And you sent the invite perfectly. I thought you might have lost your touch. Yeah. Right there. Hey, we're doing a six-day wait. Right there. And you're going to turn eight. Okay. You're going to do one of the led with now. Try to get brought in. Whatever you want. Yeah, it'll be over the next year. Multiple panelists. You can message someone. Yeah. How did it come out of this moment? But it didn't move me. And you do it again. Well, something's on. Oh. It's. You've been muted. It's been. You've been muted. We're going to be doing this for you. We'll be doing this for you. We'll be doing this for you. I the Mr. Halbert, Supervisor Marquez, Supervisor Tam, Supervisor Carson, President Miley. We have a call. I'm going to be going to be going to be going to be going to be going to be going to be going The detailed instructions are provided in the teleconferencing guideline. A link to the document is included in today's agenda. If you're joining the meeting using a computer, use the button at the bottom of your screen to raise your hand to speak. When called to speak, please unmute your microphone and state your name. If you're calling in, dial star nine to raise your hand to speak. When you're called to speak, the host will enable you to speak. When called, you will have two minutes to speak. Please limit your remarks to the time allocated. Public comment will generally alternate between in-person and online speakers as determined by the president of the board and subject to overall time limits. Thank you. I don't know. I'll go to the committee. Please. One of the plans is to speak. One of the plans is to speak. The person speaks. Please speak. I believe your mic isn't on. Okay. There we go. I held it. It works now. Okay. We can. We will now take public comment on closed session items on the agenda. We have no public speakers. Right. Okay. All right. Okay. All right. So the board supervizures is back from closed session. Take a roll, please. Supervisor Halber. Supervisor Marquez. Supervisor Tam. Excuse. Super supervisor Tam. He's present. Present. Present Miley. But we have a quorum. We have four operations to move the movement. Now is it back off? I'm going to go to the next slide. I'm going to go to the next slide. I'm going to go to the next slide. I'm going to go to the next slide. I'm going to go to the next slide. I'm going to go to the next slide. I'm going to go to the next slide. I'm going to go to the next slide. I'm going to go to the next slide. I'm going to go. Hello, testing. Am I on now? Yeah, now they're all here now. Okay. Do we need to take the role again? All right. So back from Colossus, she was the clerk. Please take the role. Supervisor Halbert. I'm dreaming. Dream. Here. Here. It was turning both of them on. I think it's canceling them. One out of time. Okay, now supervisor Halbert. Not turning green. Here we go. I'm here. This is where Supervisor Marquez, Supervisor Tam. That's working. And Supervisor Carson. President Miley. Yes. Present here. County for. So we're back from closed session. And we have a quorum. Okay. County Council anything. Report out from closed session. No, I'm not thinking to report from closed session. Thank you. Any board of supervisors remarks. Yes. Thank you. Any board of supervisors remarks? Yes. Thank you. President Miley just want to invite the entire community out to science in the park on Saturday, October 5th and really excited to announce the theme this year is a greener future. This is going to be hosted in partnership with Cal State East Bay and we're going to have free hands-on activities. This is going to be hosted in partnership with Cal State East Bay. And we're going to have free hands-on activities. This is a free family-friendly event from 9 to 3 p.m. We're going to be focusing on technology, engineering, art, and math. So just really encourage those that have young children to bring them, expose them to a college campus and come out and be in community. So again, that Saturday, October 5th and come out and be in community. So again, that Saturday, October 5th from 9 to 3 p.m. Thanks. You have the Board of Supervisors remarks. I'll just mention the Healthy Living Festival. The 21st annual Healthy Living Festival for seniors in those who love them is this Thursday, 26th at the Oakland Zoo. I could say come one, come all, but it's only for those who are seniors and those who've registered close to 4,000 at this point town, but we've cut off registration, we've got too many people coming. Okay, now what I'd like to do is take the privilege of acknowledging an honoring administrative associate Brenda Lacorio. Whereas the Aluminum County Board of State provides his wishes to honor Brenda Lacorio for 30 years of dedicated administrative support within the Alameda County Administrator's Office and so Service Agencies through her tenure. She has consistently provided exceptional administrative support services, significantly contributing to the growth, success and professional reputation of both Social Services Agencies and the Alameda County Administrative Office, as well as those involved in developing the county's inter-budget, ultimately enhancing the quality of life throughout the county. And whereas Brenda started her career with the How Many County Social Services Agency on December 27, 1993, in a clerk to position. And whereas she was promoted to an eligibility support clerk on March 25, 1996. And whereas she was promoted to a secretary I on January 13, 1997. And whereas she joined the county administrator's office, where she's so loved and enjoyed and done such an exceptional job. And she appreciated working on the fifth floor in the administrative building. I've just ended all that. On March 18, 2002, and was promoted to Secretary II, after nine years of service at the Alameda County Civil Service agency. She was promoted to an administrative associate, a management designated position in the County Ministry's office, January 24th 2012. Whereas Brenda has consistently enhanced every assignment she undertook demonstrating on wavering dedication to her role. Her tireless support with the program and budget staff, as well as for the leadership of social services agency, the county administrator has been instrumental. Through her efforts, the county administrator's office has upheld its commitment to serving the citizens of Alameda County and preserving the quality of life across our diverse communities. Now, therefore, the border supervisors, the County of Alameda, the Lacario, the Serial Locario, the Cario. For her many years, the devoted public service, the assistant's Alameda County, it extends their appreciation and deep gratitude to her, for her contributions and commitment to the vatement of Alameda County Ministry's office and the communities within Alamed County Ministry's office and the communities within Alamed County. So I've enjoyed seeing you up on the fifth floor. I hope you're not leaving us just yet. Anybody else have any comments? Supervisor Croschen, who's known you for way so very long? Yeah, I'm personally gonna miss Brenda. She's been counting down the weeks coming into my office, talking to me about, I got five weeks left. I got four weeks. And each time I started noticing that you were getting more immerse, more emotional about it. And I knew last week when I briefly, he was you were in my office that you were getting ready to break down because you're going to miss the family that you adopted for so long here. But I appreciate you educating me and schooling me about county government. I mean that sincerely. You learn from different people throughout the system, what it really means. And one of the things that has always been and press up to me is how dedicated, dedicated you are to the county. And that kind of dedication makes our county what it is and really appreciate it and I hope you enjoy a lot of Memorad old days in the Philippines one By thinking about your family back here at now. I meet a county Other comments because I didn't know you were returning. I thought we're just honoring for 30 years. Other other other supervisors, other county administrators, anybody else from the county? And see you've got some folks in here who anybody else want to speak on this matter. Surprise you to him. Thank you, President Miley. I have had the opportunity to spend a lot of time I'm going to be able to talk to everybody else on a speak. On this matter, surprise to him. Thank you, President Miley. I have had the opportunity to spend a lot of time lately on the 5th floor because I'm one of the newer supervisors that had to catch up. So I see Brenda often. And so I appreciate her very and positive attitude every time I come in and every time I leave the building kind of late at night. So I know that she has formed a really strong bond with all of the supervisors in the past and current ones and I look forward to her coming back as a retiree and Newton. So let me just add on behalf of the County Administrators Office and all of it. Department heads a big thanks to Brenda who's been there in our office for 22 years. She's the backbone to the budget system. She's staffed the budget committee and a number of other projects. She knows where all the secrets are. Brenda takes care of all of us and we're gonna really miss her very, very much. So thank you, a big thank you from all of us. As she said, how many budgets? 22. You do, you wanna say anything? You wanna say anything? Floor is yours. That was what you really mean now. My problem is. I'm sure it's great. Thank you, Mod. I really appreciate it. I'm looking forward for my 30 years, but then I think I was out that they, you know, when you guys, you know, recognize for a recognized employees of 30 years in the service. It's hard for me not for my family. I'm not even doing it. My sister's been diagnosed with stasis for breast cancer, so I am going home. I have to take care of her. And one thing that's really kind of hard for me is leaving the budget book. I don't know, it's going to look next year. So they said brands don't figure it out. Okay. I told you, you better not call me back from the Philippines because it's $10 a day. Nobody increase its $12 now. When they did. You still owe me 50 bucks last year. But I really appreciate it. Working with Supervisor Carson being the chair of the budget work group. My relationship with Laura has been a supervisor too. Met with Melanie, with Donna, even, you know, the baby supervisors, the late supervisor, Chan, the late supervisor, Gail, still, supervisor, Hagerty. And you know, until he returned, he doesn't call me my name. He calls me trouble. So, humanly, I used to find a argue that, you know, her name is Brenda. Whenever I go to his office and the scat said, I know, but to me, her name is trouble. Until he retired, I'm still trouble. I don't know why he calls me Trouble. Yeah, I always do a thing. I don't know why. And to Pat, I really appreciate everything besides us and with your trust and the appreciation you always, always give me every time I finish my job. Particularly, we adopted the budget. You know, and I didn't know what to do, frankly, I didn't know what to do because I wake up at 4.30 in the morning, hop on the shower at 5.30, get out of the house at 6.30, I'll be in the office between 7.30. So I didn't know what to do that next week. So I'm not sure yet. I'm not sure yet, but I think I have to relax. And I really appreciate everything, the, yeah, so, but anyways, I'm going to try in these situations in a while. Okay, I didn't know yet, but I'm just, if I'm back here, I'll be in touch for everybody. Supervisor Tom, thank you so much. Nate, I've learned you've been so long. There we go. Let's see if we can get a picture. We got it to plaque or the accommodation. Let's go get a picture. I might not take it. Mom, can I borrow a picture? We're going to have some fun. We're going to have some fun. We're going to have some fun. We're going to have some fun. We're going to have some fun. We're going to have some fun. We're going to have some fun. We're going to have some fun. We're going to have some fun. We're going to have some fun. We're going to have some fun. We're going to have some fun. Thank you. you you I'm sorry. I'm sorry. I'm sorry. I'm sorry. I'm sorry. I'm sorry. I'm sorry. I'm sorry. I'm sorry. I'm sorry. I'm sorry. I'm sorry. I'm sorry. a good one. I think we're going to do more operations. We're going to take a measure. Did you want to board an issue and that's the overview of measure C that County Council will present. So this is update on board initiatives, item number three. So we're taking them out of order. Measure C. you you All right. Good afternoon. Thank you. Everyone I was asked to provide an update on the children's health and child care for Alameda County tax and specifically to provide a presentation on our summary of the pediatric health care account. So that's what this presentation will focus on. So just by way of background, just a little information about how this works. So maintenance of the tax proceeds, a voter initiative imposed a countywide retail transactions and use tax. This matter was tied up in court for a long time. We finally prevailed and now we're able to use the tax revenue that has been stored up while the matter was in litigation. All proceeds from the tax shall be deposited into the county treasury and a special fund entitled the Children's Health and Child Care for Alameda County Fund. All monies, including interest in that fund, are split into two sub-accounts. The two sub-accounts are the pediatric health care account, and that will 20% of the revenue or funds raised by this tax will be placed in the pediatric health care sub-account, and then 80% of the funds go into the account that's called the Child Care Pre-School and Early Education Account. This presentation is about use of the pediatric health care account that 20% of funds. So permitted uses of the tax revenue, the tax, the initiative voter approved initiative defined what the permitted uses of the tax revenue were. And just as a reminder to everyone to be clear, this was a voter initiated tax. It was not a tax that the Board of Supervisors or county staff put together. The voters went out, they got signatures, and they requested that the board place it on the ballot. And so it was a voter initiative. So for example, my office played no part in drafting this initiative. So the proceeds from the tax are to be used and I highlight the word exclusively. Throughout this presentation, a lot of the language and verbiage that you we weren't involved in the plant, or my office was not involved in the planning or drafting or decisions that were made regarding this. So I am presenting this to you based on interpreting the legal documents. And of course, we were involved in defending the measure. So we are understanding of what the measure means and provides based on having to defend it in court. But a lot of this language is true to what was in the measure itself, so I just wanna be clear about that. So the proceeds from the tax are to be used exclusively to keep open and fully staff a local level one pediatric trauma center and emergency department in Alameda County. Maintain and protect the availability and accessibility of local healthcare services that are specific to the unique needs of pediatric patients. To increase access to high quality childcare, preschool and early education services to benefit low and middle income children and families in Alameda County to improve wages and compensation for family child care providers and early educators who provide those services and to support the efficient administration of tax proceeds. You will note that on this slide I have put in bold those first two bullets. And that's because those are the purposes for which the pediatric care account that 20% of funds will be used for, can be used for. The other three on this slide refer to uses of that 80%. And today we're talking about the pediatric percentage. So what are the requirements when using pediatric health care funds? Each year, the Board of Supervisors shell. And again, I'm highlighting certain of this language because those are the key parts that you have to focus on. The Board of Supervisors shell in consultation with the local pediatric hospital and specialty provider representatives expend money from the pediatric health care account based on demonstrated need for any of the following purposes. So I highlighted in bold and pulled out some phrases because that's that that dictates sort of