we're receiving items that is structured in that way, that you're telling me some of the reductions that you're making, some of the improvements that have been done internally in the departments, how you're becoming more efficient, and then some of the sources of the grants. And I know we saw that

Sylvia Arenas 6:11:03

somewhat in the mental health, but not really. I think we just, I'd like for us to continue with this three -prong approach and how we're actually moving things forward with that in mind. So if you could please begin, either

James Williams 6:11:22

one of you. Absolutely, Supervisor. And I know you were not able to be here for the last board meeting where we had the SCVH study session, but included in that presentation were some very specific examples of what you're talking about. And let me just highlight a couple. Paul and the department talked about some of the initiatives to increase revenue and billing, such as the Revenue Guardian program and how that's being utilized to actually increase revenues received in the health system, the utilization of looking at service lines and our enterprise system, you know, taking advantage. And this was one of the strategic reasons also behind the acquisition of regional medical center that goes beyond, obviously, number

James Williams 6:12:11

one, the direct service delivery at regional, but some of the strategic pieces around thinking about what we can then do as a holistic system that Paul had walked through. And you'll see included actually here a number of those kinds of efforts. So for instance, included in the mid -year report, and Paul mentioned this briefly, is actually the addition of some employed physicians and the elimination of contracted physician groups because we actually now have some heft as a broader system to be able to bring some of that coverage in -house in a way that maximizes revenue and allows us to deploy resources more flexibly. Paul mentioned specifically the anesthesiologists, but there's a few others as well

James Williams 6:12:59

that are included in the recommendations here at mid -year. And Paul, I don't know if you want to expand on some other examples. I know there's a family residency example too,

UNKNOWN 6:13:09

but the

James Williams 6:13:10

majority, not actually just majority, it's almost about three -quarters of that 200 million is actually the whole series of efficiencies, revenue opportunities, and related endeavors.

Public Comment 6:13:25

Thank you, James. And so let me just give some percentages. So approximately 38 % of the $200 million is related to physician reductions, reduction in overtime usage and so forth. So that represents 38 % of that $200 million.

Public Comment 6:13:48

Another $32 million,

Public Comment 6:13:52

which brings it up to in total about $100 million, is related to services and supplies.

Public Comment 6:14:00

So that's $100 million approximately. What's the percentage? The balance of that is all revenue opportunities through restructuring and efficiencies.

Margaret Abe-Koga 6:14:11

Can you repeat the supplies by percentage? Yeah,

Public Comment 6:14:16

so let me just give dollar amounts. Approximately $68 to $69 million is related to positions. In other words, deletion of coded positions, filled or vacant, as well as a reduction in overtime.

Public Comment 6:14:36

Supplies is around $32 to $33 million in

Public Comment 6:14:42

terms of reductions in some of the items, Supervisor Ellenberg, that I mentioned, whether it has to do with pharmaceutical supplies, other supply chain needs of the organization, where we've identified a certain percentage that we believe is achievable in savings, either through renegotiation of those contracts or through better management of that supply chain. The balance, to James's point, is all related to revenue improvement opportunities, either through revenue cycle improvements, right, making sure that we're collecting every dollar that we're due, denials management, et cetera.

Public Comment 6:15:22

Another part of that is through operational efficiencies. In other words, seeing more patients in our primary care and specialty clinics as well as in our hospitals. Those volumes, if we're able to be more efficient, we're able to generate revenues to help cover our cost.

Public Comment 6:15:43

Another part of it, as James has mentioned, we propose there are a number of different initiatives that will actually allow us to better manage the quality of care that we offer and improve accessibility to care. And let me give you a couple examples of that. James had mentioned that the proposal in the midyear includes a number of programs in the P -41, physician provider support providers. And they come in the form of replacing contracted specialists in the hospital anesthesia. I mentioned hospitalists. But also a number of different specialties where we're having difficulties in contracting for coverage at regional medical center at O 'Connor Hospital. In order to have consistent coverage, it's better to hire our

Public Comment 6:16:35

own physicians to maintain consistent coverage and to ensure that we're providing a level in the quality of care that I think all of you expect of us as a healthcare system.

Public Comment 6:16:48

Those actually allow us to generate not only savings related to not contracting in the market, but also allow us to generate professional fee revenues in the care that we are providing both in the hospital but also in our specialty clinics. So we're able to generate revenues and provide more access to care. Another example is that Stanford has notified us that they're no longer going to support the family medicine residency program. And these are 27 residents, nine residents per year, plus an additional two sports medicine residents. We

Public Comment 6:17:34

know in our system, we need primary care physicians. And we have to grow our own. And for us, that family medicine program is critically important to our health system and to this community.

Public Comment 6:17:49

Stanford has chosen not to support that program. They're not focused on family medicine or primary care. They're more focused on hospital -based services, internal medicine, and so forth. So what we've done is agreed to take on that program because we actually see two things happening, not only relative to maintaining and growing our physician workforce in primary care, but also from a financial perspective because the way in which we're modeled relative to our federally qualified health centers, we're able to generate revenues to cover the cost of the program and potentially see a margin there to help cover other services that we want to provide in the community. So that's an example where we're trying to strategically

Public Comment 6:18:37

grow the system in ways in which we're better able to serve the community.

Public Comment 6:18:46

And let me just say this about the family medicine program, and this is something that Supervisor Aranis has talked about, is finding ways in which we can grow a workforce, hire physicians and staff that are reflective of the community we serve. We have the ability to match residents to our mission in this community as a healthcare organization. That's critically important. That is something that we have to start now because we're talking about not just challenges this year in terms of hiring physicians, but we're talking about five years from now, 10 years from now, having a workforce that's more reflective of the community we're trying to serve. So you can see we're trying to balance strategically

Public Comment 6:19:31

during this time, financially how to offset the challenges that we have related to HR1, but also strategically grow the system in a way that it can be sustainable going forward.

Public Comment 6:19:47

So those are a few examples of the initiatives that are under the midyear budget.

Otto Lee 6:19:53

Okay, I'm going to rotate this one for next round. Let's go with Supervisor Young for your question, 10 minutes.

Betty Duong 6:20:01

Thank you. Thank you. 10 minutes on the clock. I want to echo what was already said up here by Supervisor Ellenberg and Supervisor Arenas, your words about how hard this is. And James, thank you for, I know you don't often share your personal stories, and I've heard that story in private with you. I know, I trust that every single person here to carve out this budget is carving a part of yourself out because we all love this county. And I want to acknowledge that this discussion is going to be a push -pull, and it's to try to arrive at the best conclusion possible.

Betty Duong 6:20:38

Something of concern to me about this whole process that we don't typically do these type of deletions at midyear. It's usually a very long involved process, the annual budget process through workshops and hearings where we're able to have information, seek information. Something that I do is that when I see proposed deleted codes, I contact the department heads. I contact my labor partners. I contact staff that I may have used to work with myself. There are some opportunities for that once in a while. To kind of, well, one, to find, not kind of, but to understand what is the service impact, right? What is going to be the impact to our clients at the end of

Betty Duong 6:21:17

the day? And I take this personally, too. I was raised by this county. I received your Medi -Cal benefits. I received care at VMC. I stood in line at SSA. I stayed at SSA with my parents. And then when we couldn't have a translator, we were sent home back on the bus to come back another day. That other day never came because my mom couldn't take time off of work and she couldn't pull me out of school anymore.

Betty Duong 6:21:42

Like, these are the consequences that happen at the ground level. You all feel it. I know it. And I'm sunshining this to the audience and to those who are watching that this is a painful, painful process. And to have this

UNKNOWN 6:21:56

done at midyear did not

Betty Duong 6:21:57

give me the opportunity to understand the full service impacts. But let me just say this. Of the phone calls and the consults I was able to make, the majority of what you're proposing today is really the best possible scenario for us. I can't say that for a small minority of, like, a portion of this budget because I don't have the answers. So, Paul, one of my questions to you is that we heard from the Vietnamese American Service Center staff today. And having been at the VAS, we started all... I didn't say not a long time ago, a few years ago in 2021, with one charge nurse. And then over time, a second charge nurse was

Betty Duong 6:22:34

added. And now we're hearing that one charge nurse was removed. So, basic questions. Number one is, the charge nurse that is slated for deletion, once that code is deleted, does she have a place to land? Will she go to another job, another clinical setting, where she can continue working for the county and providing care? That's my first. The second is, operationally, because we've gone from a one charge nurse, multi -clinic model, integrated service model, which is unique to the VASC. We have dental. We have lab. We have ambulatory care, behavioral health. We have pediatricians. We have... We... Multi -service.

Betty Duong 6:23:17

Can they survive and thrive and meet the client demands with one charge nurse who won't be able to have another nurse relieve? If they're the only ones. Or, am I wrong? Is there a way for them to be relieved? This is really to understand.

Public Comment 6:23:33

Thank you, Supervisor. To your first question, the answer is yes. The RN will have a place within our healthcare system to continue her invaluable work for our patients.

Public Comment 6:23:47

And let me just kind of give some background before I answer your second question. This is where we as a healthcare system have asked every department and program to identify where there's opportunities

Public Comment 6:24:02

to operate more efficiently, identify cost savings in order to get to that $200 million mark. That ask is throughout the system, every program, every clinic. And as we receive these proposals, we balance that with the needs of the entire healthcare system in terms of trying to maintain access.

Public Comment 6:24:28

So, to your second question, the VASC is geographically very close to

Public Comment 6:24:40

Tolley Clinic. And so, the management of both Tolley and VASC is under one individual, the health center manager. And he is responsible to ensure that there's appropriate coverage at both clinics. And so, there will be an opportunity for us to provide relief to that clinic, and not just relative to the RN, but also relative to the HSA, the HSR, excuse me, and or the LVN, because we have to maintain consistent coverage there. So, we are going to have to work differently in order to achieve a situation where we are lowering our cost of care, but still delivering the same level of service.

Public Comment 6:25:30

It is something that we are going to have to monitor. You know, I would tell you if three months from now,

Public Comment 6:25:39

volume goes up, because we fully expect, and one of the ironic situations that we're confronted with is that we fully expect going forward, as people lose coverage, they're going to become dependent on your healthcare system. So, I think across the board, we're going to start to see volumes of change and shift to your healthcare system, and we are going to have to make adjustments there, but it's going to vary by clinic, and it's going to vary by location, and we have to be flexible enough to adapt and to shift our resources. We started to see that, I'm probably going on, but I think it's a really perfect example. We started to see that between Regional

Public Comment 6:26:23

Medical Center and O 'Connor Hospital in Valley. We started to see, you know, the census of Regional Medical Centers spike. Some days, it reached 218, 220 in terms of a census. We started to see O 'Connor census kind of level off, and some units start to decline, such as in the ICU.

Public Comment 6:26:47

We have to be, as a healthcare system, flexible to shift our resources to where they're most needed in order to maintain the level of service set we expect to provide to our community and maintain accessibility to those services. So you're going to start to see that throughout the healthcare system. In primary care, not only were there positions that were filled deleted, but there were vacant positions deleted where we believed that we can achieve some efficiencies across the board within primary care and specialties. And so we are going to monitor the volumes in the staffing needs by clinic and adjust accordingly. Thank

Betty Duong 6:27:31

you, Paul. What I'm hearing, I'm going to make sure I repeat back to you that I received it correctly, since this is the first time we're having this conversation. It's the coverage is not going to be a concern at this time, but you will monitor the volume of patient care here. And when we say monitor, does that mean adjust accordingly to ensure that there is appropriate coverage for our patients?

Public Comment 6:27:55

Yes. Okay.

Betty Duong 6:27:56

And then that, that does have another position. It sounds like a lateral move at another clinic.

Public Comment 6:28:02

Yes. Okay,

Betty Duong 6:28:02

thank you. I do have two more questions, but I'm going to use the remainder of my time just to say that it's not normal for this to be done at mid -year. I'm not acute. James, I'm going to look at you. I'm not saying that you did this on purpose. This is just a really crappy situation that we're in through like a manufactured crisis through no fault of our own. That's why we're here. And I hope that for future cycles of mid -year that we don't have deletions discussed here, but at a more, at a more forgiving setting that allows us the time to dive in and have these conversations about

James Williams 6:28:38

things. Yes, Supervisor. We actually learned a lot. It's been many years since our organization. It's not unprecedented. I actually remember the board having to pull $52 million out of the contingency reserve at mid -year in 2011

James Williams 6:28:56

related to a failure by the city of San Jose to pay an amount owed by the county. So it's not unprecedented,

James Williams 6:29:05

but it's been a very long time. I don't think we've had something like these kinds of mid -year adjustments probably since around that timeframe. We've learned a lot. The board heard public comment I think at the last meeting about some concerns related to the timeline and process of notifying staff. We've learned a lot from that as well. Suffice to say, it's been very challenging for our departments and OBA and ESA as well. We did need to, and that is why we also forecasted many, many months ago that these health system impacts were coming. We did need to do something related to what was going on in SCVH now. And so we've had to take action

James Williams 6:29:52

to bring that forward here. We are fortunate that it's really two departments we're talking about with filled position impacts, the DTAC and SCVH. But we agree that it is easier managed for everyone through the budget process. Of course, we don't know what might happen over the course of the next few years if the federal government does something, whatever else. But we agree with you on that bigger picture principle.

Betty Duong 6:30:21

We also know it's going to be worse next year, right? This budget picture right now is going to be for sure worse next year.

James Williams 6:30:28

Absent something else surprising happening, that's our best information, unfortunately.

Otto Lee 6:30:35

Okay, thank you. I'll go to Supervisor Abacoga for your first round of 10 minutes. Thank you. I know we're getting late

Margaret Abe-Koga 6:30:42

into the hour. So first of all, just thank you for this presentation and the report. I will say I appreciate the details. It is a lot, frankly, to digest. And I think that's why, well, I know that's why Supervisor Ellenberg and I have continued to ask for information in advance as much as possible. You've explained to us this is complicated. I totally know that. And that's why we need the time to digest this. I appreciate the details. Thank you, Paul, for your responses to Supervisor Ellenberg's questions about object one versus object two. And again, I know this is big, but I take my fiduciary responsibility very seriously. And I believe that we should all understand

Margaret Abe-Koga 6:31:44

the budget. So even if it's complicated, we need to have the information. I hope that our new budget system will be able to provide this more easily because, to be frank, it's been a challenge to actually get some of these answers. And my staff and I have been working on this and asked many questions of the staff. We didn't get all the answers in time. I think I was going to ask some of the big ones. There's some reconciliation items I'd like to ask, but I'll save the others and resubmit them and ask for staff to respond to those in writing. But I'll say overall, yes, this is very difficult. I realized in a conversation

Margaret Abe-Koga 6:32:29

the other day that it's been 17 years since the Great Recession, and that was probably the last time that any of us has dealt with something major like this. And then, you know, interestingly,

Margaret Abe-Koga 6:32:46

frankly, I would say because of PEPRA, we've had a lot of turnover and there are very few staff who are with us who were back there back in the 2008 -9 era. So this is probably new and maybe the first time to see such drastic impacts on the county. And so this is really new territory for many people. But I would say that I understand that much of this has come from H .R. 1, and that's probably why we've had to do some mid -year adjustments that we normally wouldn't have. But I would point out that something I see is that there's actually been a structural deficit for several years now. And the big overall

Margaret Abe-Koga 6:33:43

concern I have is when costs are increasing at a faster pace than revenue is increasing, that's the ultimate problem. So that's something that is just, you know, continuous, you have to work on. I appreciate that we've strengthened our reserve policy, but that's just, you know, day to day, every day, every year, you know, discipline that we have to be working on. And I know it's hard when times are good and there's, you know, funding available, there's always going to be needs, so, you know, there's a desire to fill that need, but for internally to keep our, you know, organization strong and to prepare for these types of crises, because they do happen, we have to

Margaret Abe-Koga 6:34:33

just be very disciplined on a yearly basis. I was going to mention, and, you know, I very much appreciate from a workforce perspective that we discipline despite the reductions in positions, most of those people, staff, will be able to transfer to other positions, but I did see that we factored in a salary savings from those vacancies at about 2 .57%. As we fill those vacant positions, you know, the assumption is that that is going to diminish the number of vacancies. Is that correct?

