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HomeMy WebLinkAboutmeasurea-20-21-layout-6Measure A — Health Care for All Measure A Essential Health Care Services Tax Ordinance MEASURE A CITIZEN OVERSIGHT COMMITTEE 15TH REPORT TO THE ALAMEDA COUNTY BOARD OF SUPERVISORS AND THE PUBLIC Review of Expenditures July 1, 2020 – June 30, 2021 Measure A — Health Care for All MEASURE A Essential Health Care Services Tax Ordinance MEASURE A CITIZEN OVERSIGHT COMMITTEE 15TH REPORT TO THE ALAMEDA COUNTY BOARD OF SUPERVISORS AND THE PUBLIC REVIEW OF EXPENDITURES IN Fiscal Year (FY) 2020/2021 July 1, 2020 – June 30, 2021 PHOTO CREDITS Cover (Clockwise from top left): Center for Early Intervention on Deafness; LifeLong Medical Care; Service Opportunities for Seniors (Meals on Wheels); Health Services for Day Laborers: Multicultural Institute; Health Services for Day Laborers: Street Level Health Project; Health Services for Persons Who Inject Drugs: HIV Education and Prevention Project of Alameda County. Page 7 (L to R): Health Services for Day Laborers: Multicultural Institute; Alameda Boys & Girls Club, Inc.; Direct Medical and Support Services (Oakland): Preventive Care Pathways; Service Opportunities for Seniors: Meals on Wheels; Senior Injury Prevention Program for Day Laborers: Street Level Health Project; Alameda Boys & Girls Club, Inc. Page 9: Alameda Boys & Girls Club, Inc. Page 10: Center for Early Intervention on Deafness; Washington Hospital Page 11: Public Health Prevention Initiative Page 12: Alameda Boys & Girls Club, Inc.; Emergency Medical Services (EMS) Corps Page 13: Children’s Hospital & Research Center at Oakland; LifeLong Medical Care Page 14: Health Services for Day Laborers: Multicultural Institute Page 38: Washington Hospital Healthcare Foundation Page 45: Direct Medical and Support Services (Oakland): Preventive Care Pathways Page 49: Health Services for Day Laborers: Multicultural Institute Page 50: Health Services for Day Laborers: Street Level Health Project Page 62: Alameda Boys & Girls Club, Inc. Page 66: Center for Early Intervention on Deafness Page 67: CityServe of the Tri-Valley Page 73: Emergency Medical Services Corps/Alameda County Health Pathway Partnership Page 76: Health Services for Persons Who Inject Drugs: HIV Education and Prevention Project of Alameda County Page 77: Healthy Homes Department: Fixing to Stay & Group Living Facilities Project Page 80: Homelessness 3-Year Action Plan Page 84: LifeLong Medical Care (Heart 2 Heart) Page 86: Public Health Prevention Initiative Page 96: Service Opportunities for Seniors (Meals on Wheels) Page 97: Tri-Valley Haven for Women CONTENTS Measure a Citizen Oversight COMMittee MeMbers ................................................................................6 ...............................................................................................................................7 ................................................................................................................14 ...................................................15 Behavioral Health and Alcohol and Other Drug Community-Based Providers .............................................19 Center for Healthy Schools and Communities (School-Based Behavioral Health Initiative) ............................21 Cherry Hill Detox and Sobering Station .................................................................................................23 Criminal Justice Screening and In-Custody Services ................................................................................24 Mental Health Services for Juvenile Justice Center ...................................................................................25 Mental Health Services for Newcomers and Immigrants (CERI) ................................................................26 Substance Use Disorder Services .........................................................................................................28 The Alliance for Community Wellness dba La Familia Counseling Services (La Familia) .................................29 hOspital, tertiary Care, Other Children’s Hospital & Research Center at Oakland dba UCSF Benioff Children’s Hospital Oakland ................31 Children’s Hospital & Research Center at Oakland dba UCSF Benioff Children’s Hospital Oakland (BCHO) ....33 St. Rose Hospital ................................................................................................................................36 Washington Hospital Healthcare Foundation .........................................................................................38 priMary Care Alameda County Dental Health ............................................................................................................40 Center for Elders’ Independence .........................................................................................................42 Center for Healthy Schools and Communities (School Health Centers) ......................................................43 Direct Medical and Support Services (Oakland): Preventive Care Pathways ...............................................45 Direct Medical and Support Services: Roots Community Health Center.....................................................47 Health Enrollment for Children ............................................................................................................48 Health Services for Day Laborers: Multicultural Institute ...........................................................................49 Health Services for Day Laborers: Street Level Health Project ...................................................................50 Health Services for Unaccompanied Immigrant Youth .............................................................................52 Medical Costs for Juvenile Justice Center: Direct Service Planning and Administration .................................53 Medical Costs for Juvenile Justice Center: Niroga Institute .......................................................................54 Medical Costs for Juvenile Justice Center: Victims of Crime ......................................................................56 Primary Care Community-Based Organizations ......................................................................................58 publiC health Alameda Boys & Girls Club, Inc. ...........................................................................................................62 Asthma Start......................................................................................................................................64 Center for Early Intervention on Deafness ..............................................................................................65 CityServe of the Tri-Valley ....................................................................................................................66 Countywide Plan for Seniors: Home-Based Nursing Case Management ....................................................68 Countywide Plan for Seniors: Hospice & Advance Life Planning................................................................69 Countywide Plan for Seniors: Senior Injury Prevention Program ................................................................71 Emergency Medical Services Corps/ Alameda County Health Pathway Partnership ....................................72 Health Services for Persons Who Inject Drugs: HIV Education and Prevention Project of Alameda County .....74 Healthy Homes Department: Fixing to Stay & Group Living Facilities Project .............................................76 Home Visiting Services .......................................................................................................................77 Homelessness 3-Year Action Plan .........................................................................................................79 La Clinica De La Raza ..........................................................................................................................80 Latino Men and Boys Program ..............................................................................................................81 LifeLong Medical Care (Heart 2 Heart) ..................................................................................................83 Needle Exchange Emergency Distribution ............................................................................................85 Public Health Prevention Initiative ........................................................................................................86 Public Health Prevention Initiative: EMS Injury Prevention .......................................................................90 Public Health Services for Homeless Residents: Abode Services ..............................................................92 Roots Community Health Center ..........................................................................................................93 Senior Injury Prevention Program .........................................................................................................94 Service Opportunities for Seniors (Meals on Wheels) — District 3 .............................................................95 Service Opportunities for Seniors (Meals on Wheels) — District 4 .............................................................96 Tri-Valley Haven for Women ................................................................................................................97 West Oakland Health Center ...............................................................................................................98 Youth and Family Opportunity Initiatives ...............................................................................................99 appendiCes appendix a: Measure a auditOr-COntrOller repOrt Fy 04/05 thrOugh Fy 20/21 .......................................... 104 ............................................................................................. 105 appendix C: Fy 20/21 Measure a Fund distributiOn by prOvider Or prOgraM .................................................. 107 appendix d: Maps: geOgraphiC distributiOn OF prOviders Funded by Measure a in Fy 20/21 ............................... 112 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 6 MEASURE A CITIZEN OVERSIGHT COMMITTEE MEMBERS The Measure A ordinance established a Citizen Oversight Committee, which consists of 17 members appointed by the Alameda County Board of Supervisors (Board), to annually review the expenditures for the prior year and report to the Board on the conformity of the expenditures to the ordinance. The Committee develops, publishes, and presents a final report, based on individual reports submitted by fund recipients at the end of each year, to the Board. Each nominating agency is responsible for appointing a new member to any current vacancy. For more information regarding the Measure A Oversight Committee, please contact the Alameda County Health Care Services Agency at MeasureA@acgov.org. SEAT COMMITTEE MEMBER REPRESENTING/NOMINATED BY Seat 1 (vacant) League of Women Voters Seat 2 Susan Hauser League of Women Voters Seat 3 Ann E. Maris, PhD Alameda County Taxpayers Association, Inc. Seat 4 (vacant) Alameda County Mental Health Board Seat 5 Nestor Castillo Alameda County Public Health Commission Seat 6 (vacant) Central Labor Council of Alameda County Seat 7 Rachel Richman Central Labor Council of Alameda County Seat 8 Rebecca Rozen Hospital Council of Northern & Central California Seat 9 Frank Staggers Jr., M.D. Alameda-Contra Costa Medical Association Seat 10 (vacant) City of Berkeley Seat 11 Christine Martin City Managers’ Association Seat 12 Kelly McAdoo City Managers’ Association Seat 13 Michael McCorriston District 1 Supervisor David Haubert Seat 14 (vacant) District 2 Supervisor Elisa Marquez Seat 15 Ryan LaLonde District 3 Supervisor Lena Tam Seat 16 (vacant) District 4 Supervisor Nate Miley Seat 17 (vacant) District 5 Supervisor Keith Carson ALAMEDA COUNTY HEALTH CARE SERVICES AGENCY STAFF Colleen Chawla, Agency Director Kristel Acacio, Financial Services Director James Nguyen, Administrative & Financial Services Manager Ricca Espiridion, Director of Hospital Finance Justine Eclipse, Secretary 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 7 About the Measure A Citizen Oversight Committee O ne of the provisions of Measure A required the establishment of a Citizen Oversight Committee. The Measure states: “The citizen oversight committee shall annually review the expenditure of the essential health care services tax fund for the prior year and shall report to the Board of Supervisors on the conformity of such expenditures.” With ongoing support from the Alameda County Health Care Services Agency (HCSA), the Oversight Committee spent several months reviewing allocation reports, highlighting accomplishments while deliberating and communicating concerns to providers, and reviewing and editing the Measure A annual report. Report forms that are based on the Results-Based Accountability methodology, along with in-person presentations from several providers, were used to review all funding allocations. History of Measure A Passed by 71% of Alameda County voters in March 2004 Extended through 2034 (as Measure AA) by 76% of voters in June 2014 Raises County sales tax by one-half cent for health care services: Emergency medical, hospital inpatient/ outpatient, public health, mental health, and substance abuse Target populations: Indigent, low income, and uninsured adults, children and families, seniors, and other residents of Alameda County Overall Conclusion The Oversight Committee found that Alameda Health System (AHS) and other recipients of the sales tax revenue spent the funds in compliance with the provisions of Measure A. FY 2020/21 Measure A Executive Summary (July 1, 2020 – June 30, 2021) 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 8 Revenue and Expenditures: At a Glance Of the $161,547,180* that Measure A generated in FY 20/21, AHS received 75%, and the remainder of the funds was distributed by the Alameda County Board of Supervisors (Board) to many health care providers who provide essential health care services. DISTRIBUTION OF MEASURE A FUNDS Alameda Hospital 8.5% Parkbridge 1.4% Highland Acute 37.9% Fairmont 4.7% Provider Services 28.1% Ambulatory 3.9% John George 7.8% San Leandro 7.7%Public Health 33% Behavioral Health 24% Primary Care 24% Hospital, Tertiary Care, Other 19% * Does not include interest earned. ** Board allocations are made in advance of a given fiscal year. Therefore, the amount generated by Measure A for that year does not equal the amount allocated by the Board. $37.8 M Allocation of Measure A Funds Approved by the Board of Supervisors** $121.2M Allocation of Measure A Funds to Alameda Health System 75% $121.2 M GENERATED 25% $40.4 M* GENERATED 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 9 Alameda Boys and Girls Club, Inc. Highlights Since the full implementation of the Affordable Care Act in 2014, more than 18,000 newly eligible Alameda County residents have been enrolled in the state’s Medi-Cal program, and more than 77,000 County residents have been enrolled in Covered California. Despite these achievements in increasing the number of individuals who have health insurance, an estimated 69,452 individuals, or 5% of County residents, remain uninsured, according to the American Community Survey estimates for 2021 (Source: U.S. Census Bureau, Small Area Health Insurance Estimates). The novel coronavirus (COVID-19) pandemic, which began in December 2019, has disproportionately impacted communities of color, in particular Latinos and African Americans, in terms of COVID-19 cases and hospitalizations as a result of inequitable access to a range of resources that enable people to be healthy, in Alameda County. Collectively, many of the community-based organizations, health care providers, County agencies, and school and city partners funded by Measure A responded to the pandemic to expand COVID-19 testing and contract tracing; support shelter- in-place, isolation, quarantine, and protective measures, especially for high- risk groups; and participate in other countywide responses to address the needs of marginalized communities most impacted by the pandemic. However, during this time period under the Trump administration, serious efforts were taken to dismantle the Affordable Care Act, which may erode public health coverage. Thus, Measure A revenues continue to play a critical role in helping indigent, uninsured, and low income residents of the County—who depend on the County’s health care safety net—maintain access to essential health services. With regard to Measure A recipient reporting, the Committee recognizes an ongoing trend of improvement in the quality and level of detail in the reporting process compared to prior years. This is due in part to the ongoing effort of the Committee and HCSA to improve the accountability of Measure A recipients. Supporting Health Care for Many… During the height of the pandemic, the need for health care services increased dramatically, while providers faced mounting challenges due to the shelter-in-place and staffing issues. Nevertheless, Measure A funding continued to support many recipients in providing health care services to large numbers of County residents. For example, AHS used its 75% of Measure A tax revenues to provide services to 107,796 patients in FY 20/21. Providers under the Public Health Prevention Initiative served a cumulative total of 77,257 County residents through Measure A, while the member agencies of the Primary Care Community-Based Organizations served 278,291 residents. AHS served 107,796 County residents through Measure A in FY 20/21, while the member agencies of the Primary Care Community- Based Organizations served 278,291 residents. 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 10 Center for Early Intervention on Deafness …Across All Segments of County Residents Measure A funding supports health care services for County residents across all demographic groups, including seniors, youth, the unhoused, the incarcerated, and those struggling with substance use. Recipient providers are located throughout the County, serving all Supervisorial Districts. Reflecting the diversity of County residents, providers continue to offer services in more than 33 languages, including Spanish, Cantonese, Mandarin, Cambodian, Armenian, Tongan, and Vietnamese, among many others . Achieving and Exceeding Goalss Even during a year constrained by the pandemic, many Measure A recipient providers met or even exceeded their targets for service delivery. For example, at the Alameda County Juvenile Justice Center, Criminal Justice Screening and In-Custody Services provided an average of 3,124 hours of crisis intervention services each month, compared with a target of 1,000. The Alliance for Community Wellness dba La Familia Counseling Services (La Familia) conducted outreach, information, and referrals to basic needs and services to 1,094 participants, compared with a target of 250. And the LifeLong Medical Care Heart 2 Heart Program serve 2,191 community members at 96 community health events, compared with a target of 50 members at 15 events. Continuing COVID-19 Innovations In FY 20/21, many providers continued to expand innovative efforts to respond to the COVID-19 pandemic. Recipients such as Alameda Health Services and Public Health Department programs provided services via telehealth, including phone- and video-based contacts. The City of San Leandro Senior Injury Prevention Program created the Virtual Senior Community Center (VSCC) web page that provides links to health resources, virtual exercise, travel, and craft videos to provide an alternative source of activities. One of the Youth and Family Opportunity Initiatives providers, YR Media, adapted their arts education curriculum to run virtually and keep young people engaged with the program and staff. Washington Hospital Healthcare Foundation administered 42,886 COVID-19 tests to 32,837 people. And the Alameda County Office of Homeless Care and Coordination (OHCC), in coordination with the HCSA, continued to provide critical shelter and support to access permanent housing at a time when the ability to safely shelter in place in a non- congregate setting was more crucial than ever. Washington Hospital 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 11 Serving Body and Mind Mental and behavioral health plays an equally important role as physical health in whole-person wellness. Recognizing this, many Measure A providers offer programs that support improved outcomes in personal and social development for clients ranging from youth to seniors. Students at the Center for Healthy Schools & Communities (CHSC) School Health Centers made 13,045 behavioral health visits, while 98% of Mental Health Services for Newcomers and Immigrants (CERI) clients receiving mental health services agreed or strongly agreed that they dealt more effectively with their problems. Achieving Satisfying Results At the Countywide Plan for Seniors: Getting the Most Out of Life (GMOL) program, 100% of survey respondents out of 1,180 clients served by Measure A reported they were satisfied or very satisfied with the overall quality of the education and training presentations. Similarly, 100% of survey respondents out of 405 Needle Exchange Emergency Distribution (NEED) participants receiving services funded by Measure A were satisfied with the services. Promoting Better Outcomes Through Knowledge While all Measure A providers work to address existing health issues, many also look to prevent health and life crises before they occur by focusing on knowledge and education. For example, Asthma Start’s services include increasing parents’ knowledge of asthma management and improved asthma control. Multicultural Institute (MI) hosts health care trainings or workshops as well as street-based health education sessions, at which over 90% of attendees report an increase in knowledge. The Senior Support Program of the Tri-Valley’s Medication Safety program provides clients the tools and knowledge necessary to safely take their medications. Bringing in Additional Health Care Funding Measure A continues to prove itself as a wise financial investment of County sales tax dollars, as over 45% of recipients leveraged their Measure A allocation to obtain matching funds from government programs, private and public foundations, and individuals totaling more than $71M . These matching funds often represented a more-than-50% return on the allocation, and sometimes exceeded 100%. The Washington Hospital Healthcare Foundation received a return of almost 500% in matching funds, Mental Health Services for Newcomers and Immigrants (CERI) almost 800%, and the CHCS School Health Centers over 1,000%. $61.77 MILLION $37.8 MILLION Measure A Funds Approved by the Board of Supervisors Matching Funds Public Health Prevention Initiative 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 12 Alameda Boys and Girls Club, Inc. General Concerns and Recommendations In developing this report, the Oversight Committee identified several concerns regarding the state of health care funding both during the years of Measure A implementation (2004-2021) and in the foreseeable future. Many families, especially those living in disadvantaged communities, have not benefited from the economic recovery in recent years and face rising housing and living costs, which significantly impact the health of County residents. According to EveryOne Counts! 