the exercise that has to occur when you want to spend money from this fund. It doesn't prescribe as compared to the childcare account. It's not like you do have to do this once a year. We talked previously about the childcare account and where that money is given to first five um in one fell swoop and then they manage the money thereafter. That's not how this fun works. So um With this fund Each year in consultation with the local pediatric hospital and specially provider representatives You can expend monies from it based on demonstrated need for any of the following purposes. And there's no requirement that you do it in one fell sweep. I mean, you could do it throughout the year. It's not as prescribed as the other fun. But the purposes are to maintain, upgrade and expand as needed, a level one pediatric trauma center in Alameda County and programs for training and recruiting the highly skilled personnel necessary for its effective operation. center in Alameda County and programs for training and recruiting the highly skilled personnel necessary for its effective operation. To assure the financial viability of the local children's health care safety net and its accessibility, including the maintenance and expansion of specialized staff and facilities that provide board certified pediatric and pediatric sub-specialty care for the treatment of complex illnesses and conditions, and other health problems, including mental health for young adults without regard to insurance status or their ability to pay, and to explore and implement innovative programs that enable pediatric and young adults and their families to better access pediatric health care services and that enhance the effectiveness of such services. So this does not provide that the money the money in this fund has to go to just one of those things. You have the flexibility based on demonstrated need and your consultation with the local pediatric hospital and specialty provider representatives to expend money for any or all of those purposes described in the screen. Money's from the pediatric healthcare fund may be expended as direct grants. Contractual are program payments for services and activities. The non-federal share of Medicaid payments or other federal program payments through certified expenditures or intergovernmental transfers, re-embasement, I'm sorry, reimbursement or other compensation for costs, incentives, through programs or other vehicles identified or deployed are developed in conjunction with the local pediatric hospital and specialty provider representatives. And the significance of that is it really gives you, it speaks to you having a lot of different options in terms of how you spin this money and how you give it out based on your evaluation and consultation with these specialty providers in the hospital. Moneys from the pediatric healthcare fund may not be used to replace or otherwise supplant the tax revenue funding and other county funding and payments currently provided or otherwise available in support of health care providers, including but not limited to county payments for indigent care services, essential health care services, tax funding, emergency medical services, district special tax funding, or Maddie emergency medical services fund funder. So you can't if you're already spending money through these other these and and it's remember this is an including but not limited to source. You can't supplant that money and say we'll stop giving that money because we're going to give this money now. This money would be an addition to any of these funding sources that you already have available to you. I was asked a question about funding sources that may go away. If those funding sources went away, meaning the county was no longer able to access those funding sources and you didn't have it, then that would not be a sub, you wouldn't be supplanting those funds because the money is not there. But you can't just make a choice to say oh We've been using the original measure a you know health care Funding source But now we'll take that away and use it for something else because we have this new source of money Thus it prohibits supplanting existing funding resources So the fund also requires some auditing and oversight requirement for the pediatric childcare fund. It requires the board to establish an appoint a citizen over site committee that shall annually review the expenditures from the pediatric healthcare account for the prior year, report to the board on the conformity of such expenditures to the purposes set forth in the applicable provisions of this article. This oversight committee is, and these are my words, is a look back body. It doesn't advise the board how to spend the funds. That's not its role. You're not required to consult with this body in making your decisions. They are, they are, they are, basically the same body that exists for that original measure A healthcare oversight that has been in existence since that was adopted way in 2004, something when that measure A first became. Yeah, so there's, county has a longstanding history of an oversight committee for that, which is a look-by over the years we've consistently told that body your role is not to say oh I think the funds would have been better used for this or they would have been better used for that your sole purpose is to say was the use that that was made of the money consistent with the requirements of the measure so that that same type of the money consistent with the requirements of the measure. So that same type of committee must be appointed with respect to this. Additionally, there is also a committee that will exist for, well, you're also required to have an audit of both funds, an independent audit of both funds, the pediatric care fund and the child care, that has to happen on an annual basis as well. And that's a financial audit of those funds. So that's it, based on what is provided in the voter initiative. That's the explanation of the uses for that fund. It's significant. I'll take any questions if you have them. Thank you, Ken and Council. Does that ask the County of Minister of Kern and Council in the health care agency director? Do you be prepared to discuss this with the board today and to receive any public comments because people have been approaching us in terms of how we're going to proceed with kind of developing the programs and allocations associated with the pediatric portion of measure C. So I want the board to begin to provide some guidance today if at all possible. So other questions from board members? So Mr. Tame. Thank you, President Mali. And thank you for placing this important item on the agenda. Let me start backwards. So the slide that you showed about auditing and oversight. So the board was established an oversight committee for both the pediatric and the early childhood components. So I'm sorry. No, that's on a look back on a look. I'm not sure that the childcare has a requirement for an oversight body on the look that face, but you said the auditing would be on both. Yes, two different things. Right. So that the oversight body is a look back committee just to say that we're the funds spent in conformity with the initiative. The audit is an independent financial audit. The independent financial audit applies to both. The oversight is just for the pediatric care fund. So the requirements when using the pediatric healthcare funds falls to the board of supervisors in consultation with the funds and more to build out some of the mental health care facilities that have been planned for a while. How does that work in terms of the flow of funds because it's on an annual basis and there's several, I guess, ways in which the funds could be expended whether it's direct grants or contracts or payments. So in a situation where the need for the funds exceeds what's in the fund currently and then moving forward prospectively, is it recommended that we enter into a contract or is it done on an annual basis? So I would defer to others regarding recommendations about how you do it. I can tell you what legally is permissible. What it contemplates is that your board has discretion in consultation with the local pediatric hospital and especially provider representatives. You have some discretion about what you what ultimately because ultimately the fun rests with us is in the county treasury and so ultimately you have the decision-making authority regarding how do it actually spend the fun. So it could be that when you consult with the pediatric hospital and the specialty providers and the asks and the demonstrated need for the funds exceeds what you have, your board then needs to make a decision based on that information regarding how to allocate it. So it may be that, you know, and I'm just making this up, but it may be that you look and say, well, you know, it's really important that the hospital be able to do this function. So we're going to give them, you know, three quarters of what we have available this year. But we also really want to see this other program that focuses on youth mental health that this specialty care provider is doing, and the consequences of youth marijuana on psychotic disorders is really important, and they've got a novel program over here that focuses on that, so we wanna fund that too. These are the decisions that your board will be making, and then it's up to you, and I would defer to the county administrator and the healthcare director. They have ideas about how, you know, you how you want to deal with that process. Okay, those decisions. I'm sorry. I, you know, that that would not be within my scope. Yeah. I appreciate that clarification and we should think about establishing a process and perhaps it can be through healthcare and then going through the health committee and then going through the board. There are two programs that have come before us in some way, shape or form and just trying to understand whether it meets the intent and the spirit. So the first one is there's an outreach program that is currently funded by the first five to early childhood portion and also by the Alameda Alliance for Health in outreaching to pediatricians and making sure that there's a connection between children and families and their pediatricians, especially for medical patients. That outreach effort requires some funding and there's been a request for like $2 million worth of funding for that type of program. With that fall under some of the categories that you just listed and then the second one that we've been asked about In the health committee There's data that shows that The homicide rate particularly among youth that are under 25 is biking back up and So there's been an effort through health care to look at violence prevention the year. The year is going to be a year. The year is going to be a year. The year is going to be a year. The year is going to be a year. The year is going to be a year. The year is going to be a year. The year is going to be a year. The year is going to be a year. The year is going to be a year. The year is going to be a year. The year is going to make the call here on the fly without any information about the scope of the proposed program, but it could be. I mean if you look at the bottom bullet on the slide on the screen it says to explore and implement innovative programs that enable pediatric and young adult patients and their families to better access pediatric health care services and that enhance the effectiveness of such services. So maybe, you know, that may fit under that. And if those programs fall under that category, would they be administered by the county or by the local pediatric hospital, in this case, children's hospital? So again, I wouldn't make that call about how and where those programs should be administered. I would not be within my role to advise on that. Okay. But you know, as I read this and as based on my familiarity with how the decisions were made in the court of appeals and how the court ruled based on the arguments of the challengers to the tax measure. It is very clear that the ordinance does not require that all of the money go to children and that all the programs that are funded through children's hospital. It's very clear in the court of appeals decision that the court spoke to the fact that as a matter of law, you can't establish a tax measure to raise funds, it's specifically for a private entity, even if that private entity is a nonprofit. So it was very important to the court that the language in the ordinance didn't say children's hospital that it said the local pediatric trauma center and that there was the consultation regarding spending those funds was broader than just with children's hospital. So that, and I think the court fairly acknowledged that sure all of the money could end up with children's hospital if that was what was determined based on this activity of consultation that's required and demonstrated need that's required but that that's not required by the ordinance so it's not required that the programs all run out of children's hospital. Thank you. And so, Ms. Carson. I appreciate the questions and the presentation. A little context, just my personal context for my engagement. Not only as measure C was being thought through and put together, but also with respect to measure A in terms of the thought process and the structure that we now operate under. Obviously, there were a number of things that were at play. One is, since we had a measure on the ballot, how was it drafted, what specificity was it drafted with, in order to one, hopefully make sure that it was successful at the ballot. And then secondly, gave enough latitude in that flexibility to operationalize the outcome of that if we were successful at the ballot. And so as a result of that, I mean, clearly not have children's name as the dominant recipient of the funds, kind of is where we are. But the reality is that children was a part of the thought process and engagement in looking at what the initiative was. Having said that, let me kind of start from this premise. I mean, on one level, we have a world-class pediatric facility that we happen to be blessed with. It's in our county. World-class pediatric facility is in our county, world class, pediatric facility. This is in our county. Not only do they provide hospital health care services that are world renowned, they do research. They do teaching. They do all of those things that you would really like to have optimized in your in your county in your area for the purpose of children in this particular case. The second part too it is we've had a systemic and fundamental relationship with children's hospital. Fundamental in terms of we probably spend close to $25 million a year with contracted services from them in the area of pediatric work. Some of that is assistance with services in our school system throughout our school system. In terms of the health care centers, we have a couple of those. They provide EMS trauma center services. They provide family services. They provide indigent care in that area, they provide juvenile justice care in our own facility. And so we have an integrated partner that is world-respected that provides these services. So we shouldn't dismiss that. We should leverage that. We should leverage that. We should take advantage of that to begin with as we talk about the distribution of dollars. I happen to have been totally surprised even though it around the campaign that when the theoretically oversight committee started to meet after it was passed and we received the funds, I attended those meetings, those early meetings personally in San Leandro before I got to a place that we didn't have any more board presence at those meetings. And it was quite, I shouldn't have been caught off guard, but I was caught off guard, but it because it was in the rear view mirror. It wasn't advising them on what to do with the money. It was review of what they did with the money. You can make comment and review after they spent the money performing the services. Who knows whether or not that that would be impactful for future decisions, but it was review after the fact, as opposed to being political, which we increasingly are becoming around decisions where we have specialists, we have technicians, we have people who are knowledgeable, we have people who have been received worldwide for making decisions. We're kind of being dismissive of that and kind of being more political on how we wanna make sure everybody gets a little bit of money and maybe the impact is not as