Thank you. you you you you you you the I'd like to call the order of the Alameda County Board of Supervisors of Personal Administration and Legislative Committee meeting for Monday. November the 25th, first item that we have or the item that we have on the agenda is our federal legislative update. Good afternoon. You have Emily and John from CJ Lake and I know we haven't talked. I don't think there's been a pal meeting since the election. So kind of a lot to unpack. But as far as the schedule, the House and Senate are both in recess this week, the House recessed on Thursday and the Senate recessed on Friday of last week. So they will both return the week of December 2. And at this point, they're supposed to be in through, I believe it's December 20th. I'll turn it over to John who's going to focus on kind of the political appointments and also pending California waivers and approvals. Thanks Emily. So I'm sure we have all seen President Elect Trump has nearly completed the process of selecting his cabinet and other high-ranking administration officials. Our team will continue to monitor these selections at the cabinet and sub-tabinet levels as they are announced. But we do expect an expedited process to approve his choices once he takes office given given the Republican majority, and in addition to the pending cabinet, Mr. Trump has also empowered Elon Musk and the Vague from a Swami to head up an organization outside of the government, titled the Department of Government Efficiency, commonly known as Doge. Doge is charged with downsizing the federal government, either by executive authority or through recommended congressional action. Musk and Ramaswami have indicated their intention to cut government agencies down to essential staff and the federal budget by roughly $2 trillion. Mr. Muth laid out his plans in an op-ed in the Wall Street Journal last week and just for level setting the work force, the federal workforce represents about 4% of overall annual federal spending. Despite this roadmap that is expected to come out on July 4th of 2026, the Trump administration will have to contend with existing federal law and of course Congress in order to execute its plans to dramatically reduce the size of the federal government. They may be able to achieve some of these stated goals, particularly on the staff reduction by mandating a five-day return to office policy, potentially implementing the schedule after designation for the civil service or eliminate certain positions throughout the federal agencies that are civil service and replace them with political appointments. So many of the broad changes that will be recommended by this outside organization will be led with both legal or met with legal and procedural hurdles for the Trump administration. So we do expect sort of a long process despite many of the headlines that we've seen surrounding doge. In addition to that, we've seen kind of the rise of fall of any of these blue-ribbon commissions. Really for the past hundred years, you know, President Reagan had a blue-ribbon commission to reduce the side of federal government. The Clinton administration had a similar blue-ribbon commission, and we've seen sort of a lot of hubbub around these commissions, only to see them kind of fall flat in their face or an inability to get many of their ideas through Congress. Despite this, both Vivek, Ramaswamy, and Yalan must believe that the Trump-friendly Supreme Court will ultimately uphold many of the recommended actions of executive authority to downsize the federal government's absent congressional action. Donald Trump has re-nominated Rust Vot who will return to his role as OMB director and has already indicated that he will work with Musk and Ramaswami doge to execute many of recommendations. Vat was also the chief architect of the Heritage Foundations Project 2025, one of the chief advisors on that Heritage Foundation product. An oversight committee led by Marjorie Taylor Greene in the House has been tasked with coordinating the future of the Department of Government Efficiency and Joni Ernst, Senator from Iowa, has created the Doge Caucus in the Senateett to help usher those through Fennett. Outside of this organization, President-elect Trump nominated RFK Jr. and Dr. Oz to head of HHS CMS respectively. Neither man had experience running eight agencies or experience with federal health systems, but both have either fully endorsed or flirted with conspiracy theories that have sought to undermine the existence of scientific establishment. And if confirmed, RFC a junior will have authority over CMS NIH to lead these B first FDA and all of the agencies that make up HHS. Dr. Oz will administer the Medicare Medicaid programs, which represents about a quarter of total federal spending. But we have also provided a list of all the nominees that have come through to fill President elect from cabinet. And he is nearly completed in that endeavor with the exception of I believe the SBA administrator of still remains to be billed. But I'll stop there in case there are any questions about transition. Any questions? Where is Tim? to have. Thank you chair Carson. I still kind of distraught over what you just described, but that's that's the nature of what we have to go through. I and my team have been meeting with a number of nonprofits in our area and certainly a lot of the healthcare CBOs and they're very, very concerned and I would like to get some advice on what reassurances we can provide for them. In terms of well, you're lost in their funding, mandate, they're agency structure. I think what Emily feel free to jump in as well. I think what Emily and I have been kind of approaching this is despite a lot of the rhetoric that has come out of the administration. The House is set to have one of the most majorities in the last 100 years. There are still three races that need to be called and then we will go into this a little bit later. But the legislative filibuster still exists in the Senate. Republicans have 53 seats. They are only slated to have a two-seat or three-seat majority in the house with a number of Republicans that remain in pretty moderate districts. So they still will have to contend with some pretty difficult political realities if they are truly in-pent on cutting the federal budget, especially when it comes to SNAP, Medicaid and other federal assistance programs. The Farm Bill has to be negotiated this next year. Congress was unable to come up with an agreement this year and that bill still requires 60 votes. And then it will still have to get the approval of the seven Democrat to get that bill passed. And the same goes for the regular reparations process approval of the Democrat to get that bill passed. And the same goes for the regular preparations process that requires a bipartisan approval in the Senate to get passed. The leadership of the Senate Appropriations Committee in particular will remain the same. So Senator Collins has worked very closely with Senator Murray from Washington on drafting bipartisan pieces of legislation. We expect that process to continue to be bipartisan. The Senate appropriations bills all came out of committee nearly unanimous or unanimous. The House will remain a partisan enterprise. We do expect that to that trend to continue. But they will still have difficulty passing legislation, especially with particularly controversial items. That being said, we do anticipate