James Williams 6:35:19

Yeah, that's actually a slightly lower, I think you're referencing the portion of the report similar to Supervisor Ellenberg that describes the base year forecast for the upcoming year. That's actually a slight downward adjustment from our current year and prior year salary savings factor. We've always had a salary savings factor built into the base budget to basically recapture, so to speak, on an ongoing basis some of the savings associated with natural turnover and vacancies, and so that's an allocation that every department carries as part of its Object 1 appropriation. That number has been adjusted downward slightly precisely for the reason you just mentioned, which is we track that against actuals and have noticed that with the

James Williams 6:36:10

deletion of so many vacant positions over the last several years, that it's becoming very hard for departments to stay on track with that, and so that's a slight downward adjustment from the 3 % that's currently assigned to departments.

Margaret Abe-Koga 6:36:28

So then next fiscal year, will we expect to see an even lower percentage?

James Williams 6:36:37

Possibly. I mean, we will continue to look at it based on actuals and based on, you know, what the forecast is of departments. There will always be some, some amount, because, you know, there will always be some level of turnover, and I should say, you know, it's not complete across the board because there are some departments where they're carrying higher percentages of vacancies than others, but it's essentially an attempt to make sure that we're not,

James Williams 6:37:11

without preventing departments from appropriately filling budgeted positions, it's an attempt to capture for budgeting purposes some amount of vacancy -related savings so that those can actually then be used to either preserve other things or be spent, in a good year, be spent on, you know, other programs or initiatives, and in a bad year like we're in now, be used to preserve and reduce the number of cuts that we have to make.

Margaret Abe-Koga 6:37:41

Thank you. Going to, following up on some of the other questions, or comments regarding these reductions and positions,

Margaret Abe-Koga 6:37:52

Valley Health being one of them, the other area that is highlighted here in the mid -year position reductions, the 41 .5 positions in behavioral health, and I know we had the study session earlier, but again, the request is, well, how, you know, what are these reductions, how are they going to impact services, and again, this is going to be offline, as follow -up to the other questions that we had earlier that we've asked for

James Williams 6:38:20

answers on. We absolutely can provide that. They're all vacant positions. Okay. So every, for every department on that list, except SCVH, DTAC, and that one position in ESA, all the rest of those positions on that entire table are vacant. Okay.

Margaret Abe-Koga 6:38:39

Okay, well, that's good. Public Defender's Office, I'm, it's a little confused reading the background. There's, it looks like there's, there are these positions in PDO and the County Council's Office.

James Williams 6:38:54

Is that, Yes, so these were all,

Margaret Abe-Koga 6:38:56

Could you explain how that works? Sure,

James Williams 6:38:57

so this actually falls more in the vein of the kind of adjustments we normally see in a normal mid -year. A couple years ago, the county received a significant grant. The grant was used to fund positions in the Public Defender's Office, as well as in the County Council's Office. For the Independent Defense Council Office portion of County Council. That grant has expired. Yeah. So the, the reason the item is here at mid -year is to reflect the expiration of that grant and the deletion of those grant -funded positions. There, the grant was only partially funding some of those positions. Again, these are all vacant position deletions. Okay. The grant was funding a portion of the

James Williams 6:39:44

cost for those positions. We've assured the Public Defender that the balance of the amount will be applied, so to speak, towards the, and is considered part of the department's targets for the upcoming budget. But the reason the item's coming forward at mid -year is the expiration of that grant, which was funding the portion of the cost for all of those positions.

Margaret Abe-Koga 6:40:11

So currently the cost, or the funding of the grant is showing, and we see the grant expiring, but there's a category in the County Council's department, I believe, for those positions. Yes, so County

James Williams 6:40:23

Council operates the third tier public defense function. So we have the Public Defender's Office, the Alternate Defender's Office, which is a part of the Public Defender's Office budget. And then in the event that both of those offices have conflicts, then the IDO, the Independent Defense Office, manages a panel of private contracted attorneys that provide public defense services.

James Williams 6:40:51

The grant was a grant related to indigent defense more broadly. Most of that grant funding, this was several years ago, the grant was appropriated actually for whatever reason, I couldn't speak to it, it was before I was County Executive. The grant was actually appropriated in the County Executive's budget, and then had funding transferred out from the County Executive budget unit to the Public Defender's Office, which is what you now see reflected in the positions there, as well as a smaller portion to the County Council's office budget related to the IDO function, and the position deletion there, which relates to a paralegal position that was supporting that panel of private attorneys. So it's the same grant,

James Williams 6:41:37

the action in both offices relates to the same issue.

Margaret Abe-Koga 6:41:41

Did you have, Public Defender, any comments?

Sylvia Arenas 6:41:45

Answer

Sylvia Arenas 6:41:51

any specific questions. I think CEO Williams has explained, I think the broad strokes of the grant, in a nutshell, and I know the hour is late, so I won't belabor this. In a nutshell, what the grant was funding was, in essence, four positions between the Alternate Defender Office and the Public Defender Office. That was three attorney positions, and a paralegal position that was funding for our post -conviction services. We've had presentations at PSJC regarding that. The grant expired this fiscal year, and the funds were depleted earlier in the year. So there, in essence, was an unfunded liability in our office. That's resulted in the additional six positions being up for deletion beyond what were traditionally

Sylvia Arenas 6:42:44

being funded by the grant. That's an additional two attorneys and five other support staff in our office doing various services. And I'm happy to answer those questions, but in essence, it would fall with an elimination of an immigration attorney, an elimination of one of our juvenile justice attorneys, some support staff traditionally dedicated to our juvenile justice space, and then additional support staff. And the way that's being absorbed is really redistribution of that work to current staff who, in essence, do have their current caseloads, and I think it's what's being wrestled with across the county. I'm not sure if that exactly answered the question, but I felt that's kind of where it was going.

Margaret Abe-Koga 6:43:29

All right, thank you. My time's up. I have a couple more questions, but I'll wait till the next round. Thank you.

Otto Lee 6:43:36

We're going to start the next round. Spice Zellenberg. Thank

Susan Ellenberg 6:43:40

you so much. I just want to make one observation and a closing comment this time. The behavioral health narrative on page 36 notes that the contract maximums in the prior two fiscal years exceeded the budgeted Object 2 amounts, which prompted the $71 million for costs that were never budgeted. Is that a correct reading first? It's

James Williams 6:44:09

complex, but yes, and this relates to the transition to the fee -for -service payment structure, which has wreaked some havoc, I will just say, on the shift in kind of appropriations and management related to the contract providers' contracts.

Susan Ellenberg 6:44:29

Yeah, what was challenging particularly to me, and James, I can hear you in my head, that budgeting and contracting are separate processes, but it seems like the misalignment was significant here. Very. The CalAIM transition to fee -for -service potentially is a one -off, but there are so many other shoes, I think, that can keep dropping that may not be anticipated years out. How do you think we can better anticipate and plan for large multimillion -dollar adjustments like this?

James Williams 6:45:08

That's an ongoing conversation we've been having with behavioral health. You know, one of the big challenges we have here, and as was noted in the presentation earlier this morning, you know, 85 % of the network is through contracted providers. They're allowed to bill up to 15 months

James Williams 6:45:33

post delivery of the service. And so that means that costs can hit across fiscal years. Which has posed significant challenges. So one of the things that we have asked the department to work on with the providers is to try to tighten up a mechanism. There's already guidance on billing to occur in a more rapid timeframe, but the dragging across fiscal years has been very challenging. Ideally, the way this would have been handled better would have been

James Williams 6:46:09

the ability to more real -time track those claims coming in and then a rollover of appropriation across fiscal years to address the prior year's amount. Because what you also see,

James Williams 6:46:24

to look at this holistically, you'll see on an earlier page that behavioral health was actually a department that had an unexpectedly large fund balance at the end of the year. And that's the flip side of the same coin, which is, that was an underspending of an amount in the prior year that ended up hitting the books in the current fiscal year. So ideally, we would have rolled that amount over and you wouldn't have seen such a big swing. They kind of, if you add them across the fiscal years, it's much more modest a number. Interesting.

Susan Ellenberg 6:46:58

Is that kind of conceptually similar to the investment that we make in the health system every year? Because Medicaid reimbursement can take a year or

James Williams 6:47:11

more. It's different. I mean, the supplementals, it's similar only in the sense that it's also a timing -related issue. The Medicaid supplementals are their own totally independent timing issue, which is, there the state is paying sometimes up to 24 months in arrears, although recently, the state has made a little progress on being slightly more timely and being more like 18 months in arrears. But with the state calculation, this issue isn't state payment timing. The state's actually relatively timely. This issue really is the timing of when claims are flowing into the system from our contracted providers. So it's also a timing issue, but it's almost the 180 timing issue. It's essentially when the claims are coming

James Williams 6:48:06

in, as opposed to when the payments are coming down from the state.

Susan Ellenberg 6:48:11

Got it. Thank you. I'm going to close by just referencing once more the referral that Supervisor Abacoga and I introduced in November. I think then and through subsequent meetings and certainly today and with our colleagues on the same page, we're making it quite clear that the board needs to see detailed information regarding programs, positions, and contracts that will be impacted by any reductions. And I still feel that as it currently stands, the budget process is not or has not met these expectations. So I will look for opportunities to continue to offer direction, to provide sufficient details necessary to make... We're all talking about making difficult decisions. We haven't actually been put to the test, honestly,

Susan Ellenberg 6:49:04

yet, in terms of... in a way that we can say we're going to live with cutting or reducing something that we know is of great value because we need to do other things. But I think in order to do that, we really have to be so clear about what impacts are. Did you want to make a motion for this, Supervisor Abacoga?

Susan Ellenberg 6:49:38

I...

Susan Ellenberg 6:49:40

Oh, I'm so sorry. No, I didn't... It really was after all of that just to receive the report. I think... I think we've given all of the direction already that we're looking for. But I want to make sure... The recommended actions

James Williams 6:49:57

include an appropriation modification and the adoption of two salary ordinances. So

Susan Ellenberg 6:50:04

I will move adoption of all the recommended actions.

James Williams 6:50:10

And we'll understand that motion to include the information and requests that have been made. Thank you.

Betty Duong 6:50:16

I have a few more questions to ask before I can make that... decide what my vote is. Sure. Before continuing with the conversation, there needs

Margaret Abe-Koga 6:50:25

to be a second. I'll second the motion and then continue.

Otto Lee 6:50:31

Okay. All right. So that's one, two. Yep. Vice President. Great.

Sylvia Arenas 6:50:36

Thank you. All right. So the other piece that I wanted to ask about... Listen, I know that you'll have a lot of positions in terms of your system.

Sylvia Arenas 6:50:51

And while I'm very respectful that you're making the kind of decisions that are going to continue to keep our health and hospital system flowing and healthy,

Sylvia Arenas 6:51:06

there's still a significant amount of general fund money going into the health and hospital system. How do you figure... I think it was last year or two years ago is when we actually tapered off or stopped increasing that amount. And then last year, I think, it actually decreased. What do you project in terms of the future and general fund? What can we expect? What we

James Williams 6:51:38

have told the health system... So your correct, Supervisor, we held it flat and then actually it did reduce. Given all of the HR1 and other related impacts to the health system, our goal right now with all of those impacts is to hold the general fund investment study. That's going to be a daunting task because it actually then is a reflection of the system absorbing disproportionately the federal related cuts. So that's what we're doing so far. I don't know if that honestly would be my recommendation to the board in the subsequent fiscal year if there are not state -related mitigations because I think that the impacts to the system at that point from a service delivery

James Williams 6:52:35

standpoint would be so significant that it would merit you know, increased general fund investment. Obviously that's ultimately a decision 100 % for the board to make. But just in terms of my thinking of recommendations. But right now, we've told the health system to operate with a flat funding. I don't mean flat percentage. Flat dollar amount. And that distinction is very important. A flat dollar amount is equal to a cut because as the board knows when we're talking about budgets and budget deficits, the costs, operating costs grow every year. They grow significantly every year. Whether it's health insurance or CalPERS, retiree health, wages, services and supplies, utilities, you name it. And so when we say flat

James Williams 6:53:28

dollar amount, that actually represents a cut. The general fund next year, even though we're facing all of these budget challenges, we are forecasting a general fund that is larger than this year's general fund. Just not larger by enough of a percentage to cover the growth in cost. And so a flat dollar amount actually represents a cut. But we don't believe we're in a position to propose a dollar cut right now with all of the federal cuts impacting the system.

Sylvia Arenas 6:54:07

I'm going to move to the public defender. I was concerned about the comment that was made earlier

Sylvia Arenas 6:54:16

about the kinds of cuts that are happening. And actually, if you can step up, Damon, and you can sit in the well if you like.

Sylvia Arenas 6:54:26

One of the things that I'm very concerned about is how the public defender impacts the whole system in terms of the justice system. And I want to make sure that you know that you have what you need in order for our lawyers to be able to carry out the work in time and not have folks sitting in our jails because that's an expensive place for them to sit. Aside from that, I want them defended. So what is your reductions? How do you forecast making up for any of the reductions? What's the impact? I appreciate the question. And I'll try and be brief, but try and answer what I think is kind of a complex question.