2020 Homeless Count and Survey data submitted to the U.S. Department of Housing and Urban Development (HUD), an estimated 8,022 County residents experiencing homelessness were counted. As the housing and homelessness crisis continues to grow in Alameda County, Measure A continues to play a vital role in providing essential health services to many vulnerable residents, including low income families and seniors. The Committee urges Alameda County to pay close attention to public health policy changes that relate to homelessness and housing affordability that may have significant impacts on health care access or the County’s safety net. In addition, Alameda County should continue to closely monitor efforts that threaten entitlement programs, change the definition of Public Charge, or dismantle the Affordable Care Act. Realizing the full promise of these Affordable Care Act reforms presents a significant challenge, as the health care delivery system remains fragmented, eligibility systems are cumbersome and difficult to negotiate, and access to care continues to be compromised by low reimbursement rates, chronic underfunding, and a shortage of providers—particularly in primary and preventive care. In addition, the public health system, which has experienced long-term underfunding, requires additional resources to build a strong and qualified workforce and modern data and information systems to deliver essential public health services. Measure A will continue to serve as an essential revenue stream in developing creative and innovative ways to improve access to care, lower the cost of care, and improve the patient experience. This in turn helps promote equity in health care service delivery by addressing the root causes of poor health outcomes. The COVID-19 pandemic has had a profound negative impact on the mental health and well-being of people, with increasing numbers of people experiencing anxiety, depression, loneliness, and other mental health concerns. Furthermore, the increased isolation as a result of the shelter-in-place and social distancing measures highlighted the critical ways natural, social, and built environments affect mental health and the need for more clean and healthy outdoor spaces, particularly in urban Alameda County. Emergency Medical Services (EMS) Corps 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 13 Insufficient Reporting Although reporting continues to improve, the Committee expresses the ongoing concern that its review is impacted by the varying level of detail provided in fund recipient reports, as well as varying levels of responsiveness to questions posed by the Committee to recipients. This makes it difficult for the Committee to determine whether funding is being spent on the Measure A target population. For example, multiple provider reports listed objectives that were not measurable, and many stated positive outcomes that were not supported with quantifiable data. RECOMMENDATIONS • HCSA should receive continued funding to provide training to Measure A recipients to increase their capacity to effectively collect and report demographic data on the clients that they serve and their results-based effort, quality, and impact measures. The Committee further advocates that HCSA be sufficiently staffed to successfully implement such a process. • Organizations that do not provide adequate information may not be considered for future funding. Economic Impacts from COVID-19 While the U.S. economy has had more than eight years of growth following the Great Recession, the COVID-19 pandemic could continue to affect the global and local economy as a result of production and supply chain slowdowns and financial market disruptions, which would have a negative impact on many of the providers and programs that receive Measure A funding. RECOMMENDATION To sustain base funding, adequate Measure A reserves should be maintained to address projected decreases in revenue. Children’s Hospital & Research Center at Oakland LifeLong Medical Care 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 14 HOW THE MONEY WAS SPENT Measure A tax revenue is used to provide emergency medical, hospital inpatient, outpatient, public health, mental health, and substance abuse services to indigent, low income, and uninsured adults, children and families, seniors, and other residents of Alameda County. Each year, the Alameda Health System (AHS) receives 75% of Measure A funds, which is allocated by their Board of Trustees to provide primary and specialty care, preventative, and mental health services to patients served at AHS’s multiple facilities, including Highland Hospital, John George Psychiatric Hospital, Fairmont Hospital, San Leandro Hospital, and Alameda Hospital. The remaining 25% of the Measure A funds received is allocated by the Alameda County Board of Supervisors (Board) to provide critical medical services offered by community-based health care providers, emergency care, and public health, mental health, and substance abuse services to address the many health needs of communities throughout the County. In FY 20/21, Measure A generated $161,547,180 (not including interest earned). The funds were allocated as follows: Alameda Health System (75%): $121,160,385 Alameda County (non-AHS) (25%): $40,386,795 TOTAL: $161,547,180 In FY 20/21, the Alameda County approved budget totaled $3.5 billion. The Alameda County Health Care Services Agency* approved budget totaled $974.6 million, or 28% of the total County budget. Measure A revenues not specifically designated for AHS accounted for $38,004,832, or 1%. * Excludes Emergency Medical Services and Vector Control The following sections in the report provide more detail on how AHS and the Board spent Measure A funds in FY 20/21, which includes revenue generated in the reporting year as well as unspent funds earned in previous years. Alameda County Board of Supervisors Alameda Health System Board of Trustees 25% 75% 25% DISTRIBUTION OF MEASURE A ALLOCATIONS Background Alameda Health System (AHS) works for the caring, healing, teaching, and serving of all. It provides a patient- and family-centered system of care that promotes wellness, eliminates disparities, and optimizes the health of its diverse communities. AHS services are based on the following pillars: • Access. Decrease the median time from decision to admit to inpatient bed at the Highland Hospital Emergency Department (ED). This not only reduces congestion in the ED but also improves quality of care and patient satisfaction, can decrease the number of patients leaving without being seen, and minimizes exposures to COVID-19 and other infectious diseases in waiting areas. • Quality. Decrease hospital-acquired infections and harms. This improves the health of patients and decreases the length of stay, which can lead to improved outcomes and decreased utilization. • Experience. Improve Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) and Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CGCAHPS) scores. The HCAHPS and CGCAHPS surveys reflect the voices of patients and provide AHS with information about their experience. AHS uses the data and patients’ comments to determine what key drivers impact the overall scores. • Network. Decrease rehospitalization during the first 30 days of home health. AHS has partnered with Golden Pacific Home Health to provide home health services to eligible uninsured patients within five days of inpatient hospital discharge. This partnership helps ensure that patients reach prior levels of function with effective home health care. FY 20/21 Allocation: $121,160,385 | Expended/Encumbered: $121,160,385 Individuals served by Measure A: 107,796 (Total individuals served: 107,796) Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors Services provided: Emergency Medical, Hospital Inpatient, Hospital Outpatient, Public Health, Mental Health, Substance Abuse Service area: Countywide FY 20/21: 75% of Measure A Funds Allocated to Alameda Health System alamedahealthsystem.org Matching Funds $30 M through an Intergovernmental Transfer. 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 15 • Workforce Development. Reduce workplace injury. The ability to provide a safe environment for staff and volunteers is not only a priority for the health of employees but also essential to providing high quality patient care. Strategies to improve patient safety and employee safety go hand in hand. During the COVID-19 pandemic and stay-at-home orders, telehealth became an effective alternative to in-office appointments. AHS offered video and phone visits to underserved patients, which improved the ability of chronically ill patients to keep their appointments. Clients indicated they had greater flexibility and fewer transportation barriers to access care. AHS provided “tech advocates” to call patients in advance of appointments to determine if phones were preferable over computers or tablets. AHS continues to advocate for and enhance its ability to conduct telemedicine visits in order to achieve health equity for low income residents. AHS provides services in over 25 languages in person, by teleconference, or by videoconference. An additional 10 languages are offered through contracted phone interpretation. Measure A Funding Achievements AHS does not have programs specifically or separately supported by Measure A funds. As a result, the results below are for AHS as a whole. Its overall programs, goals, and strategies are aligned to ensure its ability to meet the purpose of the voter-approved Essential Health Care Services Initiative, providing additional support for emergency medical, hospital inpatient, outpatient, public health, mental health, and substance abuse services to indigent, low income, and uninsured adults, children, families, seniors, and other residents of Alameda County. In FY 20/21, Measure A helped AHS achieve the following across its strategic pillars. Access AHS decreased the time from decision to admit to inpatient bed at the Highland Hospital ED to two hours, 52 minutes (target: three hours, eight minutes). It continued multidisciplinary rounds with all medicine and surgical teams daily and efficiently responded to hospital surges through the Systems Throughput Steering Committee. Quality AHS reduced the hospital-acquired infections (HAI) index to 0.88 and the number of hospital-acquired harms (HAH) per 1,000 discharges to 0.34 (targets: 0.64 and 1.38). Success Story Mike was a COVID-19 patient and had extended stays at various long-term care facilities, including AHS’s Fairmont campus. During his stay, he was wheelchair- bound and had multiple medical complications. His number one priority was to walk again. With the support of a rehab team, his mobility and strength improved. But he wanted more—a sense of purpose to go along with his physical recovery. He got involved as a Bingo caller at Fairmont and helped keep the outdoor visiting area clean and welcoming. The AHS Fairmont team recently helped him find housing and a job, and he left Fairmont walking on his own two feet. Highlights Access AHS exceeded its target time from decision to inpatient bed by about 15 minutes. 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 16 It continued monitoring and daily collaboration with unit staff, which resulted in just-in-time corrections. Experience AHS increased its HCAHPS scores for hospital ratings, with 69.11% giving a 9 or 10 rating (target: 70.8%). It also increased its CGCAHPS scores for provider ratings, with 72.18% giving a 9 or 10 rating (target: 68.78%). AHS implemented service standards and Patient Experience Boot Camps for AHS leaders; conducted monthly consultations with leaders at three acute facilities; disseminated data, analysis, and highlights of positive comments and concerns; and implemented No Pass Zones, which empower all staff, including non-nursing personnel, to respond to call lights and decrease patient waits. It also reinforced Greet-Introduce-For- Thank you (GIFT), which helps create human connections in both acute and ambulatory areas; continued to offer virtual care within Ambulatory Care and shared patient comments with ambulatory leaders weekly; utilized volunteers to activate electronic health records for ambulatory patients; and implemented “first-touch resolution,” an approach for managing incoming calls at Hayward Wellness. Network AHS decreased the rehospitalization rate for home health patients within 30 days to 12.08% (target: 11.91%). It improved patient care transitions, with the Care Transitions and Complex Care teams doing outreach to patients within 72 hours of discharge to ensure their needs were met and they had the resources needed to transition home. Workforce Development AHS reduced the number of workplace injuries occurring during the year to 252 (target: 282). It revised its Injury Illness and Prevention Plan (IIPP) to focus on management, leadership, employee protection, hazard identification and assessment, hazard prevention and control, education and training, and program evaluation/improvement. AHS also held monthly meetings with departments exhibiting high claim rates to review claims and discuss potential workplace safety measures, had ergonomic vendors complete over 300 preventative ergonomic evaluations, and established a Workplace Violence Prevention program covering risk assessment, reporting/recording obligations, incident response and investigation, and training. Highlights Quality The HAH index decreased by 78%, including a six-month period where no HAH were reported. Experience AHS exceeded its FY 20/21 goal for the CGCAHPS provider rating. 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 17 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 18 FUNDS ALLOCATED BY THE ALAMEDA COUNTY BOARD OF SUPERVISORS BEHAVIORAL HEALTH Behavioral Health and Alcohol and Other Drug Community-Based Providers ...................................19 Center for Healthy Schools and Communities (School-Based Behavioral Health Initiative) ..................21 Cherry Hill Detox and Sobering Station .......................................................................................23 Criminal Justice Screening and In-Custody Services ......................................................................24 Mental Health Services for Juvenile Justice Center .........................................................................25 Mental Health Services for Newcomers and Immigrants (CERI) ......................................................26 Substance Use Disorder Services ...............................................................................................28 The Alliance for Community Wellness dba La Familia Counseling Services (La Familia) .......................29 2019–2020 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 18 Background Alameda County Behavioral Health Care Services (BHCS) works to maximize the recovery, resilience, and wellness of all eligible Alameda County residents who are developing or experience serious mental health, alcohol, or drug concerns. Community-based organizations (CBOs) provide mental health services under contract with BHCS to meet the diverse cultural and language needs of County resident populations. The CBOs that receive Measure A funds provide services that include outreach, engagement, linkage to housing, linkage to services, and education and support for families. Services are provided in Spanish, Vietnamese, Cantonese, and Mandarin. Measure A Funding Achievements Measure A funding helped BHCS providers achieve the following: • La Familia Adult Service Team provided 2,667 service hours and 717 medication support hours to 110 unique clients, with an average monthly caseload of 100 clients (target: 5,320 service hours and 875 medication support hours to 150 clients, with an average monthly caseload of 112 clients). • Mental Health Association of Alameda County (MHAAC) Family Caregiver provided 1,736 service hours and responded to 2,056 questions from family caregivers and consumers (target: 1,026 service hours and 3,600 questions). • MHAAC Certification Hearing Representation Program provided 2,020 service hours; interviewed 5,630 certified patients; and attended 4,880 FY 20/21 Allocation: $150,000 | Expended/Encumbered: $150,0000 Individuals served by Measure A: 194 (Total individuals served: 25,540) Populations served: Indigent Adults, Families, Seniors Services provided: Mental Health, Substance Abuse Service area: Countywide Behavioral Health and Alcohol and Other Drug Community-Based Providers www.acbhcs.org Matching Funds $150,000 from Medi- Cal. Highlights 39% 39% of ABODE HOPE clients received at least one non-cash benefit such as WIC, CalFresh, CalWORKs, child care, or transportation (target: 30%). 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 19 certification review hearings (target: 5,465 service hours; 2,000–4,000 interviews; and 2,000–4,000 hearings). • Patient’s Right Advocacy Program provided 4,878 service hours and responded to 13,931 calls (target: 2,722 service hours and 900–1,200 calls). • Homeless Outreach for People Empowerment (HOPE) provided 4,451 service hours to 2,107 outreach contacts, with 570 engaged clients entered into the County’s Homeless Management Information System (HMIS) (target: 5,594 service hours to 3,600 contacts with 300 engaged clients entered into HMIS). Highlights 67% 67% of participants received permanent or temporary indoor housing (target: at least 30%). 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 20 Background The Center for Healthy Schools and Communities (CHSC) works to foster the academic success, health, and well-being of Alameda County youth by building universal access to high quality supports and opportunities in schools and neighborhoods. Across districts, District Health and Wellness Leaders (DHWL) and School-Based Clinical Consultants (SBCC) support the establishment, maintenance, and performance of systems to support youth mental health, behavioral health, and social-emotional development. The two key strategies for the program’s success are the central nature of the DHWL/ SBCC, with one person holding and coordinating the vision for behavioral health at the district and school level, and the collaborative nature of the program: DHWLs/SBCCs are expected to interface with youth, teachers, district leadership, parents, and community partners. While DHWLs are placed at the district level, SBCCs are placed at the school level and currently serve schools in the Oakland and Hayward Unified School Districts. Similar to DHWLs, SBCCs support school- based health and wellness efforts by providing skill-building trainings and consultations with teachers and staff, developing relationships with community partners, connecting families to internal and external health services, and providing clinical case management for students with mental health service needs. Coordination of Services Team (COST), a school-based strategy for managing and integrating learning supports and resources for students, continues to be successful. Providers funded via Measure A have the capacity to serve clients in multiple languages, with a particular focus on Spanish, and have access to the County’s interpretation and translation services that expand the capacity to serve students and families who speak other languages. FY 20/21 Allocation: $1,333,336 | Expended/Encumbered: $1,333,336 Individuals served by Measure A: 4,837 (Total individuals served: 13,820) Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors Services provided: Mental Health, Substance Abuse Service area: Countywide, Homeless or Transient Center for Healthy Schools and Communities (School-Based Behavioral Health Initiative) achealthyschools.org Matching Funds $2.48 M from the Tobacco Master Settlement Fund (TMSF), Medi-Cal Administrative Activity (MAA), and Mental Health Services Act Prevention and Early Intervention (MHSA PEI). Highlights 97% 97% of youth reported that the people who work at the program helped them deal with stress and anxiety better (target: 80%). 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 21 Measure A Funding Achievements Through the School-Based Behavioral Health Initiative, CHSC-supported sites used their Measure A allocations to achieve the following: • Refer 2,990 students to Tier 2: Early Intervention Behavioral Health services • Refer 3,683 students to Tier 3: Treatment services • Provide 14,383 hours of treatment services • Implement the COST program at six new schools and 275 total schools in 14 school districts (target: 250 schools in 14 districts) • Refer 13,820 students to COST services • Through DHWLs, SBCCs, and District Health and Wellness Consultants (DHWCs), conduct capacity-building trainings and consultations providing: - 409 hours of training to school districts and staff - 253 hours of training to parents and caregivers - 3,167 hours of coaching and consultation on mental health issues and school health initiatives • Through DHWLs, spend 2,524 hours supporting school health initiatives and mental health consultations to schools across all 14 districts supported by CHSC • Through SBCCs, spend: - 747 hours providing direct services to students and families through individual, family, and group support - 575 hours providing capacity-building consultation to district and school staff Success Story A family with students at three different schools in San Lorenzo Unified was referred to COST at each of their school sites. As a result of the COST referrals, school social workers from the three sites collaborated to connect the students to mental health supports. One of the school social workers completed a home visit with the school principal to check in with the student's family regarding counseling and basic needs. The school social worker then connected the family to the school-based therapist, who began following up to get all three students connected to counseling services. 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 22 Background Cherry Hill Sobering and Detox (CHSD) works to cultivate or restore a sense of hope, self-confidence, and community to people impacted by substance use and mental health challenges by providing effective, trauma- informed prevention, treatment, and recovery services. CHSD services are life-saving for the suffering addict and alcoholic, who would otherwise risk living and dying on the streets. As overdoses in Alameda County have risen due to the COVID-19 pandemic and lockdown, CHSD provides a safe place for an individual to come and receive life- saving services, such as health stabilization, medication-assisted therapy, and withdrawal management. CHSD facilities for some clients are the only place they feel safe, cared for, and cared about, thus making a client feel like they are still a part of a caring community. CHSD offers services in English, Spanish, Hindu, and Tagalog and partners with Alameda County Behavioral Health Care Services for additional interpreter services. Measure A Funding Achievements CHSD used its Measure A allocation to achieve the following: • Provide detoxification services to 2,018 individuals (target: 1,676) • Maintain a daily occupancy of 20.76 residents at the Detoxification Center (target: 22) • Provide a total annual bed day service capacity of 4,460 (target: 6,205) • Admit 12.22 clients each day for sobering services (target: 17) FY 20/21 Allocation: $2,295,875 | Expended/Encumbered: $2,295,875 Individuals served by Measure A: 6,478 (Total individuals served: 6,478) Populations served: Indigent, Low Income, Uninsured Adults, Seniors Services provided: Substance Abuse Service area: Countywide, Homeless or Transient, Outside of Alameda County Cherry Hill Detox and Sobering Station horizonservices.org Highlights 90% 90% of intoxicated clients engaged in services for a minimum of six hours per episode (target: 50%). Matching Funds $1.88 M from Medi-Cal and the Substance Abuse Prevention and Treatment Block Grant (SABG) program. 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 23 Background Alameda County Behavioral Health Care Services (BHCS) works to maximize the recovery, resilience, and wellness of all eligible Alameda County residents who develop or are experiencing serious mental health, alcohol, or drug concerns. BHCS uses Measure A funding to amplify the mental health system coverage in the Adult Forensic Behavioral Health (AFBH) area of Santa Rita Jail. AFBH provides critical services to clients who find themselves in very stressful and often traumatizing situations while being incarcerated. Without AFBH services, clients would not have access to mental health services and could be at greater risk for significant mental health challenges such as depression, self-harm, and crisis. AFBH staff work to de-escalate crisis situations, make recommendations to Alameda County Sheriff staff to keep clients safe and healthy, refer clients to higher levels of care when needed, ensure clients have appropriate mental health medications, and support release and re-entry planning to ensure continuity of care. AFBH staff at Santa Rita Jail speak Spanish, Mandarin, Vietnamese, Tagalog, Hindi, Punjabi, Japanese, Farsi, and Russian. Measure A Funding Achievements AFBH used its Measure A allocation to achieve the following: • Each month, provide an average of: - 3,124 hours of crisis intervention services (target: 1,000) - 1,845 hours of mental health services (target: 1,500) • Be available to Sheriff’s Department and medical staff, either on call or in person, 24 hours daily, 7 days per week, 100% of the time for consult (target: 100%) • Through AFBH psychiatrists, provide an average of 390 medication supportive services to clients (target: 250) FY 20/21 Allocation: $4,306,000 | Expended/Encumbered: $4,306,000 Individuals served by Measure A: 4,301 (Total individuals served: 4,301) Populations served: Indigent, Low Income, Uninsured Adults, Seniors, Other: Incarcerated Individuals Services provided: Mental Health, Substance Abuse Service area: Countywide Criminal Justice Screening and In-Custody Services Success Story An incarcerated client was connected to substance use services by AFBH mental health staff and spent four months in treatment. The client is currently enrolled in BHCS intensive outpatient services, receiving mental health therapy from a community provider, connected to a primary care physician, and living in a recovery residence. The client reports that part of the determination to continue community services and treatment was based on the support received while at Santa Rita Jail. The client reports that the mental health and substance use services at Santa Rita Jail provided some hope that life changes were possible even while incarcerated. 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 24 Background Alameda County Behavioral Health (ACBH) Juvenile Justice Center (JJC) Guidance Clinic/Mental Health Services works to maximize the recovery, resilience, and wellness of all eligible Alameda County residents who are developing or experiencing serious mental health, alcohol, or drug concerns. The JJC Guidance Clinic provides critical services to their clients who find themselves in very stressful and often traumatizing situations, such as being detained. Staff work to de-escalate crisis situations, make recommendations to probation staff for clients’ health and safety, make client referrals to higher care levels when needed, ensure that clients have appropriate mental health medications, partner with JJC medical services to create coordinated care plans, and support release and re-entry plans to ensure continuity of care. Mental health services provided to youth in detention are not eligible for reimbursement by Medi-Cal or the state. The Measure A funding that the JJC/Guidance Clinic receives provides access to mental health services and contributes to preventing greater risk for significant mental health challenges, such as depression, self-harm, or crisis. Measure A Funding Achievements BHCS used its Measure A allocation to achieve the following: • Ensure that: - 90% of youth booked into the JJC were seen by a mental health clinician (target: 80%) - 90% of youth referred for crisis counseling services were seen by a mental health clinician (target: 90%) • Pilot a new screening tool to identify clients who require intensive mental health and case management services upon their return to the community FY 20/21 Allocation: $360,000 | Expended/Encumbered: $360,000 Individuals served by Measure A: 306 (Total individuals served: 306) Populations served: Low Income, Uninsured Adults, Children, Families, Other: Detained Individuals Services provided: Mental Health, Substance Abuse Service area: Countywide Mental Health Services for Juvenile Justice Center Success Story A youth was detained at the JJC after making threats to harm others. The client was from a Vietnamese family that had experienced multiple traumatic events. The client was supported by a Vietnamese JJC Guidance Clinic staff member who offered a perspective that was culturally responsive and who had a similar family history and experience. The staff member encouraged the client to fully engage in therapeutic services and medication to address the client’s issues. The client’s mother also supported the staff member to get the client referred to community mental health services. Both mother and client were extremely grateful for the staff member and JJC’s support. 