maximized as it could be if we would really take advantage of the richness that we have in this area. So, I mean, I think we should be happy that the voters in Alameda County saw the important need to pass this. I think that there has been a working relationship for the pediatric hospital that's world renowned in this area and while things do change on a regular basis in the area of health, I think as they change, it is only right that we analyze that change and understand that change and figure out how we appropriate any kind of differences as a result of the change that takes place that we think is positive, especially as it relates to the health, and especially as it relates to the health of our young people. Anybody else? Duncan, to press work. Thank you, President Malay. Thank you for the presentation. With regard to the oversight committee, are there any guidelines as to when it has to be established? How many people? So it just says that you shall establish it in the back because it is a look back, it would necessarily need to be established by the end of the first year that this is operational because that's what it's usually doing. It's doing a look back at the end of the year on half for the prior years spending. But no, you have the ability to find the oversight committee. And I think that when the authors of this put that provision in, they were thinking about our mirroring what existed for a measure A. Got it. Okay. And I'm also presuming there is no guidelines with respect to when we have to appropriate these funds. How soon? No, there's nothing that there's no timeline other than, you know, you have the money now, but there's no, it doesn't say you must disperse. I mean, it says each year. I mean, it does say each year. So there's an expectation that you are, you are spending the money or trying to spend the money. And the lawsuit was just a resulted in April. Is that correct? When did we finish this this year? Yeah, I think it was April because that's when all of the activity started to get the childcare committee set up right after that. So just a couple comments. I'm not quite sure about the timeline, but what I would like to see as much as possible if we could align this discussion after we adopt our EB 2036. You know, we're looking at our goals and priorities. the overall health and well-being of young people in our community. I'm sure there are many areas that we can partner and that we're in agreement with children's hospital in terms of services and programming, but I think there's an opportunity to get as much alignment as possible with our own strategic road map, so to speak. I'm also, I want to echo the comments made by a supervisor Tam very much interested in having our public health department work in collaboration with us to identify a priority. I'm also very concerned about the number of minors that have been killed by gun violence, so I really want to make that a priority. Also, I want to look at staffing retention and training levels to make sure that services can be addressed to maximize the highest impact as possible to the people that are utilizing services at children's hospital and beyond. So I don't know what next steps looks like if there's proposals that are going to be vetted at health committee with recommendations brought forward to the full board but really want to see us collaborate with our in a little bit of a unique situation in terms of the district that I represent. I have Eric Hospital, Health Deb a lot of kids, a lot of kids, a lot of kids, a lot of kids, a lot of kids, a lot of kids, a lot of kids, a lot of kids, a lot of kids, a lot of kids, a lot of kids, a lot of kids, a lot of kids, a lot of kids, a lot of kids, a lot of kids, a lot of kids, as long as I had the privilege of serving on the Board of Supervisors, I convene on a regular basis, have convened on a regular basis, on the CEOs of those hospitals, for the purpose of not just kind of communing with each other, but kind of getting a sense every single year, what is the lay of the land, kind of what's happening with all of those hospitals in terms of service delivery in our area, right? And because we're not a standalone in terms of how we provide our services, either as a county, overseeing public health, behavioral care, and health care in general in concert, not only with the system that we have through Alameda County Health System, but the system that we have with the other hospitals, right? And with the challenges and difficulty of running hospitals. It's good to know if you can get a heads up where there may be some change, substantive changes taking place, right? In which you can leverage those resources. Case in point, we were actually in a physical meeting actually in a county facility across the street with the CEOs in one of my meetings when Bernard Tyson was still alive and Bernard announced right then. In the meeting with respect to Obamacare, Kaiser's getting ready to go after all this money. It was a shockwave in the room because all of a sudden everybody knew that now we got to compete against Kaiser for monies that we at Hope was coming strictly to more so public hospitals. And there's been a number of those kind of revelations in the meetings that says this is a system, how do we maximize the resources, dollars, as well as the structural resources that we have in order to provide the best care that we can to the residents, in this case, of Alameda County. And that system has fought to make sure that, as UCSF been off and children in San Francisco continue to stay focused in spending their resources in Oakland and in Alameda County. So while we are sitting here and contemplating and thinking about this kind of singularly looking at this tax measure. I just wanna expand on the fact that it is about the dollars and cents from measure C, but it's also about what's the impact to the entire healthcare system. I've got a couple of questions. So when it says in consultation, is there any legal definition of that? There's nothing in the measure itself or the initiative itself that defines what being consultation with me, what it means. So essentially it means what it says that you need to consult. I mean, I would interpret it to mean that there has to be some consultation. You can't just exclude that community from the conversation now. Does that mean that you have to touch everyone who claims to be a specialty provider, no, because it says specialty provider representatives. So it doesn't say every specialty provider, you know, in the county has to be touched. But you need to, you would need to make some effort to demonstrate that you were consulted. Obviously, the clearly with the local PDS hospital, we know that's children. And that's children. Yeah. So the local PDS hospital would be children. Would be children. And what's a specialty provider? Is that like the... I would defer to the healthcare community. Somebody helped me with that. What's especially providers that CBOs is that organized labor. What's it supposed to provide? I mean, organized labor doesn't provide medical services. So I do think you have to read it in context of the goals and the senses that it's a specialty provider representative who is the representative. The staff that provide services, a specialty provider representative. Is it because the staff, the staff that provide services, would they be considered especially providers? So you could probably include them in terms of, because some, you know, they do talk about that, the programs for training and recruiting, the highly skilled personnel, necessary for its effective labor. So labor. Well, so I'm saying labor could be included in the discussion to the extent it's labor that represents. Specialty providers. Yeah. But I don't think that that term is limited to labor. Yeah. I think it's the providers themselves. Can you give me some help with this? Well, I would say certainly Colleen Chauvla, Director of Allemita County Health. I think it's the providers themselves. Can you give me some help with this? Or probably? Well, I would say, certainly, Colleen Chauble, Director of Allemita County Health, I would say that specialty providers referred to medical service providers and healthcare service providers that's focused on specific areas. So you could have oncologists, you could have behavioral health providers, mental health or substance use disorder providers. So those who focus on specific elements of a person's overall health. Okay. And then, I don't know if the county administrator can answer this question. I don't think the auditors here, the representative, the auditors office here. Now, so how much is an escrow? Is it $ 400 million? What's the amount that's been collected? It exceeds 400 million. I think it's closer to 600 million now. Because you'll recall that we started collecting both the tax measures in July of 2021. So there's at least three complete fiscal years of what I will call one time a prior year funding that has been set aside as well as the current year collections. So 600 million, 20% of 600 million is 120 million. So there's 120 million dollars that can go towards the electric services. Presently, plus, roughly, I'm saying about 150 million. He's being collected annually. So 20% of that is roughly 30 million. But it's a moment we've got about 120 million. It would include whatever interest, because interest on the funds is required to be deposited with that 80-20 million. That as well. But I mean, just caution as you know, that I mean a large portion of that is what I, you know, we would now consider one time funding. Yes, exactly. I think that that's part of the. Yeah, so 120 million of one time money and potentially 30 million, or they're about of ongoing if the measure is collecting about 150 million annually. Okay, so once again today is just a discussion if the measure is collecting about 150 million annually. So once again, today is just a discussion to get input from the board and the public. We're not taking any action today. We want to at least provide some direction. And I do think supervisor Tams' suggestion potentially would be the direction I would suggest we do. And I would add on, I would suggest we do and I would add on I would suggest we ask the health care agency in consultation with county council and the minister's office to make a report to health committee on both a process for this month these initial one-time monies and maybe an allocation for the next year of annual monies and a process for that and maybe it be an R or P process, you know the categories, the prioritization, bring that to the health committee so the health committee can grapple with the process, grapple with the prioritization and grapple with the process, grapple with the prioritization and the grapple with how we're going to move forward and then bring that to the board for approval. And then we can launch that endeavor if you know if it meets approval. And I think if the health care agency takes us up, we would also need to know. And it's the question for County Administrator. Is this money? Can any of it be used for administration? So if the health care agency has kind of reading colleagues mine here, because we give her more work. If health care agency has to take on the responsibility for administering this, can we use any of it for administration like 3%, 5% whatever or is there any strict restriction? Okay, because I know if we ask the health carry to see to take on this obligation we need to provide resources so that they can effectively do this but that might be what I would add to supervisor Tam's suggestion is that we have the health care agency in consultation, kind of administrator, and kind of counsel to bring to the health committee a process, a prioritization, a way that we can begin to grapple with moving forward with this one-time funding and then the ongoing allocation annually, as well as a recommendation relative to the setting up of the look back body, as well as I think if the healthcare agency brings us to the health committee, county council, and then ultimately the board. And we receive input from the specially committee, community providers and children's, that might be in consultation, but if that's not sufficient enough, even a mechanism to ensure consultation. So that's kind of what I'm thinking maybe as a result of today's conversation, just a thought. Because we need to, we need to get consultation. We need to deal with the one-time money. We need to go with ongoing money. We need to have a prioritization. There's clearly, from that one slide, there are three kind of broad categories that can be utilized for possible funding. And then there's a whole slew of ways that funding can be expanded from direct grants all the way to incentives and programs, et cetera. I would just add, unlike other measures, it does not call out a percentage that you can use for administrative costs. Literally what is on the slides is what it provides. So it contemplates that your board is, again, a Request Your Board action, but it contemplates that your board is making determinations and giving the money out. Now I wouldn't say if to the extent our internal healthcare is a specialty provider of services or provide some direct services then they could receive money based on demonstrated need and consultation for providing those services, but it contemplates the language contemplates that the money's going to follow within the scope of the permissible use of the money. There's no administrative off the top. Okay, so this language like 10% for administrative overhead. And it also doesn't regulate, you know, other than that the money is for this purpose. It doesn't say that when you give out a grant, it's not a good thing to do. It's not a good thing to do. and it also doesn't regulate, you know, other than that the money is for this purpose. It doesn't say that when you give out a grant, that, you know, it's limited to 10% of that is for their overall. I got you. Well, I don't want to prolong my questions, but, there's, so if the health care agency has to administer this and there's no direct correlation in terms of delivery of services it's just strictly administration of grants, of processing payments and doing all that kind of stuff, that we would have to absorb that cost. I'm not even sure it would require processing of payments. I mean, the way I read it, you could literally grant children's hospital, for example, $5 million based on demonstrated need. And then it's a grant and you're not, you're not necessarily responsible for, I mean, whether good government would dictate that you do it or you don't, but you wouldn't necessarily be responsible for billing. I mean, you could give them the $5 million if you chose. I think the most important thing. But Bill even I think the health center is going to do that. There's administration associated with that. So I don't know, Director Chow. Sure. Thank you. So if we go based on our experience with Measure A, there's an oversight committee. If the F all in the county health is going to have responsibility for an oversight committee, there's the convening, there's the, the, uh, tracking of meetings, there's the, you know, notification in the minutes and the materials and so forth. So there's a body of work that's related to the oversight committee. Uh, your board had determined that contracts with providers were, was how you wanted to, uh, administer the, the measure A funding. And if you do that, then there's a whole body of work around finance and contracting. And then additionally, we do in under measure A, we have a three year planning process. So every three years, we look at the base allocation come to your board with recommendations around the base allocation using some criteria that we identified to make those recommendations and so that planning process also has a body of work associated with it So I do I do think that I appreciate your attention to art It's a support for the process because it's not a small a small thing. Yeah, and then also Let's suppose their grants that are given out, we just don't give grants out, we may be there's an RFP and there's work associated with putting together the RFP, evaluating the RFP. I mean, so there's administrative costs whether you look at, I mean, I'm just trying to figure out. I'm not denying the administrative-up. Can we absorb that minister of course through this measure C or does that is that an expenditure that we've got to eat? So I don't think that this measure C is tracking the same language that is in