Sylvia Arenas 6:55:16

And I know I've spent a lot of time with the CEO, the COO, and other criminal justice stakeholders discussing really the kind of ecosystem of the public safety world. And that's really what we're oftentimes talking about, which is what's the right balance so that that ecosystem is working in a healthy way. Let me be specific about these. Well, let me interrupt you. Sure. Because that conversation needs to have our board involved. You're appointed by the board. And we are making these kinds of decisions. If you leave us out of this conversation, we're just playing catch up. Absolutely. And ideally, what I would do today is help contribute to that conversation and to you all collectively

Sylvia Arenas 6:56:06

understanding, at least from my perspective, where we sit. Let me speak just briefly about my particular agency and in this equation. So as we discussed a minute ago, 10 positions are being eliminated from the public defender office. Five of them are attorney positions. Three of them are dedicated to post -conviction services. One of those post -conviction services was the single attorney doing post -conviction services at our alternate defender office. The elimination of that position means that work in our alternate defender office will work and be redistributed to the other attorneys in the office at that time. Basically, additional caseload. The two additional or the two other attorneys that were originally funded by the PDP grant,

Sylvia Arenas 6:56:51

the public defender pilot grant, program grant, were post -conviction services in our office, which is really the resentencing of people who may have been unjustly sentenced in the past. One of those positions was associated with our Racial Justice Act, our retro Racial Justice Act. And that was the Racial Justice Act. And the reason we had invested in a point person for that is there's a lot of expense. It's a statistical analysis of whether people were getting disproportionate sentences, charges, or convictions. We will no longer have that dedicated position. That work will continue, but again, be redistributed among our current staff, and we will likely have an increase in cost in the retention of computational scientist

Sylvia Arenas 6:57:33

experts to help advise us. We envisioned it as a cost savings. Those were the four, and then we had a paralegal who was helping us with that work. Those were the four positions that were eliminated or were being funded specifically by that grant. The remaining six positions, two positions are attorneys, one is our juvenile, one of our juvenile justice attorneys. Approximately, and I have to check the data, I believe six years ago, we had six juvenile justice attorneys. We are currently down to five, and that will now be reduced to four. Those caseloads will increase, but we will continue to do that. We have compared the numbers across the organization, including in our felony caseloads,

Sylvia Arenas 6:58:13

and we believe that's where we have to absorb that particular work. The other position is an immigration attorney. We currently have two immigration attorneys, and we have some special funding where we've tried to support our immigration attorneys through the emergency grant that was provided or was created by the county last January. That money has been expended, but we have committed to keeping that individual there until next year. We're not going to But unfortunately, and this is kind of the circumstance that we're in, which is we did not have an intention of removing one of our immigration attorneys, but ultimately, one of our immigration attorneys resigned. We are not in a position to recruit a specialist

Sylvia Arenas 6:58:52

into that position because we are expecting additional layoffs by the end of the fiscal year. So if I were to recruit an immigration specialist into my office, the reality is I'd have to tell them my best prediction is they very well may get laid off by June. So it makes no sense for me to actually try and drag someone away from other employment or their specialty. Let me interrupt you because we have a minute and 21 seconds. And so here's my concern. My concern is that, and thank you for breaking all that down, but in this system, systemically, what this represents is brown and black people in our carceral system staying there longer, maybe not

Sylvia Arenas 6:59:37

having the kind of defense that they merit or that they should have. And it really concerns me. I wonder if, I don't know who was given the motion. I made the motion. You made the motion. So I don't know what my colleagues think, but I'm hoping that we can have a bit of a study session in our,

Sylvia Arenas 7:00:05

in our public defender. And I don't know if it could extend to probation, just our justice system that we have as it impacts, because the public defender, if you don't have the resources that you need, you're going to impact the incarceration rate, right? And if we get, our incarceration rate gets impacted, then that, one, that isn't more expensive. It just, it's a cycle, right? And then behavioral health is somewhere in there. So I'm wondering, can we get a study session that involves some of the systems that involve, that are peripheral to the public defender? What do you all, so the, that would be my, my

Susan Ellenberg 7:00:53

answer. Let me ask a question first and see if this fits. I know that you provided programmatic and service level impact to the finance department. That wasn't reflected in the mid -year report. Is there a pathway or something in process for a discussion on, on how you, we are going to solve for the ever -increasing workloads and resulting retention challenges? I

Sylvia Arenas 7:01:22

think we continue, continue to be in conversation with the, the county administration. That's to include us. And developing and working with the, and we would, we would happily come and discuss. We certainly can share in particular the information relevant to the, the mid -year decisions. We are preparing and, and will welcome a conversation about how this plays in tandem with our, our fiscal 26, 27 proposals. And we would certainly happily in whatever way the, the board feels is most appropriate engage in that dialogue. Whether it's a written form, whether it's a combination of a written form and a public setting, certainly we would welcome that, that conversation. Thank you. And

Susan Ellenberg 7:02:09

your preference is full board as opposed to PSJC? Oh, absolutely. Full

Sylvia Arenas 7:02:13

board. I think the, Then

Susan Ellenberg 7:02:14

I would, it's, it's fine with me but as it's the president's prerogative to set the agenda, President Lee, I would ask if you're open to finding a, an existing board meeting that that can, that that item can be agendized into.

James Williams 7:02:31

Sure. I, I would suggest maybe in, in the April timeframe prior to budget.

Susan Ellenberg 7:02:37

If that works for me I'm happy to add it. How is that? Prior to budget. Does that work for everybody? So the, the, they asked us

Betty Duong 7:02:43

to have a study session on the public defender's budget impacts? Yes. Yeah. So does that mean we hold off on the deletion of the 10 codes today? Or do we move forward with that? I want to

James Williams 7:02:53

clarify these positions

James Williams 7:03:00

standpoint. I just wanted to make sure that that was clear. I also wanted to make sure that the board also was clear that there is no current appropriation available to fill the positions because of the expiration of the grant. So they will not, that's why I described these as basically in the form of the kind of things that the board would see in a normal mid -year budget. This is really a reflection of the kind of actions that we normally take in a mid -year related to things like expiring grants.

Susan Ellenberg 7:03:33

So I think maintaining the motion given the fact that they are empty and given the fact that we have the authority anytime we're on the dais as a board to make changes and make new decisions. But I think this makes sense today and where we are and what we're trying to accomplish.

Betty Duong 7:03:53

I'm fine with the study session. I think that's important. I am very uncomfortable with the deletion of a juvenile justice attorney and an immigration

Betty Duong 7:04:08

The positions are vacant and we do have to course correct and right -size a budget. And I hear you, Supervisor Annenberg, that we do have the authority to add those positions back. Should that be the prerogative of this board through a vote?

Susan Ellenberg 7:04:22

Right. And here's the challenge. If we're looking at these and I'm sure you know that those are very important areas of work for me as well. What I'm very worried about our doing is looking at these positions without seeing everything with you know because along the way there are so many positions that I want to say oh but not this and let's save this and what I would like to do is literally have the whole menu in front of me so that I can understand oh if we save these that means we have to give up something here. If we go piecemeal in this way and save the things that we like and the humans

Susan Ellenberg 7:05:11

department is high on my list of work that I want to continue. I'm afraid that we're going to dig ourselves into a hole that is going to be that much harder to balance in June because we'll have already predetermined of all the important things these are really really the most important and I just I don't know what the whole menu is. So I'm not comfortable as a single supervisor and obviously we only act as a board but I'm not comfortable today advocating for any particular

Susan Ellenberg 7:05:49

filled one without having everything in front of me. Yeah

Betty Duong 7:05:54

I think I think my reservations don't conflict with that that pointing out that we do have I'm not comfortable with these positions being deleted specific like I said juvenile justice and immigration attorney in light of what's happening in the world and the amount of investments that have already been made on these fronts.

Betty Duong 7:06:19

So I'm positions and I'm at this time because we have a study session coming up and we do have the authority and the prerogative to add these back should that study session yield that type of measure. Right. And

Sylvia Arenas 7:06:31

for the for the sake of clarity we have actually been working for in essence the last 12 months as part of our broader budget strategy on how we would in essence right size the organization in anticipation of a reduction. So like for instance today we still have five juvenile justice attorneys assigned to that particular unit. The reality is that that particular attorney is frankly owed to a different unit that has a much higher case load and we need to address that. Similarly that resignation from our immigration attorney she does not actually leave the office until I believe the end of the month. So this is all in some ways a fluid process of where those

Sylvia Arenas 7:07:15

vacancies are sitting and being absorbed currently in the organization.

Sylvia Arenas 7:07:26

So we fellowship to help support our misdemeanor team to basically fill one of those or backfill one of those current holes. So we are adjusting and right sizing in real time as these decisions are being made. Thank you

Betty Duong 7:07:40

Damon. I really appreciate what you said about I can't justify

Betty Duong 7:07:56

what you This is 10 minutes. It was.

Betty Duong 7:08:01

It

Sylvia Arenas 7:08:02

was. And listen I'm listening to you having this conversation and I'll be honest with you. I think we need to right size the efforts from the public defender's office because there is no one else. No one else. If we reduce and I'm sorry Paul cover your ears but if we reduce staffing at one hospital or one specialty another of our hospital systems can take it up. There's nobody else. There's nobody else. So you have a very unique service to our community. One that is also brown and black unfortunately people are overpoliced continue to be overpoliced and end up in the system that you are trying to manage. And so I'd like to just encourage you

Sylvia Arenas 7:08:58

to continue to have conversations with the board. While I understand the county executive is the lead of our county we

Sylvia Arenas 7:09:13

do.

Sylvia Arenas 7:09:16

And so and for the rest of the appointees I would say the same thing. Otherwise we'll be having these conversations very late in the game here on the dais. That's it for me. Supervisor I would leave with one final point and I think goes to your original question which is one issue that continues to be front of mind for us I think as an organization and for me as the department head is really thinking about that balance between us and the district attorney. You're never going to hear me walk in and say the district attorney's office

Sylvia Arenas 7:10:01

appears to be diverging is really something that I do plan to uplift for the office. We know for instance the district attorney office hired 10 district attorneys within the last 30 days and I simultaneously am eliminating 10 positions from my office and that's the type of conversation I think we would welcome engaging in.

Sylvia Arenas 7:10:23

So James

Otto Lee 7:10:24

you want to say something about this? All right next 10 minutes. Next 10

Betty Duong 7:10:29

minutes. Paul could you come back up?

Betty Duong 7:10:38

So this morning we heard public comment from staff from the integrated care team and I have to be honest that was the program that I was not able to reach out to in time because I think they appear in the midyear budget under a different title but what I did have a chance to speak to some of the folks outside the board chambers where the meeting started. So question number one do the nurses or the staff being deleted the deleted codes from this team will they have are they going to

Betty Duong 7:11:19

have a All

Public Comment 7:11:20

of the individuals that are quote unquote filled deletes will have a position to fall into. Yes.

Betty Duong 7:11:27

Do we know if they're lateral moves or if they're going to be bumping or in placements I'm sorry all the terms I'm probably using them interchangeably.

James Williams 7:11:35

For all of the RNPA and SEIU represented staff I know that they're all lateral.

Betty Duong 7:11:49

At first I thought it was their colleagues and then I learned it was their clients past and present that all stood in this section of the room holding signs and standing up while their care provider was speaking and I had a chance to talk to some of them. It's incredible stories. They talked about the number of years they've been sober. They talked about where they came from. They talked about the number of years they had spent on the streets battling dependency. This is one of those rare moments where we see these success stories firsthand. With the deletion of these codes what is the impact to service? Where will this bridge now live? Somewhere else in

Betty Duong 7:12:32

the organization or not at all? Thank

Public Comment 7:12:35

you for that question supervisor. I would first start up by saying to you and the board that these are the difficult decisions that we have to make under the circumstances. The expectation going forward for those clients is that we work with

Public Comment 7:13:00

them to of care for custody that is run by Santa Clara Valley Healthcare in conjunction with custody health is really an opportunity for us to ensure that individuals that are incarcerated when released have the best success possible in moving into the community and that means making sure that they receive the appropriate supports. The program is not meant to provide ongoing treatment and support indefinitely. It's a transitions program. So what we need to do is work very closely with the clients and the staff to ensure that these individuals remain supported in the community in some form or fashion. Are there

Betty Duong 7:13:45

efforts underway already to ensure a transition plan for each of the clients? Yes,

Public Comment 7:13:51

I did have a conversation with Michelle Delacaya who oversees the program and that is exactly our intention going forward. Thank you,

Betty Duong 7:14:00

Paul.

Betty Duong 7:14:09

I would like and their commitment to their treatment plans and their road to recovery. I know you understand that full well. You live this every day.

Betty Duong 7:14:20

The sooner we can communicate to them that this is the plan forward to craft transition plans for them built around their

Betty Duong 7:14:39

care and we don't know if we will have a job.

Public Comment 7:14:43

The

Betty Duong 7:14:44

next question I have is that we receive considerable feedback from RNPA regarding 10 .1 clinical nurse positions in custody health services. Do they have a place to go to and what is the impact to service? Do we have a plan to ensure those services are covered? Especially taking into account the robust conversation about custody health services.

James Williams 7:15:09

I would invite to come forward regarding custody health. I do want to clarify a

Betty Duong 7:15:16

couple

James Williams 7:15:20

things. First of all, all the positions in custody health are vacant. So there's no question about landing spots for individuals. And in broad strokes the proposal related to custody health is about consistent with direction that we've gotten from staffing analyses as part of the consent decree work. Using vacant

James Williams 7:15:50

will work for those who are registered nurses and adding positions like LVN positions for other work. And I would invite Rocio to provide additional comments on that. But they're all vacant positions.

Betty Duong 7:16:03

Thank you, Rocio. And sorry, Paul, this is a different operation.

Betty Duong 7:16:08

We're still partners, so thank you. Just to add to what James has already said, we are continuing to optimize the operations in custody health and we'll be continuously making changes to ensure that we are supporting our core staff, so we are maintaining our core RN staff and adding a significant amount, I would say significant amount of paraprofessionals to support the work already underway. So we are netting really additional FTE overtime to help our expanding operations. And I think the moves that you see at mid -year really support nurses to optimize the work. So we're really just moving some tasks on to LVNs and other paraprofessionals like MAs to offload some of our nurses and I

Betty Duong 7:16:54

think that's going to help the nurses work in a way that I think maximizes their licensure and we're doing that pretty much across the board. So all the clinical nurse positions are vacant, currently vacant, so no one's being moved or compromised?

James Williams 7:17:11

Every custody health position at mid -year is vacant.

Betty Duong 7:17:14

Okay. And then you said that LVNs are being added? That's correct. Great. So then the service level of care and service will not be compromised. Okay. Thank you.

Betty Duong 7:17:25

Looking at my list,

Betty Duong 7:17:29

I'm done with my 10 -minute round with three minutes to spare. Thank you so much.

Otto Lee 7:17:33

Sure. Thank you.

Otto Lee 7:17:36

I'll

Margaret Abe-Koga 7:17:37

try to make this quick. So I just had a couple more questions. I noticed that there were some enhancements being proposed. One is the IGR $1 million. And I would like to just find out what that $1 million is going to get us.

James Williams 7:17:58

Well, our goal is $500 million in ongoing revenue.

James Williams 7:18:04

That is part of our effort in coalition public hospital systems to have an effective advocacy effort aimed at the state level related to our that category of work, which is the lobbying campaign and outreach work. We are

James Williams 7:18:27

leaning forward with that appropriation also because we're hoping to have other entities match that contribution.

James Williams 7:18:40

So that is our goal. Now, you know, I'm not I just want to be also clear not making promises that that's going to be the outcome. But the goal is to finance that effort

James Williams 7:18:52

and make sure that it's as effective as it possibly can be.

Margaret Abe-Koga 7:18:56

So, can you give me more to what is the million? Is it, you know, five staff? What are we talking about with the million dollars?

James Williams 7:19:05

We're not adding any positions. The funding would be used for a combination of

James Williams 7:19:13

contract services for

James Williams 7:19:17

joint advocacy in Sacramento, but also for informational materials and outreach probably done as a coordinated campaign in conjunction with the other public hospital counties. So we're hoping that the other public hospital counties will match that contribution and pull it together in that advocacy effort. One of the things that is important in

James Williams 7:19:47

recognition of kind of where we're at in Sacramento is making sure that there is better awareness of the role of public hospitals. There's a very significant presence from the California Hospital Association and other entities, but not as strong and visible a presence from the public systems. And so this is in part an effort to ensure that that voice has a significant presence in Sacramento.

Margaret Abe-Koga 7:20:18

So, I can appreciate that. I guess in light of the cuts we're looking at, it is hard for me to

Margaret Abe-Koga 7:20:29

support adding money into

Margaret Abe-Koga 7:20:39

the staff, where we have a department there already. So, what more can they do, frankly? And then as elected officials, and I've found the most effective advocacy, frankly, going to Sacramento is using us. And I certainly, I know we're all busy, but I think we have our

Margaret Abe-Koga 7:21:09

own would look to being more utilized. And so, it's a question of resources versus what we already have and better maximizing what we have already. It

James Williams 7:21:26

is. So, a couple things I would just add.

James Williams 7:21:40

First of Sacramento and we have a lot of resources in Sacramento and we believe

James Williams 7:21:54

that we

James Williams 7:21:58

a lot

James Williams 7:22:03

of are

Margaret Abe-Koga 7:22:05

And I think

Margaret Abe-Koga 7:22:08

we of resources to help

Margaret Abe-Koga 7:22:14

mental

Margaret Abe-Koga 7:22:26

health. So, that would be helpful. The other item is the correctional recruitment, the 1 .75 million. And again, what is that going to entail?