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 25 Background The Center for Empowering Refugees and Immigrants (CERI) is a grassroots, nonprofit organization dedicated to providing culturally competent mental health and other social services to refugee and immigrant families with multiple layers of complex needs, exposure to violence and trauma both in their current environment and in their native countries, and weakening intergenerational relationships. The agency’s focus is on refugees and immigrants from Afghanistan, Cambodia, and Vietnam. Presently, the majority of its clients are Cambodian refugees living in Oakland. CERI’s senior clients are unable to work and subsist on SSI, relying heavily on local food banks and pantries. CERI clients were among the highest risk for COVID-19 due to age and underlying health conditions. Initially, many had to stay home and were isolated. CERI doubled its ability to connect members to public benefits, as well as provide individual counseling and support groups for self-care strategies, manage PTSD, and identify solutions to keep the community safe. Other forms of assistance included case management for public benefits, medical care, direct aid, and resource referral. CERI provided rental assistance to families who lost income due to COVID-19 and had a case management team to support clients in accessing rental assistance. CERI bought five sewing machines and worked with CERI community members to make masks as well as deliver them to clients, other community groups, and the homeless. Meals, vaccine clinics, testing days, and vaccines were provided over this time period. CERI also provided support to ensure clients had reliable Internet connections, phones, laptops, tablets, and Zoom training and tutorials to ensure connection during pandemic-induced isolation. Services are offered in Burmese, Khmer, Mien, and Vietnamese. FY 20/21 Allocation: $86,096 | Expended/Encumbered: $86,096 Individuals served by Measure A: 52 (Total individuals served: 475) Populations served: Low Income, Uninsured Adults, Children, Families, Seniors Services provided: Mental Health Service area: Countywide, Homeless or Transient Mental Health Services for Newcomers and Immigrants (CERI) cerieastbay.org Matching Funds $671,546 from the Mental Health Services Act (MHSA), Medi-Cal Administrative Activities (MAA), No Kid Hungry, Medi-Cal/CalFresh, Emergency Rental Assistance Program, CalHope, other COVID-related funding sources and relief funds. Highlights 98% 98% of clients receiving mental health services agreed or strongly agreed that they dealt more effectively with their problems (target: 80%). 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 26 Measure A Funding Achievements CERI used its Measure A allocation to achieve the following: • Host or cohost 54 community events (target: seven) • Provide 42 monthly psycho-education workshops to community groups (target: 24) • Provide 11 support groups (target: six) • Provide 39 culturally based education workshops (target: six) • Distribute 28 newly developed promotional materials (target: 10) • Make 64 mental health consultations with community-based organizations, community leaders, health care providers, and/or community groups (target: eight) • Engage 77 clients in preventive counseling (target: 80) • Provide 18 referrals to Alameda County Behavioral Health Care Services mental health treatment (target: 12) Success Story Soch is a single mother who has had physical and mental health issues due to surviving the Khmer Rouge genocide. After attending her first support group at CERI, Soch was connected to public benefits, psychiatric services, and medication, as well as individual trauma-based therapy. Soch’s children participate in CERI’s youth program, as well. Soch says that CERI has been integral in supporting her wellness and changing her current life conditions. 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 27 Background Alameda County Behavioral Health Care Services (BHCS) works to maximize the recovery, resilience, and wellness of all eligible Alameda County residents who develop or are experiencing serious mental health, alcohol, or drug concerns. Measure A funds support the Center Point Substance Use Disorder (SUD) Helpline to provide SUD screening and referrals, care navigation, and connection to treatment and recovery programs for residents seeking help for a substance addiction. This support increases the availability of behavioral health services in a wide variety of geographical and cultural settings across the County. All SUD services are available to clients with the use of a language translation line and/or counselors who speak their language. Measure A Funding Achievements The Center Point SUD Helpline used its Measure A allocation to achieve the following: • Receive and respond to 2,242 calls for SUD-related information or screening and referral for SUD services (target: 940) • Answer 100% of phone calls in less than 30 seconds during normal business operating hours (target: 95%) • Provide callers with a wait time of six seconds (target: less than five minutes) • Drop or miss only three percent of calls (target: five percent) • Provide care navigation service to 33% of residential-referred callers FY 20/21 Allocation: $450,000 | Expended/Encumbered: $450,000 Individuals served by Measure A: 1,964 (Total individuals served: 5,949) Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors Services provided: Substance Abuse Service area: Countywide Substance Use Disorder Services www. acbhcs.org Success Story SUD’s Center Point Helpline sent Matthew to El Chante for residential treatment while in Santa Rita County Jail. After completing treatment at El Chante and completing after care at Second Chance, Matthew pursued his education and started working as a resident monitor at El Chante, and was then hired by them as a register counselor. Matthew said he knew what he wanted to do, but didn’t know how to get there. From Center Point to El Chante, he is now working on his personal recovery and has not re-offended. El Chante indicates he is one of the best counselors they have today. 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 28 Background The Alliance for Community Wellness provides underserved multicultural communities with the tools and support necessary to build resilience, wellness, and economic power. Due to COVID-19, The Alliance for Community Wellness experienced an increase in service requests from the Asian community by 12-30% over the preceding fiscal year. More community members sought information and referrals in connection to their personal, children, family, and community wellness. Services are provided to clients in English and Spanish. Measure A Funding Achievements The Alliance for Community Wellness used its Measure A allocation to achieve the following: • Provide one-on-one behavioral health services to 20 individuals and families (target: 20) • Conduct 50 one-on-one intensive case management services, excluding behavioral health services, and including connecting to family public benefits (target: seven) • Distribute 75 hot meals in partnership with Dig Deep Farms (target: 25) • Conduct outreach, information, and referrals to basic needs and services to 1,094 participants (target: 250) The Alliance for Community Wellness dba La Familia Counseling Services (La Familia) lafamiliacounseling.org FY 20/21 Allocation: $30,000* | Expended/Encumbered: $30,000 Individuals served by Measure A: 1,583 (Total individuals served: 1,583) Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors Services provided: Public Health, Mental Health, Substance Abuse Service area: Castro Valley, Cherryland, Hayward, Oakland, San Leandro, San Lorenzo, Union City, Homeless or Transient *Includes Board of Supervisors discretionary allocation from District 2/Supervisor Valle Success Story JT self-referred to The Alliance for Community Wellness because she felt depressed and anxious, lacked self-esteem, and was having marital discord. Through one-on-one counseling, JT learned new skills to bring to her marriage, which resulted in a shift for the better with her husband. Though sadness is still part of her life, JT feels better each day because of a closer relationship with her husband, as result of the one-on- one counseling. 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 29 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 30 FUNDS ALLOCATED BY THE ALAMEDA COUNTY BOARD OF SUPERVISORS HOSPITAL, TERTIARY CARE, OTHER Children’s Hospital & Research Center at Oakland dba UCSF Benioff Children’s Hospital Oakland ............................................................................31 Children’s Hospital & Research Center at Oakland dba UCSF Benioff Children’s Hospital Oakland (BCHO) ................................................................33 St. Rose Hospital ......................................................................................................................36 Washington Hospital Healthcare Foundation ...............................................................................38 Background The Center of Excellence for Immigrant Child Health and Wellbeing (CoE) is a cross-bay entity based at Children’s Hospital & Research Center at Oakland. It serves as the infrastructure for collective action to address the health of children in immigrant families through education, evidence- based clinical services, and advocacy. Its mission is to establish an inclusive community that provides leadership and guidance toward the promotion of optimal health and well-being for immigrant children. In FY 20/21, in partnership with the American Academy of Pediatrics Chapter 1 (AAP CA-1), CoE developed a series of webinars to disseminate information on the clinical care of immigrant children. Webinar topics included the clinical impacts of immigration policy, including public charge; social drivers of health that immigrant children face; and communicating effectively with immigrant families. Thirteen Alameda County-based providers participated in the initial protocol webinar. Fifty pediatric residents were trained with the new pediatric training curriculum, which included self-paced modules, didactic and experiential learning, case-based discussion, and feedback that allowed trainees to adopt a more assertive role in their learning and to transfer academic knowledge to practical application learning. Immigrant families receive primary care services at three CoE clinics: Claremont Clinic, Teen Clinic, and Castlemont School-Based Clinic. An integrated clinical model approach is used that recognizes immigration as a strong influencer at the intersection of health, housing insecurity, food insecurity, trauma, and other social determinants of health that impact child health and well-being. Providers at the clinics demonstrate cultural competence in their care for immigrant and refugee patients and provide initial medical examinations, including vaccinations and laboratory exams. FY 20/21 Allocation: $100,000 | Expended/Encumbered: $100,000 Individuals served by Measure A: 130 children/families (Total individuals served: 130 children/families) Populations served: Indigent, Low Income, Uninsured Children, Families Services provided: Hospital Inpatient, Public Health, Mental Health Service area: Countywide, Outside of Alameda County, Homeless or Transient Children’s Hospital & Research Center at Oakland dba UCSF Benioff Children’s Hospital Oakland immigrantchild.ucsf.edu Highlights 100% 100% of County providers reported that the clinical protocol was useful in helping them provide care for immigrant families (target: 75%). 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 31 Through institutional and community partnerships, CoE refers families to additional services for patients with special needs. Also in FY 20/21 coordination took place for the East-Bay Pediatric Asylum Clinic, which launched in August 2021. Community and institutional partners took part in building a solid foundation for the clinic, which provides a way to responsibly work with immigrant children and youth who have experienced trauma and are seeking support with their asylum cases. CoE co-directors trained 21 pediatric clinicians to provide medical and psychological forensic exams for children and youth with an asylum case. In addition, CoE conducted targeted outreach to over 70 contacts at legal community-based organizations and listservs to publicize the pediatric asylum clinic. A team of seven social workers were convened to work in rotation at the clinic. CoE provides services in languages that include Spanish, Dari, Arabic, Tigrinya, Amharic, Mam, Mongolian, Mandarin, Vietnamese, Nepali, Urdu, Hindi, and Punjabi. Measure A Funding Achievements CoE used its Measure A allocation to achieve the following: • Offer a clinical protocol for providing care to immigrant children to 19 providers in Alameda County (target: 100) • Provide a new pediatric training curriculum to 50 pediatric residents (target: 60) • Provide primary care services to 130 immigrant families through the specialized clinic (target: 150) • Screen 67 immigrant children for basic needs and adverse events at the clinic (target: 150) • Ensure that 55 immigrant children who received care at the clinic were up-to-date on their immunizations (target: 150) Success Story The CoE primary care clinic began care for a recently arrived immigrant family, of whom one child had complex medical needs. The family arrived right before the COVID-19 shutdown and had not established community support systems. The child suffered beyond his medical condition because of isolation and disconnection. The clinic helped the family navigate systems to obtain needed materials for the children’s virtual schooling as well as medical testing and medications for the child. Clinic staff were able to perform medical visits in person and virtually and to refer the child to a culturally responsive mental health therapist. Today, the child is doing well and wants to be a doctor. 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 32 Background Children’s Hospital & Research Center at Oakland (BCHO) works to protect and advance the health and well-being of children through clinical care, teaching, and research. At BCHO, Measure A funding supported three programs: • The pediatric trauma unit in the Emergency Department (ED), specifically to provide adequate staffing for the large volume of children seen there • The Center for Child Protection (CCP), which treats children who experience abuse and other types of trauma • Two school-based clinics in Oakland Trauma Services BCHO provides highly specialized pediatric emergency services for the children of Alameda County, 24 hours a day, seven days a week. BCHO’s ED sees a broad array of pediatric disease and injury from the basic to the most complex. BCHO is the leading provider for Alameda County children in need of acute care. Children with Medi-Cal rely nearly exclusively on BCHO for emergency services since the public hospitals in the area do not provide specialized pediatric care and do not have any beds for children in the event a child needs to stay overnight. Trauma services are a subset of the ED, requiring fast action, highly specialized equipment, facilities, and a specially trained multidisciplinary team. BCHO’s ED is one of two designated Level 1 Pediatric Trauma Centers in Northern California and the only one in the Bay Area. Children’s Trauma Center has 24-hour in-house staff including pediatric specialists in emergency medicine, trauma surgery, anesthesiology, neurosurgery, orthopedics, diagnostic imaging, and critical care. FY 20/21 Allocation: $2,000,000* | Expended/Encumbered: $2,000,000 Individuals served by Measure A: 18,892 (Total individuals served: 69,800) Populations served: Indigent, Low Income, Uninsured Adults, Children, Families Services provided: Emergency Medical, Hospital Outpatient, Public Health, Mental Health Service area: Countywide *Includes Board of Supervisors discretionary allocation from District 3/Supervisor Chan Children’s Hospital & Research Center at Oakland dba UCSF Benioff Children’s Hospital Oakland (BCHO) ucsfbenioffchildrens.org Matching Funds $1.05M through an intergovernmental transfer using supplemental funds from the California Department of Health Care Services. Highlights 100% 100% of psychotherapy referrals that were contacted and got care all received a culturally focused screening assessment to address treatment barriers (target: 100%). 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 33 BCHO maintains an extensive in-house and outpatient rehabilitation department for pediatric trauma patients. The Trauma Center also supports an injury prevention program for the hospital and the community. Approximately 70% of patients seen in the BCHO ED receive Medi-Cal. This number is higher than almost any other hospital—child or adult—in California. The percentage of children on Medi-Cal has been trending higher over the last decade. CCP CCP is a comprehensive child abuse program within BCHO. It is the designated site for forensic medical services in Alameda County for social services, the courts, and the police and is the only provider in Alameda County that has the capacity to offer many of its services. It maintains staffing 24 hours per day to respond to acute forensic examinations for children under 14 years old when the alleged sexual abuse occurred within 72 hours. CCP employs one of only three board-certified child abuse pediatricians in Northern California. In FY 20/21, CCP restructured its mental health services in an effort to ensure that Alameda County’s children receive the most effective and efficient services, as well as to prepare for an anticipated increase in child abuse cases post-pandemic. Due to the department’s role in the County’s child abuse investigation protocol, the CCP has a unique opportunity to provide mental health services to children and youth in the immediate aftermath of child abuse discovery or disclosure. Research has confirmed that properly placed mental health services can significantly mitigate the short- and long-term psychological impact of trauma. School-Based Health Services BCHO runs two school-based health centers: one at Castlemont High School and one at McClymonds High School. The specially trained teams at the centers look at all aspects of an adolescent’s life to help address the many medical and mental health issues they could be facing. Both sites are integrated into full-service youth and/or family centers that promote youth development and serve as national models for adolescent health care. In FY 20/21 the Youth Wellness Advisory Board (YWAB), with Castlemont student leaders, met once a week via Zoom, created a survey on bullying in classrooms and distributed it to Castlemont students, then analyzed the results and provided the analysis to the school principal with hopes of preventing bullying. The health education team taught comprehensive sex education in Spanish and English to the 10th and 11th grades and a life skills class for international students. They hosted two COVID-19 vaccine information workshops, provided two healthy eating and physical activity workshops, and ended the school year ended with an in-person celebration of YWAB student leaders. Success Story The Castlemont Coordination of Services Team (COST) and school- based health center worked to provide critical support following two Castlemont community deaths. Behavioral health teams provided immediate consultation to school staff, worked in collaboration with school staff to identify support systems for students and staff impacted, and had a presence at the memorial to support staff and students impacted by loss. The behavioral health team also worked with the COST Community Schools Manager, OUSD Behavioral Health Consultant, and vice principal to shift practices and respond to youth who were experiencing mental health crisis through consultation and connecting youth in need to community emergency services and follow up. 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 34 Services are provided to patients who speak one of over 50 languages. BCHO has onsite Spanish interpreters, and video- and phone-based interpreters are provided for other languages. Measure A Funding Achievements BCHO used its Measure A allocation to achieve the following: • Provide specialized treatment for 1,103 children who had acute physical trauma (target: 1,000) • Reduce the time between admission and when a patient gets a CT scan to 39 minutes (target: under 60 minutes) • Reduce the time between admission and decision to admit to 60 minutes (target: under 60 minutes) • Obtain an “under triage rate,” where patients get the correct resources for their level of trauma severity, of 1.5% (national benchmark is 2.5%; lower is better) • Serve 278 unique patients at CCP (target: 600) • Assess 135 children in the ED for maltreatment (target: 100) • Provide individual or group psychotherapy to 212 unique children (target: 200) • Perform 58 non-inpatient forensic or medical examinations related to sexual or physical abuse (target: 125) • At McClymonds Chappell Hayes and Castlemont Youth Uprising health centers, provide: - Health service for 432 students in person or remotely (target: 1,500) - Behavioral health service for 4,779 students in person or remotely (target: 1,000) - Health education for 1,182 students from health educators (target: 300) Highlights 96% 96% of patients agreed that health center staff helped them learn how to better take care of themselves (target: 90%). 91% 91% of patients agreed that the people who worked at the school health center helped them to deal with stress and anxiety (target: 90%). 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 35 FY 20/21 Allocation: $5,000,000 | Expended/Encumbered: $5,000,000 Individuals served by Measure A: 2,208 (Total individuals served: 19,154) Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors Services provided: Emergency Medical, Hospital Inpatient, Hospital Outpatient Service area: Countywide, Homeless or Transient Background St. Rose Hospital (SRH) provides quality health care to the community with respect, compassion, and professionalism. SRH works in partnership with physicians and employees to heal and comfort all those it serves. SRH is a safety-net, independent, nonprofit hospital that provides critical access to emergency medical, hospital inpatient, and outpatient services for indigent, low income, underinsured populations in Central and Southern Alameda County. SRH serves approximately 11% of Alameda County’s indigent population, and over 75% of their inpatient admissions are through the Emergency Department (ED). The ED is staffed with licensed physicians 24 hours a day, seven days a week, providing better patient care and enhanced service quality. SRH offers a tele-psychiatry program, which provides a valuable service to patients who come to the ED with mental health issues. Prior to this program, SRH physicians were not able to write or release 5150s and had to call the Hayward Police Department (HPD) to write the hold or release. Because of HPD’s workload and call priority, there were times that SRH physicians and staff would wait several hours before HPD would arrive. Since SRH physicians are now able to write or release 5150s as part of this program, HPD is no longer pulled away from its primary duties. In addition, SRH operates as a Center for Excellence in Cardiac Care and is designated as an ST segment elevation myocardial infarction (STEMI) receiving center. In FY 20/21, SRH also expanded its telemedicine program by implementing tele-neurology, tele-critical care, and tele- pulmonary services. SRH is also an active participant in the Alameda County Care Connect Problem Solving Learning Community. St. Rose Hospital strosehospital.org Matching Funds $6.74M from an intergovernmental transfer through Medi-Cal. Highlights 74.8 The patient satisfaction score for the overall hospital rating increased 6.4 points from the preceding year to 74.8. 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 36 Services are provided to clients in multiple languages, including English, Spanish, Mandarin, Farsi, Tongan, Vietnamese, Dari/Pashto, Hindi, Cantonese, Punjabi, Tagalog, and Nepali. Measure A Funding Achievements SRH used its Measure A allocation to achieve the following: • Experience: - 21,859 ED visits - 17,057 ED walk-ins - 4,799 ambulance counts - 4,111 inpatient admissions • Serve: - 272 ICU patients - 3,199 multiple subpial transection (MST) patients - 655 full blood count (FBC) patients • Integrate the Alameda County Emergency Medical Services (ALCO EMS) ESO transport system with SRH Meditech Electronic Health Records (EHR) via barcode scanning for patients on arrival • Integrate ambulance run sheets instantly into the patient’s medical record • Implement an ED e-status board to highlight incoming ALCO EMS transports en route to positively impact door-to-triage (APOT) times • In the ED, implement: - A provider group/service program - A tele-psych program - A buprenorphine opioid use disorder treatment protocol and referral process • Reduce the time between when an ED provider decides to admit a patient and when the patient leaves the ED for admission to 116 minutes (target: under 84 minutes) • Reduce the average length of ED stay to 230.8 minutes (target: under 220 minutes) • Reduce the time to maintain APOT to 26 minutes (target: under 30 minutes) • Reduce the average Bundle Door-to-Balloon time to 69 minutes (target: 69 minutes) Success Story A patient presented to the SRH ED and was admitted. They wrote: “I am writing to thank you for forgiving my debt to St. Rose Hospital in early September 2020. We are forever grateful for the service and kindness I received at St .Rose Hospital during my stay, especially during these hard times in a pandemic while sending my first-generation daughter to college, who also volunteered through the SHINE program at St. Rose from October 2019 to the start of the pandemic lockdown. We would also like to thank Ms. Martha, a St. Rose patient advocate, who helped us through this process with great professionalism and human kindness.” 