measure A. So I think it's a different provision. I don't recall anything in measure A that talked about, you could give the money as grants, and that required you to consult with, I know there's nothing in measure that says, you have to consult with this body of people to determine, to me this was more akin to, well, it's not directly akin because you couldn't do it. But in measure A, where the money, the money that goes to the Alameda Health System, just goes to Alameda Health System, right? It's not a grant, but it just goes. They get that much. And so how I read this is it contemplates something similar that your board engaged in some kind of process. And whether you have the health care services agency performed that process for you and then bring the recommendations for it, that certainly would be permissible within the scope of, I think within the scope of the measure, but it gives you a lot of flexibility on how you award the funds, but it also contemplates a process where you go, you consult, people provide the demonstrated need, and then you can make decisions to say, I'm gonna do a grant, you consult, people provide the demonstrated need, and then you can make decisions to say, I'm gonna do a grant, you know, based on this demonstrated need, and after this consultation. I mean, it clearly defines a process where you're looking at what the need is and allowing certain stakeholders to participate, not to participate, to be heard regarding this, to have an audience. And then your board makes some decisions. There's a lot of it. There's a lot of it. There's a lot of it. There's a lot of it. There's a lot of it. There's a lot of it. There's a lot of it. There's a lot of it. There's a lot of it. There's a lot of it. for everything. Yeah, I understand. But you said direct does not provide specifically in here that there's nothing in here that says the county's administrative costs for those processes can be taken from these funds. Okay. And that's my that's all I'm trying to understand. Well, they may need money. It would have to come from a different source. So, I have to mention, with health care, if they're doing a function under pediatric care, then they could get money for that, but they can't get money for administrative costs. Not from this source, I've got that. Okay, because I do think, it says direct grant contractual program payments, non-federal share of Medicaid payments or federal programs, reimbursements or the compensation of cost, incentives and programs or other vehicles identified. So I mean, we have to have a mechanism for administering these funds and giving them out on the streets. So I just think the likely agency in the county take on this function. I think it's healthcare. So I think as a result of today, depending on what the board wants to do, I would support supervisor Tams suggestion that health care take this on and bring a process and a report to the health committee on how we might move forward with this. And I think it does contemplate that each year you are awarding money. So I don't think it allows you to just say, we're gonna hold the money for years and not get it out on the streets because it does say each year in consultation you shall award money. Yeah, because maybe the healthcare agency based on the need, besides like 80% of the needs to go to the pediatric trauma center, the pediatric trauma hospital, and the other is allocated for these other programs or these other categories. But I'm saying once again, I think the way to do this, or be to take it through the health committee, there could be that it publicly as well. But I'm saying once again, I think the way to do this would be to take it to the health committee. There could be that it publicly as well. And then ultimately, be brought to the full board as an action item to vice-carson. Yeah, again, I appreciate the thought and the focus on structured everything. It does say 20% of the funds go to the pediatric health care out and it says 80% goes to the area of childcare, preschool or education. So it's divided almost similar to the way that measure A, except for it's a 25 to 75% split, 75% goes to the AHS. So can I clarify? I know it's a different, it's different. Yeah, no, I just want to clarify. Everything that we're talking about today is just the pediatric account. So none of my comments relate to the other reason I'm putting it in that context is because at least I'm, I'm interpreting a lot of the things I'm hearing today as being in these areas of child care early education mental health all that other stuff and Conce요ling right and and and it's it's very specific in terms of the division that's here and so I Do think that healthcare is the appropriate place to kind of oversee and look at, thought and process and structure here. I do agree with that without exception. I do think that, again, as we contemplate these things, we also got to bring in some of our other healthcare providing partners just so that we get a real thorough lay of the land, as opposed to just look at it only from the perspective of just this isolated and what's there, right? I mean, case in point, children spends about $14 million a year on mental health in that area. Already that the county is supporting in that regard. So I heard mental health mentioned earlier in this. Is it enough? Maybe it's not enough, but let's look at it holistically as we kind of make this thought, as we think this through. So if I was just gonna suggest that maybe it come back to your, through the health committee in a sort of phased way. So initially, you know, we would look at a proposed process and address some of the questions that have been raised so that we have a chance to do a little bit more work in terms of what's, you know, in the measure and then, you know, get further direction to come back because you also mentioned coming forward with, you know, priorities and recommendations for funding. So I think it can be done in the same time frame, but maybe on a ph to approach. So just first approving sort of the process and then getting into more specifics with regard to recommendations. Supervisor Taylor. Just to clarify, I would like to see the process also include beginning to appoint the oversight committee members because if we're having to use the funds every year, push them out. We don't want to get caught in a position where we're not looking back until several years later. So it's part of the process in addition to the cruel expenditures, the priorities, but also looking at the oversight. And from what I'm hearing on the dialogue between you and county council, it doesn't appear that the healthcare agency would be precluded from assessing some sort of administrative fee. What that amount is is not something that I have enough background because when I looked at the EV 2026, the admin fee, I think is like 25%. Right? Yeah. Well, I thought you were going to say something different because I think my conversation in back fourth county council, I think the health care agency is precluded from assessing administrative costs to measure C. They can do programs to measure C, but not assess administrative costs. That's what I said. Memory serves me, I haven't read measure A in a while, but there may have been some specific language, I don't know if anybody in the room remembers in measure A that allows for a certain amount of administrative services. Do you know? Well, does health care take an administrative? I mean, is that part of how you allocate measure A to cover administrative costs? We have just recently begun doing that. And we do. I know it's $400,000. Is the current admin fee for measure A and the 25% Yes and the just to clarify supervisor Tam the admin fee for EV 2026 is 5% but that's built into the legislation no for that was a board decision for the 5% on the EV 2026. That was a measure A. It's discretionary about that. But as part of your three-year plan, you've allocated or you said you just started allocating some for agency administration. That's right, 400,000 for the administration. I just wanted to clarify, Supervisor Tams said 25% admin on EV 2026. It's not. It's five. Was it 15 before? 10 said 25% admin on PV 2026. It's not. It's five. No, it was lower. It's. So what was the process in which that was determined? Is it similar where the health committee made a recommendation? The health committee of the board and it went to the board or did it just come through? I mean, if you're going to be going to be going to be going to be going to be going to be going to be going to be going to be going to be going to be going to be going to be specific to health care. So yeah my point is if measures C cannot legitimately cover admin costs but there's going to be admin costs then we need to make sure we know what that is so we can include that in what we have to allow appropriated to health care to to oversee this. If measure C can't be used for some of it, then we have to determine what proportion we are comfortable with, three percent, five percent, whatever that might be. But what I'm hearing from county council today is that administrative cost cannot be allocated to measure C. That's what I'm here. But health care is not precluded from programs that are associated with pediatric. Yeah. Thank you for that clarification, Supervisor. And I also just want to say I've heard the recommendation that our agency work with the County Administrator and the County Council to develop a process and come to your board through health committee with a process. And we can include some of this administration information in the information and options that we present to health committee about what a proposed process could look like. And the county administration suggested that it be kind of phased. Yes. And I also think it's important that we don't lose track of those one words that in consultation. So we need to figure out what that, how we manage that. Yes, I did hear your board's desire to make sure that we're doing, making addressing the in consultation piece as well as the one time piece compared to the annual piece as well. Yep, all right. Yes. Thank you. I just want to make sure we all should have mentioned this earlier, but want to make sure we don't lose sight of our youth that our system impacted at JJC making sure that they're part of the discussion as well. All right. Let's see if we were to bounce us around now. Let's open it up for the comment. I will take speakers both in the room as well as online speakers. It will start in-house. Jessica, you have two minutes to speak. Yeah, just hit that button, it'll turn to green. Okay, there we go. Hello everyone, nice to see you. I'm Jessica with Phineon Children's Hospital at Oakland and I'll say that we are very eager to start the planning process to figure out how we can enhance and expand our trauma service programs. As you know, we are the only Level 1 pediatric trauma center in the East Bay, where one of six in all of California are very proud of that designation. We provide highly specialized emergency medicine services to thousands of children annually. The measure C fund dollars will be critical to our ability not only to enhance and improve our existing trauma services, but also allows to provide technological resources and tools for our emergency medicine staff to diagnose quickly. As you know, every second counts in the emergency room when we're providing life-saving measures to children. And so I've had the pleasure of meeting with most of you with our president, Dr. Holmes, and some of the ideas that we are thinking about in terms of how we'd like to use that funding would include building out an interventional radiology program. Also including a cath lab suite, which is very important to emergency services. Additionally, in terms of training, we'd like to be able to provide simulation-based training for our trauma teams. And then additionally, what we're really looking at too also is enhancing our existing hospital-based youth violence prevention specialist program. We have this program in partnership with youth alive to help address the issues around community violence, and we're very proud of that partnership. And we'd like to expand upon that. So what I'd like to say is that we are looking forward to working with you all to help make sure ensure that the hospital is able to provide top-tier quality emergency medicine services to our children and families of the East Bay and beyond. Thank you. Over the speakers. No other speakers. One person just raised and then lowered. And she's back. Or he's back. Allow. she's back or he's back. Hello. Mr. Swanson, you're on the line. You have two minutes to speak. Please say your name for the record. And what city you live in? Yeah, hi. This is a Sandra Swanson. And I had the pleasure of working with the Super supervisor Chan and the measure C coalition and I wanted to just at least for the record say what a huge amount of gratitude that the community owes supervisor Chan working in coalition with labor and being off children's hospital and pushing this measure. And I would associate myself with the Supervisor Carson's statements about how Benny off, if you're about in this wonderful trauma center, a workplace trauma center. And Supervisor Carson and supervisor Carson and supervisor Miley worked with the supervisor Chan that assisted this community after of passing this wonderful initiative. And so I think the community has a lot to look forward to because this was a lot of very hard work. But I think that the priorities that you're talking about today fit the spirit and objective of measure C. We are fortunate to have Benioff in this community there in the process of building a billion dollar campus expansion in Oakland. And I think that working together is going to be extremely positive. So I thank the supervisors that were part of this effort and and labor and the community for responding and signing the initiative that allows us to go forward. Thank you all very much. and the community for responding and signing the initiative that allows us to go forward. Thank you all very much. We have no first speakers. Right. Thank you. I've helped which mic now. Okay. So we've heard some from a few speakers or it's passes around. So once you're going to take any action today, what is the board consensus to hunt this to the health care agency and have the health care agency take on the task of coming up with a report to the health care committee on process prioritization, phasing in, the look back body and everything associated with this is the next step. And then the health care committee could, you know, grapple with this, get public comment, public input, and then make a recommendation or recommendation to the full board. Okay, seeing no objections we have consensus. So thank you. So what's our next thing, County Administrator? Your next item is under Board Operations and we want to present the board the proposed response from your board to the 2023-24 grand jury report, there were limited recommendations and findings that require your board's response. And so I mean, it will distribute a draft, Melanie will walk through them there in the area of recruitment and retention initiatives, and we're developing consultation with the interim HR director. Thank you. Good afternoon, Melanie at Tendido County Administrator's Office. Thank you. Good afternoon, Melanie at San Diego County Administrator's Office. As you know, as the County Administrators mentioned, the grand jury issued at 2324 final report in June and in that report, your board was asked to respond to findings and recommendations regarding the county's vacancy rate so we have worked with human resource services to prepare a draft response, a draft responses to those findings and recommendations for your board to consider. So I'll start with the three findings. Finding 2415 was that the your board has no policy regarding how long a budgeted employee position can remain vacant. The proposed response to that finding is that the board agrees with the finding vacancy rates are reviewed as part of the budget development process and salary savings budget adjustments have been and can continue to be made based upon historical data. This approach affords the county agencies and departments much needed operational flexibility to fill those vacancies. Finding 2423 is that overall county salaries have not kept peace with the county's goal of remaining at least in the median salary range of surrounding counties and the proposed response to that finding is that the your board