James Williams 7:22:39

I'll see if county council wants to add anything to this, but as the board is aware, we have an ongoing compliance related issue in our consent decree litigation associated with the hiring of correctional deputies. And one piece of that effort is the use of a recruitment firm. This will cover those costs. And I don't know if county council wants to add anything now or add something confidentially off agenda, but that's what that item relates to. I'm happy to provide more detail off agenda, but I'll just say that this is critical to deal with imminent litigation that we're currently dealing with associated with the consent decree and ensuring that we're able to make the progress that

James Williams 7:23:25

we need to make quickly in terms of staffing up that particular function within the car school settings.

Margaret Abe-Koga 7:23:32

I know that we have a lot of vacancies in that department that we need to fill.

Margaret Abe-Koga 7:23:51

So I'm more details on what the sequencing of that process is. And IGR too, I'd like to midyear I guess or when we get to the fiscal year or see how we're doing in this effort to reevaluate whether we continue with it or not. And then the last one is the impoundment of the $82 million due to the measure A funds and litigation. And I understand that, but I just want to clarify. So that basically means that we're not able to draw down the sales tax revenue that will most likely start in April until the litigation is finalized. Is that correct? Yeah, this

James Williams 7:24:32

is a really significant issue. Just to be very clear and transparent, at this time, we are planning to budget the measure A revenue in the recommended budget and in the forthcoming budget process.

James Williams 7:25:02

And we are do in the next couple of So, we are going to that the next

James Williams 7:25:13

of weeks.

James Williams 7:25:19

So, we

James Williams 7:25:23

are going to start with the measure on the urgent basis that we did. I know County Council is doing everything that it can to make sure that the court understands that. And we will remain optimistic that the court will expeditiously resolve what, in my opinion,

James Williams 7:25:55

to deal with this federal challenge. And we will continue to do everything we can. Thank

Margaret Abe-Koga 7:26:02

you. Again, my concern is the time. I know I dealt with the RM3 bridge tool revenue measure that took, I think, at least three years to resolve. And so,

Otto Lee 7:26:27

if we go back of rounds and debated this issue in very huge depth.

Otto Lee 7:26:35

These cuts are very real. And I certainly want to say that that's the three prongs that's been laid out. One prong that I do want to say, instead of just cut and cut, is the revenue side. And I'm looking forward to see if there's any possibility in many other ways to find more revenues. I do want to say thank you for proposing additional resources to try to see, find more of that in Sacramento from a state partner. I'm not seeing a whole lot from the federal partners. But from state partners, I think we certainly have a better possibility to try to shake that Sacramento money tree. Not that there's that much to shake. But at

Otto Lee 7:27:15

the same time, I do want to propose, maybe in the future, something we'll talk about, any type of potential public -private partnership that we might be able to look into to come up some revenues from other private entities that could help us to get through this

James Williams 7:27:44

regulated strategy. There are absolutely things that the state can do that would help mitigate impacts to us that don't necessarily cost the state money or very much money. And I want to highlight that because I think it's very easy to say, well, of course the state is not in a position to just backfill billions of dollars statewide in Medi -Cal cuts. We agree. We agree. But there is an important role for the state to play in doing a couple things. One, helping keep people on Medi -Cal in the first place, which helps us continue to draw down federal funding. Second, helping facilitate some of the structural maneuvers that we have taken to try to maximize

James Williams 7:28:30

federal revenues, but also to maximize the utilization of funding directly for service delivery. And third, important choices for the state to make in how Medi -Cal funding is allocated that can preserve vital public hospital resources given the outsized role that public hospital systems play in the healthcare of all Californians. And those are all things where the state can make a very meaningful impact without just backfilling the HR1 losses. And I think that there is a dearth right now of those concrete ideas coming out in front of the state other than, frankly, the leadership of this county and our coalition partners. And so part of these efforts are to make sure we can get that message

James Williams 7:29:20

in the right places, make sure that it's coordinated, make sure that we're able to coordinate across the types of allies that we need to successfully move that forward. But the state has some opportunities here to show real leadership in pushing back on the federal administration the way that this board has already shown great leadership in pushing back on the federal administration and not just taking the HR1 cuts lying down. And that was one of the disappointing things.

Otto Lee 7:30:01

And I just also want to say thank you and your team and the budget team to look very deep. These are very tough cuts for two things. One is measure A. We're the only county in the state of California if not the entire nation that has actually gone through this evolution to come up with the new revenues from the voters back in November. And that certainly has made a huge difference in terms of how deep this cut would be. It would be much, much deeper for one. Second of all is the fact that you've gone through to look for all these places to be able to find places for those who've been affected in filled

Otto Lee 7:30:40

positions so that no one, I just want to make sure everybody here, there's no one in this county is being laid off and without a job based on these decisions. I think that's a huge

Otto Lee 7:30:52

feat that your staff and you can be able to decide. I just want to give you a shout out for able to come up with that. There's a lot more discussion we need to have on all these different issues we discussed with my colleagues, but I just want to say thank you for coming up with that proposed solution. And with that, we've got a motion and a second. Let's take the roll.

Otto Lee 7:31:16

I'm sorry, through the chair, can we have a restatement

Otto Lee 7:31:22

for all three of the requests, correct? Yes, for three items.

Otto Lee 7:31:29

That is a motion by Abacoga and second by Ellenberg. Sorry,

James Williams 7:31:34

motion by Ellenberg. I'm sorry, Ellenberg.

Otto Lee 7:31:39

Supervisor Abacoga? Aye. Supervisor Young? Yes. Supervisor Ellenberg? Yes. Vice President Arenas? Yes. President Lee?

Otto Lee 7:31:58

Vice President N Palestine .

Otto Lee 7:32:05

We

James Williams 7:32:09

received a request from the board to highlight and catalog the very significant cost for our county organization associated with these incredible sporting events that our broader community is fortunate to host, including the world cup and the the Super Bowl, which just happened two days ago. We have a brief kind of overview report. What we want to highlight is a couple things. One is, although the county has no role in agreeing to host these events, and the county does not receive revenues associated with these events, I just want to say that yet again, does not receive revenues associated with these events. We don't get revenues from the ticket sales, we don't get revenues from the other

James Williams 7:32:57

activity associated with them, and these events don't affect our property taxes, which is our significant local revenue stream. We do have costs. Those costs include our emergency operations center, those costs include the sheriff's office, those costs include other county departments, and our hospital system, all of which are involved in the preparedness activities. Fortunately, the Super Bowl went off very smoothly, but that doesn't mean we don't still have costs associated with all of the activity that happens to ensure that we're prepared. That doesn't mean we don't have costs associated with the staff who are involved in all of that planning and coordination, and including the up -staffing that we have to have associated with these events

James Williams 7:33:45

and activities. We will be in a position to report more tangibly on what the costs look like after the fact. We do cost tracking, but because it's somewhat fluid, we don't have those cost numbers in advance. I can give you one cost number, which is the activation for the emergency operations center. We don't have the final numbers yet. We only finished the activation yesterday, but probably will come in at around the $200 ,000 mark, just for that specific staffing for the week. But significant costs in the Sheriff's office, we'll take a little time to get on the back end. The other thing for the board to know related to this is that very little of

James Williams 7:34:35

the funding is coming to us. We do have one small grant that has come through the California Governor's Office of Emergency Services that's flowing through the county, but 90 % of that is being distributed to the city. That's a lot of funding. That's a lot of money. That's a lot of by direction of the state is being distributed to the host committee and to other partner agencies only 10 % is retained by the county itself a portion of that 10 % is associated with the administration of those funds because we're the fiscal agent responsible for all the tracking and invoicing related to that and a small portion is roughly 5 % of that that 7

James Williams 7:35:19

.8 million will help reimburse some of our costs but as of today that is our our only offsetting funding source separate from the contract that the board approved on consent today with VTA where VTA is reimbursing sheriff related costs for VTA specific services that of course doesn't cover other sheriff's related costs but where we are getting cost reimbursement from VTA for sheriff's services associated with security at VTA platforms and and in the VTA system so happy to answer any questions

Otto Lee 7:35:58

thank you

James Williams 7:35:59

do you mind if I go

Otto Lee 7:36:00

to public first yes anybody public would like to speak on this item I

Otto Lee 7:36:06

don't have any cards in chambers but I do see one hand in zoom this is for item 16 Sharon DeNoa please accept the MU

Public Comment 7:36:14

thank

Public Comment 7:36:17

you I'm Sharon DeNoa with the South Bay Coalition to End Human Trafficking I want to acknowledge the difficult decisions being made by the county with regards to the budget and also thank the Board of Supervisors for your leadership on prioritizing safety especially with these large sporting events your support for safety for the bay our our initiative for community resource navigator is helping us maximize quick informed access to resources that we have around the region we know we cannot rely on law enforcement partners to be the only means for safety it's not economically feasible or sustainable and our community is increasingly in fear so the resource is helping us provide that access informed access to individuals

Public Comment 7:37:00

in our community to prioritize safety for these events thank you so much for your support

Otto Lee 7:37:04

that was our only speaker thank you okay close the public speaker portion I see some lights I think who's first thank you

Margaret Abe-Koga 7:37:15

thank you thank you president Lee and I appreciate this being on our agenda this has been a thorn in my side since Superbowl 50 because I was from a transit perspective on VTA and the same issue came up as well how who's gonna pay us for the extra costs that we're putting out to provide more transit service frankly we were told sales tax revenue will be so great that that'll cover it but we ended up with a I believe a four million dollar hole back then so when this came up again or last early last year I'd you know I was recommending through SBRI a and VTA and a number of agencies to get ahead

Margaret Abe-Koga 7:38:01

of the issue and discuss this with the Bay Area host committee I went to meet with the host committee myself and

Margaret Abe-Koga 7:38:13

unfortunately I think the challenge was that there is no one lead agency to take care or to bring everybody together to work together to figure out how to how we were going to get full or cost recovery and I think that is something that we should consider I know that the funding we were the holder of the money that came in the money that we came that came in but everyone you know I was asking around who's in charge of asking the host committee or whoever NFL a FIFA whoever you know to cover our costs and there was no answer to that so I think we should can really consider maybe taking that lead and

Margaret Abe-Koga 7:38:57

then I look forward to seeing the the numbers and the rundown and seeing if sales tax revenue did really generate the you know amount we needed to cover all of our costs but it's security it's transit it's you know how all of the there's so many different costs to it I think it's you know everybody loves these events and I think they're great too and hopefully they were money makers for their business but for the public agencies that have to provide the services it's the money loser and I don't want that to continue to be that way so I would like for us actually to just take charge next because I hear the 2028 soccer

Margaret Abe-Koga 7:39:38

games are coming I think we're gonna continue to you know see more of these events happening and so I think we just need a coordinated organized system I've talked to some actually it's not a person and la -metric they're getting ready for the Olympics she mentioned there's a interest or effort to you know ask IGR to maybe take this up but ask the state to provide legislation requiring that these you know these groups entities do pay for the full cost of the services so I hope we can work on that and I'm happy to support that effort

James Williams 7:40:15

now thank you supervisor I I heartily concur with your your comments it would be a great opportunity to work with the state and I think that would be a great opportunity to work with the state and I think that would be exceedingly helpful to have some state legislative framework because what what happens is we learn about the event after it's been agreed to so we learned about Super Bowl when it was announced we learned about World Cup when it was announced we're not a party because we don't own the facility and we're not the city where it's hosted we're not a party to those conversations where those agreements are being made and so I think

James Williams 7:40:52

we're not a party to those conversations where those agreements are being made and we don't then receive the ticket revenue we don't then receive you know the sales tax revenue you know there could be a surcharge on those very expensive tickets that would be quite modest and have no impact on sales that could cover security costs for example but we're not a party to any of that conversation and so we're then in the position after the fact of reaching out to the state reaching out to others we were lucky to get this tiny 10 percent but most of the money including the federal money bypassed us all together and just went straight to the host

James Williams 7:41:34

committee so some framework would be helpful especially when you think about the South Bay from a jurisdictional standpoint because it's a at least a little bit of a different story if you're talking about a city like Los Angeles where the city itself can substantially address not all but at least a very significant portion of the resource needs itself but we all know and this is not a knock in any way on the city of Santa Clara they did a tremendous job by the way this weekend with the Super Bowl but given the modest size of the city of Santa Clara relative to the events we're talking about they inherently will depend on mutual aid on

James Williams 7:42:22

the county on the sheriff's office and a whole litany of other partners too and so we do actually need that kind of engagement and we do need to be a part of those discussions there isn't exactly an incentive on the part of the city or in this case also the entity that manages the stadium which is not the city um to necessarily include us or others in those conversations and so I do think it it takes some role from the state or someone else to say you have to at least engage those partners if you know you're going to be inherently relying on them to actually show up and then provide the services and that's

James Williams 7:43:11

always going to be the case here even for much smaller scale events in a way that it may not be in some other parts of California so

Margaret Abe-Koga 7:43:21

I I I I I think I should I make a motion to receive the report but um also I don't know how to word it but to to explore uh taking on that that role of um and having IGR work on this issue um and I would say just regarding the surcharge that was my suggestion and then I was told that um the post committee had I believe signed away the rights to do that um so I believe this committee is going to be around to continue to be in charge of these events and so that that would be my suggestion is that we asked to to meet with them and to you know present

Margaret Abe-Koga 7:44:05

our case thank you thank

Margaret Abe-Koga 7:44:11

you

Otto Lee 7:44:11

um can

Betty Duong 7:44:13

I I'd like to also add to that motion that um to the maker and the secondary that we do assign this as a priority to IGR for their legislative advocacy um and then and whenever appropriate for them to come back with a report back and for this report to also come back to the full board when we have um either either as an off agenda and agendized item when we have the full scope of costs that were incurred during the Super Bowl and I hope that that happens before a World Cup just because we're about to experience six more Super Bowls and and James earlier you said that we're not a party right but we

Betty Duong 7:44:50

have to be we inherently are to your words these these type of bids don't get awarded to towns in the middle of nowhere. They get awarded to sites that have robust infrastructure for public safety, health, emergency response, emergency operations. So congratulations to the host committee, congratulations to all of our cities, congratulations to our communities that derived such great joy from this sporting event, from the Super Bowl, congratulations to Bad Bunny, right, and to all of us. But the thing is that what I worry about is that at some point when our budget situation becomes so dire, do we then signal to the world that we don't have the bids for World Cup, we don't have

Betty Duong 7:45:33

the bids for the Super Bowl, or we don't have the bids for the next Taylor Swift tour, I don't know. Just the next major sporting event that's gonna bring hundreds of thousands of millions of people from all parts of the world here, at what point do we say, and I'm looking at you, Paul, right, I'm sorry, I don't hope that you don't have to say this, but at what point do we say that our budgetary cuts, our deleted codes, our compromised service lines, right, is not gonna be capable of responding to a crisis in this moment? So I would say that we're not technically a party to the party planning, but we're critical for the

Betty Duong 7:46:18

party to be had. And - We're the responsibility. We're the responsibility. We're the responsible parents. We're the responsible parents, yes. The county has always been the responsible big brother, big sister, mom, dad in so many ways. And so, yeah, let's lean into this and make it really clear at Bay Area House Committee. At some point, we may have to raise, sound the alarm that we don't have these resources.

James Williams 7:46:44

No, Supervisor, you make a really important point that we've tried to make in a few other contexts. You know, we are San Jose's only trauma centers. Think about it, one of the largest cities in the United States. And 100 % of its trauma services are delivered by the county government.