that a debate over Medicaid funding and that program in addition to immigration spending will be the heart of the incoming Republican reconciliation package. That requires a simple majority in both chambers, but the Republicans will have to deal with the pretty significant backlash from jurisdictions around the country that rely on federal welfare programs, on the Medicaid program. If they truly want to essentially cut these critical support programs in order to pay for tax cuts for businesses and the very wealthy. So that's gonna be a political call that the Republican conference is going to have to contend with and of course the Trump administration is going to have to also push but there still are regulatory barriers that the agencies are going to have to go through in order to undo many of the Biden administration rules. You know, they can't just revoke a rule. They have to go through the American Procedures Act in order to provide a draft proposed rule that didn't have to go through the rulemaking process, and it goes through the notice comment period. So this is going to take a process in order to get to kind of get to the Trump administration's goals. It's not going to be a wave of the the wave of their magic wand and then suddenly everything's going to change. We will see a number of his executive actions that will be issued on day one that will lay out the the groundwork for what the government administration wants to do. But executive orders often have charge are basically charging documents for what they want to see the federal agencies undergo. But I'll stop there and Emily feel free to jump in if there's anything that I that I missed. Kind of how we've been approaching the second term kind of mapping it out. Yeah, honestly, I think you hit it all in terms of both what Congress can do and then on the regulatory side. Supervisor Tam, the only other thing I would add is that I think we are tasked with meeting with department heads and leds staff. I believe it's next Monday. This is something that the CAO's office is organizing to kind of talk through the leds platform for next year, certain priorities. And I think a lot of our discussion will be around kind of what's in the possible. And then, you know, just again, talking through the procedures that everything seems to take longer, then what kind of the rhetoric is saying right now. So. Thank you. So a little follow-up on the question, which is, I think, while there's all of this angst, rightfully so, the first big hit is the executive orders, because I think the shockwave starts there, right? That's theoretically first day. This is what I'm going to wipe out. And so to the extent that that can be defined and kind of clarified, for the first wave of things, what he has the ability to actually do under executive order on that first day, even though there is a process which follows the executive order. It may kind of pump the brakes a little bit as people are kind of thinking the executive order is made the next day, it's executed. And so kind of giving us a couple of the first steps that he has the ability to actually implement if that's possible, I think it would be important for us. It doesn't stop the anxiety, but it does give us a sense to say, this can actually happen under executive order so that we're clear or this is what executive order means and what is to follow after executive order. So I'm not sure, I don't know what the distinction is between today I'm giving you my speech and this is my executive order which starts today and we don't have to get agreement from any of the other legislative bodies. Then this is my executive order and this is the process that will follow. And this is my wish list and we have to go before the legislative bodies. If we can kind of get the definitions or the understanding of those three different buckets that may give a little additional, a different additional clarity to what is actually happening at the time in which he makes these pronouncements. Sure. No, we can try and do that for you. And I think the other piece that we didn't mention is resources. So day one, President Trump can issue a number of executive orders. And as John says, that's basically charging various agencies with certain direction, with an approach he wants them to take. But also, there has to be money. And so John was talking about, that means funds need to be appropriated. And again, in any sort of like appropriations bill with like discretionary spending, you are going to need 60 votes in the Senate. And again, I think the House is going to be depending on these two kind of California races that haven't been called yet. They're going to have the slimmest majority potentially in like over a hundred years. So those types of things will still be challenging in order to get kind of the funding that would be needed to implement a number of these policies. But Supervisor Carson to your point, we can try and kind of work on some sort of written document that kind of explains these kind of the various buckets that you were talking about. I appreciate that. That would be very helpful. And it starts to let people know what's foregone and what how we come up with not only a legislator fight, but legal fights around these actions that are stated. Any comment or question from people online? I have no speakers for this item. Okay, then we have a request for HR 7354 Kelly, Protect Black Women and Girls Act. And there's a recommendation of support from the Alameda County Health Department, Hulling Chala. the Alameda County Health Department, Kool-Ain Chawa, and then a letter sent in support of HR 9631, Lee, national fund as medicine program act of 2024. And I don't know if there's any comments or questions regarding those, but that was an informational item, but the other was the recommendation for support. Not hearing any. Then we'll move on on the State Legislative of the Letter sent to, in support of access to home and community-based alternative assisted living waiver for Medicare beneficiaries experiencing homelessness. That's Informational Item. That's coming from both social service agency as well as a healthcare agency and the executive directors of both. We have from probation department proposal tonight, McKowney facility, Richard, VA, technology lab, Brian Ford, Chief of probation officer, sending that letter to the board. I'm trying to provide the chief probation officer sending that letter to the board. Okay. Any comment on any of these? I have no speakers on those items. Okay. Any speakers on anything which is not on today's palvage? I have no speakers for public comment. Okay. I want to thank Legislative Update. I know you're going to have a lot more work, especially the first six months of next year, but I know we're incapable hands to be able to at least keep us up to the minute informed and giving clarity to what is and what is and what steps need to be taken. With that, hope you have a nice Thanksgiving week to you and your families. That's everybody online. People want to go on record of who's attending. Good afternoon. This is Hana Hamilton,in with supervisor Miley's office. Good afternoon. This is Eileen Eng with Alameda County Health. Okay, with that and thank you very much, Claire, good to board. You've had a very long morning afternoon afternoon, no break from 10 30. So we appreciate your service. We are adjourned. Take care, everybody. Thank you. Thank you.