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 37 Background Washington Hospital Healthcare Foundation provides financial support and increases public awareness in order to enhance the health care system. The respiratory waiting area tent acquired through Measure A funds in FY 20/21 helped ensure that patients awaiting COVID-19 testing were accommodated safely and quickly at Washington Hospital. The hospital continues to work with local community and government organizations to provide COVID-19 testing to all symptomatic, asymptomatic, or physician- referred patients for testing, regardless of their insurance status or other demographic factors. Translation services are offered to patients in the emergency department (ED) and those presenting themselves for COVID-19 testing. A medically certified translator is available by phone. Languages available for translation include Arabic, Cantonese, Farsi, Hindi, Mandarin, Spanish, Tagalog, Spanish, and Vietnamese. Measure A Funding Achievements Washington Hospital Healthcare Foundation used its Measure A allocation to achieve the following: • Provide one respiratory waiting area tent designated for COVID-19 testing and respiratory patient waiting area outside the ED (target: one) • Test 32,837 people for COVID-19 (target: 3,000) • Administer 42,886 COVID-19 tests (target: 3,000) FY 20/21 Allocation: $66,000* | Expended/Encumbered: $66,000 Individuals served by Measure A: 26,029 (Total individuals served: 32,837) Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors Services provided: Emergency Medical, Hospital Inpatient, Hospital Outpatient, Public Health, Mental Health, Substance Abuse Service area: Countywide, Homeless or Transient *Includes Board of Supervisors discretionary allocation from District 1/Supervisor Haubert Washington Hospital Healthcare Foundation whhs.com/giving-volunteering/foundation Matching Funds $310,000 from the community. 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 38 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 39 FUNDS ALLOCATED BY THE ALAMEDA COUNTY BOARD OF SUPERVISORS PRIMARY CARE Alameda County Dental Health ..................................................................................................40 Center for Elders’ Independence ...............................................................................................42 Center for Healthy Schools and Communities (School Health Centers) ............................................43 Direct Medical and Support Services (Oakland): Preventive Care Pathways .....................................45 Direct Medical and Support Services: Roots Community Health Center ...........................................47 Health Enrollment for Children...................................................................................................48 Health Services for Day Laborers: Multicultural Institute .................................................................49 Health Services for Day Laborers: Street Level Health Project .........................................................50 Health Services for Unaccompanied Immigrant Youth ...................................................................52 Medical Costs for Juvenile Justice Center: Direct Service Planning and Administration .......................53 Medical Costs for Juvenile Justice Center: Niroga Institute .............................................................54 Medical Costs for Juvenile Justice Center: Victims of Crime ............................................................56 Primary Care Community-Based Organizations ............................................................................58 2019–2020 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 39 Background The Alameda County Office of Dental Health (ODH) supports efforts to improve the oral health of Alameda County residents by partnering with the community to assess oral health status and resources and ensure access to community-based services and oral health education. ODH actively engages in policy development that incorporates evidence-based dental disease prevention and promotes oral health equity. ODH provides an accessible early entry point for oral health assessment and preventive dental services for high risk families and children ages 0–5 years at Women, Infants, and Children centers (WIC), as well as continuity and referral for regular follow-up dental care in the community. As a result of WIC Dental Days and the Care Coordination program: • Each family learns about the critical dietary and brushing practices that reduce the risk of tooth decay and periodontal (gum) disease. • Families learn the skills of positioning and assessing their child’s oral health and tooth brushing routines to maintain good overall health. • Parents and caregivers learn the benefits that fluoride in toothpaste and tap water has in reducing or preventing tooth decay. • Each child receives a fluoride varnish application that reduces the risk of caries (cavities) by 50%. • Parents and caregivers are encouraged to set goals for sustaining the oral health of their child and their family. • Each caregiver receives the opportunity to have care coordination assistance to access a dentist in the community who is willing and able to become the ongoing dental home for the care of that child. • Prenatal women learn about how to maintain their own oral health and the health of their future newborn by attending a prenatal class at WIC that incorporates oral health information and emphasizes the importance of visiting the dentist during their pregnancy. FY 20/21 Allocation: $257,580 | Expended/Encumbered: $257,580 Individuals served by Measure A: 1,132 (Total individuals served: 24,027) Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors Services provided: Public Health Service area: Countywide, Homeless or Transient Alameda County Dental Health dental.acphd.org Matching Funds $7,912 from Maternal, Child, and Adolescent Health (MCAH) and Child Health and Disability Prevention (CHDP). 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 40 WIC Dental Day services are offered to clients in multiple languages, primarily Spanish, Chinese, Mandarin, and Vietnamese. Phone translation services for other languages are used as needed. Measure A Funding Achievements ODH used its Measure A allocation to achieve the following: • Refer 104 children to care coordination (target: 150) • Refer 70 children to a dentist (target: 113) • Provide COVID-19 support to 1,010 Alameda County residents from ODH staff Success Story A 14-year-old ODH client had not seen the dentist since 2016. After an initial tele-dentistry video call, the dentist was able to determine that the client needed multiple extractions and restorations. For the next few months, the client was able to get the care she needed. After the completion of the dental treatment, the client was very grateful and in better spirits, since the issues related to her oral health were now resolved. She also mentioned that she was no longer embarrassed to smile due to the dental issues being resolved. She is now a believer of preventive dental care and understands the value of good oral health. 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 41 Background The Center for Elders’ Independence (CEI) provides high quality, affordable, integrated health care services to the elderly that promote autonomy, quality of life, and the ability of individuals to live independently at home. Services are provided in English, Spanish, and Chinese. Measure A Funding Achievements CEI used its Measure A allocation to achieve the following: • Provide 11 life care planning training sessions (target: 10) • Train 90 participants in life care planning (target: 40) • Certify and recertify six life care planning professionals (target: two) FY 20/21 Allocation: $57,397 | Expended/Encumbered: $57,397 Individuals served by Measure A: 56 (Total individuals served: 56) Populations served: Low Income Adults, Families, Seniors Services provided: Emergency Medical, Hospital Inpatient, Hospital Outpatient, Public Health, Mental Health, Substance Abuse Service area: Berkeley, Castro Valley, Hayward, Oakland, San Leandro Center for Elders’ Independence cei.elders.org Highlights 75% 75% of trainees completed a Physician Order for Life-Sustaining Treatment (POLST) (target: 75%). 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 42 Background The Center for Healthy Schools and Communities (CHSC) aims to foster the academic success, health, and well-being of Alameda County youth by building universal access to high quality support and opportunities in schools and neighborhoods. A program of CHCS, School Health Centers (SHCs) play a vital role in creating universal access to health services by providing a continuum of age-appropriate and integrated health and wellness services for youth in a safe, youth-friendly environment at or near schools. SHC services are focused in the following areas: • Increased access to care • Physical health • Behavioral health • Oral health • Youth development and academic outcomes • Integration of health and wellness support services Services are provided in Spanish, Mam, Cantonese, and Vietnamese. Other languages are accommodated through translation services as needed. Measure A Funding Achievements CHSC used its Measure A allocation to achieve the following: • Increase access to care with 28 SHC sites (target: 28) • Ensure that 36,562 students countywide had SHC access (target: 38,000) • Register 7,268 students as clients (target: 7,000) FY 20/21 Allocation: $1,350,000 | Expended/Encumbered: 1,350,000 Individuals served by Measure A: 7,268 (Total individuals served: 7,268) Populations served: Indigent, Low Income Adults, Children, Families Services provided: Public Health, Mental Health, Substance Abuse Service area: Alameda, Ashland, Berkeley, Cherryland, Emeryville, Hayward, Oakland, San Leandro, San Lorenzo, Sunol, Union City Center for Healthy Schools and Communities (School Health Centers) achealthyschools.org Matching Funds $12.7M from: • Medi-Cal and other third-party billing • Tobacco Master Settlement Agreement funding • Kaiser Foundation • Early Periodic Screening, Diagnosis, and Treatment (EPSDT) • Funding from the County, cities, school districts, and state and federal governments • Private grants 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 43 • See 29,275 registered clients at SHCs (target: 25,000) • Provide 17 hours of medical service hours per week (target: 20) • Conduct medical visits with 15,039 clients (target: 15,000) • Reach 6,648 youth contacts through health fairs (target: 5,000) • Provide vision screening to 84 youth clients (target: 50) • Offer classroom health education to 6,676 youth (target: 3,000) • Provide 29 behavioral health service hours per week (target: 25 hours) • Make 13,045 behavioral health visits (target: 10,000) • Discuss 6,610 youth in school staff consultations and Coordination of Service Team (COST) meetings (target: 5,000) • Conduct 305 crisis intervention/grief contacts for individuals and groups (target: 500) • Make 60 school safety/climate presentation/activity contacts and 238 trauma screening contacts (target: 250 each) • Offer nine hours of dental service per week (target: 12) • Make 995 dental visits (target: 1,000) • Offers dental services to 646 clients (target: 500) • Provide 21 health education hours per week (target: 20) • Contact 3,417 clients for youth development (target: 1,500) • Provide 276 youth development sessions (target: 200) • Make 2,011 peer health education group contacts (target: 1,000) • Provide 128 peer health education group sessions (target: 100) • Make 203 job training/career exploration contacts (target: 250) • Make 1,322 academic support contacts for youth (target: 500) • Have 22 SHC sites provide information and/or referrals (target: 21) • Make 394 health fair/outreach contacts to adults over 18 years of age (target: 500) • Make 154 parent/family workshop contacts to adults over 18 years of age (target: 250) • Make 107 school safety/climate presentation/activity contacts to adults over 18 years of age (target: 200) • Make 142 school staff workshops/trainings contacts to adults over 18 years of age (target: 200) • Make 67 parent/family workshops contacts to youth up to age 18 (target: 125) Success Story A teenage patient was seen at the SHC for unexplained chest pain. The patient, a newcomer immigrant, disclosed having significant post-traumatic symptoms related to separation from her parent at the border. The youth had post-traumatic panic attacks and intrusive thoughts and fears of being taken away when she was in public. The youth learned skills of self-regulating when she was having a panic attack. She taught these skills to her younger sibling. After several sessions, the patient and her mom reported that she was no longer having panic attacks and was feeling much calmer and less anxious overall. 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 44 Background Preventive Care Pathways offers “Pathways to Wellness” to the general population by providing medical services for at-risk and indigent patients, producing and presenting educational videos and literature, providing health care services for individuals re-entering the community from the prison system, and conducting health fairs and community education presentations at schools, churches, and other community sites. By collaborating with other community organizations, including Oakland Frontline Healers, Roots Community Clinic, and Umoja, Preventive Care Pathways staff is able to provide resources to the community, including free COVID-19 testing onsite and at other locations, free masks, free hand sanitizers, and other needed supplies. They are able to provide access to free food and housing as well. Services are provided in English, Spanish, and Arabic. Measure A Funding Achievements Preventive Care Pathways used its Measure A allocation to achieve the following: • Conduct 3,314 medical visits to 263 unduplicated low income patients with Alameda Alliance or Anthem Blue Cross Medi-Cal (target: 2,500 visits to 500 patients) • Screen 1,029 patients for Hepatitis C (target: 400) • Provide treatment for 54 patients who tested positive for Hepatitis C • Coordinate 10 community outreach events, health fairs, and/or workshops that were attended by 1,235 participants (target: 10 events/ health fairs/workshops with 50 participants) • At the health fair/workshop, provide 707 Hepatitis C and/or prostate cancer screenings, representing 85% of attendees FY 20/21 Allocation: $229,587 | Expended/Encumbered: $229,587 Individuals served by Measure A: 4,618 (Total individuals served: 4,618) Populations served: Indigent, Low Income, Uninsured Adults, Seniors Services provided: Emergency Medical, Hospital Outpatient, Mental Health Service area: Countywide, Homeless or Transient Direct Medical and Support Services (Oakland): Preventive Care Pathways drwatsonwellness.comJames A. Watson, M.D. Matching Funds $125,000 from General Assistance funding and Medi-Cal Administrative Activities (MAA). 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 45 • Provide Covered California or Medi-Cal application assistance to 246 uninsured residents, of whom 105 submitted an application (target: 200 residents) • Have 105 applications select the Preventive Care Pathways/James A. Watson Wellness Center as their primary care provider Highlights 100% 100% of patients who tested positive for Hepatitis C received education, follow-up tests, and treatment referrals within one month (target: 80%). 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 46 Background Roots Community Health Center works to uplift those impacted by systemic inequities and poverty. They accomplish this through medical and behavioral health care, health navigation, workforce enterprises, housing, outreach, and advocacy. Roots Community Health Center provides services in threshold languages including English and Spanish. Measure A Funding Achievements Roots used its Measure A allocation to achieve the following: • Hire a 0.60 full-time employee (FTE) Client Services Specialist to provide additional benefit application assistance (target: 0.60 FTE) • Hire a 0.10 FTE Community Services Manager to supervise the Client Services Specialist (target: 0.10 FTE) • Hire one Intake/Eligibility & Enrollment Specialist to provide benefit application assistance • Submit: - 15 new Medi-Cal applications - Four renewal Medi-Cal applications - 15 CalFresh applications, of which six were approved FY 20/21 Allocation: $250,000 | Expended/Encumbered: $250,000 Individuals served by Measure A: 19 (Total individuals served: 83) Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors Services provided: Public Health, Mental Health Service area: Hayward, Oakland, San Leandro, Homeless or Transient Direct Medical and Support Services: Roots Community Health Center www.rootsclinic.org Success Story Mrs. G and her husband are elderly people who are currently not working. Mrs. G’s husband stopped working since he had an accident and injured his arm. Mrs. G has been taking care of him. They were struggling to buy food, so someone recommended them to come to Roots and apply for CalFresh. Roots staff assisted Mrs. G with the application, and she and her husband received approval by the next day. They were really appreciative and are looking forward to working with navigation services. 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 47 Background The Alameda County Health Care Services Agency Health Insurance Enrollment Assistance department provides services to families who want to gain access to health care and benefits programs. Health Insurance Technicians (HITs) can schedule enrollment assistance appointments to complete new and renewal applications. The Health Insurance Enrollment Assistance department is a critical resource for some of the hardest-to-reach and most vulnerable populations in Alameda County. The department provides a client-centric and culturally competent approach to help residents enroll into health care and benefit programs and has the unique ability to serve the whole family regardless of what program they are eligible for. In FY 20/21, benefits assistance was provided to clients according to the following percentages by program: • Medi-Cal: 58% • HealthPAC: 15% • CalFresh: 16% • Covered California: 9% • CalWORKs: 2% Services are provided in Spanish and Cantonese. Measure A Funding Achievements The Health Insurance Enrollment Assistance department used its Measure A allocation to achieve the following: • Provide benefit application assistance to 4,506 low income County residents (target: 4,500) • Receive 6,415 calls on the HIT assistance toll-free line (target: 6,000) FY 20/21 Allocation: $300,000 | Expended/Encumbered: $300,00 Individuals served by Measure A: 885 (Total individuals served: 4,650) Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors Services provided: Public Health Service area: Countywide Health Enrollment for Children www.acgov.org/health/indigent/hiea.htm Success Story A HealthPAC client, Jose, had an infection in a sensitive area on his body. He was embarrassed by the location and did not seek help right away. After encouragement by his wife, Jose used his HealthPAC benefits and, upon going to the ER, was admitted to the hospital and had four surgeries over three days. Had he not gone when he did, he might have suffered amputation of the body part or even loss of his life. Jose appreciates the importance of his health care access and is grateful to the HITs who assisted him in renewing his health coverage. 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 48 Background The Multicultural Institute (MI) accompanies immigrants in their transition from poverty and isolation to workforce participation and prosperity. MI’s health services address the language, cost, and coverage eligibility barriers that immigrants and low income community members encounter. MI brings health services to community members and tailors services to make them accessible to individuals who otherwise would not have access or trust other places to receive them. MI contributes to the goal of reaching health equity for all by being available for day laborers, domestic workers, and the immigrant community by answering questions, connecting them to resources and direct services, and welcoming them into a relatable and safe space. Services are provided primarily in Spanish and, when needed, in English. Measure A Funding Achievements Measure A funding helped MI achieve the following: • Provide outreach to 741 unduplicated day laborer and other low income clients (target: 700) • Provide 753 one-on-one health-related consultations (target: 100) • Host 17 health care trainings or workshops for 531 participants (target: eight workshops for 129 participants) • Provide nine street-based health education sessions to 531 participants (target: eight sessions to 120 participants) • Provide six health care screening events to 397 individuals (target: four events to 100 individuals) FY 20/21 Allocation: $95,662 | Expended/Encumbered: $95,662 Individuals served by Measure A: 741 (Total individuals served: 821) Populations served: Indigent, Low Income, Uninsured Adults, Families, Seniors Services provided: Hospital Outpatient, Mental Health, Public Health Service area: Berkeley, Oakland, Homeless or Transient Health Services for Day Laborers: Multicultural Institute mionline.org Highlights 98% 98% of individuals who were served reported that their health care needs were met with MI’s assistance (target: 80%). 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 49 Background Street Level Health Project (SLHP) is an Oakland-based community center dedicated to improving the health and well-being of underinsured, uninsured, and recently arrived immigrants in Alameda County. As the pandemic continues, there has been an increased need for mental health consultations in the community. SLHP visits increased by 135% in FY 20/21. Community members indicated they had no other source of mental health care that is culturally or linguistically appropriate. Nutritionist/ herbalist consultations were available to the community, allowing them to access services not offered by organizational partners. SLHP’s nutritionist/ herbalist tailors specific homeopathic remedies for each member and conducts home deliveries for those who are unable to travel or in quarantine. Food bag distribution increased in FY 20/21, and community health workers continued to provide assistance to the community. Services are provided in Spanish, English, and Mam. Measure A Funding Achievements SLHP used its Measure A allocation to achieve the following: • Provide health care screening and episodic care visits to 314 unduplicated clients across multiple languages (target: 250) • Provide 3,304 health-related navigation/referral services to 1,912 clients across a network of 223 local health care agencies (target: 2,000 services) • Provide 214 mental health consultations with 906 unduplicated clients from low income communities in Alameda County (target: 200 consultations) • Provide 229 nutritionist/herbalist consultations to 180 clients (target: 200 consultations) FY 20/21 Allocation: $95,662 | Expended/Encumbered: $95,662 Individuals served by Measure A: 1,422 (Total individuals served: 1,537) Populations served: Indigent, Low Income, Uninsured Adults, Families, Seniors Services provided: Public Health, Mental Health Service area: Countywide, Homeless or Transient Health Services for Day Laborers: Street Level Health Project streetlevelhealthproject.org Highlights 100% 100% of clients who called the hotline for Health Access Program (HAP) services were screened that same day (target: 95%). 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 50 • Distribute 5,453 free food bags to low income individuals (target: 3,000) • Recruit and train 18 prospective and current health care providers, providing them with experience in working with uninsured low income communities (target: 10) Success Story “Maribel,” a 50 year-old female suffering from chronic depression, was referred SLHP’s herbalist and nutritionist. Having lost her business and suffering financially and emotionally, her health was affected. Her care team worked to provide both clinical and natural remedies for her depression and other symptoms. Her care team reported that her condition improved over the course of four months. Maribel shared that she recently started exercising again and has been losing the weight she gained during the pandemic. She also started cutting hair again from her home thanks to being in a healthier mental state. Maribel has expressed gratitude to SLHP staff. 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 51 Background The Center for Healthy Schools and Communities (CHSC) works to foster the academic success, health, and well-being of Alameda County youth by building universal access to high quality supports and opportunities in schools and neighborhoods. CHSC’s Unaccompanied Immigrant Youth (UIY) Care Team utilizes a variety of strategies to address and support UIY needs including trauma-informed treatment modalities, addressing spirituality and/or folk traditions, addressing language barriers, utilizing cultural humility principles to promote inclusion and acceptance, and empowerment techniques to improve UIY agency and sense of belonging. Families and caregivers receive support as well by being directed to key service referrals. With COVID-19 still a factor, the UIY Care Team supports families and students with virtual case management, workshops, and community-based services. The team provides basic need support with food, groceries, toiletries, and more. Services are provided primarily in Spanish. All direct staff are bilingual in Spanish/English or Mam/English. Presentations and workshops for school educators and community partners are conducted in English. Measure A Funding Achievements The UIY Program used its Measure A allocation to achieve the following: • Provide 113 outreach activities (target: 20) • Hold 51 workshops for UIY students, families, and caregivers (target: 14) • Conduct 404 consultation sessions or trainings with teachers, staff, and providers • Conduct 45 consultation sessions or trainings with school administration • Provide 19 Provider Learning Community (PLC) sessions for providers and school administration and staff FY 20/21 Allocation: $350,000 | Expended/Encumbered: $350,000 Individuals served by Measure A: 1,047 (Total individuals served: 1,047) Populations served: Indigent, Low Income, Uninsured Adults, Children, Families Services provided: Public Health, Mental Health Service area: Cherryland, Fremont, Hayward, Newark, Oakland, Union City Health Services for Unaccompanied Immigrant Youth achealthyschools.org Matching Funds $324,365 from Alameda County Behavioral Health Care Services (BHCS) and Medi-Cal Administrative Activities (MAA). Highlights 100% 100% of UIY clients agreed that, because of the services, they had a place to go when they needed health and wellness services (target: 80%). 