James Williams 7:47:05

And in order to host any of these kinds of events, in addition to, of course, our emergency management functions and our sheriff's office, you have to have access to these services. Right. They're absolutely essential. No one will host these events in a community that doesn't have access to those services. And so, it is one of the reasons these are essential services. It is a point that we have to continue to emphasize. And I do think it is a good investment, candidly, on the part of the host committee and on the part of others involved in organizing and bringing these wonderful events to our community, to be attentive to the cost recovery needs of the infrastructure

James Williams 7:47:59

that helps facilitate and make them possible. And I don't think doing so would in any way negatively impact the ability of those events to be realistic and successful, but I do think it would, in fact, help enhance our region's ability to continue to host these kinds of events of all sorts of types. Many years into the

Betty Duong 7:48:22

future. Yay sports. But yay safety. So, James, no, sorry, not James, but just to the staff at large, the, oh, wait, it's Ezekiel's name on here. When these reports come back in the future, can we make sure to link it to, obviously, link it to previous iterations at the board, but either attach as a, include as an attachment or link to the FGOC report, that this initial report at FGOC, which prompted, you know, me and Susan to forward it to the full board, was, had a lot of background context and detail ranging from the type of services being offered, and it's going to be very helpful for conversation moving forward.

James Williams 7:49:01

We'll make sure to link to that. Yeah. Thank you.

Betty Duong 7:49:06

Yes,

James Williams 7:49:06

Vice President Ramis. Wonderful.

Sylvia Arenas 7:49:09

I agree with all of my colleagues.

Sylvia Arenas 7:49:13

And one of the things I think that we could take stock in is figure out what, and thank you, Sharon, for all the work that you are doing. I think that we have to do a lot more work as a community and as a group to make sure that we protect our community from human trafficking and from just all the other things that happen along with these sports events. And I would like to see what the impact is in terms of interruption of human trafficking,

Sylvia Arenas 7:49:47

either what are the tactics they used. If we were in the, if we were in a situation where there was a lot of public opinion, you able to put away some bad guys and be able to support some of the folks who get, you know, drawn into these webs, I'd also like to figure that piece out, because I think it's part of the cost of doing business in terms of these sport events that I think we can use as leverage, because this is how they damage our community. And it is something that needs to create balance. We need reparation for some of the damage that those sporting events, just like you said earlier, you know,

Sylvia Arenas 7:50:31

it's a party without the parents there, and somebody's got to pay for the broken lamps.

Sylvia Arenas 7:50:37

But unfortunately, this is not, I wish it was just broken lamps. It's much more than that, right? And as exciting as, I don't even, I'm not even into sports. But as exciting as I thought it was, and I thought it was really exciting to have it come to the Bay Area, I still don't think it's worth the cost of human life in the way that we are seeing it. And so I'd love to see a report back on that piece. My

James Williams 7:51:09

understanding is, I believe the Sheriff's Office and District Attorney's Office is going to report on some of that information to the Human Trafficking Commission, and we can make sure that that report is shared with the full board.

Sylvia Arenas 7:51:19

Okay. Thank you. I appreciate that.

Sylvia Arenas 7:51:23

Yes,

Otto Lee 7:51:24

on that note, regarding the issue of human trafficking, I just want to mention that both myself and Suva Ziyong had a chance to visit our county's hosted Joint Task Force for Human Trafficking, and the great work that they're doing. I remember when we were there, they were showing the numbers. As of that date, it was a few days before the Civil War, there was already nine minors that was rescued. And I'm sure there were more thereafter. And also, the traffickers being monitored and being arrested and whatnot. So the work is extremely important that's being done. And I just wanted to thank the folks that work on this project on behalf of the county and working

Otto Lee 7:52:06

with all the federal, in this case, we did cooperate with state and federal authorities. We don't deal with ICE, but there are other groups that we work with, certainly, to help catch these bad guys. And I just want to say thank you for the folks who did that. Amazingly important work. And there are actually many volunteers and those who actually used to be victims of trafficking that was in that room that helped provide the counseling, peer services, and whatnot. So I just want to say thank you for all the amazing work that was being put in. Yes, Suva Ziyong.

Betty Duong 7:52:36

I would be remiss if I did not acknowledge. Just thank you to our administration, James, I only saw your photo in the yellow vest or colored vest for the Emergency Operations Center. Not going to lie, it brought me back some PTSD. But I'm glad, just not every county has their county executive and the Emergency Operations Center. So I just want to acknowledge you for that. And thank you for giving up your Sunday to serve alongside our

Otto Lee 7:53:02

staff. Actually, it was, I think, 12 hours on Saturday and 12 hours on Sunday. Something like that.

Betty Duong 7:53:08

Oh, double

Otto Lee 7:53:09

the thanks. Thank you.

Otto Lee 7:53:11

Just saying. And I know that you do get overtime, but you still get paid for it, right James? Yes. Yes.

James Williams 7:53:18

Can I just clarify for the record that Supervisor Yung's addition regarding the addition to the legislative priorities is acceptable to the motion maker and seconder?

Susan Ellenberg 7:53:28

Yes. Thank you.

Otto Lee 7:53:30

Okay. We have a motion. We have a second. We have no more lights. Oops. Supervisor Abacoga, are you ready to vote? We'll take a vote. Thank you. So that was a motion by Supervisor Abacoga, second by Supervisor Ellenberg. Thank you. Supervisor Abacoga? Aye. Supervisor Yung? Yes. Yes. Supervisor Ellenberg? Yes. Vice President Arnaz? Yes. And President Lee? Aye as well. Motion passes. Thank you. All right. Moving to Item Number 17, which I believe this should be the last item. Now let's do a quick time check. 3510, sometimes we normally break for dinner. I heard there's rumor that dinner is here. However, only one item left, so should we just punch it through everybody? Yes. Yes. Yes,

Otto Lee 7:54:13

I get the consensus on that. Okay, let's go. I don't want any hangry people on my diet here. Yes, item 17, which recommendation relating to a fiscal year budget process?

James Williams 7:54:25

Go ahead. Yes, thank you, members of the board. This is the annual budget process memo. We have made a recommendation regarding the inventory program in light of all the context of everything we've been talking about the whole day, so I won't repeat any of that. Obviously, it's a decision fully within the discretion of the board to make, and I'm happy to answer any questions.

Otto Lee 7:54:46

Thank you, James. Before I open up the public speaking, I actually would like to say that thank you so much for preparing all this. The proposal right now, my understanding is to zero out the entire inventory grant program for the fiscal year 26 -27, which I think personally would affect far too many nonprofit groups that we have worked with for so many years. That's doing so much important work, so I would plan to, I'm not going to mention it, but I do plan to make a motion to make an adjustment to that after the public speaker is done.

Otto Lee 7:55:22

Okay, all right. Go ahead. Julie, any public would like to speak on this item? We do have several cards. I'm not sure if they're still here, but I will start calling names. Oh, I'm sorry, we have... How many people do we have total? We have 14 cards. And seven hands raised. Just one minute each. One minute, okay. We'll see who's here. Sandra Asher is first, and please, in any order, you can approach the podium. I have a Jose Limones, forgive me if I'm mispronouncing that, Julie Anderson, Raymundo Armendariz.

Otto Lee 7:56:01

I have a Michaela Character, Andrean Altamirano.

Otto Lee 7:56:09

Elizabeth. Eladio Cortez, Juliana Sands,

Otto Lee 7:56:16

and Yanneth Oh. We'll pause there. If you're here and wish to speak, please come forward. Good

Otto Lee 7:56:29

evening,

Public Comment 7:56:29

I'm Sandra Asher from the Board of Directors of Parents Helping Parents. I'm here today to address strong support for continuing funding of the inventory item process for nonprofits. This funding is vital to organizations like ours, enabling us to support families raising children, with disabilities. These families face complex health care and public benefit systems while managing immense caregiving responsibilities and challenges. Thanks to this funding, PHP has been able to open our Gilroy office and expand services to South County families, increase outreach and support to East San Jose, provide direct caregiver support, including free weekly mental health workshops offered both in English and Spanish. It's helped us build capacity for our community. Our staff and assist immigrant

Public Comment 7:57:16

families in navigating public benefit services. This funding allows the county to partner with trusted CBOs, and it reduces isolation, improves access to services, and strengthens caregiver abilities. Thank you.

Otto Lee 7:57:31

Thank you. I'll continue with the cards and chambers. Marty Estrada, Carmen, Samantha Rojas. I have Kiana Ward, and Kira, in any order, please. If I

Otto Lee 7:57:56

can get a little bit more time than one minute. I've been here since a little bit past 10 a .m. Ten of those cards came from CODIS folks in South County. They're not here because my colleagues had to go back to work, or they had to go back to school. So anything, if you can, let me pause the time real quick. Let's just, let's talk them over again. Let me explain the situation. I'll give you the time back. We give everybody the same amount of time, however, if you have a statement that's longer than one minute, please give it to our clerk, and we'll absolutely add it to our record. Thank you. Yes, please proceed.

Otto Lee 7:58:25

We'll start the clock when you start. We strongly support the continuance of the inventory budget to support nonprofits. This is a crucial support. We help the county save millions of dollars and hundreds of thousands of dollars with that funding source to our agencies. And in CODIS. CODIS, Community Agency for Resources, Advocacy, and Services in South County, we provide services to youth, marginalized youth, at -risk youth, and this money goes towards that endeavor. We have a youth hub, a climate change hub, and that money goes to support those marginalized youth that are not out in the community or getting in trouble or getting hurt, getting injured. So we encourage this body here to support the inventory

Otto Lee 7:59:08

budget going forward. I know there's a lot of costs. If we would have did back. And when we pass. Prop A, if we would have just put less than two cents into that, it would have brought back $1 billion into the county. There's a lot of ways y 'all can raise money through different private entities. So I encourage you, Sylvia Arenas, we're here, we're your people from Gilroy. We please ask.

Otto Lee 7:59:36

Thank you. Thank you. Your name. I'm sorry. So your name for the record. Right. Oh, Marty Estrada. Thank you.

Public Comment 7:59:42

Good

Public Comment 7:59:49

morning. Good afternoon. Good afternoon. Almost good evening. Yeah. I've been here for a while. To President Lee and to the board members, my name is Kiana Ward. I reside in District 2. And I am here just as a citizen, but also as a co -chair of the advocacy committee that is within the Black Leadership Kitchen Cabinet, one of the individuals who do receive funding from the board's inventory grant. And I'm here asking you to not eliminate the board inventory grant process for the upcoming fiscal year. This grant has supported essential programs, and what I mean by that is that we're able to help fund other small organizations, non -profits and organizations that are working in

Public Comment 8:00:47

the community to bring education. That was fast, but yes, I hope that you got it.

Otto Lee 8:00:55

Thank you.

Public Comment 8:01:03

Good afternoon, Board of Supervisors. My name is Carmen, the organizer of Latinas Contra Cancer, Organizing Director of Latinas Contra Cancer. And I'm here on behalf of our Executive Director, Darcy Green. I want to begin by acknowledging the difficult moment the county is in. We recognize the real financial strain, the uncertainty ahead, and the responsibility you carry to make decisions that impact the safety and well -being of our community. We're deeply grateful for the care and support that you've given us. I also want to express sincere appreciation for the budget inventory investments the county has made. For our organization, these resources have truly mattered. They have strengthened our ability to care for vulnerable patients and families,

Public Comment 8:01:41

respond to urgent needs, and serve as a reliable partner to the county during this time of growing hardship. Another thing I want to highlight is that the inventory items have also been the way this board has ensured racial equity, particularly in moments when the traditional contract process has not. These investments have helped sustain culturally responsive organizations that are deeply rooted in and accountable to the communities most impacted by the health inequities. Thank you.

Public Comment 8:02:10

Good

Public Comment 8:02:10

afternoon. My name is Samantha, and I'm here representing Latinas Contra Cancer and the Patient Organizing Committee. Just like my compañera Carmen mentioned, I first want to acknowledge a difficult financial moment the county is facing and the

UNKNOWN 8:02:21

hard decisions ahead. So I strongly support the continuation of inventory budget. For my role as a patient organizer, I want to highlight something essential. Our patient organization is a place where we can share our knowledge and experience with the community. Our patients depend on us to navigate their health insurance and basic health care

Public Comment 8:02:32

services. The system is extremely complex, especially for those facing language barriers, fear, or limited access to information. Without our patient navigation team, many of our patients will fall into the most concerning health outcomes statistics, not because they did anything wrong, but because the system is too hard to navigate alone. Listening to patient stories and experiences is also key. Their voices help us identify where the health care system is failing and allow us to work with the county to prevent the same harm from happening. This is how we close gaps, improve access, and create a safer, more responsive system for everyone. For this, funding is part of a shared responsibility to keep people healthy, stable, and

Public Comment 8:03:08

connected to care. Thank

UNKNOWN 8:03:09

you.

Public Comment 8:03:10

Kira

Public Comment 8:03:14

Kazantzis Good evening, President Lee and members of the board. My name is Kira Kazantzis. I am the CEO of the Silicon Valley Council of Nonprofits, an alliance of nonprofit organizations serving Santa Clara County. We do also understand that the county is facing an extremely constrained budget environment due to federal policy changes, and there are difficult decisions to be made ahead. However, we are committed to ensuring that the health care system is maintained and that we provide the best care for all of our residents. However, we strongly feel that eliminating the inventory process entirely would have real and harmful consequences for community -based organizations and the residents they serve. The inventory process is one of the

Public Comment 8:03:44

county's few flexible tools to support innovation, rapid response to emerging needs, and access for smaller, community -rooted nonprofits that often cannot compete in traditional RFPs. In full disclosure, to illuminate the kind of projects that are funded through the inventory process, SVCN received a county inventory grant. This grant supports community budget town halls in partnership with the county and advocacy and policy capacity building for nonprofit leaders. We respectfully urge the board to apply a proportional and measured approach to reductions in the inventory process rather than

Otto Lee 8:04:18

Thank

Otto Lee 8:04:20

you.

Otto Lee 8:04:22

I've called all speaker cards in chambers, so we'll move to Zoom. Our first speaker is Parent. Please accept the unmute.

Public Comment 8:04:37

Yes, I'd like to support the budget process recommendations, and I would like to ask the board if you could ask, direct Larry Rose to look closely at the district attorney's office. There's a lot of misuse of funds there. For instance, there was altering of timesheets, giving free vacation time to a lot of paper attorneys. And when James Sibley refused to take the money and he blew the whistle, he got retaliated against and investigated.

Public Comment 8:05:15

So we don't know if there's any other whistleblowers. It's really critical to look closely at his budget, particularly also because he's sex trafficking children. He's using criminal proceedings to conceal child abuse and to incentivize physical assaults. Please look at Jeff Rosen very closely. Thank you. Thank you so much for your time.

Public Comment 8:05:40

The next

Otto Lee 8:05:40

speaker is Maryam Arif. Please accept the unmute.

Public Comment 8:05:46

Good evening, and thank you for your time. My name is Maryam, and I'm the Director of Communications and Development and Services, Immigrant Rights and Education, better known as SIREN. The temporary suspension of the county's budget inventory program for this fiscal year significantly limits our access to flexible, one -time funding that supports rapid response to the needs of the community. response and time -sensitive community education. Without it, our ability to meet urgent community needs during heightened enforcement periods will be constrained, weakening the county's capacity to partner with trusted organizations that protect immigrant families and community stability. In 2025 alone, SIREN received and responded to over 160 community requests for immigration, education, and outreach across multiple counties.