partially disagrees with this finding in accordance with the Myers-Millius Brown Act the county's required to meet and confer and good faith regarding wages hours and other terms and conditions of employment with representatives of recognized employee organizations in this context and play wages are determined based on surveys of either the county's Bay Area Comparator counties or other survey method the county conducts salary reviews with the intent of ensuring a competitive salary. And as part of MOU negotiations the county also considers special salary adjustments in addition to general wage increases for classifications that fall below the median of the county's Bay Area comparator agencies. Finding 24, 24, as the board has not conducted an annual salary survey per the requirements of the charter and the proposed draft response to that finding is that the board partially disagrees with this finding. Employee wages are determined based on surveys of either the Bay Area Comparator Counties or other survey methodologies is outlined in existing MOU or driven by negotiations on a successor and MOU is required under the MNBA. Moreover, if the county is experiencing a recruitment or retention issue with a specific classification, the county conducts salary reviews with the intent of ensuring a competitive salary. And as part of MOU negotiations, the county also considers specially special salary adjustments in addition to general wage increases for classifications that fall below the median of the Bay Area comparator agencies. Moving on to the recommendations recommendation 24 or 13 is that the board of supervisors should establish a policy to review the amount of time at position can remain vacant in individual departments. The proposed response is that the board will not implement this recommendation because it is not warranted. Vacancy rates are reviewed as part of budget development and salary savings budget adjustments have been and can continue to be made based upon historical data. Again, this practice affords agencies and departments must need an operational flexibility to fill vacancies. Recommendation 2414 is that the board should increase staffing in human resource services to enable recruitment to be processed more quickly and eliminate the backlog of recruitment. The proposed response is that this recommendation requires further analysis. HRS has identified that increasing dedicated staff in the personal services division will allow the county to expand its recruitment efforts. By the end of the calendar year, HRS will work with the CAO to review existing vacancies and budget projections to determine whether adjustments can be made within current resources or if alternative options can be explored. The recommendation 24-16 is that the board should conduct a comprehensive analysis of the hiring and recruitment process from beginning to end, both in HRS and the individual departments to identify ways to improve and streamline the hiring process. And the proposed response to the recommendation is that this recommendation has been partially implemented in January of 2023. The county formed the recruitment task force to spearhead the recruitment enhancement project, the task Force identified high priority initiatives that involve enhancements and changes with the goal of implementing a variety of new programs, processes, enhancements, and changes in the current policies, procedures, and practices to address the recruitment challenges facing the county and speed up the recruitment and selection process. Staff has also implemented the voter approved shortening of the recruitment posting period from 25 to 14 days, enabling the county to speed up the recruitment process and enhance our ability to compete for a higher top-tier talent. Additionally, significant progress has been made on streamlining the business processes of the recruitment selection process to implement a wide array of technological improvements collectively. These efforts will make a significant impact on improving the county's recruitment and selection process. Recommendation 2418 as the board should expand the hiring list rule of five to the rule of eight. And the proposed response is that this recommendation has not been implemented. Previously in August the county issued to all the county employee organizations and offered to meet and confer and proposed to move from the rule of five to the rule of eight. After several meetings with the county's employee organizations, the county was not successful in implementing the rule of eight as a result. The discussion was tabled. The county will again approach our employee organizations and endeavor to reach agreement on an alternative to the rule of five that allows the county greater hiring flexibility. And finally recommendation 2420 is that the board needs to conduct a comprehensive salary survey per the requirements of the county charter. And the proposed response is that this recommendation has been partially implemented and that the county is in substantial compliance with the charter employee wages are determined based on surveys of either the county's Bay Area Comparator Counties or other survey methodologies is outlined in an existing MOU or driven by negotiations or meeting confer. As part of MOU negotiations, the county also considers special salary adjustments in addition to general wage increases. So those are the specific recommendations that the Granger report asks the board of supervisors to respond to. Yeah, I'm thank you for the report. I just have a question just a process. Does the grand jury typically look at things that they've received questions or complaints about from the community? Did other words, did somebody from the community or employee organization or some advocacy group, raised these questions about vacancy rates, about rule of five versus rule of eight, or did they come up with the idea to look into these questions? How do they typically operate? And I'm just kind of surprised that this is getting into like negotiations with employee groups that's getting in really some sensitive kinds of things. They would receive input from a variety of sources. That's not anything that's disclosed to us or specified in that report. All right. With regard to our responses, the first one, you know, they're calling out that we have vacancies and we don't really have a policy around how long it takes to fill vacancies or what level of percent vacancies we should maintain. They're calling that out and asking us about that. Our response seems to be more of a budgeting response. Like, you know, we have a fully staffed level and we don't get there because we use it as a mechanism of flexibly budgeting and that we look at historical levels. Like, will it begs the question, why don't we just have our fully funded employment rate be what the historical levels are. So with regard to salary savings, that is essentially what salary savings does. We go back and look at it. We typically budget at the top step of all the funded positions and the salary savings factor, if you will, actually reduces the appropriations to better align with what is actually occurring within the departments. But with regard to your question about the first finding and millionaire or the HR director can correct me, I believe the suggestion there was that we would have a policy that if a funded budgeted physician was vacant for a specified period, let's just say a year or two years, that we would automatically eliminate it. And I think that kind of policy would really eliminate any flexibility that our departments have, whether they're using another unfunded position and using this funded, whether they're using a different classification. So I think this suggests that after so many years we would automatically eliminate those positions that haven't been filled. So it begs a question that a fully staffed organization, if we say we should be at 100 people and we're only at 90. If you assume that well you can't provide the adequate services at 90 because you should be at 100. But what we're saying is we might like to be at 100 but we can do it with 90 and that's what we do and we take savings and we budget if we have more money we hire more so that we can but we don't have to. I think what's really getting down to is are we able to provide services for our constituents with a vacancy rate and I think we're we take the position that yes we can whereas I think the assumption is we're not providing our constituents with the services that they need because we're never fully staffed. So that's what I don't know. Maybe it's a definitional issue because it keeps coming up where we have a vacancy rate. We have a vacancy rate. We have a vacancy rate. We'll always have a vacancy rate. And I don't think people understand that. They think that if we have a vacancy rate, we're falling short of providing services unless we're 100% full. So I don't know if we should be having some sort of watermark that says we'll never be at 100%, but as long as we're at 90% or 85%, or 95%, we're still providing the services that we should expect to provide, and that the delta between 100% full and where we are is a play factor that allows flexibility. It's just a definitional thing. I guess the public isn't as attuned to the intricacies of our budgeting and financial mechanisms maybe as we are. That's what it calls out to me. I don't know if the HR director wants to just comment on what I kind of I don't want to say comment but sort of benchmarks in terms of vacancy rates because you're correct. I mean there is always a vacancy factor. Marguerite is a more interim director of human resources. Every public agency carries a vacancy rate and that's we're not an outlier by any stretch of the imagination. And there is a, like the CEO mentioned, there's a flexibility with this classification or this position is vacant. But my need is over here. And I think as an organization, it does provide department heads greater flexibility to address the changing needs of the community in COVID. There might have been a great number of positions related to some function, but all resources were shifted to the need of COVID. So there was over staffing and certain classifications that maybe weren't necessary pre-COVID, post-COVID or when it hit, we needed to divert the resources for that. So I think, again, all public agencies have a vacancy factor. Even private agencies, it's just a matter of course. So to have an absolute 100% occupancy or a filled position is really, it's, while it's ideal, I don't think it's something I can ever be achieved. And the added value of the flexibility I think is paramount to a public agency. Anybody else? Okay. Let's see if we have any public speakers on this item. No. No public speakers. Okay. So we'll bring this forward to your board for formal adoption at your next regular board meeting and transmit it to the grand jury. Thank you. So the next area we wanted to focus on is budget and finance and the key issues that we want to share with your board are items two and three Alameda Health System overview as well as the update on the American Rescue Plan Act funding. So we want to start with Alameda Health System overview and this really is an overview of the financial relationship if you will between the county and AHS as it relates to a permanent agreement and the line of credit that the county provides. So the auditor is going to walk through that background. And again, this is just for informational purposes. We know that there's often reference to a negative balance. And we wanted to be sure that our board and the public fully understood what that relates to and some of the history behind it. Good afternoon, Okay. Great. So I'm Melissa Wilk, the Alameda County Auditor Controller. Clark Aquar, good afternoon. And I'm going to do a brief overview, provided brief overview of the County and Alameda Health Systems financial agreements over the past 20 years or so. So the purpose of the agreements have been repayment of debt to the consolidated treasury and to provide operational liquidity to Alameda Health System. Since 2004, the Board of Supervisors has approved a series of agreements between AHS Elimate Health Systems and the County on Repayment of Dets. Beginning in August 2004, there was a resolution confirming and directing the establishment of limitations on lending to ACMC Elimate County Medical Center from the County Treasury. This resolution was established because at that point, ACMC had borrowed approximately $190 million from the county treasury. Auditing standards required immediate limitation on the interim loan balance and establishment of a plan to reduce the loan over the following 10 years. It set the maximum balance for fiscal year 2005 not to exceed $200 million and it required that the maximum balance be paid down to not greater than $30 million over the following 10 years. This was set in 2004 and that limit was set to coincide with the beginning of the collection of measure A revenue. In April 2011, an amended agreement was established. The goal was to enable ACMC to establish operating and capital reserves. The repayment schedule of the agreement adjusted the maximum negative balance, ending on June 30, 2010 from 130 million to 140 million. ACMC at that time also reaffirmed their obligation regarding the pension obligation bonds and Established that as of June 2018 a loan balance would be reduced to 30 million dollars the June 2018 deadline was set due to measure a expiration in June of 2019 There's also an agreement that beginning on July 1, 2019 and for each year thereafter that until the debt for the acute tower replacement had been retired, ACMC was willing to contribute $7 million toward the debt. There's also some questions regarding documenting invoice payment terms and that was included. In October 2014, there was an interim agreement approved. H.S. had requested a revision to the 2011 agreement once again to focus on establishing operating and capital reserves and that agreement was supposed to be valid through December of 2014 with the focus of developing a county and H.S. long term agreement. In December 2014, February 2015, March 2015, May 2015, in December, there were five subsequent amendments and extension to the interim agreement. And those extensions were to provide time for a health care services agency consultant to finalize an analysis. They were conducting the financial and operational condition of H.S. I'm going to allow the board to review proposals from health care. And they were focused on the appointment of a new CEO and they also wanted to final of 2016 where the permanent agreement, the current permanent agreement was finalized. In that agreement, H.S. indebtedness was to be reduced by $5 million per year. It's a balance of $50 million by June 30th, 2034. It also allowed for a review of the payment terms every five years or is needed. And it allowed for the county to deposit that $7 million ATR contribution from HS into a capital designation to be used for capital projects agreed to by the board of trustees and the board of supervisors. So the permanent agreement that's still in existence had three payment schedules, the first one is schedule A, that established the net negative balance limit reduction schedule. So the NNB or net negative balance is the amount loan to HS from the county's consolidated treasury, but it's somewhat similar to a line of credit and it has to be repaid. Sure. So, the, okay, so the consolidated treasury is where entities who, so the purpose of the consolidated treasury includes financial liquidity for entities that are authorized to use the consolidated treasury as a repository for their funds, so that includes the special districts, schools, counties. Yeah, so it's a combination of funds from those various entities. So the net negative balance, again, what the debt was to be reduced by $5 million each year. This current fiscal year's net negative balance for June 3, 2025 is $100 million. It's got an intra-year flexible max amount. There are times throughout the year where HAS needs some flexibility due to the timing of cash and state payments. So there's an additional $50 million allowed throughout the year. But the requirement is that by the end June 30, 2025, on the end of the fiscal year, they need to be back to the maximum set within the agreement. And again, for this year year it's 100 million. As of last fiscal year June 30, 2024, HS came in with a net negative balance actually of a positive 7.4 million. HS has