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 52 Background Alameda County Behavioral Health Care Services (BHCS) works to maximize the recovery, resilience, and wellness of all eligible Alameda County residents who are developing or experiencing serious mental health, alcohol, or drug concerns. Juvenile Justice Health Services plays an important role in ensuring continuity of care for justice-involved youth and families. This role has been particularly important given the impacts of COVID-19 and the continued reassignment of Public Health Nurses to support countywide COVID-19 response efforts. The Juvenile Justice Center (JJC) health services team provides services to youth who are often in critical condition. The team connects youth suffering from serious gunshot wounds or injuries to specialty care, including surgery and rehabilitation. The health services team also vaccinates youth against COVID-19 and treats them for sexually transmitted infections (STIs). Services are provided in Cantonese, English, and Spanish. Measure A Funding Achievements BHCS used its Measure A allocation to achieve the following at the JJC: • Provide a comprehensive physical exam to 81% of youths booked into the JJC (target: 70%) • Provide dental screening to 74% of youths (target: 70%) • Screen 100% of youths for risk of self-harm at intake (target: 95%) • Treat 88% of youth for an STI while in detention (target: 90%) • Provide a dental treatment to 21% of youth (target: 10%) FY 20/21 Allocation: $261,000 | Expended/Encumbered: $261,000 Individuals served by Measure A: 306 (Total individuals served: 306) Populations served: Low Income, Uninsured Adults, Children, Other: Detained Individuals Services provided: Emergency Medical, Hospital Outpatient, Public Health Service area: Countywide Medical Costs for Juvenile Justice Center: Direct Service Planning and Administration acbhcs.org Success Story A JJC-detained youth was scheduled to go home and was concerned about exposing his grandmother, with whom he lived, to COVID-19. The health services team was able to get the youth the first vaccine dose, but he went home before receiving the second one. The team was able to provide him with personal protective equipment and explained ways to avoid exposing his grandmother. He received a COVID-19 test upon release and received his second vaccine when it was scheduled. The team’s efforts to get the youth the vaccine enabled him to avoid exposing his grandmother and provide protection for him in case of future exposures. 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 53 Background Niroga Institute strives to foster the health and well-being of children, youth, families, and communities through the practice of dynamic mindfulness, an evidence-based, trauma-informed, transformative life- skills program that strengthens stress resilience and social-emotional learning. Niroga Institute provides twice-weekly or weekly Transformative Life Skills (TLS) sessions for at-risk and incarcerated youth at the Alameda County Juvenile Justice Center (JJC). Due to the pandemic, services were also provided via online live sessions or videos that were available in each unit. Each lesson includes mindful action, breathing, and centering, with time for discussion about real-life applications of the skills being taught. The lessons support the following objectives: • Emotional development, including good emotional self-regulation skills, coping, and conflict resolution skills • Social development, including healthy relationships and a sense of connectedness to larger social networks • Intellectual development, including essential life skills, school success, and good decision-making skills • Physical development, including good health habits and health risk management skills Due to pandemic restrictions, Niroga provided one online, half-day- long immersion for youth at the JJC. Upon request, services are provided in Spanish. FY 20/21 Allocation: $89,152 | Expended/Encumbered: $89,152 Individuals served by Measure A: 2,203 encounters (Total individuals served: 2,421 encounters) Populations served: Low Income, Uninsured Children, Other: Youth at Juvenile Hall Services provided: Mental Health Service area: Berkeley, Fremont, Hayward, Newark, Oakland, San Leandro Medical Costs for Juvenile Justice Center: Niroga Institute niroga.org Success Story Soon after Niroga offered the half-day dynamic mindfulness retreat for the young men in the Student Extended Education Program (SEEP), an attorney called the JJC office and wanted to know more about Niroga’s program, particularly the workshop. She said that a young man who she represents spoke to her of being moved and transformed by the mindfulness practice and by the content of the program, and she witnessed the changes in him. 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 54 Measure A Funding Achievements Niroga Institute used its Measure A allocation to achieve the following: • Conduct 2,318 service encounters with youth through weekly videos to six units (target: five units and 1,200 encounters) • Provide 103 classes to three staff per class through weekly videos and live online classes (target: 90 classes averaging five staff per class) • Provide one day-long TLS immersion for youth and services to four youth (target: three day-long immersions to 15 youth) Highlights 100% 100% of staff reported that attending the weekly TLS class positively impacted their ability to manage stressors associated with their jobs and reduced their stress (target: 70%). 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 55 Background The Victim/Witness Assistance Division of the Alameda County District Attorney’s Office supports and empowers crime victims and their families by promoting their rights within the criminal justice system and providing services to aid in their recovery from the emotional, psychological, social, and economic impact of crime as they reclaim their sense of safety, well- being, and dignity. Under the guidelines of the California Victim Compensation and Government Claims Board (CalVCB), Alameda County Victim Services staff are committed to promptly assist with financial services to all impacted victims of crime. Ensuring that all victims of crime receive vital and essential financial services first requires that they aware of the CalVCB program’s existence. This has been a significant area of concern, with active outreach throughout Alameda County. However, a CalVCB study identified that many approved victim of crime claimants do not access program financial services and remain financially unserved. Therefore, staff has conducted more thorough research to discover the barriers that prevent crime victims from seeking program services and established a full-time employee solely focused on this in-depth research to empower and educate claimants about the CalVCB program and all its available financial services, and guide claimants in accessing approved funding. Staff are able to empower and education claimants about CalVCB Program and all the available financial services, as well as debunk myths, misconceptions, mistruths, and outdated program information. Staff also provide information, services, and other resources to those who qualify for benefit claims, providing a positive outcome for claimants. Services are primarily provided in Spanish, Chinese, and Mandarin. FY 20/21 Allocation: $90,000 | Expended/Encumbered: $90,000 Individuals served by Measure A: 569 (Total individuals served: 1,212) Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors Services provided: Emergency Medical, Hospital Inpatient, Hospital Outpatient, Public Health, Mental Health, Substance Abuse Service area: Alameda, Albany, Berkeley, Castro Valley, Dublin, Emeryville, Fremont, Hayward, Livermore, Newark, Oakland, Piedmont, Pleasanton, San Leandro, San Lorenzo, Union City Medical Costs for Juvenile Justice Center: Victims of Crime alcoda.org Success Story As a result of an assault against her mother, Mary Doe, daughter Jane Doe experienced emotional trauma, and Mary suffered physical injuries and emotional trauma. The assault caused Mary to not work, and they had to relocate to get away from the neighbor who had assaulted Mary. Mary also was unable to pay medical bills. CalVCB staff approved Mary’s case for assistance, but Mary was unaware and had not submitted a claim. Eventually, staff tracked her down and advised her of the assistance she was due, and she was able to pay off medical bills and relocate her and her daughter to a safe living situation. 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 56 Measure A Funding Achievements CalVCB used its Measure A allocation to achieve the following: • Of the 1,212 claimants with approved CalVCB funds, identify 643 who did not use their funds (target: 643) • Successfully contact 313 of the 643 claimants with unused funds (target: 643) • Attempt to contact 185 approved claimants by phone (target: 643) • In a survey of the 313 contacted claimants with unused funds, identify that: - 164 were not aware of the approved funds - 133 needed information and assistance to access the funds - 16 declined the use of the funds Highlights 100% 100% of claimants who did not utilize approved CalVCB funding were identified. 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 57 Background The Alameda Health Consortium (AHC) is a regional association of community health centers that work together and support the involvement of their communities in achieving comprehensive, accessible health care and improved outcomes for everyone in Alameda County. AHC partners with the Alameda County Health Care Services Agency (HCSA) on the Health Program of Alameda County (HealthPAC), which is partially funded by Measure A. The Consortium is guided by the following principles: • All people have the right to accessible and affordable high quality health care that prevents illness, promotes wellness, and is sensitive to the unique needs of particular communities and cultures. • The barriers that prevent people from seeking care must be eliminated. • Individuals and families must be empowered to participate in their own health care. • Low income and underserved people play an important role in the formation of health policy at the local, state, and national level. • Building consensus and coalitions around important health issues leads to innovative solutions. • Providing quality health care improves the well-being of communities. • Racial and ethnic health disparities must be eliminated to have healthy communities. The Consortium is made up of eight member health centers, who deliver outpatient services at dozens of locations throughout Alameda County: • Asian Health Services • Axis Community Health • Bay Area Community Health • La Clínica • LifeLong Medical Care FY 20/21 Allocation: $5,753,009 | Expended/Encumbered: $5,753,009 Individuals served by Measure A: 14,706 (Total individuals served: 278,291) Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors Services provided: Outpatient Health Services, Public Health, Mental Health, Substance Abuse Service area: Countywide Primary Care Community-Based Organizations www.alamedahealthconsortium.org Matching Funds $5.65M as part of Care Connect activities. Highlights 735% Community health centers increased the number of COVID-19 screenings by 735% over a June 2020 baseline (target: 100%). 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 58 • Native American Health Center • Tiburcio Vasquez Health Center • West Oakland Health The community health centers provided COVID-19 testing and vaccinations and worked to improve access to these services as well as address COVID-19 disparities through targeted outreach and education to priority populations. The health centers have been part of redirecting patients from opiate treatment for pain management to alternative modalities for pain management such as guideline-directed non-opiate treatment, acupuncture, chiropractic services, and behavioral health services. HealthPAC provides affordable health care to uninsured Alameda County residents. HealthPAC works collaboratively with AHC and its member health centers to research, develop, analyze, and report on appropriate measures for system improvements. Health care services are available in English, Spanish, Cantonese, Mandarin, Vietnamese, Tagalog, Farsi, Mam, Mien, Lao, Thai, Korean, Japanese, Hindi, Cambodian, Mongolian, Burmese, French, Armenian, and Ilocano. Measure A Funding Achievements The Consortium health centers used their Measure A allocation to achieve the following: • Perform 51,314 COVID-19 screenings (target: 12,298) • Enroll 33,083 patients in HealthPAC (target: 33,083) • Ensure that 1,163 active patients with confirmed Hepatitis C achieved sustained virologic response at 12 weeks post-treatment (target: 1,160) • Ensure that 14,706 HealthPAC patients had access to care (target: 14,706) • Provide 71,455 patient visits to HealthPAC members (target: 71,455) • Decrease the overall rate of hospital admissions to 3.3 per 1,000 members (target: 4.4 per 1,000 members; lower is better) Success Story A HealthPAC patient sought behavioral health services at Bay Area Community Health following a violent assault. The patient experienced significant post-traumatic stress disorder symptoms, which interfered with employment and daily tasks. With treatment, the patient was able to reduce their time off from work and avoidance of responsibilities and recreation due to symptoms. Eventually, the patient was able to return to taking walks in the neighborhood with family members and progressed to solitary walks, a leisure activity enjoyed prior to the assault. With the treatment available through HealthPAC, the patient was able to return to work, provide for their family, and resume previously enjoyed activities. 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 59 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 60 FUNDS ALLOCATED BY THE ALAMEDA COUNTY BOARD OF SUPERVISORS PUBLIC HEALTH Alameda Boys & Girls Club, Inc. .................................................................................................62 Asthma Start ............................................................................................................................64 Center for Early Intervention on Deafness ....................................................................................65 CityServe of the Tri-Valley ..........................................................................................................66 Countywide Plan for Seniors: Home-Based Nursing Case Management ..........................................68 Countywide Plan for Seniors: Hospice & Advance Life Planning ......................................................69 Countywide Plan for Seniors: Senior Injury Prevention Program ......................................................71 Emergency Medical Services Corps/ Alameda County Health Pathway Partnership ..........................72 Health Services for Persons Who Inject Drugs: HIV Education and Prevention Project of Alameda County 74 Healthy Homes Department: Fixing to Stay & Group Living Facilities Project ...................................76 Home Visiting Services .............................................................................................................77 Homelessness 3-Year Action Plan ...............................................................................................79 La Clinica De La Raza ................................................................................................................80 Latino Men and Boys Program ....................................................................................................81 LifeLong Medical Care (Heart 2 Heart) ........................................................................................83 Needle Exchange Emergency Distribution ..................................................................................85 Public Health Prevention Initiative ..............................................................................................86 Public Health Prevention Initiative: EMS Injury Prevention .............................................................90 Public Health Services for Homeless Residents: Abode Services ....................................................92 Roots Community Health Center ................................................................................................93 Senior Injury Prevention Program ...............................................................................................94 Service Opportunities for Seniors (Meals on Wheels) — District 3 ...................................................95 Service Opportunities for Seniors (Meals on Wheels) — District 4 ...................................................96 2019–2020 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 60 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 61 Tri-Valley Haven for Women .......................................................................................................97 West Oakland Health Center .....................................................................................................98 Youth and Family Opportunity Initiatives .....................................................................................99 Background The Alameda Boys & Girls Club (ABGC) serves thousands of Alameda youth and teens each year with a comprehensive culinary, nutrition, and health education program integrated with mental health services and physical fitness, recreational, and environmental programming. Members learn essential lessons about personal health and fitness and how their food choices affect the environment. ABGC programs address child health concerns such as obesity, heart disease, and depression, as well as tackling unequal access to medical care, mental health services, physical activity, and fresh foods. The Get Growing gardening and Get Cooking culinary programs teach participating members about personal responsibility, commitment, and caring for the environment. The physical activity component helps members with peer-group identification, teamwork, and good sportsmanship. The comprehensive program meets multiple needs among youth and organizational goals through multidimensional and creative methods. In addition, medical and mental health services help those who are low income receive necessary and beneficial medical check-ups and referrals to follow-up care such as counseling and dental and vision work. Mental health services help members think critically about the concepts of “normal” or “typical” versus “abnormal” behaviors, provide them with knowledgeable solutions to the feelings they face, and promote their ability to create a healthy and stable life for themselves. FY 20/21 Allocation: $114,794 | Expended/Encumbered: $114,794 Individuals served by Measure A: 1,000 (Total individuals served: 1,295) Populations served: Indigent, Low Income, Uninsured Children Services provided: Public Health, Mental Health, Substance Abuse Service area: Alameda, Oakland Alameda Boys & Girls Club, Inc. alamedabgc.org Highlights 100% 100% of workshop participants completed the Club Knights or Mighty Missy’s workshop series (target: 75%). 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 62 Measure A Funding Achievements ABGC used its Measure A allocation to achieve the following: • Provide three health education events and/or workshops to 46 youth (target: four events/workshops to 320 youth) • Provide two small group counseling workshops to develop behavior profiling tools to foster self-awareness and improve relationships, communication, and decision making to 52 youth (target: four workshops to 200 youth) • Provide two six-session Club Knights workshops discussing how to make good decisions, avoid harmful substances, and act responsibly to 18 middle school male students (target: four workshops to 50 students) • Provide two six-session Mighty Missy’s workshops focused on promoting self-esteem and healthy lifestyles; avoiding dating violence, harassment, and sexually transmitted diseases; discussing sexual myths; and emphasizing regular gynecological care to 12 female students (target: six workshops to 50 students) • Provide 23 Healthy Habits workshops to 140 members to encourage a commitment to healthy eating and physical activity (target: 40 workshops to 240 members) • Provide a comprehensive culinary, nutrition, and health education program to 58 youth that teaches the value of healthy cooking and eating by combining hands-on cooking activities, field trips, and a teaching curriculum (target: 250 youth) • Provide dynamic, garden-based nutrition and ecology education to 202 youth (target: 250) • Provide low and high impact recreation and sports to help 221 youth develop and/or maintain an active and physically fit lifestyle (target: 1,000) Success Story While learning and adventuring in the Alameda Boys & Girls Club “Italo’s Garden,” youth are able to experience the sounds, smells, sights, and tastes of the fresh produce grown therein. Participants are able to dig in the soil, watch caterpillars transform into butterflies, and learn about and explore where food comes from. One vibrant fourth grader learned how to make pesto, an ingredient that her mother uses often when fixing dinner. Participants had the opportunity to learn first-hand how food is grown and then how it transforms to be on their plates for a meal. 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 63 Background Asthma Start works with families of children and adolescents diagnosed with asthma to provide them with the tools needed to manage their asthma, avoid the emergency department and hospital, ensure that they have healthy homes, and live a healthy life avoiding the long-term complications of asthma. Asthma Start addresses the environmental aspect of asthma by visually inspecting a client’s home and educating the parents on how to address these issues. These interventions have proven to be effective in reducing emergency department visits and hospitalizations and increasing the parent’s knowledge of asthma management and improved asthma control. In FY 20/21, Asthma Start was awarded a grant that assists in providing asthma supplies to families like mattress and pillow encasings and other asthma supplies as needed. This grant also assists in paying for remediation in a home, such as repairing small holes where pests can enter or installing exhaust fans. Asthma Start also worked with the Bay Area Air Quality Management District to get wildfire funds to provide air purifiers to low income families of children with asthma. Staff speak English and Tigrinya. All Medi-Cal Managed Care organizations provide translators for any language that the program may need, either by telephone or in person. Measure A Funding Achievements Asthma Start used its Measure A allocation to achieve the following: • Enroll 38 clients in the program (target: 50) • Successfully discharge 23 clients from the program (target: 40) FY 20/21 Allocation: $100,000 | Expended/Encumbered: $100,000 Individuals served by Measure A: 23 (Total individuals served: 38) Populations served: Indigent, Low Income, Uninsured Children, Families Services provided: Hospital Outpatient, Public Health Service area: Alameda, Hayward, Oakland, San Leandro Asthma Start acphd.org/asthma.aspx Matching Funds $405,000 from Targeted Case Management (TCM) and Medi-Cal Administrative Activities (MAA). Highlights 100% 100% of clients improved their asthma control test score from baseline (target: 80%). 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 64 Background The Center for Early Intervention on Deafness (CEID) works to maximize communication potential through early education, family support, and community audiology services. CEID provides community audiology services to Alameda County families and individuals through two clinics in Berkeley and Oakland. Patients are primarily low income and Medi-Cal-insured, making CEID one of the few audiology providers that accept patients with Medi-Cal. CEID is an acknowledged expert in pediatric audiology and reaches out to community clinics and their doctors, birthing centers, and private pediatricians. Referred patients are able to receive timely, professional hearing evaluations and are provided and fitted with hearing devices for a diagnosed hearing loss. CEID has multilingual staff who speak Spanish, Hebrew, English, and ASL and secures interpreters for patients whose primary languages include Arabic, Asian, Cantonese, Chinese, Farsi, Hindi, Lao, Urdu, and Vietnamese. Measure A Funding Achievements CEID used its Measure A allocation to achieve the following: • Complete 580 hearing evaluations (target: 425) • Dispense 339 hearing aids and ear molds to California Children’s Services (CCS) and Medi-Cal patients (target: 150) FY 20/21 Allocation: $57,397 | Expended/Encumbered: $57,397 Individuals served by Measure A: 118 (Total individuals served: 1,093) Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors Services provided: Public Health Service area: Alameda, Albany, Berkeley, Dublin, Emeryville, Fremont, Hayward, Livermore, Newark, Oakland, Pleasanton, San Leandro, San Lorenzo, Union City Center for Early Intervention on Deafness ceid.org Highlights 99.5% 99.5% of patients needing hearing aids had the authorization process initiated within one week of referral (target: 95%). 