Public Comment 8:06:30

This included No -Year Rights presentations and other outreach events, many of which were offered bilingually. Through this work, we provide trusted, accessible information on immigrant rights and family preparedness and available resources. We just want to…

Otto Lee 8:06:49

Thank you. The next speaker is iPhone, or Carol Lillage. Please accept the unmute.

Public Comment 8:06:58

Hi, good evening, I'm Carol Lillage from St. Vincent de Paul at St. Catharines and Morton Hill. The grant funds that I received from Supervisor Bennett allow me to participate in the state's first month of rent. We were allowed, obviously, last year to move into housing 35 working families, seniors. These grant funds and our volunteer time paid the deposit in first month's rent. There is almost no other funding to help these South County unhoused persons overcome this barrier. These working folks qualify for very reasonable rents, several hundred dollars a month, but the deposit in first month's rent is $2 ,000 to $4 ,000.

Public Comment 8:07:39

So these McKinney -Vento and Farmer for Families need our help to overcome that barrier. We love what we do. We just need the funding to make these miracles happen.

Otto Lee 8:07:51

Thank you so much. Thank you. The next speaker is Eladio from Caras. Please accept the unmute.

Public Comment 8:08:07

Yes, you

Otto Lee 8:08:08

may begin. My name

Public Comment 8:08:10

is Eladio Cortez, and I'm from the Native Foreign Immigration Advocacy Project at Caras. At a time our federal government is openly attacking immigrant communities, fear has become a daily reality for our families. While canvassing in South County, I was shocked by how many people did not know about the rapid response numbers. The lack of information is dangerous. It means families are left isolated, afraid, unsure, and turned to when enforcement shows up at their door. Our community is scared. Many would rather hide than seek help. This is why we meet people where they are at. Caras, we provide free legal consultations, know your rights, presentations, and emergency toolkits. Over 200 people have been served because of

Public Comment 8:08:46

access to information. There can be a difference between safety and separation. This is not the time to turn your back on us. And yes, I say us because I am one of them. I am part of the community that is being targeted. Santa Clara County made a promise to protect immigrants. And let me be clear, the Trump administration is not over. The threats have not disappeared. South County still needs resources, outreach, and real investment. We cannot do this work alone. We are asking you to stand with us to help us continue protecting our families, our neighbors, our community.

Otto Lee 8:09:13

Thank you. The next speaker in the queue. Is Libier Gonzalez. Please accept the unmute.

Otto Lee 8:09:23

Good

Public Comment 8:09:24

evening. My name is Libier Gonzalez, family and advocacy program director for the Latino Education Advancement Foundation. Serving first generation college students and families in East San Jose. Last year we received funding from the Board of Inventory for education advocacy and community college student and family support. This funding expanded workshops and helped families understand financial aid. College system and strengthen direct support for students balancing school, work and family. East San Jose remains to be the county's most under -resourced communities with federal uncertainty and limited philanthropic funding. These grants are more important than ever. So we understand that county faces difficulty decisions, but we urge you to not eliminate the inventory process to impact, to not impact

Public Comment 8:10:18

grassroots. Thank you.

Otto Lee 8:10:24

Next speaker is Chris Scott. Please accept the unmute.

UNKNOWN 8:10:31

Good

Public Comment 8:10:31

evening.

UNKNOWN 8:10:32

My

Public Comment 8:10:32

name is Chris Scott and I serve as the managing director for youth. I strongly encourage the Board of Supervisors to continue the budget inventory for the upcoming fiscal year.

UNKNOWN 8:10:44

This

Public Comment 8:10:44

money has been instrumental not only in advancing flyers work in the community

UNKNOWN 8:10:48

but

Public Comment 8:10:48

also support and our partner community -based organizations.

UNKNOWN 8:10:52

Through

Public Comment 8:10:52

this funding flight has been able to provide legal education workshops case management services for youth experiencing crisis both on and even off probation and hosting community events and strengthening connections. And part of that,

UNKNOWN 8:11:04

we

Public Comment 8:11:04

believe that the board has the trust in the backing of both staff community members to make timely, responsive decisions that ensure funds are used when they are most needed. The flexibility of this budget is essential to addressing urgent community needs and responding effectively to emergencies arises. Thank you.

UNKNOWN 8:11:23

The

Otto Lee 8:11:25

next speaker is Patty, please accept the.

UNKNOWN 8:11:30

Good

Public Comment 8:11:33

evening,

UNKNOWN 8:11:34

my

Public Comment 8:11:34

name is and I serve as the advocacy lead at Asian Americans for community involvement.

UNKNOWN 8:11:40

Today,

Public Comment 8:11:41

I'm here to respectfully urge you to continue the inventory grant process

UNKNOWN 8:11:44

as

Public Comment 8:11:44

an organization that has received inventory funding in the past years. We have seen firsthand. How this process strengthens the partnership between the county and the nonprofit organizations working to serve communities. Most vulnerable residents. These funds have been instrumental in expanding our reach

UNKNOWN 8:12:00

into

Public Comment 8:12:00

underserved communities through inventory support. We've been able to increase our services in the community programs that bring health care providers. Directly to neighborhoods or access to care is limited by meeting people where they are. We remove barriers and make it easier for residents to receive the care and resources they need. We recognize that. This year's budget is constrained, and we appreciate the difficult decisions you face. However, many community members, especially those who fall through the cracks of traditional services. Depend on the safety net resources provided by nonprofit partners. Inventory.

Otto Lee 8:12:34

Thank you. And that there is one more speaker who turned in a speaker card in chambers that I now see on zoom. Julianne sands, please accept the.

Public Comment 8:12:49

Good afternoon. Good afternoon. My name is Julianne signs and I'm an immigration advocate with the immigration team of Kata South County I came to Kata South County as a youth in a place where I thought my voice wasn't heard But I found was one of the only organizations creating community events that they can meet together and give a voice especially Especially to youth and undocumented families in the past six months My team has canvassed over 650 homes in Gilroy 100 homes in Morgan Hill 30 local businesses and 7 farm worker sites We offer free local services know your rights information and transportation to court and check -ins We also give you the place to feel

Public Comment 8:13:21

to feel heard guidance and they often come to us for helping in their own events We ask we also host five weekly meetings for them as well to help them strengthen their skills

UNKNOWN 8:13:31

I'm

Public Comment 8:13:32

very proud of my team's impact on South County And I really urge the Board of Supervisors to continue with our regular inventory budget and to continue helping us make an impact Thank you

UNKNOWN 8:13:43

Thank

Otto Lee 8:13:44

you. That was the last speaker who had their hand raised at the time of the call of the queue Thank you Jolene So we're going to close the public speaking portion of this discussion as I said earlier, I'm trying to find a way to balance the Interests of our need to cut our budget

UNKNOWN 8:14:02

and

Otto Lee 8:14:03

certainly cutting

UNKNOWN 8:14:03

the

Otto Lee 8:14:04

entire Inventory process is far too drastic and so I'm going to propose something maybe a little bit less drastic and I just share with my colleagues to see where we're at last year We've spent a lot of time debating the base amount and then the supplemental amount and all that's a way of an allocated amount That we used for last year To make things very simple. I'm just making this proposal and we could I'm also open to any discussion is To have that very same amount that was allocated

UNKNOWN 8:14:33

from last

Otto Lee 8:14:33

year for each district to have that reduced by half million dollar each district

UNKNOWN 8:14:39

The exact

Otto Lee 8:14:39

same amount so whatever the amount you had from last year Let's reduce that by half a million and so basically that would save the county Through this process compared to last year by about two and a half million dollars Last year the total allocation of the inventory was close to seven million dollars So what I'm proposing is to reduce that by two and a half million dollars

UNKNOWN 8:15:01

And the impact would be exactly the same by

Otto Lee 8:15:04

each district with exactly half a million dollar less from what you got last year So I just used that as a open that for discussion There's a potential motion to on this issue and I see some eyes are because your lights on first and vice president You might go after good. Thank

Margaret Abe-Koga 8:15:19

you. Thank you personally first I just want to thank Ezekiel and James for the timeline on the budget process and I appreciate that you get the response to our Request to get the information earlier and to have opportunity at our committee meetings and the workshops to ask questions and make recommendations I Appreciate presently your suggestion. I was going to say the same that I think that the inventory program is Very beneficial. We've heard all of the reasons and all the great programs that have been supported by it I think that in light of what we talked about earlier today things like regulations and requirements and just the challenges that Frankly nonprofits have to deal with

Margaret Abe-Koga 8:16:09

to get funded This is the one area where we have flexibility and we can support the smaller CBOs that may not have the resources to go through all the hoops and then I've in our first my first year our offices first year really pleased at the innovation that's come out of this Inventory program, so I do think we should continue to support preserve it in some form I know that we had some target reductions with for our offices that Have been removed But I've been working with my staff to look at some reductions in our office so that we can return some funding from our office Budget and we'll be offering that later as well

Margaret Abe-Koga 8:16:50

But my my suggestion was that we just make it very simple and just I don't know I wasn't here before last year But just to for equity equity sake just to do five million dollars one million dollars each for each of the offices That

Margaret Abe-Koga 8:17:11

would be my Motion

Otto Lee 8:17:13

one million equal for

Margaret Abe-Koga 8:17:15

everybody so it saved two million that will

Otto Lee 8:17:17

save yourself your proposal would save two million Good vice president.

James Williams 8:17:21

Sorry. Just As a point of procedure if I understand correctly Presently you just put a recommendation on the table I believe Abaco supervisor

UNKNOWN 8:17:29

Abacoga has

James Williams 8:17:30

actually made a motion and so to proceed with discussion. We would need a second I'll

Sylvia Arenas 8:17:35

second it if I understand it because I think I understand it tell me again How what it is so it just

Margaret Abe-Koga 8:17:41

be that one million dollars per? Office office and then the supplemental we would reduce got it.

Sylvia Arenas 8:17:49

Okay. I will second that

Susan Ellenberg 8:17:53

um I heard use And it's my turn. It is it is you pause, and I leaped in

Sylvia Arenas 8:18:02

Listen I want to thank all the the folks who came in and especially from South County because I know it's it's a trek to Come up here And it's that's part of the the issue Perpetual issue for the folks in South County is that we may only be about a half hour or 40 minutes away but when you You're constrained by two jobs Raising kids on your own it is a huge thing to come to San Jose To speak or to advocate for services and so you've all heard me ad nauseum talk about South County and making it right for for them because they threw out the whole my predecessor throughout his whole service did

Sylvia Arenas 8:18:51

not participate in any of the grant programs so my South County folks never received anything in addition to and on top of that these are folks who have had generational trauma poverty violence they're the highest in terms of Referrals into our probation department and to the juvenile justice system is not things that I'm proud of That just very in terms of violent gun violence. It's also one of the top zip codes I'm a outside of East San Jose, and I liken it to the east side of San Jose, and I know that maybe not everybody here has a district that is in need of so much, just so basic things. San Martin doesn't even have

Sylvia Arenas 8:19:44

a city structure. We are their default city structure, so it, you know, Gilroy doesn't have a youth center. They don't have any place for our youth, and when the kids have an opportunity to do something in the streets, like they're on their bikes, all of a sudden people have problems with kids being on their bikes, and then they get criminalized for that. So all of this to say is that my district has already gone on without very much, and the little that they get through some of this inventory, because I do think it's very minimal, and we are, you know, we're an agency that has $11 billion coming into our system, and I know that

Sylvia Arenas 8:20:31

a lot of them, a lot of that money is already earmarked through state and federal mandates that we have to comply with, but the truth is that my district is in a lot of need, and when I give them something through my grant program, it is a huge, it makes a huge difference. They are used to making, you know, a lot with very little, and so when they continue to get some of this additional support, it makes a huge difference. One of the things, and I think you heard one of the speakers say, that we have this unhoused first and last rent deposit that our unhoused, our, you know, services and you know, supportive housing

Sylvia Arenas 8:21:21

department doesn't offer, and that makes a difference. We are holding on to people's homes a little bit more in south county, and as you will very well know, we don't have shelters, you know, anyways, I can go on and on, but this is the reason that I'm going to support this. I appreciate the motion on the floor. Maybe for some of you, this may not mean very much to you. So I will say that, you know, much but for south county for my folks this is the only way they can actually apply to a grant because the bureaucracy of applying to other grants is too much for them and this is the only way they

Sylvia Arenas 8:22:04

can really make things work and so i appreciate the motion on the floor i'm going to support it and hopefully we can get through this thank you yes

Otto Lee 8:22:12

surprise ellenburg

Susan Ellenberg 8:22:13

uh thank you so much i i have a few thoughts that i that i want to share um

Susan Ellenberg 8:22:23

first we worked very hard last year to add an an equity measure recognizing that the needs of each district are not the same

UNKNOWN 8:22:36

and

Susan Ellenberg 8:22:37

supervisor abecoga respectfully i heard you say for equity's sake we should each get the same thing

UNKNOWN 8:22:44

that's

Susan Ellenberg 8:22:45

equality

Susan Ellenberg 8:22:46

but to me it takes us backwards from where we where we moved last year recognizing that needs are not all the same

UNKNOWN 8:22:59

and

Susan Ellenberg 8:23:00

i would rather we be consistent um to that principle

UNKNOWN 8:23:05

um

Susan Ellenberg 8:23:06

before i heard the the clear support for the five million i had actually been interested in the other piece to just take the two million um according to the equity formula that we used last year

UNKNOWN 8:23:22

um and

Susan Ellenberg 8:23:24

and and if i'm in a minority certainly i will use that money in my community as well

UNKNOWN 8:23:30

but

Susan Ellenberg 8:23:30

in addition to the cbo you know audience and partners um some of whom absolutely have no other opportunities to receive county fundings a good number of them also have large county contracts

Susan Ellenberg 8:23:47

um we have a very wide swath of people of organizations that we fund um through inventory

UNKNOWN 8:23:54

um

Susan Ellenberg 8:23:55

i'm also thinking about our department heads and our employees who have very significant reduction targets who are facing the loss of of their positions even feeling impacted by the contraction of unfilled positions and then hear us say that we're not willing to give them the time to make a really meaningful effort toward protecting the county general fund. I love, sorry, I don't mean to pick on you, but I love that your office may be able to give back some money. That's a great example, which I'm not sure I can follow because we do use our Object 1 and 2.

UNKNOWN 8:24:43

But

Susan Ellenberg 8:24:43

to me, this is an impactful place where we really could make our contribution back to the general fund more significant than the $2 million. I would also note that we all received an audit report this morning on the inventory process,

UNKNOWN 8:25:03

which

Susan Ellenberg 8:25:03

continues to have a number of problematic aspects to it. In part, the actual administration of a huge, huge number of grants

Susan Ellenberg 8:25:25

that has caused other challenges. So I want to put that aside and ask, as the chair of the FGOC committee,

UNKNOWN 8:25:35

if

Susan Ellenberg 8:25:36

you would be willing to have that report come to, I'm not sure it should be part of the motion because I'm not sure I'm supporting the motion. But if there's some other way to figure out, would you be willing to have that report, direct that report to come to FGOC so we can look at it and, if not for this year, really be serious about putting further,

Susan Ellenberg 8:25:59

making further iterations so that this process really works well,

UNKNOWN 8:26:03

particularly

Susan Ellenberg 8:26:04

for the organizations that truly need it the most and have few other avenues for public funding.

Betty Duong 8:26:11

Yeah, absolutely. You've read my mind. So the FGOC committee is the committee that reviews management audit reports. So it makes perfect sense for it to go.