been in compliance and has met or exceeded the net negative balance limit each fiscal year, including again last year. The next payment schedule is scheduled B on pension obligation bonds. For the 2016 agreement, the POB obligation was 70 million at that time. The final payment was received in 2021 and H.S. was in compliance with that payment schedule. Schedule C is the capital designation fund contributions. So the original term was $7 million was actually from H.S. to pay down the H.S. debt. There was a subsequent agreement to allow the $7 million to be contributed to a grid upon capital projects. In February 2018 there was a discussion and then in July 2018 an agreement was set where HS could begin in 2019 for a period of up to 10 years to use that 7 million annually to fund the electronic health record system project. Provided the following conditions were met. They needed to be in compliance with the permanent agreement, the totality of the permanent agreement. They needed to be in compliance with the permanent agreement net negative balance at June 3rd each year. They were required to deposit 7 million into the capital designation fund at the end of each year. They were required to achieve project benchmarks set by the county, provide quarterly updates on their finances in the EHR project, and sign an agreement to deposit any reimbursements for depreciation, interest and related capital expenses for county-owned facilities into the Capital Fund designation, for maintenance and investment in county-owned facilities and assets that were operated by AHS. With respect to the quarterly updates, was it stipulated where those updates would occur at the health committee? Thank you. And we do get them. So they do come just just to make sure that we're all clear, unclear, what are project benchmarks and example of project benchmarks? I don't have those with me but it was as they were rolling out the implementation of the EHR, the electronic health record system, providing updates on funding, budgeting, implementation status, and any metrics they had set, and if they were meeting those metrics. Yes. For AHS, the electronic health records was what? So we committed, the board committed to 10 years to basically returning that $7 million over 10 years. So $70 million. And was there an initial, I don't recall if there was an initial payment from the county. But the county essentially, I mean, effectively as the auditor indicated, AHS had initially agreed to contribute $7 million towards the acute tower debt, which I think you'll show later, was close to $700 million and the county is continuing to pay the debt on the acute tower as a general fund expense. That $7 million was then subsequently committed by the board towards capital and then subsequent to that specific to the epic system and the purchase of that system. So essentially they deposit it with us but we return it to them and I know there's a letter coming forward shortly for last year's contribution. And just for my own knowledge because a lot of this not as familiar, can you just describe to me what was done for the Q Tower? Was that complete renovation or? It was a complete, it was a rebuild of a new facility and it was close to $700 million project. The county issued all the debt and is repaying all the debt. Okay. issued all the debt and is repaying all the debt. Okay, so this is just a copy of payment schedule A and it basically shows this is from the permanent agreement, what the net negative balance limit is at the end of each fiscal year, shows the entry year flexible and maximum, and then the total availability throughout the fiscal year. I'm just going to underscore all of the hospitals in California as a result of the trot of the seismic issue. You have to consider that, right? And so it took several extensions, multi-year extensions in order to do that. So I know that that's a big issue right now with Alameda Hospital, some of the other hospitals, right? And so just as we're considering any future obligations, we know that under the state of California's current laws, we got to meet those. And unfortunately, most of the hospitals that have been around for the last 30, 40 years, probably are in that category. Yeah. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. the schedule of the capital designation fund contributions that are now currently being used for the electronic health record system as of 2019 for 10 years. And this next slide is the net negative balance by fiscal year. So the first column shows NNB as of June 30. That was the actual balance from HS as of June 30. The column next to it, the permanent agreement NNB is where it was supposed to be at by June 30 of each year. As you can see by this chart, HS was able to meet or exceed that negative balance limit each year. And for the prior three years it ended with a positive balance within the treasury. And then just a few more highlighted bullet points about the relationship, the financial relationship between the county. We do monitor compliance with the terms of the permanent agreement. We look at the net negative balance monthly year end, sometimes weekly. The capital designation, as Susan mentioned, we do that as a year end transfer, and that will be coming to the board for approval. We process deposits, measure a funds and wire transfers for things like IGTs, payroll repayments for HS. There's no financial reporting for H.S. in the county's financial system or financial reporting. H.S. contracts an external auditor for financial audits and we include them as a component unit within our own annual comprehensive financial report in a single audit. We do track the depreciation and interest for assets that are held by the county, but used by H.S. For example, their buildings and their facilities. Again, the current line of credit for H.S. through the county consolidated Treasury is 150 million for the fiscal year. That includes the intra-year flexible amount. The facility lease agreement, we lease the county facilities at a rate of a dollar per year with no renewal date. The acute tower placement is Susan said was between six and 700 million. The current annual debt payment for that is $47 million. measure double A 75% is transferred to HS. Last fiscal year it was about 147 million and to date it's been about two billion since the inception of measuring. And then there are a series of other direct funding and financial arrangements related to the services between Alameda County Health or Hicksa and Alameda Health Systems. That concludes my presentation. Have one question that I had asked, actually, asked at the meeting that we had around the public bank. And that is on the consolidated treasury. Is it a bylaw obligation that you got to go to the other participants in the pool to get their sanction if we're doing anything or is there a certain amount at level that you have to get their approval since we're managing and investing and overseeing their money. I don't know and I'm asking that. And I asked that at the the Treasury meeting that we have public night. Now that I'm aware of I think it's under hanks per view but not that I'm aware of. Thank you. So, what is your name? Thank you President Marley and thank you for that presentation. This is really important information to have as we are talking about some of the obligations that HS might take on. The issue that I am trying to wrap up my mind around is when ever HS comes and makes a presentation to the health committee of the full board, like this past year they talked about this $100 million deficit. And then the CEO was able to bring it down to roughly 20 million, but they seem to have a structural deficit. So when you talk about the $47 million annual debt for the tower replacement, is that part of their operating deficit? And then because then you have measure A and AA funds that seem to basically cure their deficit. So just to clarify, I believe the 100 million that you're referencing was their annual operating budget. Right. They initially identified a funding gap of 100 million. They were able to make adjustments and adopt a balance budget, right? So that's their annual operating budget, separate from the 100 million line of credit. And then on the acute tower debt, that's an obligation on the part of the county, not AHS. So the county of Alameda pays that annual debt. The AHS does not contribute towards that. So that's not an expense that's charged to their budget or is even reflected in their cash flows. That's an obligation of the county. So what debt payments were included in their $100 million death deficit when they reported that and they later balanced it. I don't recall. I don't know if they. Combination of things that caused their debt in terms of being able to make sure that they got their collectibles from services already performed to the increased cost that they might not have factored in totally was a negotiated settlement with, not just a single factor, and that at least James Jackson reported on it. Okay. So the NNB is essentially their line of credit, and they have been making good on their payment of $50 million. So the goal is that they reduce the amount of standing from the Treasury by 5 million each year. So they've been paying it down each year. So the amount, the maximum balance has been decreased by 5 million and by year end they have been meeting or exceeding that and last year they ended up or the last three years they ended up with a positive balance in the county treasury at year end. Okay, I guess I need to talk to the CEO about this because when we were looking at floating bonds for Alameda Hospital to meet their 2030 seismic requirement, they collateralized that based on the tax that was collected in Alameda, but they didn't use any of these, the funds or the $7 million intra NNB. So I'm trying to understand how come that was the situation with their funding abilities. Yeah, I'm not sure. The NNB typically is related to their operational, their ongoing operations throughout the year. And it does, like I said, it fluctuates throughout the year, depending on when they're timing of where payments from the state and IGTs and are governmental transfers. So I'm not sure where, or if they're including debt payments, it doesn't seem like it in their financials. Okay, thank you. I'll just wait here too. I want to thank the auditor. I'm 12 or recorder for presenting this today. I'm brought back to few memories. And this journey, especially as you, went through the chronology because, you know, AHS has always had a financial challenge. And it hasn't been until recently, which ends Jackson being the CEO that they've begun to become more stable and with the board that they've had for the past few years, more state or trustees, more stable with their finances, but Supervisor Carson and the auditor and county administrator. Now there's no that they have been challenged. And in 2004, and it just gives me a lot of pride to see that in 2004, when I led the effort to encourage Carthane Health and Superfiber to steal also helped, but I led the effort and we passed Measure A. You know, getting Measure A passed with two thirds in Alameda County, the voters, that was a big, effing deal. A big effing deal. Because you see, it's provided $2 billion since then to AHS and then we got to reauthorize as well later on. But if they hadn't had that money because I actually thought I didn't get that money it would have helped resolve their financial challenges but it really did but it helped but can you imagine if they didn't have measure A and A and after it's reauthorized, they'd be even, you know, even more challenged financially. But they continue to be challenged. Now, Supervisor Carson pointed out in the Treasury, that is an all-aluminium county's money. You know, we could forgive the debt AHS, but we had to pay it into the treasury. The county would have to pay, I mean, we had to pay that hundred and some million dollars into the treasury. We, you know, because it's not all county money. So that's why AHS has the obligation of paying down on it. We could alter the terms of that agreement. We could say instead of paying five, you pay three, or you pay two, you pay 10, or we could forgive it for a year, you know, suspended for a year or two to help them out. But ultimately, you know, it's rest on our shoulders if we take any actions in that regard in terms of messing with the agreement, because it's on us. And it's only reasons on us is because the county has helped AHS out historically to help it balance some of its financial obligations. And it has been difficult quite frankly when they did this strategic plan and they brought on Alameda Hospital and they brought on San Leandro Hospital. You know, we were all concerned about that because we weren't sure if that was going to pencil out. But the HF thought bring on at San Leandro Hospital, bringing on Alameda Hospital. That was going to help them become more attractive, competitive with other with the consumers and then obviously building a billion dollar to a cute tower new facility Highland in the world. Janet. Um, um, um, campus now was, you know, it was a real big deal. Uh, so But all those things complicated the situation, but they were all calculated And then as was pointed out here for a long time, in a way, H.S. didn't have, I mean, how should I say this and be polite? They had a string of CEOs that left, right, Keith? I'm a man. And he's not. No. And you know, I just want to admit this. If I had known being a hospital administrator, you didn't have to be successful, but you could leave and go somewhere else and make more money. I would have been a hospital administrator. You know, These hospitals administrators, they leave one job. They go to some other jurisdiction somewhere else in the country. And they're getting paid more money. So it wasn't like all the hospitals in administrators that were in charge of AHS. When they changed in AHS, they've always been the greatest and the best. James has done a real good job with this Board of Trustees. So I just want to kind of provide a little context here for this report as well. So that's all I got to say. Are there anybody else? Any other questions? I'll look for it later. And it was informational when I wanted to thank the auditor as well because I think it's important background information. This is very helpful. Thank you so much. So maybe, no, it's the elephant in the room saying Rose. Is that something we should discuss or just wait? Okay. All right. I would just say this historical information is relevant, useful, and I really appreciate all the fact gathering. Thank you. All right. It's if the public speakers on the side and public speakers please. We have one public speaker so far. Jane, you have two minutes to speak. This is your item. I'm sorry. I'm sorry. I'm sorry. I'm sorry. I'm sorry. I'm sorry. I'm sorry. I'm sorry. I'm sorry. I'm sorry. I'm sorry. I'm sorry. I'm sorry. I'm sorry. I'm sorry. I'm sorry. She wanted to speak to, but she missed it, but she wrote down the wrong item. Well, we don't have public. I have two minutes to speak. I always follow counting counsel. Yeah, okay. I'm looking over this syllabus and three thoughts occur to me. And it may be just the way I parse these kinds of things. One, it's not clear to me where the trauma center is going to be. Is it going to be one place or is it going to be centrifugal? It's not clear. Second thought, different populations have sometimes different health needs, and that's not clear to me in here. One size doesn't fit all. And three, again, one size doesn't fit all. There are alternative ways of providing medical care. And over time, some of them have very well established their efficacy. So what I'm simply saying is, as long as you're going through this trouble of organizing this and providing for it, provide for alternative medical care systems because if you get the problem self when the kid is a year old, then he doesn't have problems when he's 30. Any other public speakers on this item? No are the speakers? Okay, so we're, uh, Canada administrators stepped out of the room. So let's see, who should we put in the queue? I think we're going to go, the budget, oh, we're going to the ARPA, we're going to bring up that. Okay, bad, you're up. We'll put you on deck? Can you hear me? Okay. Good. I'll talk about arpin now for a while. Okay. Okay. Okay. Okay. Okay. Make you want to go to the first one. Okay, great. I just wanted to update everybody that under CARES Act we received $330 million under ARPA. We received $324 million. So between the two programs for COVID relief we received $654 million and I just want to remind everybody it was all one time money. It will not be repeated. The eligible uses... Thank you. The elder uses for ARPA were to support public health related to COVID-19. Address negative economic impacts caused by the emergency. Replace loss public revenue due to COVID-19. Provide premium pay for central workers, and then you could invest in water sewer and broadband infrastructures. The items you could not use would be to replenish your rainy day funds or reserve amounts. You could not pay interest on principle or outstanding debt. You could not pay interest on principal or outstanding debt. You could not use the funds to satisfy non-federal matching requirements for other programs. And you could not use the funds to deposit in your pension funds or to cover unfunded liabilities or accrued expenses. Funds must be used for cost incurred on a reform March 3 of 2021. Funds must be obligated by December 31st of 2024, which is what we're almost there. And the funds then have to be expended by December 31st of 2026. So after you have everything enc cumbersome and set aside, you have two years to spend it. On the next slide is basically an overview of kind of where we are right now. There is a summary, it's a summary by departments and their programs. The first department is healthcare and you can see their allocation was 168 million expenses to date were 114 million and in expenses for 48.7 they will have total expenses of about 163 in healthcare. Overall, totals, you have a $324.6 million allocation, 224 million in total expenses to date, 95 million for pending expenses, which we will go over in the next several slides. I have a question, you'll be. Sure. Yeah. I have a question, you'll be sure. Yeah, on the various allocations that have been in cumbersome. I guess that's, is that what you're referencing is also expenses or is that a separate category that I don't see here that's in cumbersome. And the reason I'm saying that is because in the ones that were in cumbersome was there a time frame that those contracts had to be or those dollars had to be allocated or can they be reallocated even though they've been in cumbersome? The expense column includes actual expenses and incumbrances. And the incumbrances, they're most, most of the incumbrances go beyond December 24. So we, you have to incumbr all the by December 24th, but the services can be provided after that day. And then, and so even though we get this money from the feds and we've incumbent it, we don't have to register how it's incumbent. We only have to give a final accounting of how we spent. We report to the feds quarterly. And in this quarterly reports we show what's in comfort and what's actually spent. In the final report that we give them when the program is all over, it will all be expenditures. You will not have any income benefits. Okay, and that's good, but since we have to report quarterly, the income rate dollars, if we change our, we don't spend those income rate dollars and we reallocate them someplace else, do we have to go back to the federal government and readjust what the allocation was for? No, no, we do those internally. Okay And the total expenses with the pending expenses are 319 million and We have an under expenditure of about 5.6 on the next slide Which is just health care will go through the allocation is 168.3 million. Expenses for healthcare, you can see the total programs there, 114.3 million. Pending expenses are 48.7 million. And the total of those are 163 million. And we have, you can see in the final column there's some over expenditures by program areas, some under expenditures by program area, the total under expenditures is about 5.3 million and we will go over what makes up the 48.7 million pending items, such a board will be getting on the next slide. There's two slides with pending items for healthcare. The first grouping is 25.2 million for total contracts and amendments that will come to your board between October and November of 2024. Sorry, the next item, $1 million of pending purchases, these are items that health care will purchase through a purchase order system, about 816,000 in vaccines, and then there are several small expenditures for public health that told about 142 million, 142,000. On the next page, there is 18.2 million pending contract adjustments. The most recent one that's coming forward is 11.4 million for home key shelter operations. That's the largest one and you'll be seeing that shortly. There's 4.3 million for pending charges for staff costs. 1.6 million is for the public health staff that's been an ongoing charge that healthcare is recorded each year that their staff have been working on COVID issues. There are two other small ones. There's 1.2 million that's for violence prevention, which the staff will be charged in doing the program from now through December of 26 and then the capacity development. Those two items, about 1.6, 1.7 million and staff charges are gonna be a little bit risky in the sense that the two programs that they're going to be working for and administer haven't really started yet. The contracts for violence prevention and the capacity development will all be coming to your board shortly and. The federal government or Treasury could look at that, but no, usually the last two years that you have year 25 and 26 is to wrap up your programs and clean them up. We're almost like starting some of them. So we might have some potential issues. We'll have to deal with the federal government on that. On the next slide is Social Services Agency. Their allocation was 56.4 million. They have expenses and incumbrance of about 53 million. There's 3.4 million that's pending. And after we do that, we'll have spent everything. On the next slide, you'll see what's pending. There's 2.4 that's for child care grants. Those will be paid out through October and November of this year. There's about 600,000 for workforce training, which will probably be paid out by the end of the year. And then the shelter program has about 400,000, which will also be paid out. Next slide is the CDA programs. They have $28 million in allocations. 20.7 was already spent or uncovered in our accounting system. 7.3 million is pending. And when you look at the right, if I call them, everything will be spent when we actually when we get to December. On the next slide you'll see this detail of the 7.3 million that's pending. The largest item is the $3 million for the affordable housing. That item is going to be on the October 8th board Agenda for approval. The other items we're coming forward, a lot of them are fairly small, $200,000 to $300,000 items. That will all be taken care of by the end of this year. Next slide, you have the Board Community Needs France. That was $15.5 million. To date, we've spent 15.3 million. There's about $200,000 left, and that will be spent by the end of the year. On the Auditor's Art Grants program, it was a million and a million was spent. The East Bay EDA Small Business Grants Program was 10 million, 9.7 million was spent. There's about 300,000 that they underspend. On our capital program, we budgeted 45.4 million for capital, 10 million is spent in a cupboard. 35 million remains outstanding. And after we spend that, or come and remember that we'll have 45 million, there will be all the capital that we spend. The next slide is the detail on the $35 million of capital that will come to your board. There's 18.3 million that will, the RFPs have been led in July and they'll be finalized in October. It can come to your board October and November. $15.5 million for facilities will come in November and December. And there's 1.6 million for site infrastructure work. You will see on your board agenda October 1st there's 13.8 million dollars of contracts which will then lower the amount that was to work in on to 22 million and you'll see the 22 million come to your board in October November and December. The very last slide a recap, this is the one basically which we saw a little earlier. The total allocation is 324.6 million. We've expanded 224 million. We have pending expenses of 95 million. To bring us to a total of 319 million altogether. We will have underspent by about $5.6 million. Since we don't wanna return any funds to the US Treasury or the federal government, one of the options that we can use to cover the unspent 5.6 million, there's what's called the allowable ARPA-Revenue Laws category, which covers general government expenses. We can use our share in that program, the revenue loss category, which covers general government expenses. We can use our share of that program, which is our planning to cover the 5.6. So we won't be returning any funds to the federal government. And any questions? So the $5.6 million that's unspent, you said instead of returning to the federal government, it goes into governmental expense. No, there is a category under ARPA that we qualify for. If you had a revenue loss during COVID-19, there was this huge calculation you go through. We went through the calculation and we qualified for a portion of the program. So we have the ARPA funds that we can use that are in the 326 million to cover the 5.6 million. Okay. So when I look at the 5.6, I wanted to make sure that I'm not like missing an allocation because it sounds like this was the total unspent and we were tracking those expenditures versus funding that was encumbered and committed to someplace else. This is money that after all the allocations and encoverances is what's left over the 5.6. That is basically the art of funds that are left over. Yes. Okay. Yes. As of today. As of today. As of today. As of today's calculations. Yes. Status of the procurements and other activities that the majority of the 5.6 million is from Alameda County Health, 5.3 million from Alameda County Health. And just to be clear, we have the ability to expend further what we were looking at, where we were in our various processes and other needs in the community. And we're thinking that this would be a way, there would be a way to keep these funds within the health realm. And it could be an amount used to support an Alameda health system in conjunction with what we talked about earlier. So yesterday's social services committee meeting, we had a request for closing a funding gap that the Jewish family community services had with respect to helping refugees from Ukraine and Afghanistan. So they needed some one time funds of around $2 million this year. Is that correct? And since they were one time funds and they had to be expended, I wasn't sure whether there was any opportunity to look at ARPA funding for that. Is this something that falls in that category? So just a point of clarification, Andrea Ford, Agency Director for Social Services. And we don't know if the amount is $2 million, that's the amount that gave us in February of 2024. And they were supposed to go back and reconcile. The numbers based on the update that we received yesterday's social services community meeting. So it could be less than two million, but it won't be more bad. Okay. Can it come from this 5.6? I think it would have to be procured, but out. Our paper has very strict procurement requirements. You'd have to do an RFP and get your bids and do all that. And you probably don't have time to do that. Do we have an existing contract with the Jewish Family Community Services Group? I don't think we contract directly with them. So we contract with Amriff who then works with those organizations. But some of the organizations were from South County, so we don't have a contract for them for sure. Is it something if we can suggest to them that they pursue. Absolutely. If the funding opportunity opens up, we can ask them to pursue. And we have in the past and they decided not to. I didn't attend the meeting, but I'm sensitive to our refugee population. I think in prior discussions, their feeling is that we, as a county, don't provide the same resources that other counties provide Santa Clara, country cost. It doesn't sound like our present choice, but I would be supportive of side-by-side comparison of the counties, an understanding of what we provide and if there's any gaps and Search to close those gaps if they exist and that's what I would hope that the What's the name of the committee social services could it would maybe look at doing Who's on that you You? Each here is it. And you. So, God speed to that endeavor. But I know that we have a large afghan and Ukraine population. I've been told that we don't do what other counties do. That's what I've been told. I don't know. But look, we take people into other countries. How do we expect them to be successful if we don't provide support that they need? So I'd be very supportive of that to my colleagues, please. So supervisor Halver based on the updated information yesterday, we are paying the different community partners, um, $16 million from Alameda County. And we are providing many of the like services that Santa Clara's providing. I think the area that's needed is around housing. So they were asking for funding for housing and in transportation. So that's what this money is for. I did ask where are they getting from Santa Clara and contra cost on an ongoing basis. They don't get ongoing funding. They've gotten one time funding from one county and funding from a different county twice. Thank you. I always follow county advice. I was looking at the opportunity with our funding. I think the challenge is that the funding that's allocated from the federal government is the same nationwide. So if you're housing costs in the Bay areas different than in Wyoming, then there's going to be a gap and we're trying to figure out how to help them and whether it was tied to a period of time during COVID when this service was needed, then it would fall under ARPA. Other board comments? So that 5.6 will just go to be utilized as a authorized expenditure that we will record those expenses in the ARPA fund for them. We have additional obligations as well. Or do we just. When you say additional obligations beyond the 326. No, you're going to use that 5.6. It covers some. That we use up all our. defenses. But is there any? We have eligible expenses. Oh, yeah, I'm sorry. Yeah. If you have eligible expenses greater than the five six. Yeah. Yes, we'll be able to cover. There's a, yeah, we can cover some of them. Yeah. And all right, let's see if there's any public comments on this item. No public comment. So we are going to go to item 4 and we're going to cover recruitment and workforce demographics. So, more green. That'll be the last time for today. I'm going to go to the next room. I'm going to go to the next room. I'm going to go to the next room. Thank you, supervisors. Margarita Zimura, interim director of human resources. I guess I have a fat finger. No, that's okay. Yeah. So we're looking at our workforce demographics. The period that the data is gathered is January 1, 2023 to December 31, 2023. We're going to be looking at our workforce by occupational categories broken down by gender and generational groups. We're going to look at our workforce ethnicity demographics by occupational categories, workforce turnover, both from generational groups, occupational and ethnicity. We'll be looking at our workforce, their separations, our retirements, biocupations, seniority and generational groups groups. And we're gonna look at our workforce retirement eligibility and where our workforce resides. When we're looking at a workforce by occupational categories, we're looking at our professional, the different categories, our professionals, protective services, administrative support, technicians, paraprofessional service maintenance, skill crafts, officials, and administrators. So when we're looking at our total workforce by occupation, you see that our professionals make up 40% of our employee population, and our professionals are like child welfare workers, social worker, program specialists, deputy DA, deputy public defenders. It's followed by our protective services, which is 19% of our population of about 15, 58 employees. And those are your sheriff technicians, deputy sheriff, juvenile institutional officers, followed by our administrative support, 1,280 employees, 16% of our population, our administrative support, our specialist clerk one, specialist clerk two's, our eligibility support clerks. That's followed by the technicians. We have a thousand forty employees that's 13% of our