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 65 Background Designed to humanize human services, CityServe of the Tri-Valley mobilizes mercy and practical compassion through care coordination/case management, outreach efforts, and community engagement. By working with chronically homeless/unsheltered individuals, previously homeless/now housed but who face obstacles related to keeping their housing, and housed individuals who are at risk of becoming homeless, CityServe coordinates services to assist clients who are working through crises in order to help them gain stability. Assistance is provided in the areas of: • Supporting formerly homeless clients to move into The Goodness Village • Supporting formerly homeless clients housed through Project Room- Key/Safer Ground • Performing two weekly pop-ups to provide a consistent meeting place for clients • Providing fliers for resources, holiday events, gifts, food, and mental health assessments • Providing Clipper Cards for transit system use and gift cards for groceries, gas, food, shoes, clothing, and phone minutes, as well as for various services for transitioning from streets to housing • Providing hotel stays for medical procedures, surgeries, inclement weather, and respite care • Connecting homeless clients to programs and ministry groups that provide holiday gifts for them and their children • Performing multiple outreaches weekly for people who are resistant to services to build trust and provide information, resources, and support • Supporting clients with severe mental health or substance abuse issues and connecting them to programs and resources FY 20/21 Allocation: $100,000* | Expended/Encumbered: $100,000 Individuals served by Measure A: 161 (Total individuals served: 393) Populations served: Low Income, Uninsured Adults, Families, Seniors Services provided: Mental Health Service area: Dublin, Livermore, Pleasanton, Homeless or Transient *Includes Board of Supervisors discretionary allocation from District 1/Supervisor Haubert CityServe of the Tri-Valley cityservecares.org Highlights 75% 75% of clients assessed with positive mental health needs were given an action plan for wraparound care services (target: 75%) 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 66 Measure A Funding Achievements CityServe of the Tri-Valley used its Measure A allocation to achieve the following: • Distribute 1,035 mental health care services informational brochures (target: 360) • Serve 161 unsheltered individuals (target: 120) • Provide 122 basic mental health assessments (target: 120) • Have 25 staff members participate in behavioral/mental health assessment and other trainings (target: two) • Conduct eight virtual trainings specializing in mental health and addictions and sexual or domestic abuse (target: four) • Develop 32 printed/electronic resource and trainings guide of mental health and substance abuse services/providers for outreach staff and volunteer use (target: one) Success Story An unsheltered client, who is a veteran with physical and mental health needs, took CityServe’s mental health assessment during an outreach session. He was referred to and began meeting with an intervention care coordinator over a six-month period. During that time, he was given many mental health and addiction resources along with a well-defined care plan. His life has completely changed. He has been working full time for three months and is now saving money to be able to get into housing. The CityServe team has been able to encourage him through the process and provide him with consistent support. 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 67 Background The Alameda County Public Health Nurse (ACPHN) provides public health nursing care, community outreach, home visits, care coordination, and advocacy to address individual and community health needs, promote healthy practices, improve health outcomes, eliminate health disparities, and ensure optimal quality of life for all Alameda County residents. Older Adults, Healthy Results (OA/HR) is an ACPHN program that provides public health nurse case management to low income Alameda County adults who are 60 years of age or older, promoting wellness, maximizing function, and supporting clients to live safely in their homes and communities. During FY 20/21, the two OA/HR nurse case managers and one nurse manager were deployed full-time to Alameda County Public Health Department COVID Outbreak Teams. The Outbreak Teams investigate outbreaks in congregate settings that either serve vulnerable populations or are at very high risk for transmission. The OA/HR nurse manager established a Long-Term Care Facilities (LTCF) Outbreak Task Force to control and prevent LTCF outbreaks; to develop a network of community partners for guidance, staffing, and testing support; and to amass a toolkit of resources to respond to COVID-19. Client service languages are provided in multiple languages. Measure A Funding Achievements The Countywide Plan for Seniors program used its Measure A allocation to achieve the following: • Investigate 428 reports of COVID-19 outbreaks at LTCFs • Confirm 255 outbreaks • Find 5,599 COVID-19 cases that were linked FY 20/21 Allocation: $500,000 | Expended/Encumbered: $500,000 Individuals served by Measure A: 428 (Total individuals served: 428) Populations served: Low Income, Uninsured Adults, Children, Families, Seniors Services provided: Public Health Service area: Countywide Countywide Plan for Seniors: Home-Based Nursing Case Management acphd.org Highlights 16 The nurse manager manages a team comprised of 16 nurse investigators plus multiple program, administrative, and data entry staff. 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 68 Background Alameda County Care Partners (ACCP) Getting the Most Out of Life (GMOL) offers a culturally competent, community-based palliative care program (CBPC) with supportive services, virtual community outreach activities, and life care planning education in Alameda County. ACCP works with Alameda County In-Home Supportive Services (IHSS) recipients and care providers; GMOL serves non-IHSS, low income seniors and/or disabled and individuals. GMOL works with community champions to design and deliver high quality services to meet the needs of elders to keep them safe and comfortable and have an improved quality of life at home based on goals- of-care conversations in which they share the kind of health care they desire. During the pandemic, GMOL utilized telehealth calls to help clients document their health care choices and provide care coordination and support. Staff also provided clients with COVID screenings, safety assessments, and health care system navigational support to connect to vital social resources. The team also developed a telehealth train-the-trainers advance directive education presentation, which was presented to a diverse array of partners and disseminated widely. A virtual survey was developed and conducted to track the effectiveness of the training. To serve all languages, GMOL uses the language line along with Samuel Merritt nursing student volunteer translators, bilingual IHSS care providers, GMOL/Care Partners bilingual staff, and community and faith-based organization partners. Languages include Cantonese, Vietnamese, Korean, Spanish, and Mandarin. FY 20/21 Allocation: $250,000 | Expended/Encumbered: $233,154 Individuals served by Measure A: 1,180 (Total individuals served: 7,909) Populations served: Indigent, Low Income, Uninsured Adults, Families, Seniors Services provided: Public Health Service area: Countywide, Outside of Alameda County Countywide Plan for Seniors: Hospice & Advance Life Planning gettingthemostoutoflife.org Highlights 100% 100% of IHSS clients reported having more knowledge of local resources following an ACCP telehealth visit (target: 75%). 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 69 Measure A Funding Achievements The hospice and advance life planning providers used their Measure A allocations to achieve the following: ACCP • Provide four client education/training presentations to introduce 99 clients to the program (target: 120 clients) • Provide one in-service presentation to IHSS professionals to introduce 15 professionals to the program (target: 10 professionals) • Receive 48 referrals from IHSS care providers and professionals to provide CBPC to IHSS recipients (target: 50) • Offer CBPC to 40 new IHSS clients (target: 15) • Ensure that 40 CBPC clients were successfully discharged from services (target: 10) • Train 6,590 IHSS care providers on ACCP-related topics during orientation (target: 5,000) GMOL • Provide 11 education/training presentations to introduce 1,120 clients to the program (target: 400) • Ensure that 1,095 class participants who did not have an advance directive either completed or planned to complete one at the end of the training • Provide three in-service presentations to introduce 31 professionals to the program (target: 75 professionals) • Serve 30 new GMOL clients with CBPC via telehealth (target: 25) • Successfully discharge 30 clients from GMOL services (target: 25) • Receive referrals from 50 clients (target: 50) Success Story The GMOL team assisted a 62-year-old woman who suffers from severe rheumatoid arthritis and other ailments. Through consultations, risk assessments, and listening, the team assisted the woman in obtaining safety equipment in her home, understanding how to better navigate the health system to have her concerns and wishes attended to, and getting free durable medical equipment to keep her safe and comfortable. The team also educated her about the benefit of updating her advance directive to ensure that her health care wishes are honored. The client expressed her appreciation and gratitude to the team. 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 70 Background The Alameda County Area Agency on Aging (AAA) works to ensure and sustain a life free from need and isolation for all older Alameda County residents. Through leadership and collaboration, AAA’s community-based system of care provides services that support independence, protect the quality of life of older Californians and persons with functional impairments, and promote older adult and family involvement in the planning and delivery of services. Through AAA, clients receive nutritious home-delivered meals and grocery bags of healthy foods, and participate in physical education classes to learn about the importance of and how to make healthy nutritional choices as well as physical exercise. The Senior Injury Prevention Program (SIPP) makes minor home modifications to help minimize fall risks and allow older adults to stay at home safely. Modifications include grab bars, railings, shower chairs/ benches, smoke detectors, and more. Grocery bag inserts are often translated into Chinese and Spanish, and nutrition education materials are translated into Chinese, Vietnamese, Farsi, Japanese, and Spanish as needed. Measure A Funding Achievements AAA used its Measure A allocation to achieve the following: • Deliver meals to 612 Meals on Wheels clients • Distribute grocery brown bags to 700 Mercy Brown Bag clients • Provide services to 1,489 SIPP clients FY 20/21 Allocation: $797,808 | Expended/Encumbered: $797,808 Individuals served by Measure A: 612 Meals on Wheels clients; 700 Mercy Brown Bag clients; 1,489 Senior Injury Prevention (SIPP) clients (Total individuals served: 3,876 Meals on Wheels clients; 700 Mercy Brown Bag clients; 1,673 SIPP clients) Populations served: Low Income Seniors Services provided: Public Health Service area: Countywide Countywide Plan for Seniors: Senior Injury Prevention Program alamedacountysocialservices.org Matching Funds $142,869 from state SNAP Ed funding. Highlights 97% 97% of Mercy Brown Bag clients said they would skip meals without the food provided (target: 80%). 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 71 Background The Emergency Medical Services (EMS) Corps works to increase the number of underrepresented Emergency Medical Technicians (EMTs) through leadership development, mentorship, and job training. Through its life coaching, community service, mentorship, and health and wellness programs, EMS Corps helps give participants the tools to be successful in their personal and professional lives. EMS Corps students participate in health fairs and community events and teach life-saving skills to middle and high school students, which exposes other youth to the EMS workforce. Alameda County Health Pathway Partnership (ACHPP) serves as a hub for a consortium of organizations that includes EMS Corps, the Alameda County Health Coach program, and the Alameda County Health Care Services Agency (HCSA) internship program for high school students. The Alameda County Health Coach program trains youth and young adults to become health coaches who subsequently educate community members about managing chronic diseases more effectively. Services are provided in English and Spanish Measure A Funding Achievements EMS Corps used its Measure A allocation to achieve the following: • Provide workforce development activities to 95 youth and young adults at four school sites (target: 90 youth/young adults at five school sites) • Recruit 69 and 59 applicants respectively for EMS Corps Cohort 1 and Cohort 2 (target: 80 per cohort) • Interview 36 and 39 applicants respectively for EMS Corps Cohort 1 and Cohort 2 (target: 40 per cohort) FY 20/21 Allocation: $607,791 | Expended/Encumbered: $607,791 Individuals served by Measure A: 665 (Total individuals served: 815) Populations served: Low Income, Uninsured Adults Services provided: Emergency Medical, Substance Abuse Service area: Countywide Emergency Medical Services Corps/ Alameda County Health Pathway Partnership acphd.org/ems Highlights 100% 100% of ACHPP participants reported they would continue to work together to serve youth and young adults (target: 100%). 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 72 • Enroll 17 and 18 students respectively for EMS Corps Cohort 1 and Cohort 2 (target: 20 per cohort) • Work with nine partners (County staff, employers, mentors, presenters, and community-based organizations) in the implementation of two workforce projects/activities (target: five partners and two activities) • Hold seven meetings with partners and employers to provide technical assistance for recruitment and retention of boys and men of color for EMS Corps and other related youth programs (target: five) • Share six communications to support assistance for recruitment (target: three) • Conduct six community service events (target: five) • Have participants reach 512 peers to educate them on social determinants of health and COVID-19 (target: 250) • Through the Alameda County Health Coach program, place eight coaches primarily at COVID vaccine and testing sites to assist with language translation and provide isolation and quarantine orders, COVID school outreach, and town night events. • Serve 650 community members through the Alameda County Health Coach program • Serve 15 students through the HCSA internship program Success Story After the pandemic began, ACHPP interns partnered with COVID testing sites that needed outreach. Interns were trained on COVID-19 education and debunking myths. They created a social media campaign that reached their family and friend networks. They also made a huge impact in assisting with outreach at several COVID testing sites in the summer of 2020. They were able to serve Homies Empowerment, Arise, and San Lorenzo High Schools. In addition, they worked with various community health projects. 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 73 Background The HIV Education and Prevention Project of Alameda County (HEPPAC) works to stop the further spread of preventable diseases among people who use drugs (PWUD) in the community. HEPPAC’s fixed and mobile integrated services span throughout Oakland to enable more unhoused and homeless individuals to access harm reduction supplies including sterile syringes, biohazard containers, medical attention, and education that support them staying healthy, alive, and able to thrive to make healthier choices and gain impactful, lasting change in their lives. HEPPAC is the primary program in Oakland that provides services in a non- clinical setting. Access points allow clients to have a place where persons who inject drugs (PWID) can access sterile syringes and other ancillary services. HEPPAC’s fixed Site Supervision Plan (SSP) sites act as access points for all PWUD to access life-saving supplies and medical treatment if they cannot access their assigned brick-and-mortar medical home locations, such as a Federally Qualified Health Center (FQHC). Access to these sites on a consistent basis decreases PWUD access to County emergency departments for non-emergency, acute soft tissue infections and other co-morbidities that can be addressed by the HEPPAC services at fixed and mobile sites. HEPPAC’s services are impactful in the ever- growing population of homeless and unhoused in the community, which is inflated by the housing crisis occurring in the larger Bay Area, and Oakland specifically. SSP sites occur throughout the day as mobile sites and are fixed at evening locations in nonclinical settings and at nontraditional business hours. Services are offered in Spanish. FY 20/21 Allocation: $310,684 | Expended/Encumbered: $310,684 Individuals served by Measure A: 1,154 (Total individuals served: 3,690) Populations served: Indigent, Low Income, Uninsured Adults, Seniors Services provided: Emergency Medical, Hospital Outpatient, Public Health, Substance Abuse Service area: Berkeley, Emeryville, Oakland Health Services for Persons Who Inject Drugs: HIV Education and Prevention Project of Alameda County | heppac.org Success Story “Eric” is a 55-year old African American male who began snorting, then injecting, heroin after a work-related injury. Eric experienced homelessness, recidivism, trauma, and rape while in prison, all contributing to his continued homelessness. Eric has been coming to HEPPAC for over three years and utilizes its services. Infected with Hepatitis C, HEPPAC provided Eric two RNA blood draws to check the levels of virus in his system. Eric was linked to Trust Clinic in mid-December and started his 12-week treatment for Hepatitis C. Eric completed his treatment and continued to work with HEPPAC staff to access food, harm reduction supplies, and medical support. 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 74 Measure A Funding Achievements HEPPAC used its Measure A allocation to achieve the following: Overdose Prevention Education and Naloxone Distribution (OPEND) • Administer OPEND trainings to 428 clients (target: 400) • Conduct eight OPEND trainings to 38 service provides (target: five trainings to 20 providers) • Provide OPEND training to 40 organizations (target: five) • Establish five OPEND sites (target: five) • Train 60 staff in OPEND refresher/follow-up (target: 32) • Conduct seven OPEND trainings for 18 community-based organizations (CBOs) (target: five trainings for five CBOs) • Provide new OPEND training to 60 staff (target: 20) • Display Narcan information and accessibility campaign materials in five cities throughout Alameda County (target: three) • Display 30 Narcan information and accessibility posters throughout the County • Display eight different visual advertising products • Participate in three planning committees to increase Narcan access (target: two) • Conduct four OPEND presentations to city and County officials (target: two) Syringe Exchange Program (SEP) • Distribute 2,400 pieces of information material for SEP • Ensure that 421 syringe access participants utilized services and were aware of available alternative holistic health services • Serve 2,100 residents during mobile syringe access services • Collect 106,429 used syringes (target: 100,000) • Distribute/exchange 110,000 sterile syringes for used syringes (target: 50,000) • Offer six hours of fixed syringe exchange access each week (target: six) • Offer 24 hours of mobile syringe access each week (target: 24) • Serve 2,949 Oakland residents through mobile syringe access and fixed syringe access services • Offer 19 mobile syringe access sites • Reach 1,286 self-reported active PWID Oakland residents • Distribute 11 safe drug-using supplies • Reach 1,486 PWID self-reported residents • Provide medical treatment for soft-tissue infection to 76 participants (target: 40) • Conduct 34 safer injection workshops (target: 20) • Provide alternative holistic health services to 428 participants during syringe access services (target: 400) Highlights OPEND 100% 100% of clients trained reported that training increased their ability to respond to an overdose (target: 90%). SEP 94% 94% of syringe access participants said they learned about safer injection techniques and proper disposal methods of used/littered syringes (target: 65%). 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 75 Background The Alameda County Healthy Homes Department promotes an integrated approach for safe and healthy housing through collaborative community initiatives, applied research, and policy developments to improve the lives of vulnerable populations. The Healthy Homes Department Fixing to Stay program helps older adult clients stay in their homes as long as possible in housing conditions that contribute to their well-being. Interventions include essential items such as grab bars, functioning water heaters, and electrical and plumbing work. Independent living homes are group living housing environments for disenfranchised residents facing multiple obstacles including being formerly incarcerated, elderly, or mentally ill or having other disabilities. While many are formerly homeless and unsheltered, the Department’s interventions ensure that these residents have good quality, affordable housing. The Department has been able to assist public health providers in identifying where congregate settings are located to maintain an up-to-date database. The Department provides information regarding maintaining COVID safety, as well as information about vaccinations. Clients receive some services in Spanish. Measure A Funding Achievements The Healthy Homes Department leveraged its Measure A allocation to achieve the following: • Conduct outreach to 143 older adults and their families (target: 70) • Conduct 24 health and safety risk assessments (target: 45) • Conduct 80 site visits and healthy home assessments (target: 80) • Respond to 14 complaints/grievances related to independent living homes (target: five) FY 20/21 Allocation: $$311,511 | Expended/Encumbered: $311,511 Individuals served by Measure A: 187 (Total individuals served: 273) Populations served: Low Income, Uninsured Adults, Seniors Services provided: Public Health Service area: Albany, Ashland, Castro Valley, Cherryland, Dublin, Emeryville, Fairview, Newark, Oakland, San Lorenzo, Union City Healthy Homes Department: Fixing to Stay & Group Living Facilities Project achhd.org Matching Funds $339,054 from Alameda County Cares Connect funds and Minor Home Repair funds. 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 76 Background The Family Health Services (FHS) division, under the auspices of the Alameda County Public Health Department (ACPHD), works to ensure the health and well-being of diverse families with compassionate, comprehensive, and collaborative services. Within FHS, the staff of the Maternal, Paternal, Child, and Adolescent Health (MPCAH) Unit work to ensure that women, children, youth, mothers, fathers, and families achieve optimal health and well-being through the delivery of client-centered, culturally responsive, high quality, strength-based services that are merged with community transformation efforts to improve neighborhood conditions. The MPCAH’s Starting Out Strong Home Visiting and Family Support System of Care, which includes programs supported by Measure A funds, supports three programs: Children’s Hospital & Research Center at Oakland Special Start Program, Tiburcio Vasquez Health Center (TVHC) Family Support Services Program, and Brighter Beginnings Family Support centers. Services are provided in the language that the family prefers. There are some bicultural and bilingual case managers providing services in Spanish, Cantonese, and Mandarin. Additional languages are accessed through interpretation services. Measure A Funding Achievements FHS/MPCAH used its Measure A allocation to achieve the following: • Serve 445 parents, of whom 97% of eligible parents were screened for depression (target: 401 and 90%) • Serve 412 children, of whom 95% of eligible children received early developmental screening (target: 350 and 85%) FY 20/21 Allocation: $1,850,170 | Expended/Encumbered: $1,850,170 Individuals served by Measure A: 999 (Total individuals served: 2,674) Populations served: Indigent, Low Income, Uninsured Adults, Children, Families Services provided: Public Health, Mental Health Service area: Countywide Home Visiting Services acphd.org/mpcah Matching Funds $1.27M The three Measure A-funded providers leveraged their Measure A allocations to obtain funds from Targeted Case Management (TCM) and Medi-Cal Administrative Activities (MAA). Highlights 82% 82% of parents who screened positive for parental depression were referred to mental health supports or treatment (target: 80%). 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 77 • Ensure that 81 children ages 6–11 months were breastfed or fed breast milk, of whom 47% were fed in this way for at least six months (target: 65 and 60%) • Of 365 parents eligible for a Reproductive Life Plan, ensure that 93% had a documented plan (target: 274 and 75%) • Increase practice of safe sleep behaviors among 62 children 0-6 months old, representing 65% of these children (target: 80%) Success Story Referred by her TVHC medical provider, a 19-year-old mother with a 12-month-old child was overwhelmed by the care of her child. She was also referred for mental health services but was reluctant to engage in such. She was unemployed, isolated because of COVID-19, and had limited support. The TVHC case manager encouraged her to identify a career interest and got her enrolled in Women, Infants, and Children (WIC) and CalFresh. The case manager also helped her develop a resume, and she was then hired by a local beauty store. She applied and was accepted to cosmetology school. She’s also working to identify day care for her child, and both have shown much improvement. 