UNKNOWN 8:26:25

And

Betty Duong 8:26:25

this also brings up another point that I know for years now, our partners through SVCN have advocated for a partnership and being able to think about the inventory process, right? And what part of it stays inventory to respond to emerging, responsive, pivoting needs, right? Grassroot efforts that don't fall into a traditional line of funding or RFP through the county

UNKNOWN 8:26:51

and

Betty Duong 8:26:52

also what other lanes of capacity building can look like. I'm not saying I'm saying land anywhere, but that's a conversation. Yeah, so that's, I think, that reviewing the Harvey Rose management audit on the inventory process.

UNKNOWN 8:27:05

Also,

Betty Duong 8:27:06

SVCN would ask for you to also, we'll coordinate with you for that meeting just to hear some of the conversations, your

UNKNOWN 8:27:13

thoughts

Betty Duong 8:27:13

based on your membership over the years. But for, yes, so yes to that.

UNKNOWN 8:27:19

Okay.

Betty Duong 8:27:19

And then, is it Harvey Rose that we got this morning? I know Harvey Rose last night. I got an audit report about the inventory process last night from Harvey Rose.

UNKNOWN 8:27:29

Yes,

Susan Ellenberg 8:27:29

I did too.

UNKNOWN 8:27:30

Is

Betty Duong 8:27:31

there another report this morning?

Susan Ellenberg 8:27:32

By the Board of Supervisors Management Audit Division.

UNKNOWN 8:27:34

No,

Susan Ellenberg 8:27:34

that's Harvey Rose.

UNKNOWN 8:27:35

Thank

Susan Ellenberg 8:27:36

you.

UNKNOWN 8:27:36

Yeah,

Betty Duong 8:27:37

but back to the, oh, sorry. It's still your time for the primary motion on the table.

Susan Ellenberg 8:27:42

Sure.

UNKNOWN 8:27:42

And

Susan Ellenberg 8:27:42

the primary, the primary motion, and I'm not prepared to support, one, because I don't like that we're moving back away from an equity division.

UNKNOWN 8:27:55

And

Susan Ellenberg 8:27:56

two, I think that the overall number is still too big. But I would make a substitute motion and see if there's support for that for the two million rather than the five million from last year. And done. I would like to hear from you about using that equity division such that essentially districts one and two are receiving more than the other districts, given also what you described about your district feels very much in line with where we should be moving.

UNKNOWN 8:28:35

If

Susan Ellenberg 8:28:35

there's not a second, I will keep going. I am,

Betty Duong 8:28:39

it's a substitute motion, so how does it?

James Williams 8:28:43

Substitute. That's good. Substitute motion takes precedence. So the first question is whether there's a second for the substitute motion

UNKNOWN 8:28:51

Okay, I

Betty Duong 8:28:52

think the team two million would amount to five hundred thousand per right,

UNKNOWN 8:28:56

right? Am

Betty Duong 8:28:57

I mathing in public incorrectly?

UNKNOWN 8:28:59

That's

Betty Duong 8:28:59

like my worst night.

Susan Ellenberg 8:29:00

Well

Susan Ellenberg 8:29:03

Approximately, but it would not be divided Equally five ways.

UNKNOWN 8:29:08

We

Susan Ellenberg 8:29:08

would use the lens that was created last year.

UNKNOWN 8:29:11

Yeah,

Susan Ellenberg 8:29:12

or secondarily to my own substitute motion if folks were determined to have the higher number a second substitute if this one doesn't go anywhere would be To maintain the five million of the original motion, but still use the equity lens.

Betty Duong 8:29:28

Yeah, the very simple math I just did right Remind

Betty Duong 8:29:35

Reminds me of 2020 When the pandemic hit and the board during that time

UNKNOWN 8:29:43

allocated

Betty Duong 8:29:44

I'm trying to go by memory here 500 each and there was also equity metric as well.

UNKNOWN 8:29:50

No,

Betty Duong 8:29:50

no equity metric

UNKNOWN 8:29:51

Last

Susan Ellenberg 8:29:52

year was the first year

Betty Duong 8:29:52

for an equity metric.

UNKNOWN 8:29:55

Is

Betty Duong 8:29:55

that is that right at first?

UNKNOWN 8:29:56

Yeah,

Otto Lee 8:29:57

so so during 2020 I wasn't here, but I did remember it was a 3 -2 votes

Otto Lee 8:30:03

Cortez II and Chavez against for the five hundred thousand dollar per district reasoning being that they felt that is basically only the Equality

UNKNOWN 8:30:14

but

Otto Lee 8:30:14

not equity that was how that was being interpreted at the time. I just mentioned that's the history I remember if anybody correct me if I was wrong

UNKNOWN 8:30:25

I

Betty Duong 8:30:28

I do feel strongly about an equity metric as well and Supervisor, why not as you were talking what you said about Eastside D2 and D1 being such kindred spirit, right? IT JUST REMINDS ME ALL THE MORE THAT OUR DISTRICTS ARE GOING TO BE HIT HARDEST WITH THE FALLOUT OF OUR BUDGET AND THIS FEDERAL ADMINISTRATION.

Betty Duong 8:30:55

IN TERMS OF THE BASELINE AMOUNT, I WAS PREPARED TO SUPPORT AN AMOUNT THAT WAS MORE THAN NOTHING.

Betty Duong 8:31:12

FOR ME, COMING INTO TODAY, THE NONNEGOTIABLE WAS TO NOT HAVE AN INVENTORY PROCESS, WHERE IN YEAR ONE OF A MULTI -YEAR BUDGET CYCLE OF ARMAGEDDON AND BUDGET DOOM, AND THAT MY CONCERNS WAS THAT, AND MAYBE IT'S ONLY MY CONCERN, IF WE WERE TO DO AWAY WITH THE INVENTORY PROCESS THIS YEAR, WE WOULD NOT BE BRINGING IT BACK

UNKNOWN 8:31:32

BECAUSE

Betty Duong 8:31:34

THE SAME REASON WILL STILL EXIST NEXT YEAR AND THE SAME REASON WILL STILL EXIST NEXT YEAR.

UNKNOWN 8:31:38

I I ,

Betty Duong 8:31:39

I WOULD LIKE TO HEAR FROM MY COLLEAGUES,

UNKNOWN 8:31:42

I

Betty Duong 8:31:42

FEEL LIKE THIS IS A DISCUSSION THAT REQUIRES JUST MORE.

James Williams 8:31:47

I'M SORRY, WE NEED TO CLARIFY PROCEDURE HERE

UNKNOWN 8:31:49

BEFORE

James Williams 8:31:50

THERE CAN BE A DISCUSSION OF THE SUBSTITUTE MOTION. WE NEED TO KNOW WHETHER THERE'S A SECOND ON THE TABLE.

Otto Lee 8:31:54

I 'LL SECOND IT FOR THE PURPOSE OF DISCUSSION SO I CAN CLARIFY WHAT THE MOTION IS,

UNKNOWN 8:31:57

SUAZ

Otto Lee 8:31:58

ELENBERG. IS THAT OKAY?

Susan Ellenberg 8:32:01

SURE.

UNKNOWN 8:32:01

THE

Susan Ellenberg 8:32:01

MOTION WOULD BE TWO MILLION AMONGST THE FIVE OFFICES DIVIDED ACCORDING TO THE EQUITY PRINCIPLE WE APPLIED LAST YEAR.

Otto Lee 8:32:09

OKAY. SO TWO MILLIONS IS WHAT YOU'RE PROPOSING,

UNKNOWN 8:32:15

YOU'RE

Otto Lee 8:32:15

BASICALLY SUGGESTING A REDUCTION FROM LAST

UNKNOWN 8:32:19

YEAR

Otto Lee 8:32:19

OF FIVE MILLION DOLLARS APPROXIMATELY BECAUSE LAST YEAR WE GAVE OUT SEVEN MILLION DOLLARS. I JUST WANT TO MAKE SURE WHAT WAS THE VARIOUS PROPOSAL ON THE TABLE SO FAR. SO MY FIRST BOOK I WAS SAYING THAT, HEY, LET'S DO A TOTAL OF FOUR

Otto Lee 8:32:36

AND A HALF MILLION WITH A REDUCTION OF 2 .5 MILLION FROM LAST YEAR.

UNKNOWN 8:32:43

THE

Otto Lee 8:32:43

INITIAL ACTUAL MOTION MADE BY COGA ACTUALLY SAYS, ACTUALLY, WHY DON'T WE JUST DO FIVE MILLION TOTAL FOR FIVE EXACTLY SAME AMOUNT SO THAT RESULTS IN A REDUCTION OF TWO MILLION

UNKNOWN 8:32:57

DOLLARS.

Otto Lee 8:32:58

AND THIS THIRD ONE THAT WE'RE NOW TALKING ABOUT FROM SOUTHERN ELENBERG IS BASICALLY SAYING THAT LET'S REDUCE IT EVEN FURTHER TO REDUCE IT BY FIVE MILLION DOLLARS AND THAT THE TOTAL ALLOCATION FOR INVENTORY IS ONLY TWO MILLION

UNKNOWN 8:33:12

DOLLARS. AM

Otto Lee 8:33:13

I RIGHT? AM I CORRECT IN TERMS OF THESE NUMBERS?

Susan Ellenberg 8:33:15

YOU'RE PUTTING AN ADJECTIVE SO I MAY NOT HAVE INCLUDED BUT YES.

Otto Lee 8:33:20

OKAY. SO I WON'T BE SUPPORTING THIS MOTION. LET ME EXPLAIN WHY.

UNKNOWN 8:33:23

I

Otto Lee 8:33:24

ABSOLUTELY AGREE WITH YOU REGARDING THE EQUITY FOR PARTS OF IT. AND MY INITIAL IDEA WHEN I PUT IN MY FOUR AND A HALF THERE HAD THAT EQUITY PART BUILT IN. BECAUSE THAT'S ALREADY WHAT WE GAVE LAST YEAR.

UNKNOWN 8:33:37

AND

Otto Lee 8:33:37

THAT'S WHY WHEN I SAID WHEN WE REDUCE OUR BUDGET EQUALLY BY HALF MILLION DOLLARS EACH, THE EQUITY PART FROM LAST YEAR IS ALREADY IN THERE.

Otto Lee 8:33:46

AM I LOSING YOU THERE? AND THAT'S WHY I'M TRYING TO USE THAT AS A COMPROMISE TO TAKE CARE OF TRYING TO REDUCE AS MUCH AS WE CAN,

UNKNOWN 8:33:54

WHICH IS

Otto Lee 8:33:54

TWO AND A HALF MILLION. AND THEN I HAVE THE FOUR AND A HALF. SO ANYWAY, THAT'S THE REASON WHY THAT PROPOSAL I PUT IN WOULD RESULT IN DIFFERENT AMOUNTS FOR EVERY DISTRICT.

UNKNOWN 8:34:03

AND

Otto Lee 8:34:03

THE DISTRICT THAT GOT THE MOST LAST YEAR WILL ALSO GET THE MOST THROUGH THESE EQUITABLE PRINCIPLES WE HAD LAST YEAR. I JUST WANT TO EXPLAIN WHAT I WAS SAYING.

Susan Ellenberg 8:34:12

I APPRECIATE THAT CLARIFICATION AND THAT FEELS BETTER TO ME. OKAY. THANK YOU.

Margaret Abe-Koga 8:34:18

SO, MATTHEW, WHAT IS THE MOTION?

UNKNOWN 8:34:22

WE

Margaret Abe-Koga 8:34:22

HAVE A MOTION.

UNKNOWN 8:34:23

WE

Otto Lee 8:34:23

HAVE SECOND.

UNKNOWN 8:34:24

THE

Otto Lee 8:34:24

SUBSTITUTE MOTION HAS BEEN

UNKNOWN 8:34:25

REMOVED.

Otto Lee 8:34:27

SO WHAT I'M GOING TO SORRY. THE SUBSTITUTE MOTION IS STILL I DID NOT REMOVE IT. YEAH. THE SUBSTITUTE MOTION IS STILL ON THE TABLE.

UNKNOWN 8:34:34

IT'S

James Williams 8:34:34

BEEN SECONDED.

UNKNOWN 8:34:34

IT

James Williams 8:34:34

BELONGS TO THE BODY.

UNKNOWN 8:34:36

SO IT WOULD

James Williams 8:34:37

NEED TO OH, NO. I SAID I REMOVED MY SECOND.

UNKNOWN 8:34:39

SO

James Williams 8:34:39

WE NEED TO VOTE ON IT.

UNKNOWN 8:34:41

IT'S

James Williams 8:34:41

NOT SECONDED ANYMORE. ONCE THE MOTION IS MADE AND THERE'S A SECONDED IT BELONGS TO THE BODY.

Sylvia Arenas 8:34:47

OKAY. CAN WE HAVE A DISCUSSION SINCE HE'S SECONDED?

UNKNOWN 8:34:51

I

Sylvia Arenas 8:34:51

WANT TO EXPRESS WHAT

UNKNOWN 8:34:52

OKAY.

Sylvia Arenas 8:34:54

SO I'M NOT GOING TO SUPPORT THE MOTION

UNKNOWN 8:34:56

ON

Sylvia Arenas 8:34:56

THE FLOOR. I'M GOING TO TELL YOU SOMETHING.

Sylvia Arenas 8:35:02

WHY THIS IS AN ITEM ALL BY ITSELF IS SOMETHING THAT I DON'T AGREE WITH. I'M NOT SURE WHY WE'RE HAVING THIS MOTION. BECAUSE I THINK IT'S A CONVERSATION.

Sylvia Arenas 8:35:16

BECAUSE IF ALL IS TO BE FAIR, THEN I'D LIKE TO SEE WHAT THE CEO'S OFFICE IS DOING IN TERMS OF REDUCING THEIR OWN RESPECTIVE TRAININGS, CONFERENCES, THINGS THAT MY OFFICE DOESN'T HAVE THE PRIVILEGE OF DOING. EXPENSES THAT GET PAID.

UNKNOWN 8:35:36

THIS

Sylvia Arenas 8:35:37

IS NOT FOR ME.

UNKNOWN 8:35:38

THIS IS

Sylvia Arenas 8:35:38

NOT FOR ME TO LINE MY POCKETS WITH. THIS IS FOR ME TO ENHANCE WHAT THE COMMUNITY IS DOING.

UNKNOWN 8:35:45

AND

Sylvia Arenas 8:35:46

THIS FEELS SO PETTY.

UNKNOWN 8:35:51

IT

Sylvia Arenas 8:35:52

FEELS SO PETTY.

UNKNOWN 8:35:53

I

Sylvia Arenas 8:35:54

AGREE THAT WE NEED TO HAVE THIS BE MORE EQUITABLE. AND I LIKE THAT WE ARE GOING TO DISTRIBUTE IT DIFFERENTLY. SOME OF YOU CAN AFFORD NOT TO HAVE THIS AND BE OKAY WITH IT. I CAN'T.

Sylvia Arenas 8:36:09

AND SO YOU ALL CAN DECIDE ON WHATEVER IT IS. I'M NOT SUPPORTING YOUR ORIGINAL AND I'M NOT SUPPORTING THE MOTION ON THE FLOOR. I'M SUPPORTING SOMETHING THAT ACTUALLY SPEAKS TO OUR COMMUNITY. AND RIGHT NOW I THINK IT IS BEING PETTY AND IT IS BEING TRIVIAL WITH WHAT THE NEEDS OF MY COMMUNITY REALLY ARE. AND SO UNTIL WE GET TO A NUMBER THAT I JUST, IF YOU DON'T WANT TO ACCEPT IT, LET ME HAVE IT. LET ME HAVE IT AND I 'LL DO WONDERS WITH IT.