population. The technicians include the supervising eligibility technicians, eligibility services technicians, water plant operator three, followed by our paraprofessionals of 5% of our population or paraprofessionals of 5% of our population, our paraprofessionals, our administrative assistance, mental health specialists, three assessors, technicians, community outreach, outreach worker 2. Then we have our service maintenance and those are our janitors, food service workers, supply clerk to labor, that's 3% of our population. Our skilled crafts are our heavy equipment operators, station engineers, building equipment maintenance worker, our bridge tender, that's 2% of our population. And the final is our officials and administrators. Those are division directors, SSA, division chief auditor or behavioral health, clinical administrative financial services manager and division commander. When we're looking at our workforce by gender and occupational category, our professionals, our female, are comprised of 68% of our population, the male population being 32%. Our protective services, 26% female, 74% male, our administrative support, 78%, 22% male, technician, 71% male, technicians, 71% female, 29% male, paraprofessional, or 79% female, 21% male, services, maintenance, 27% female, 73% male, and skilled crafts, we're talking about 1% being female and 99% male with the officials and administrator almost evenly spaced, which is 58% female, 43% male. It's interesting to note our professional and technical, a female decrease from the prior year data by 1%, male increase by 1% in that same category. The officials and administrators female increased from 54% to 58% in male decrease from 46% to current of 43%. When we're looking at our workforce by generational group, our Gen Zs are born between 1997 and 2012. That's only 3% of our population are millennials born between the ages of 1981 to 1996. That is 36% of our population. Gen X is now our biggest. That generation is born between 1965 and 1980. Baby boomers is getting smaller in our organization. They're born between 1946 and 1964. And traditional now make up less than 1% of our employee population. Our traditionals are born 1928 to 1945. Interesting that our, as our generations are either retiring, terminating or coming in, our Gen Z and millennials both increased by 2% from last year. And baby boomers decreased by 5%. And that generation is retiring. So if we look at Alameda County population and our workforce ethnicity demographics, we have a very diverse community, both in population and our employee, our workforce. Our white category, our population is at 29% our employee demographics is at 26%. Asian population in Alameda County is 34% our employees are at 25%. Our Hispanic Latino population is at 22% our employees are at 20%. When you're looking at the black African American, our population in the county is 11% or employee population is 23%. If you two or more races almost evenly split 6% Alameda County population 5% employee Native American are exactly 1% both our county population and employee and American Indian or Alaska Native both less than 1%. Our 2023 workforce by ethnicity. 26% of our employee population is right, 25% Asian, 23% African-American Black, 20% Hispanic Latino, 5% two or more races, 1% Native Hawaiian, other Pacific Islander, and less than 1% of American Indian and Alaska Native. In our prior year from 2022 data, our white category went down from 28% to current 26% Asian by 1% from 24% to 25%. Black African American went% from 24 to 25%. Black African-American went down from 24% to the current 23%. Latino went up from previous 18% to the current 20%. And two or more races went up from 4% to the current 5%. No change in native Hawaiian other Pacific Islander or the American Indian Alaska native. When we're looking at our workforce by ethnicity and occupational category, first category of professional, again, those are child welfare worker 2, social worker 3, deputy probation officer. We're looking at our workforce in that category, in the professional category, 28% white, 27% Asian, 23% black African-American, 16% Latino, 5% two or more races, and less than 1% each of Native Hawaiian or the Pacific Islander and American Indian Alaska Native. Category B, protective services, 42% white, 22% Latino, 17% Black African American, 13 percent Asian, 4 percent to a more racist, and actually it's a 2 percent of consolidated meaning there was a significant number to break out the categories. And again, the protective services are your share of text, your deputy sheriff, your juvenile institutional officers. Category C of administrative support, your specialist clerk, eligibility clerk, 35% are Asian of our workforce, 24% are black African American, 21% Latino, 14% white, 5% tour more races, and 1% consolidated. Category D, the technicians, the eligibility services technicians, information systems technicians, 30% are black African American, 27% excuse me Asian, 23% Latino, 13% white, 5% 2 or more races and 1% consolidated. In category E of Para Professional, again the administrative assistant mental health specialist assessors technicians, we have 30% of our population of Latino 25% Asian 23% in Black African American, 18% white, and a 5% of consolidated. Category F of service maintenance, 38% of our population are Black African American, 29% Latino, 16% Asian, 13% white, and the rest, 5% consolidated. Category G of skilled crafts, heavy equipment operators, station engineering, building equipment maintenance worker, and so on, 50% are white, 23% are Latino, 17% are Asian, 5% are tour more races, and the rest of the categories are consolidated. Category age of officials and administrators, 36% are Black African American, 30% are white, 18% of Asian, 11% Latino, 6% consolidated. And now we're looking at the separations and retirements. On a countywide term on overrate, if you look at that, it is a 6.3% that's an increase from 5.2% to 1.1% increase. And that's primarily driven by a greater number of traditionalists that are retiring and baby boomers who also retired. The baby boomers went up from previously 11.4% retirement. Oh, there you go. Excuse me. Previously 11.4% are now this past year, 14% of the baby boomers, those in that category retired. So it's a big increase in retirements both in the traditionalists and in the baby boomers. Our turnover rate by occupational category, you're looking at the highest separation being in professionals, the highest retirement in officials and administrators and the highest turnover in the administrative and administrators, sorry, officials and administrators category. Our turn of array by ethnicity. We're looking at our turn around by ethnicity. The greatest number is in your separations is the two more categories. So two more categories. We have a 10.9 separation rate, native Hawaiian, other Pacific Islanders of 10.3% followed by Black African-American of 7.6, Latino at 6.4, white at 5.4% Asian at 5.2. Well, we're looking at our separations and retirements by occupational category. And these are, this is where you're looking at our separations and retirements by occupational category. And these are, this is where you're looking at, okay, where do we need to plan for each of the areas, the primary areas of work in our county. So in our professionals, we have 48% take up the separations versus a retirement of 35% for the professionals. Administrative support, 15% of those who went out the door are separation versus 17% for retirement, 14% for protective services were separations versus 20% retirement technicians at 12% separation, 15% for retirement and consolidated all other categories at 11% separations and 13% retirements. Those who left county employment, this does not include anyone who was terminated for cause. It's anyone who was actually just separated left the county or otherwise retired. Our probationary separations is less than 1%, which is a great, that means that we are investing in those employees who are coming in, we're training them, then those who pass the training and our investment in their being part of our employee community, they are passing the probationary period. Again, our, the percentage of our probationary terminations, those that do not pass the probationary period is less than 1%, which is very good. For those who are retirement eligible,, that is eligible for retirement. 41% of our population, of our baby boomer population, their average age is 65 and the average age of actual retirement is 65. Generation X, Gen X, that's 58% are employee population. Their average age of eligible to retire is 54, but that their actual average age of retirement 53. For a retirement eligible biocupational category, when you're looking at the professionals, their average age of eligible to retired is 58, but their average age of the 2023 retirees was 62. So that tells us that although they're eligible to retire, they're not really going out the door right away. They're waiting a little bit. Protective services, their average age of eligible to retire is 54. They don't go out until they're 55 years old. That's going to change with PEPRA because with PEPRA, depending on you're not eligible for maximum benefit until you're 57, if you're in the protective service, the deputy sheriff, that category of employees, they won't reach that highest level of benefit. So they're going to stick around a little bit longer. But right now at 55, that they're they're going out the door, they're retiring. For administrative support, their average age, the average age of our eligible is our 59, but they stick around to around 66 years of age. For technicians, their average age is 58, but they stick around until about average of 62. Paraprofessionals, the average age of the eligible are 59, but they stay until around 67 service maintenance. They average, the average age is 60, but they stay until around 64. Officials and administrators 58 and the average age of going out retiring is 64. So they tend to stay a little bit longer. Skills crafts, they're average ages 60, but they stay around 65. So that last category of the skill crops really impacts general services agency and public works that is where those costifications exist. This is really interesting. Where do our employees live in the community that they serve in the county of Alameda. Followed by Contrast Costa County at 19% and Harkin County at 7% and the rest, Salano at 3% San Francisco at 2% Santa Clara at 1% and so on. So it's good to see that our own employees live in the community that they are serving. And when you look at where in the county to the 64% of our employees live, Oakland comes in at the top. So 29% of those who live in Elimita County live in Oakland, followed by Hayward, San Leandro and Castro Valley. Any questions? So we live in our community. Thank you. This is extremely informative. Appreciate the presentation. Do we track individuals that are just to involve giving them employment opportunities? Do we have any data around that? I need to verify that. I think at one point the county did track the justice involved, but I'll need to see if that's in our HRMS system. Okay, if we're tracking it internally. Okay, yeah, be curious if we are, want to know what that data is. We might not have been tracking it, but because of the ban the box, we were trying to keep, because we had a specific number that we were trying to employ, because we had a specific number that we were trying to employ 1000 individuals in that category. We are not anywhere close to it. So while we might not be carrying it in that regard, we should be able to add up how many people have been just as involved that we've hired. Okay, and then doing now the last time we got an update to see where we're at with hitting that thousand mark. I need to go back and verify. Okay, okay, and then thank you Supervisor Carson for mentioning been the box. I wanted to clarify that we do bend the box here in Illinois County. Thank you for the very interesting data, but which is good. Are there any things besides, I mean, I think what was new, I don't know if I've seen the resonances before, maybe I have, I just forgot about that, that was pretty interesting. But from what you're able to absorb, are there any changes we need to make and we need to concentrate on, anything we need to do, to alter these numbers next time we see them, or is it just kind of interesting stuff? No, it's not just interesting stuff, particularly for the terminations and the retirements. That is great information for succession planning. So that informs our training and education center on the types of programs that we offer our division managers, our supervisors, our directors on preparing for that succession. And that's the kind of outcomes, action steps that I'm glad to hear. So do we have more of those? Are there other things that we're gonna do because of this? So what I'm going to do is I'm gonna take my show on the road meaning I'm gonna be meeting with each of the department has presenting their specific data and then seeing how HRS can support their agencies in whatever they think they need. We spent a lot of time on the demographics and by job classification. Are there any things that we're going to try to, I mean, anything that came out that said we're underperforming, overperforming, under performing, over performing underrepresented, overrepresented needed change. Well, I think from looking at the early slides, we can see that we are incredibly diverse organization. I think we're probably one of the most diverse, not only in population, our community, but also our own employees. There's always an opportunity to see to encourage greater diversity and specific categories of jobs. And that's one of the information, some of the pieces of information that I'll be giving our department heads. Yes, with the separations, do we have an actual number? People who separate leave the calendar. I see a broken down by occupational categories, numbers. So 517,ations and 280 retirements. So with the separations, does that mean it goes somewhere else to work? Any number of retirements? No. So we have 517 separations and 280 retirements. Okay, so with the separations, does that mean that goes somewhere else to work? Any number of things. So they went, they had a change in family status and now they're staying home or they move out of state and any number of reasons. And they are lumped in with, I got another job somewhere else. Okay, because what I'm interested in is, do we have a sense of, as we have the workforce of 8,000, 8,185? Do we have a sense of longevity. How long people stay with us? Yes, so based on, and I can certainly come back and provide you with additional information. Yes, hi. But yeah, I'd be curious enough, you know, how long do people stay? Mm-hmm. Yeah. There was longevity. Cause I think that would be a good indication of job, you know, satisfaction and institutional knowledge and strength of the organization, possibly. Okay. And I can break that down by category. Right. Anybody else have any questions? As a follow to that, do we have often what people will look at, if you say, of our organization, the comment are about to retire. But in the next three years, we're going to see an anticipation of a wave of retirements. And I guess it's in here somewhere, I just didn't jump out at me. But do we have a issue where we should really be, to your other point about succession point? Should we be worried about a wave of retirements? And in general, definitely, and we have a small percentage of original numbers, but the next big wave is the big move. So on slide, 2018, we have the number of the age of our population of our 20 population when generally they are retiring. And that is a cycle of a department of figure out, okay, of my different categories of employees in my agency, who's going to be looking to entire network? Of course, you're talking about it. No, they're age when I use those types. But it all provides insight in what is the case. It's amazing. Okay. So let's see if there are any public speakers on this item. We have no public speakers. No public speakers can. All right, I think we're looking up with kind of a few other items on the work session today, but we're going to table those items. So can the administrator be anything else for today? That concludes today's agenda. All right. So thank you all. The Board Supervisors special meeting for September 24th, 2024 is now concluded. A journey in each, in detail, and goodbye. Oh, of law. Hot eos. Thank you. of law. Daniels.