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 78 Background The Alameda County Office of Homeless Care and Coordination (OHCC), in coordination with the Alameda County Health Care Services Agency (HCSA), strives to achieve health equity by working in partnership to provide high quality services, foster safe and healthy communities, and promote fair and inclusive opportunities for all residents. During the ongoing COVID-19 pandemic, individuals served by HCSA continued to receive critical shelter and support to access permanent housing at a time when the ability to safely shelter in place in a non- congregate setting was more crucial than ever. By helping to move clients off the street, both physical and mental health care needs could be better addressed, COVID risk was mitigated, and permanent housing was secured for the County’s most vulnerable residents. HCSA offers translation services in a wide range of languages, including Spanish. Measure A Funding Achievements OHCC and HCSA used their Measure A allocation to support 139 currently homeless, high risk households to move into non-congregate shelter (target: 150). FY 20/21 Allocation: $500,000 | Expended/Encumbered: $500,000 Individuals served by Measure A: 146 (Total individuals served: 633) Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors, Other: Disabled Adults Services provided: Public Health Service area: Countywide, Homeless or Transient Homelessness 3-Year Action Plan homelessness.acgov.org 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 79 Background La Clinica de La Raza, Inc. strives to improve the quality of life of the diverse communities it serves by providing culturally appropriate, high quality, accessible health care for all. La Clínica San Antonio Neighborhood Health Center offers a monthly food distribution and an onsite pantry that provides food for patients any day the clinic is open. Measure A funding enabled La Clinica to purchase fresh produce from Dig Deep Farms as well as incentives to promote the food distribution wellness: jump ropes, workout bands, reusable zip lock bags, kids’ chef aprons and hats, adult aprons, and reusable grocery bags. As a result of La Clinica program’s services, patients can improve food security in their household and receive food they otherwise would not have access to through other means. La Clinica delivers Measure A-funded services to clients in English, Spanish, and Cantonese. Measure A Funding Achievements La Clinica used its Measure A allocation to achieve the following: • Serve 2,872 individual patients and their household members via Food Farmacy distributions (target: 500) • Serve 408 unique individuals/patients via Food Farmacy distributions (target: 150) • Conduct 24 surveys with Food Farmacy participants (target: 20) • Provide 2,920 pieces of educational and/or promotional materials on nutrition/nutritious foods offered (target: 300) FY 20/21 Allocation: $20,000* | Expended/Encumbered: $20,000 Individuals served by Measure A: 2,872 (Total individuals served: 2,872) Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors Services provided: Public Health Service area: Oakland *Includes Board of Supervisors discretionary allocation from District 3/Supervisor Chan La Clinica De La Raza laclinica.org Success Story A patient diagnosed with Type 2 diabetes received personal diabetes education from the Clinical Nutritionist and was referred to the Food Farmacy. She was very motivated to change her diet and lifestyle to keep her blood sugars under control. She had several nutrition visits and started attending the monthly food distributions, which she continues to do. She stops for the nutrition education, asks questions, and takes demos and/ or education materials with her. She makes it a point to walk to the distribution to get her exercise. At the distribution she always asks for greens and vegetables. Since her diagnosis, her blood sugars have improved, and she keeps them well controlled. 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 80 Background The Unity Council promotes social equity and improves quality of life by building vibrant communities where everyone can work, learn, and thrive. The Unity Council Latino Men and Boys (LMB) program contributes to improving participants’ health, wellness, academics, and guidance. LMB mentors facilitate a cohort of 12-25 male students. Centered around restorative justice and social and emotional learning (SEL) practices, the program aims to provide a safe learning environment and role model to students. Mentors provide intensive case management and individualized support to their students and families, as well as school health centers (SHCs), to increase students’ access to health information and services. During the COVID-19 shelter-in-place, LMB mentors, despite obstacles, were able to provide support both in and outside of school. The team referred some youth and families to LMB’s food distribution events and assisted families with rental support. Services are offered in English and Spanish. Measure A Funding Achievements The Unity Council LMB program used its Measure A allocation to achieve the following: • Conduct 256 Coordination of Service Team (COST) meetings and planning sessions with school and SHC staff to recruit and coordinate care • Ensure participation of 150 students in the LMB program (target: 160) • Deliver four presentations offering a culturally responsive SEL curriculum to 150 participants • Conduct 15 virtual parent meetings FY 20/21 Allocation: $200,000 | Expended/Encumbered: $200,000 Individuals served by Measure A: 150 (Total individuals served: 150) Populations served: Low Income, Uninsured Children Services provided: Public Health, Mental Health Service area: Oakland Latino Men and Boys Program unitycouncil.org Matching Funds $350,000 from the Oakland Unified School District, The California Endowment, Kaiser, and Unity Council in-kind and fiscal sponsorship. Highlights 92% 92% of participants reported that the program helped them get healthy food when their family didn’t have enough. 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 81 • Engage four SHC staff to build capacity for health care access and services for Latino young men and boys • Support 53 male participants with 504s or IEPs with LMB services • Hold eight COST meetings in all LMB sites (target: eight) Success Story Daniel joined the LMB program in 2019. When the pandemic hit, he was no longer able to attend class in person, and his father, the breadwinner in the family, lost his job. Shortly after, everyone in the home except Daniel tested positive for COVID-19. Daniel’s LMB mentor, Mr. G, helped him adjust to distance learning and the disruptions in his family life and connected his family to direct relief provided by The Unity Council. Through the organization, Daniel’s family received cash assistance as well as bagged groceries each week from its food distributions. Daniel’s family has referred others to the food distribution because it helped keep their family fed. 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 82 Background LifeLong Medical Care provides high quality health and social services to underserved people of all ages; creates models of care for the elderly, people with disabilities, and families; and advocates for continuous improvements in the health of its communities. The LifeLong Heart 2 Heart (H2H) program hosts community outreach events to provide information about cardiovascular disease, hypertension education, screenings, resource links, and health-related topics. The heart health drop-in blood pressure clinic at the South Berkeley Senior Center provides a space in which trusting relationships are built with seniors who visit weekly. In addition, H2H trains community members to become Neighborhood Health Advocates (NHAs) and empowers them with tools to improve the health and well-being of their community. H2H also coordinates with the NHAs to participate in community engagement activities for community members to keep them active and connected to the community. Services and written materials are provided in English and Spanish, with translation services for other languages as needed. Measure A Funding Achievements The LifeLong H2H program used its Measure A allocation to achieve the following: • Organize 61 community outreach events attended by 1,224 participants (target: three events) • Provide 16 community health education training sessions to 23 residents (target: 15 residents) FY 20/21 Allocation: $100,000 | Expended/Encumbered: $100,000 Individuals served by Measure A: 2,191 (Total individuals served: 2,191) Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors Services provided: Public Health Service area: Berkeley, Oakland LifeLong Medical Care (Heart 2 Heart) lifelongmedical.org/services/heart-2-heart.html Matching Funds $35,000 from the Sutter Health Foundation. 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 83 • Administer five mini-grants to five individuals who implemented a variety of health and wellness programs that served 1,208 attendees (target: four grants to four individuals) • Serve 2,191 community members at 96 community health events (target: 50 members at 15 events) Success Story Through LifeLong’s mini-grant program, Buendia Boxing was able to provide a safe and healthy space for over 30 participants per class at San Pablo Park in south Berkeley. One participant stated, “Coming here kept me out of trouble and helped me clear my mind.” Buendia Boxing noted, “Thanks to the Heart 2 Heart program, we were able to replace worn-out boxing gear and provide our youth with their own gloves to keep. This was essential during this pandemic. The Berkeley community was able to still find a way to keep their heart pumping during uncertain times." 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 84 Background Needle Exchange Emergency Distribution (NEED) works with people who use drugs, and communities affected by drug-related harm, to reduce and prevent the transmission of HIV/AIDS, Hepatitis C, and other blood-borne diseases. NEED offers free, anonymous services that are participant-driven in order to support and improve physical and social health. NEED provides injection and smoking supplies to reduce the risk of transmission of HIV and Hepatitis C. In recent years, the ubiquity of high potency fentanyl has increased a demand for naloxone distribution and overdose prevention services. Referrals are provided for testing and treatment for HIV and HCV, an overdose prevention hotline, medication-assisted treatment for opioid use disorder, social and medical services, food pantries, and more. NEED also provides first aid supplies, personal protective equipment, new socks, sandwiches, and other items for health and well-being care. NEED is a source for answers to questions and information sharing, as well as a safe, supportive, and nonjudgmental environment. Measure A Funding Achievements NEED used its Measure A allocation to achieve the following: • Make 2,691 service contacts through fixed and mobile outreach sites (target: 2,000) • Distribute 765,234 syringes (target: 600,000) • Dispose of 314,170 syringes (target: 300,000) FY 20/21 Allocation: $25,000* | Expended/Encumbered: $25,000 Individuals served by Measure A: 405 duplicated contacts (Total individuals served: 2,691 duplicated contacts) Populations served: Indigent, Low Income, Uninsured Adults, Families, Seniors Services provided: Public Health, Substance Abuse Service area: Countywide, Outside of Alameda County, Homeless or Transient *Includes Board of Supervisors discretionary allocation from District 5/Supervisor Carson Needle Exchange Emergency Distribution berkeleyneed.org Success Story One participant recently asked for fentanyl test strips, confiding that, although he has been abstinent from heroin for nearly five years, he recently moved to California and was having trouble obtaining his suboxone, a medication- assisted treatment for opioid use disorder. He wanted to be sure that if he relapsed as a result, his drugs would not be laced with unwanted fentanyl. Consultants instructed him on the proper use of the test strips, loaded him up with naloxone, informed him about the Never Use Alone hotline, and connected him with NEED resource navigators to help get him reconnected to his medication as quickly as possible. 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 85 Background The Alameda County Public Health Department (ACPHD) works in partnership with the community to ensure the optimal health and well- being of all people through a dynamic and responsive process respecting the diversity of the community and providing for present and future generations. The programs and organizations receiving Measure A funding under the Public Health Prevention Initiative funding include the following: • Asthma Start* • Berkeley Dental* • Child Health & Disability Prevention (CHDP) Developmental Screening— Help Me Grow • Community Assessment, Planning, and Evaluation (CAPE) Unit • Diabetes Program • East Oakland Boxing Association (EOBA) • Health Equity Policy & Planning (HEPP) • HOPE Collective • Immunization Section • Lotus Bloom • Mandela Partners • Niroga Institute • Nursing • Nutrition Services Program * This provider also received standalone Measure A funding. For details, see the entry under the provider’s name elsewhere in this report. Services are provided in a wide variety of languages, which vary by provider. FY 20/21 Allocation: $3,252,820 | Expended/Encumbered: $2,977,430 Individuals served by Measure A: 77,257 (Total individuals served: 277,997) Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors Services provided: Public Health, Mental Health Service area: Countywide, Homeless or Transient, Outside of Alameda County Public Health Prevention Initiative acphd.org Matching Funds $712,912 from the following sources: • Targeted Case Management (TCM) • Child Health and Disability Prevention (CHDP) • Maternal, Child, and Adolescent Health (MCAH) • Medi-Cal Administrative Activities (MAA) • Merck Foundation 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 86 Measure A Funding Achievements Measure A funds are used for a broad array of services that benefit the residents of Alameda County. The Public Health Prevention Initiative programs used Measure A funding to help achieve the following: Asthma Start • Enroll 138 clients in the program (target: 200) • Successfully discharge 70 clients from the program (target: 150) Berkeley Dental • Provide dental screening to 70 students (target: 60) • Reach 24,027 community residents through various programs (target: 20,000) • Reach 14,800 residents affected by COVID-19 to collect demographic data CHDP Developmental Screening—Help Me Grow • Develop 62 developmental screening goals (target: 58) • Provide monthly site visits to reinforce screening practices and offer technical assistance to clinic staff at 62 sites (target: 56) • Track and evaluate screening data from 56 sites (target: 56) • Provide eight trainings to pediatric provider sites CAPE Unit • Receive 120 data requests from stakeholders (target: 75) • Complete 110 data requests within two weeks (target: 75) Diabetes • Enroll 95 clients into diabetes self-management education (DSME) classes (target: 120) • Ensure that 11 clients successfully completed DSME (target: 100) EOBA • Reach 500 families per week through the EOBA food distribution program (target: 200) • Reach 5,064 households quarterly (target: 2,000) • Ensure that 24 youth participated in cooking, gardening, and/or physical activity programs (target: 40) • Ensure that 22 EOBA youth participated in daily physical activity in online after-school and summer programs (target: 40) • Conduct two sports nutrition workshops per quarter with 11 youth participants (target: four workshops with 11 participants) • Engage 12 youth participants in the Youth Leadership program (target: five) • Create 377 activity kits to enhance home learning in physical activity, gardening, nutrition, and art (target: 40) • Train 18 UC Berkeley students to be online health/literacy mentors to EOBA youth (target: six) Success Story Asthma Start “Tanya” complained of frequent asthma symptoms and couldn’t figure what was triggering them. After consulting with an asthma coordinator, she learned proper inhaler usage as well as how to follow the prescribed dosing. Together, they also determined that the triggers likely came from Tanya’s workplace, where she was exposed to food smoke and high physicality while performing her job duties. Tanya began to use her inhaler as prescribed and also decided to change jobs. Tanya reported that the education, support, referrals, and supplies were helpful, and that she had not had any asthma attacks since making these changes. Highlights 100% EOBA 100% of youth reported satisfaction with the cooking, gardening, and art classes; physical activity classes; and sports nutrition workshop (target: 85%). 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 87 HEPP—City/County Neighborhood Initiative (CCNI) • Hold 15 community meetings to conduct trainings on making vaccination appointments and share vaccination information and resources (target: 15) • Provide 70 organizations with technical assistance (TA), training, and navigation assistance to make vaccine appointments and access County resources (target: 50) • Provide education and health information through 15,000 door hangers in Spanish and English (target: 15,000) • Train 15 organizational partners for residential and small business outreach (target: 15) • Knock on 73,876 doors with information (target: 90,000) • Hold 16,106 conversations with residents (target: 20,000) • Serve 33,131 residents in the most impacted neighborhoods at community vaccine sites (target: 40,000) • Implement six community vaccine sites (target: six) • Institute nine practices that increased access for residents of underserved communities (target: 10) • Implement three pop-up vaccine sites with community partners (target: five) HOPE Collective • Provide 19 Nutrition Education and Outreach events to 7,534 people via social media and online events (target: 30 events for 1,250 participants) • Make 30 contacts/visits per store to accomplish healthy change goals (target: 120) Immunization Section • Create 82 perinatal Hepatitis B case reports to identify women of child- bearing age infected with Hepatitis B (target: 100) • Create 46 STD reports to identify new primary cases of syphilis (target: 52) Lotus Bloom • Reach 1,430 households monthly with diaper and food distribution (target: 125) • Provide 15 physical activity classes for 320 participants (target: eight classes for 30 participants) • Provide six cooking/nutrition classes for 172 participants (target: eight classes for 30 participants) • Provide playgroups for 41 families with 82 participants (target: 60 families with 120 participants) • Train 240 parents/staff in the Physical Movement and Health Food Policy (target: 240) • Participate with two markets to engage 60 families (target: two markets and 60 families) Mandela Partners • Provide nutrition education and outreach activities to 12,683 people (target: 1,250) Success Story HEPP At the community-based HEPP site at Fremont High School in Oakland, one client was Maya Mam, an indigenous community from Guatemala. HEPP provided Mam-speaking staff at the site, and the client was served in their native language. They enlisted HEPP’s help in bringing more of their coworkers from the Columbus-Hormel factory in Hayward. The workers were eligible for vaccination, but they would not have been aware or able to access the appointment system without HEPP’s outreach and support. With the factory manager’s cooperation, HEPP’s Spanish- and Vietnamese- speaking staff reached out to more than 30 immigrant workers and supported them and their families to make appointments and receive vaccinations. Highlights 100% Lotus Bloom 100% of bags of food distributed adhered to the Healthy Food Policy (target: 100%). 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 88 • Host 16 Cooking and Conversing virtual events (target: 16) • Offer 41 wellness education and recipe posts on Instagram (target: 40) • Recruit, maintain, and assist five stores per quarter for healthy change goals (target: five) Niroga Institute • Provide semester-long, twice-weekly Dynamic Mindfulness (DMind) sessions to 550 students (target: 500) • Provide online DMind training and coaching to 28 teachers (target: 40) Nursing • Investigate 428 COVID-19 outbreaks in congregate settings, including 255 confirmed outbreaks • Link 5,599 COVID-19 cases to confirmed outbreaks Nutrition Services • Provide technical assistance to 30 community-based organizations to create events that provided and encouraged healthy eating and drinking water (target: 30) • Provide community resident champion work opportunities to five people (target: five) Success Story HOPE Collective Quetzalli, an Oakland resident, participated in HOPE’s Collaborative Winter Cook- Along, which provided a package of ingredients so she could participate over Zoom. “After I was able to participate in the cook- along, I did not realize how fun it would be to cook and interact with the HOPE staff member…. [I]t was great for my mental health as I was able to just focus on what I was doing at hand and not think about what was happening with the pandemic. Since then, I’ve been able to attend more of these Zoom cook-along events. This has been a great resource for me and my friend’s mental health.” 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 89 Background Alameda County Emergency Medical Services (EMS) provides quality emergency medical services and prevention programs to improve the health and safety of residents in Alameda County. The EMS Senior Injury Prevention Program (SIPP) works to prevent unintentional injuries among older adults and to raise awareness of the need for injury prevention programs for older adults. SIPP providers, and the services they offer, include the following: • City of Fremont. The Health Promoter Program works to improve the physical and mental health services of older adults in the community, with a focus on older immigrants and refugees. They offer increased access to health, mental health and community services, support for healthy behavior changes, medication monitoring, and health and safety education classes. • DayBreak Adult Care Centers. Individuals and families served by this program receive injury prevention assistance and information for things such as unintended medication interactions, medication noncompliance in the case of lack of information, too many pharmacy interactions, and difficult reordering schedules. • St. Mary’s Center. St. Mary’s offers a medication safety program to help participants acquire their medication and how to use their medications safely. During the pandemic shelter-in-place, many participants felt disconnected and isolated; participants have been able to build community, making them feel supported and connected as well as able to continue their medication regimens. • Senior Support Program of the Tri-Valley. The Medication Safety program provides clients the tools and knowledge necessary to safely take their medications, serves as a double-check for medical systems to ensure medications are being taken safely, offers a free resource to help clients with medication management and reduce fall risks related to medication FY 20/21 Allocation: $282,474 | Expended/Encumbered: $282,474 Individuals served by Measure A: 622 (Total individuals served: 622) Populations served: Indigent, Low Income, Uninsured Adults, Seniors Services provided: Hospital Outpatient, Public Health, Mental Health, Substance Abuse Service area: Countywide Public Health Prevention Initiative: EMS Injury Prevention ems.acgov.org Matching Funds $41,170 The City of Fremont leveraged its Measure A allocation to obtain in-kind support from the City of Fremont’s Human Services Department. 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 90 errors, and provides social interaction, ongoing reassurance calls, and vital contact during the pandemic. • United Seniors of Oakland and Alameda County (USOAC). USOAC educates older adults on improving communication with their doctors and pharmacist, resulting in better medication management. Language services provided for the various agencies include Dari, Pashtu, Chinese, Korean, Vietnamese, Cantonese, Mandarin, Tagalog, Spanish, and English. Measure A Funding Achievements Measure A helped EMS achieve the following: City of Fremont • Provide Health Promoter services to 353 refugee, immigrant, and low income seniors over 50 years of age (target: 115) • Assist 348 clients with self-management coaching, wellness checks, and accessing medical services (target: 199) • Provide health and medication education and assistance to 228 clients (target: 50) • Provide emergency planning preparation and advance medical planning support to 110 clients (target: 100) • Provide fall prevention education and health and safety assessments to 133 clients (target: 50) DayBreak Adult Day Care Centers • Complete medication safety assessments for 20 participants (target: 40) St. Mary’s Center • Enroll 36 participants in the 12-week medication safety program for older adults (target: 40) • Provide weekly calls to 18 participants (target: 40) • Send 13 emails to participants (target: 40) • Complete a capstone week and plan by 19 participants (target: 40) • Conduct 292 face-to-face medication safety conversations (target: 564) • Provide a 12-week review to 12 enrolled participants (target: 24) • Give information and guidance to 32 participants regarding the disposal of expired, misused, or unused medication (target: 28) • Give recommended nutrition education and exercise encouragement to 32 participants (target: 37) Senior Support Program of the Tri-Valley • Enroll 37 low income residents aged 60 or older in the Medication Safety program (target: 38) USOAC • Train 329 seniors in one-on-one sessions (target: 200) • Conduct outreach to 1,550 seniors (target: 1,000) Success Story St. Mary’s Center Johnnie joined the Medication Safety Program to maintain a medication regiment and stay connected to community during the pandemic. He appreciated the support of St. Mary’s programs, which helped him stay connected and healthy. He missed gathering with friends but was grateful to have St. Mary’s staff and volunteers to keep him company while sheltering in place. “I am glad I was able to get a Mediset and pill cutter to help me stay on top of my medication. My case manager, nurse, and volunteer from St. Mary’s Center really care about me and my health. They remind me that I am not alone during these COVID sad times.” Highlights 95% Senior Support Program of the Tri-Valley 95% of clients received a compliance call within one week of their Medication Services consult (target: 80%). 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 91 Background Abode Services works to end homelessness by assisting low income, unhoused people, including those with special needs, to secure stable, supportive housing and advocate for the removal of the causes of homelessness. The Abode Services HOPE Project provides clients with hygiene kits, food, harm reduction supplies, and information on needle exchange programs. Participants are also connected to street health teams and mobile clinic services for support and access to medical and mental health services. Clients receive housing matches and referrals to housing navigation services. During the pandemic, HOPE project staff provided updated information on COVID-19 and personal protective equipment, connected participants to COVID-19 testing and vaccinations, and made referrals to Safer Ground locations. HOPE Project staff speak Spanish and English, and interpretation and translation services are used to provide services in other languages. Measure A Funding Achievements Abode Services used its Measure A allocation to achieve the following: • Provide housing outreach and engagement services to 172 individuals (target: 150) • Enroll 111 unduplicated individuals in the outreach program (target: 150) • Perform 511 hours of referral and case management services (target: 312) • Have 1,460 outreach contacts with enrolled clients (target: 1,350) • Distribute 2,120 hygiene and other supply kits to homeless unsheltered individuals (target: 150) • Refer 15 eligible clients to the County Home Stretch program offering permanent housing resources (target: 60) • Help 25 enrolled clients collect and submit all needed documents for a Home Stretch permanent supportive housing referral (target: 50) FY 20/21 Allocation: $107,123 | Expended/Encumbered: $107,123 Individuals served by Measure A: 176 (Total individuals served: 357) Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors Services provided: Public Health, Mental Health, Substance Abuse Service area: Fremont, Newark, Union City Public Health Services for Homeless Residents: Abode Services abodeservices.org Success Story The HOPE outreach team met a client in an encampment near the Abode office. Through ongoing efforts, the client was successfully referred to a scattered site location, where he was matched to a housing opportunity. The client had exceptional needs, which included a vision impairment that left him nearly blind, a chronic medical disorder where he had regularly scheduled dialysis, and some mental health concerns. The team supported him in getting all of his housing documentation prepared by meeting him at appointments to ensure his success in obtaining all the necessary documents. Currently, this participant has been stably housed for several months and is doing well. 