Sylvia Arenas 8:36:49

OKAY. SO LET'S TALK ABOUT

Otto Lee 8:36:50

PROCESS. WE HAVE A SUBSTITUTE MOTION. I SECOND IT FOR PURPOSE OF DISCUSSION. I WAS TOLD I CANNOT WITHDRAWAL MY SECOND SO WE HAVE TO VOTE ON IT FIRST. SO THE SUBSTITUTE MOTION IS FOR. I'M HAPPY TO WITHDRAW

Susan Ellenberg 8:37:01

THE MOTION BECAUSE IT'S CLEAR THAT THERE AREN'T THREE VOTES.

James Williams 8:37:05

SO WE'RE MAINTAINING ORDER HERE. THERE NEEDS TO BE A VOTE ON SUBSTITUTE MOTION. IT NOW BELONGS TO THE BODY IT'S BEEN MADE IN. SO I CAN'T WITHDRAW IT. RIGHT. OKAY. SO I HAD

Margaret Abe-Koga 8:37:14

MY LIGHT ON. I WAS HOPING TO MAKE A COMMENT BEFORE WE VOTE. SURE. OF COURSE. THANK YOU. ON THE SUBSTITUTE MOTION. YES. SO AND I WILL NOT BE SUPPORTING IT. I APPRECIATE THE COMMENTS. BUT I MADE THE ORIGINAL MOTION BECAUSE LOOKING AT THE NUMBERS IT'S A 30 PERCENT REDUCTION IN THE INVENTORY PROGRAM. AND AS I SAID EARLIER TODAY I'M LOOKING TO TRY TO PRESERVE PROGRAMS, REDUCE THEM, THE COST OF THEM. WE CAN. BUT I DON'T WANT TO I DON'T THINK WE SHOULD BE COMPLETELY ELIMINATING PROGRAMS. AND THE TWO MILLION IS QUITE A I MEAN IT'S A BIG AND I APPRECIATE WHAT YOU'RE

Susan Ellenberg 8:37:56

TRYING TO DO. YES. IF IT'S NOT THREE SUPERVISORS I'M COOL. THAT'S FINE. I THINK AND THIS IS YOU KNOW I ASKED

Margaret Abe-Koga 8:38:03

THIS EARLY ON

UNKNOWN 8:38:04

OF

Margaret Abe-Koga 8:38:04

OUR JAMES. HOW WERE THE TARGET REDUCTIONS DERIVED? AND. I DON'T KNOW IF THERE'S A CLEAR FORMULA. BUT I DON'T KNOW THAT ANY DEPARTMENT IS TAKING THIS 30 EVEN A 30 PERCENT REDUCTION. AND I THINK THAT IT SHOULD BE COMMISSIONER TO WHAT OTHER DEPARTMENTS ARE HAVING TO DO. SO THAT'S THAT. IN TERMS OF THE EQUITY VERSUS EQUALITY I VERY MUCH APPRECIATE THE INTEREST. I WILL SAY AND YOU KNOW I KNOW THAT MY DISTRICT IS VERY PERCEIVED AS PROBABLY THE WEALTHIEST AND MAYBE HAS THE MOST RESOURCES. BUT THAT'S NOT TO SAY THAT THERE'S NOT NEED. AND FRANKLY I GUESS MY INTEREST IS TO FURTHER STUDY OR EXPLORE WHAT EQUITY MEANS BECAUSE YOU CAN SLICE IT MANY WAYS.

Margaret Abe-Koga 8:39:03

I KNOW WE PICK MEDICAL PATIENTS LIKE WE COULD LOOK AT SENIORS WHO ARE MAYBE FOOD ASSISTANCE DEPENDENT. WHO HAS THE MOST SINGLE MOMS WITH CHILDREN. THERE'S SO MANY DIFFERENT WAYS TO LOOK AT EQUITY AND I DON'T THINK THAT WE HAVE DONE ALL OF THAT YET. AND SO FRANKLY COMING FROM THE DISTRICT THAT RECEIVES THE SMALLEST AMOUNT FROM THIS PROGRAM, I DON'T FEEL COMFORTABLE AT THIS TIME MAKING THAT DECISION WHEN WE HAVEN'T REALLY DECIDED AS A GROUP HERE AND MAYBE PREVIOUSLY YOU HAVE BUT HERE WE HAVE NOT HAD THAT CONVERSATION. AND SO I WOULD LIKE TO EXPLORE THAT FURTHER BEFORE WE MAKE ANY MORE FUNDING DECISIONS ON THAT. AND THEN I THINK THERE'S OTHER ISSUES TOO

Margaret Abe-Koga 8:39:51

ABOUT THIS WHOLE PROGRAM. I WAS TOLD BY STAFF THAT IT ACTUALLY COSTS QUITE A BIT OF FUNDING AND RESOURCES TO ADMINISTER IT. SO RATHER THAN DOING SMALL 300

Margaret Abe-Koga 8:40:03

GRANTS, SHOULD WE BE LOOKING AT LARGER ONES? MY CONCERN HAS BEEN THAT SOME OF THE NONPROFITS WHO HAVE BEEN AROUND A LONG TIME HAVE BEEN FIGURED OUT HOW TO APPLY FROM ALL OF US AND GET FROM A LOT OF US AND THEN BECAUSE WE'RE NOT ABLE TO TALK TO EACH OTHER. AND I THINK THAT'S A BROKEN SYSTEM THAT WE NEED TO FIGURE OUT HOW TO FIX. SO THERE'S A LOT OF ISSUES AROUND THIS PROGRAM, BUT I DO THINK IT'S AN IMPORTANT PROGRAM THAT WE SHOULD PRESERVE EVEN IN THESE HARD TIMES AND CONTINUE TO REFINE IT TO MAKE IT WORK FOR EACH OF OUR DISTRICTS TO ITS BEST OF ALL. AND I THINK THAT'S AN IMPORTANT

Margaret Abe-Koga 8:40:43

AND SO I AM INTERESTED IN DOING THAT WORK, BUT FOR PURPOSES OF JUST THIS TIME, I JUST THOUGHT IT WOULD BE EASIEST, FRANKLY, TO DO THE 30 % REDUCTION.

Margaret Abe-Koga 8:40:56

THANK YOU.

Margaret Abe-Koga 8:40:59

OKAY.

Otto Lee 8:40:59

SO WE HAVE A MOTION BY

Otto Lee 8:41:03

SUBVISOR ELLENBERG, SECONDED BY MYSELF. AND AS MENTIONED EARLIER, I WAS TRYING TO WITHDRAW, SO I WILL NOT BE SUPPORTING IT WHEN I VOTE. OKAY. SO GO AHEAD. AND

Otto Lee 8:41:14

THIS IS THE VOTE ON THE SUBSTITUTE MOTION. MOVED BY SUPERVISOR ELLENBERG, SECONDED BY PRESIDENT LEE. SUPERVISOR ABEKOGA? NAY. ALL RIGHT. SUPERVISOR YOUNG?

Public Comment 8:41:25

NO.

Otto Lee 8:41:26

SUPERVISOR ELLENBERG? YES. VICE PRESIDENT ARRENAS? NO. PRESIDENT LEE? NO. MOTION FAILS. OKAY. SO WE GO BACK TO THE ORIGINAL MOTION, WHICH WAS BY SUPERVISOR ABEKOGA, BEING SECONDED BY VICE PRESIDENT ARRENAS. AND THAT MOTION WAS FOR ALLOCATION OF A TOTAL OF $5 MILLION WITH EACH DISTRICT RECEIVING EXACTLY $1 MILLION EACH. AM I CORRECT? YES.

Sylvia Arenas 8:41:54

OKAY. AND WE CAN, IF YOU CAN TAKE A FRIENDLY AMENDMENT, WE CAN STICK TO THE EQUITY -BASED FORMULA THAT WE HAVE NOW AND THEN WORK TOWARDS HAVING AN EQUITY -BASED FORMULA THAT WE ALL AGREE ON. WE WORKED SOMETHING OUT LOOKING AT THE MEDICAL ELIGIBLE RESIDENTS AND INDIVIDUAL RESIDENTS IN EACH RESPECTIVE AREA AS ONE OF THE FACTORS THAT CONTRIBUTED TO THE EQUITY -BASED FORMULA, BUT IT DOESN'T MEAN THAT THAT HAS TO BE IT. WE CAN FIGURE OUT WHAT THAT FORMULA IS COLLECTIVELY ONCE AGAIN.

Sylvia Arenas 8:42:32

ANYWAYS, SO I THINK IF WE DO THE AMOUNT, IF WE DO A TOTAL AMOUNT AND WE BASE IT OFF OF THE EQUITY -BASED FORMULA, THEN EACH DISTRICT RECEIVES THE REMAINING RESPECTIVE DIFFERENT AMOUNT. IS THAT SOMETHING YOU ARE OPEN TO?

Sylvia Arenas 8:42:52

COULD

Margaret Abe-Koga 8:42:52

WE TABLE THAT? I GUESS I WOULD LIKE TO SEE WHAT THAT COMES OUT TO, FRANKLY, BEFORE WE. I

Sylvia Arenas 8:43:01

DON'T THINK IT'S THAT MUCH DIFFERENCE BETWEEN ALL OF US BECAUSE I KNOW THAT THERE IS A NEED EVERYWHERE, AND YOU HAVE SIGNIFICANT NUMBER OF MEDICAL RECIPIENTS IN YOUR AREA, JUST AS OBVIOUSLY, YOU KNOW, SUPERVISOR YOUNG, YOU HAVE SUPERVISOR YOUNG'S DISTRICT OUTDOES ALL OF US. BUT I 'VE BEEN IN THE SPOT WHERE

Betty Duong 8:43:25

WE'RE

Sylvia Arenas 8:43:25

RIGHT BEHIND YOU JUST A LITTLE BIT. BUT I 'VE BEEN IN THE SPOT WHERE I WAS REPRESENTING DISTRICT EIGHT ON THE CITY OF SAN JOSE, AND THIS IS THE EVERGREEN AREA, WE HAVE THREE COUNTRY CLUBS, AND I HAD A PORTION OF THE EAST SIDE, AND SO THERE WAS A LOT OF TIMES WHERE I HAD TO SET MYSELF ASIDE BECAUSE I KNEW DISTRICT SEVEN,

Sylvia Arenas 8:43:47

I KNEW THAT DISTRICT FIVE ON THE EAST SIDE, I KNEW THERE WERE JUST OTHER DISTRICTS AND DISTRICT THREE IN THE DOWNTOWN AREA THAT ARE JUST NEEDIER THAN MINE. AND SO I JUST MADE, YOU KNOW, WE DON'T WIN IT ALL THE TIME, AND THAT'S WHAT EQUITY IS, IT'S WHERE THE NEED IS BASED, RIGHT? BUT I UNDERSTAND THAT THERE IS NEED EVERYWHERE. I'M NOT NAIVE TO THINK THAT, AND I 'VE WORKED IN YOUR DISTRICT BEFORE. I KNOW THERE'S A LOT OF NEED, AND THERE'S A LOT OF IMMIGRANT FAMILIES WHO HAVE DIFFERENT KINDS OF NEEDS, AND OF COURSE OUR SENIORS WHO HAVEN'T MOVED OUT OF THE AREA, AND SO I'M NOT TRYING TO DIMINISH THAT AT ALL. SO

Sylvia Arenas 8:44:33

IF WE ARE OPEN TO IT, WE CAN FIGURE IT OUT. I DON'T KNOW IF THIS IS THE TIME TO DO IT, BUT I APPRECIATE THE CONVERSATION.

Otto Lee 8:44:44

OKAY. WE

UNKNOWN 8:44:45

HAVE A

Otto Lee 8:44:45

MOTION. WE HAVE A SECOND. ANY FURTHER DISCUSSION ON THIS MOTION? CAN WE? ME? YES. CAN YOU CLARIFY

Betty Duong 8:44:52

WHAT THE MOTION IS?

Otto Lee 8:44:53

CORRECT. LET'S SEE WHAT THE MOTION IS. SO CURRENTLY THE MOTION IS $5 MILLION ALLOCATION, AND THEN WHAT WE DID TALK ABOUT IS REGARDING ALLOCATIONS. FIRST, THE MOTION TALKS ABOUT HAVING IT TO BE EXACTLY THE SAME FOR EVERY DISTRICT. AND THEN YOUR SECOND, VICE PRESIDENT REYNOS, WANTS TO HAVE A FUTURE DISCUSSION OF HOW THAT EQUITY INDEX MIGHT BE USED TO ALLOCATE THOSE $5 MILLION. SO AT THE END OF THE DAY, THOSE $5 MILLION WILL NOT BE EQUAL. AM I CORRECT TO THE SECOND?

Sylvia Arenas 8:45:32

THAT'S IF THE MAKER OF THE MOTION IS OPEN TO IT. YEAH.

Otto Lee 8:45:38

ALL RIGHT. DO YOU WANT TO MAKE A MOTION?

Margaret Abe-Koga 8:45:41

SO I THINK I KNOW WHERE THE VOTES ARE, SO I WILL ACCEPT THE AMENDMENT TO THE MOTION. SO

James Williams 8:45:48

WE

Margaret Abe-Koga 8:45:49

WILL DO THE $5 MILLION TOTAL, BUT ALLOCATE IT BASED ON THE, I GUESS, THE CURRENT EQUITY FORMULA, AND REVISIT THAT FORMULA FOR FUTURE DISCUSSION TO REFINE IT. SO FOR

James Williams 8:46:07

THIS UPCOMING BUDGET, IT WOULD BE $5 MILLION ALLOCATED USING THE MEDICAL ENROLLMENT AS A METRIC. YES. AND THEN THERE WILL BE FUTURE DISCUSSIONS AT SOME POINT ABOUT EQUITY, THE EQUITY METRICS. YES. OKAY.

Sylvia Arenas 8:46:23

IT'S BASED ON THE CURRENT METHOD THAT WE HAVE, THE UNDERLYING CURRENT METHOD THAT WE HAD. CORRECT.

James Williams 8:46:30

IT'S ACTUALLY IN THE BOARD POLICY CURRENTLY, SO THE METRIC, IF YOU'RE JUST KEEPING THE CURRENT METRIC, DOESN'T NEED TO BE PART OF THE MOTION. IT'S THE $5 MILLION USING THE CURRENT METRIC. OKAY.

James Williams 8:46:45

CLEAR?

Margaret Abe-Koga 8:46:46

EVERYBODY CLEAR?

Otto Lee 8:46:47

CLEAR AS MUCH. OKAY. WE HAVE A MOTION. WE HAVE A SECOND. ANY FURTHER COMMENTS ON THIS MOTION?

Otto Lee 8:46:55

OKAY. IF THAT'S THE CASE, LET'S VOTE. AND THAT IS A MOTION BY SUPERVISOR ABACOGA, SECONDED BY SUPERVISOR ARENAS. SUPERVISOR ABACOGA? AYE. SUPERVISOR YOUNG? YES. SUPERVISOR ELLENBERG? YES. VICE PRESIDENT ARENAS? YES. PRESIDENT LEE? AYE AS WELL. MOTION PASSES WITH FIVE. OKAY. GOOD. THANK YOU. SO, I BELIEVE THAT SHOULD BE THE LAST ITEM OF THE AGENDA. AND I JUST WANT TO SAY THAT WE HAVE NOW BE ABLE TO ADJOURN THE MEETING. IT'S ALREADY 6 .04. NEXT MEETING WILL BE ON TUESDAY, FEBRUARY 24TH, 9 .30 RIGHT HERE. THANK YOU SO MUCH, CLERK. SECURITY STAFF AND ADMINISTRATION FOR THIS MEETING ADJOURNED. THANK YOU.