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 92 Background Roots Community Health Center works to uplift those impacted by systemic inequities and poverty through medical and behavioral health care, health navigation, workforce enterprises, housing, outreach, and advocacy. Roots provides the Food Farmacy program for individuals, which improves participants’ access to food and lessens their food insecurity. Nutrition education is also provided. Language services are offered in Spanish. Measure A Funding Achievements Roots used its Measure A allocation to achieve the following: • Serve 468 individuals/patients through Food Farmacy distributions (target: 500) • Serve 405 unduplicated individuals/patients through Food Farmacy distributions (target: 150) • Make 148 food prescriptions/referrals via paper/electronic-based systems (target: 200) • Survey 26 participants of the Food Farmacy program (target: 20) • Distribute 425 pieces of educational and/or promotional materials for Food Farmacy and CalFresh enrollment information (target: 300) FY 20/21 Allocation: $20,000* | Expended/Encumbered: $20,000 Individuals served by Measure A: 468 (Total individuals served: 468) Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors Services provided: Public Health Service area: Oakland, San Leandro *Includes Board of Supervisors discretionary allocation from District 3/Supervisor Chan Roots Community Health Center rootsclinic.org Highlights 100% 100% of participants reported the distributions improved food security in their household (target: 50%). Roots Community Health Center FOOD FARMACY 7272 MacArthur Blvd. Oakland, California 94605 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 93 Background Measure A funding supported the Senior Injury Prevention Program (SIPP) offered by the City of San Leandro Senior Community Center. Though the center remained closed in FY 20/21 because of the pandemic, staff continued to offer outreach, information, and referrals by phone in the areas of COVID testing and vaccination locations, moral support, and well- being checks. Staff delivered Mercy Brown Bag groceries to participants who were quarantining as well as paratransit applications. Staff continued to offer the Virtual Senior Community Center (VSCC) web page that provides links to health resources, virtual exercise, travel, and craft videos to provide an alternative source of activities. Staff also created and mailed a periodic senior newsletter that provided resources and brain teasers. They also distributed free frozen Thanksgiving meals at drive-up distributions at the Senior Community Center and Marina Community Center. Services are offered in Spanish, Cantonese, English, and Chinese. Measure A Funding Achievements Measure A helped the SIPP providers achieve the following: • Provide 120 unduplicated senior participants with takeout lunch on weekdays (target: 40) • Provide a total of 9,754 lunches • Provide 168 unduplicated low income senior participants with a bag of nutritional groceries twice a month (target: 80) • Provide senior participants with a total of 3,423 grocery bags • Provide virtual health education to 437 participants • Offer 15 virtual health education classes (target: 12) • Provide 173 phone wellness checks to senior participants (target: 100) • Host virtual Fall Prevention Enhance Fitness class sessions and check-in conference calls for 56 senior participants (target: 75) • Host point-of-distribution-site free flu shots for 125 participants FY 20/21 Allocation: $237,985 | Expended/Encumbered: $237,985 Individuals served by Measure A: 1,136 (Total individuals served: 3,401) Populations served: Low Income Adults, Families, Seniors Services provided: Public Health Service area: Ashland, Castro Valley, Cherryland, Hayward, San Leandro, San Lorenzo Senior Injury Prevention Program sanleandro.org Success Story Mel and Irma Chavez learned about San Leandro’s essential food services from city staff. As a result of the call, they started to pick up meals from the Spectrum Senior Meal program daily. A short time later, they also signed up for the Mercy Brown Bag program. When Irma Chavez was asked about the services she received from the San Leandro Senior Community Center, she stated that she appreciated the delicious, nutritious lunches that support her and her husband’s health, and that the program was affordable for them. She also said that receiving the twice-monthly Mercy Brown Bag really helped them to reduce their grocery bill. 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 94 Background Service Opportunity for Seniors (SOS) Meals on Wheels promotes nutritional health, decreases the possibility of premature institutionalization, and fosters the independence and dignity of homebound seniors in Central Alameda County and the City of Oakland. SOS provides information and referrals to other supportive services based on clients’ intake and ongoing assessment data. Information and referrals include fall prevention, transportation, in-home health care, safety, utilities assistance, housing, legal services, assistive technology and other devices, and other nutrition services. Other services may be available depending on intake interviews and assessments. Services to clients are offered in Mandarin, Spanish, and English. Measure A Funding Achievements Service Opportunities for Seniors: Meals on Wheels used its Measure A allocation to achieve the following in District 3: • Distribute 12,716 nutritious, balanced meals (target: 13,125) • Serve 92 clients residing in unincorporated Alameda County (target: 95) • Provide 1,816 meals per month (target: 1,875) • Make 1,582 wellness checks per month (target: 1,375) • Provide 11,079 total wellness checks (target: 9,625) • Distribute 77 client satisfaction surveys (target: 67) FY 20/21 Allocation: $20,000* | Expended/Encumbered: $20,000 Individuals served by Measure A: 92 (Total individuals served: 3,047) Populations served: Indigent, Low Income, Uninsured Seniors Services provided: Public Health Service area: Countywide *Includes Board of Supervisors discretionary allocation from District 3/Supervisor Chan Service Opportunities for Seniors (Meals on Wheels) — District 3 sosmow.org Highlights 97% 97% of seniors reported that Meals on Wheels helped them to live at home (target: 80%). 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 95 Background Service Opportunity for Seniors (SOS) Meals on Wheels promotes nutritional health, decreases the possibility of premature institutionalization, and fosters the independence and dignity of homebound seniors in Central Alameda County and the City of Oakland. SOS provides information and referrals to other supportive services based on clients’ intake and ongoing assessment data. Information and referrals include fall prevention, transportation, in-home health care, safety, utilities assistance, housing, legal services, assistive technology and other devices, and other nutrition services. Other services may be available depending on intake interviews and assessments. Services to clients are offered in Spanish, Mandarin, and English. Measure A Funding Achievements Service Opportunities for Seniors: Meals on Wheels used its Measure A allocation to achieve the following in District 4: • Distribute 15,381 nutritious, balanced meals (target: 13,125) • Serve 130 clients residing in unincorporated Alameda County (target: 95) • Provide 2,197 meals per month (target: 1,875) • Make 2,001 wellness checks per month (target: 1,375) • Provide 14,010 total wellness checks (target: 9,625) • Distribute 109 client satisfaction surveys (target: 67) FY 20/21 Allocation: $20,000* | Expended/Encumbered: $20,000 Individuals served by Measure A: 130 (Total individuals served: 3,047) Populations served: Indigent, Low Income, Uninsured Seniors Services provided: Public Health Service area: Countywide *Includes Board of Supervisors discretionary allocation from District 4/Supervisor Miley Service Opportunities for Seniors (Meals on Wheels) — District 4 sosmow.org Highlights 100% 100% of seniors had decreased food insecurity and isolation (target: 100%). 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 96 Background Tri-Valley Haven for Women creates homes safe from abuse and contributes to a more peaceful society one person, one family, and one community at a time. Tri-Valley Haven’s Domestic Violence Shelter improves the lives of the individuals and families entering the shelter program by assigning a counselor and a case manager. Shelter staff provide classes on topics that include budgeting, job skills, understanding trauma, self-esteem, self- care, resume writing, nutrition, goal setting, and more to promote long- term safety and self-sufficiency. The Domestic Violence Shelter also has a Children’s Advocate who works with and focuses on the children in the shelter to make sure their needs are being met. Tri-Valley Haven uses the language line to deliver shelter services if no bilingual speaker is on staff. Services are delivered in English, Spanish, Chinese, Farsi, Russian, Tagalog, and Vietnamese. Measure A Funding Achievements Tri-Valley Haven planned to use its Measure A allocation for costs for equipment, fees, an environmental assessment, engineering, and a landscape architect for its new Domestic Violence Shelter rebuild. No Measure A funds were expended in FY 20/21 for this project. FY 20/21 Allocation: $100,000* | Expended/Encumbered: $0 Individuals served by Measure A: 236 (Total individuals served: 236) Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors Services provided: Public Health, Mental Health, Substance Abuse Service area: Countywide, Homeless or Transient *Includes Board of Supervisors discretionary allocation from District 1/Supervisor Haubert Tri-Valley Haven for Women trivalleyhaven.org 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 97 Background West Oakland Health Center (WOHC) works to improve the health and socioeconomic status of the community by providing high quality preventive care for its diverse neighbors throughout the East Bay. WOHC strives to be a hub of health, well-being, connection, and inspiration. WOHC’s Food Farmacy distributions help clients’ households by ensuring they have extra food to last throughout the month. WOHC provides educational material as well as CalFresh enrollment services. Services are provided in Spanish, Urdu, and English. Measure A Funding Achievements WOHC used its Measure A allocation to achieve the following: • Serve 600 individuals/patients and their households via Food Farmacy distributions (target: 500) • Serve 150 unique individuals/patients via Food Farmacy distributions (target: 150) • Provide 100 food prescriptions/referrals (target: 200) • Provide 1,200 educational and/or promotional materials related to nutrition and nutritious foods (target: 300) FY 20/21 Allocation: $20,000* | Expended/Encumbered: $20,000 Individuals served by Measure A: 600 (Total individuals served: 600) Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors Services provided: Public Health, Mental Health Service area: Alameda, Oakland, Homeless or Transient *Includes Board of Supervisors discretionary allocation from District 3/Supervisor Chan West Oakland Health Center westoaklandhealth.org Success Story WOHC delivered food to an elderly individual who was recovering from hip surgery. She lived alone, needed food, and was not mobile. She had an In-Home Supportive Services (IHSS) caretaker, but the caretaker was recovering from COVID and was not able to provide services. WOHC was able to provide the individual with enough food to cover one and a half weeks, and also helped this individual apply for CalFresh to help supplement her limited income. 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 98 Background The Center for Healthy Schools and Communities (CHSC) works to foster the academic success, health, and well-being of Alameda County youth by building universal access to high quality support and opportunities in schools and neighborhoods. The countywide Youth and Family Opportunity (YFO) initiative provides a variety of supports and opportunities to youth to strengthen their protective factors, encounter less risk, and ultimately show evidence of higher rates of successful transitions into adulthood, which leads to improved health outcomes throughout life. YFO partners are situated in the County’s areas of highest need based on social determinants of health and work to address those needs to interrupt cycles of inequity and create schools and communities that support all young people to thrive. In addition to the formal health and wellness services offered to youth and families, YFO organizations also offer family support and youth development services as part of their holistic programming and may serve as the safety net for a young person or family who is just short of extreme crisis. The organizations involved in the YFO initiative include the following: • Alameda Family Services (AFS) provides an array of health and wellness services to families, primarily in the city of Alameda, through their Family Support Services Center, Senior Connections program, and partnerships with the school district and other community-based organizations. • Berkeley Youth Alternatives (BYA) provides culturally competent case management, behavioral health, and youth development services to low income children and youth ages 6–18 and their families. FY 20/21 Allocation: $2,724,654 | Expended/Encumbered: $2,724,654 Individuals served by Measure A: 17,477 (Total individuals served: 17,477) Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors Services provided: Public Health, Mental Health, Substance Abuse Service area: Countywide, Homeless or Transient Youth and Family Opportunity Initiatives achealthyschools.org Matching Funds $5.18M from the following sources: • Medi-Cal Administrative Activities (MAA) • Alameda County funding: Board of Supervisors • Alameda County Probation Office • Alameda County Social Services • First 5 • Local and national foundations • Federal grants • City and school district funding • Individual donors 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 99 • East Bay Agency for Children (EBAC) operates Family Resource Centers (FRCs) that provide health and wellness supports such as language classes; parenting workshops, groups, and presentations; crisis support including referrals to case management; housing referrals; immigration-related legal referrals; a food pantry; referrals to dental care coordination; and the enrollment of eligible children and families in health coverage and other public benefits programs. • East Bay Asian Youth Center (EBAYC) provides school-day and after- school holistic supports, including care coordination, individual case management and referrals, mentoring, and youth development activities. • Fremont Family Resource Center (FFRC) is a collaboration of 24 state, County, City of Fremont, and nonprofit organizations working together to serve families living in the Tri-Cities. As a “one stop” resource center, they provide case management and referrals to a wide array of health, wellness, and basic needs supports. • Fremont Unified School District offers support across the three tiers of prevention, early intervention, and treatment; has a family liaison who supports students and their families with accessing health-related and other needed resources; and partners with Bay Area Community Health’s Outreach & Eligibility Workers to promote health coverage and public benefits enrollment services. • Health Initiatives for Youth (HIFY) runs the McClymonds Youth and Family Center and partners with Children’s Hospital & Research Center at Oakland, which runs the onsite health center. • La Familia Counseling Service serves low income, underserved, primarily Spanish-speaking communities in Hayward with health access and family support services through a partnership with the Hayward Unified School District (HUSD). La Familia runs a Parent Ambassador Program to conduct outreach and provides case management and referrals to HUSD youth and their families. • Lincoln provides school-linked health and wellness services to students and their families in West Oakland. Lincoln provides intensive case management service, individual mentoring that’s focused on social- emotional wellness, and group wellness sessions to youth and their families at each site. • Newark Unified School District’s (NUSD’s) Newark Parent Partner Program provides health access and family support services, primarily through workshops and referrals to partner organizations. Partnerships with over 30 organizations enable families to access health and benefits enrollment and health care, basic needs support, legal aid, and mental health supports. • Pleasanton Unified School District (PUSD) provides a health and wellness system and increases access to services. They also provide virtual workshops for parents on topics including Positive Parenting During Remote Learning, Coping During Transitions, and Ask the Counselor Wellness Series. • REACH Ashland Youth Center offers a variety of programs for youth that increase their healing, sense of connection, and belonging, as well as increasing their access to health care. REACH clinical case managers and Highlights 87% 87% of youth agreed/strongly agreed that they had places to go for health and wellness services (target: 85%). Success Story A family of seven tested positive for COVID. Both parents worked two jobs and would not be paid during their COVID leave. The family was behind on rent and in danger of becoming homeless. An NUSD Parent Partner helped them apply for Newark’s rental assistance program and signed the family up for food and hot lunches from NUSD. The family did not have Medi-Cal and were connected with Bay Area Community Health for both Medi- Cal and CalFresh. The Parent Partner was able to help the family through their COVID-19 crisis and connect them to resources to support their wellness, stability, and education moving forward. 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 100 community health outreach workers specifically focus on youth health and wellness. REACH partners with community providers to provide onsite behavioral, physical, and dental health services; health education and internships; youth leadership activities; recreation and fitness; arts and creativity education; and career and employment supports. • Union City Family Center (UCFC) offers a range of onsite supports and referrals to a vast partnership collaborative for children and families in the New Haven Unified School District, specifically in the Decoto neighborhood of Union City. UCFC provides significant family support as well. • YR Media provides wraparound health and wellness support to youth enrolled in their media arts education and internship programs. While their facility is closed due to COVID-19, YR Media has adapted their curriculum to run virtually and has kept young people engaged with the program and staff. YFO organizations employ bilingual, bicultural staff, many of whom are bilingual in at least one other language. Measure A Funding Achievements YFO Initiative providers used their Measure A allocation to achieve the following: • Hold 122 community events focused on raising awareness of free and affordable health care services, at which 20,419 contacts were made (target: 60–70 events and 20,000 contacts) • At the events, provide the following: - Application assistance to enroll in Medi-Cal, HealthPAC, or Covered California to 1,738 families (target: 350–400 families) - Application assistance to enroll in CalFresh, CalWORKs, or other public benefits to 1,312 families (target: 350–400 families) - Information about health insurance and benefits eligibility and/ or referrals to an offsite location for application assistance to 7,667 families (target: 3,000) • Serve 768 clients for 3,202 visits at Fuente Health Center at REACH (target: 1,000) • Serve a total of 4,448 youth through care coordination and case management (target: 1,000) • Provide counseling to 239 youth (target: 150) • Offer health and wellness workshops to 729 youth (target: 1,000) • Engage 123 youth in small wellness groups (target: 50) • Provide over 21,000 youth with healthy food through snack programs • Provide 133 youth with youth leadership activities (target: 20–30) • Involve 398 youth in arts and enrichment activities (target: 300) • Support 2,965 families of youth around health and wellness • Provide college and career support to 637 youth and academic support to 734 youth • Serve 5,533 parents/caregivers through case management (target: 2,500) Highlights 76% 76% of youth agreed/strongly agreed that their YFO program helped them get healthy food for them and their families (target: 70%). 85% 85% of youth agreed/strongly agreed that YFO helped them improve their social-emotional wellness (target: 85%). 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 101 • Serve 3,198 clients with crisis intervention (target: 150) • Serve 107 parents/caregivers who participated in counseling (target: 150) • Provide 14,825 families with healthy foods • Provide a wide range of workshops to 4,136 parents/caregivers (target: 300) • Provide 744 families with home visits to support health, wellness, and healthy development • Provide 319 people with support related to school, college and career, and financial literacy Highlights 93% 93% of youth agreed/strongly agreed that the YFO program helped them improve their life skills (target: 85%). 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 102 APPENDICES Appendix A: Measure A Auditor-Controller Report FY 04/05 through FY 20/21 Appendix B: FY 20/21 Budget Information Appendix C: FY 20/21 Measure A Fund Distribution by Provider or Program Appendix D: Maps: Geographic Distribution of Providers Funded by Measure A in FY 20/21 Map 1 Alameda County Public Health Programs Funded by Measure A in FY 20/21 Map 2 Alameda County Behavioral Health Care Services Alcohol and Other Drug Providers Funded by Measure A in FY 20/21 Map 3 Alameda County Behavioral Health Care Services Mental Health Community-Based Organization Providers Funded by Measure A in FY 20/21 Map 4 School Health Centers Funded by Measure A in FY 20/21 Map 5 HealthPAC Provider Network Funded by Measure A in FY 20/21 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 103 $123,148,555 $41,049,520 150 160 170 REVENUE RECEIVED EACH FISCAL YEAR (FY 04/05 THROUGH FY 20/21) Alameda Health System Board of Trustees Alameda County Board of Supervisors FY 04/05 FY 05/06 FY 06/07 FY 07/08 FY 08/09 FY 09/10 FY 10/11 FY 11/12 FY 12/13 FY 13/14 FY 14/15 FY 15/16 FY 16/17 FY 17/18 FY 18/19 FY 19/20 FY 20/21 $106,756,815 $35,585,604 APPENDIX A: MEASURE A AUDITOR-CONTROLLER REPORT FY 04/05 THROUGH FY 20/21 Measure A Funds received from the state and the distribution of the funds according to the provisions of Measure A: TOTAL REVENUE RECEIVED (FY 04/05 THROUGH FY 20/21) $2.1 BILLION Alameda County Board of Supervisors $531 MILLION Alameda Health System Board of Trustees $1,592 MILLION 130 1401201101009080706050403020100 $60,117,363 $20,039,121 $81,323,423 $27,107,808 $84,709,434 $28,236,479 $86,353,758 $28,784,587 $78,795,611 $26,265,206 $70,406,165 $23,468,723 $77,220,213 $25,740,069 $83,787,603 $27,929,200 $89,281,278 $29,760,426 $95,071,058 $31,690,352 $102,780,581 $34,260,195 $114,221,279 $ 38,073,760 $117,801,551 $39,267,184 $121,160,385 $40,386,795 $98,654,234 $32,884,744 75% 25% 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 104 APPENDIX B: FY 20/21 BUDGET INFORMATION TOTAL ALLOCATION5 CARRYOVER FROM PREVIOUS FISCAL YEAR2 TOTAL AVAILABLE FUNDS EXPENDED AND/OR ENCUMBERED CARRYOVER TO NEXT FISCAL YEAR2 TOTAL SAVINGS3 Behavioral Health Behavioral Health Services 150,000 0 150,000 90,996 59,004 150,000 59,004 Center for Healthy Schools and Communities (School-Based Behavioral Health Initiative) 1,333,336 0 1,333,336 1,333,336 0 1,333,336 0 Cherry Hill Detoxification and Sobering Center1 2,295,875 1,103,102 3,398,977 1,989,977 1,409,000 3,398,977 0 Criminal Justice Screening and In-Custody Services 4,306,000 0 4,306,000 4,306,000 0 4,306,000 0 The Alliance for Community Wellness dba La Familia Counseling Services (La Familia) 30,000 0 30,000 30,000 0 30,000 0 Mental Health for Juvenile Justice Center 360,000 0 360,000 360,000 0 360,000 0 Mental Health Services for Newcomers and Immigrants: Center for Empowering Refugees and Immigrants (CERI) 86,096 0 86,096 86,096 0 86,096 0 Substance Use Disorder Services 450,000 0 450,000 311,745 0 311,745 138,255 Hospital, Tertiary Care, Other Children’s Hospital & Research Center at Oakland 2,100,000 0 2,100,000 2,100,000 0 2,100,000 0 St. Rose Hospital2 5,000,000 496,000 5,496,000 5,000,000 496,000 5,496,000 0 Washington Hospital Healthcare Foundation 66,000 0 66,000 66,000 0 66,000 0 Primary Care Alameda County Dental Health 257,580 0 257,580 257,580 0 257,580 0 Center for Elders' Independence 57,397 0 57,397 57,397 0 57,397 0 Center for Healthy Schools & Communities (School Health Centers)1,350,000 0 1,350,000 1,350,000 0 1,350,000 0 Direct Medical and Support Services (Oakland): Preventive Care Pathways 229,587 0 229,587 229,587 0 229,587 0 Direct Medical and Support Services: Roots Community Health Center 250,000 0 250,000 250,000 0 250,000 0 Health Enrollment for Children 300,000 0 300,000 300,000 0 300,000 0 Health Services for Day Laborers 191,324 0 191,324 191,324 0 191,324 0 Health Services for Unaccompanied Immigrant Youth 350,000 0 350,000 350,000 0 350,000 0 Medical Costs for Juvenile Justice Health Services 511,891 0 511,891 380,011 0 380,011 131,880 Primary Care Community-Based Organizations 5,753,009 0 5,753,009 5,753,009 0 5,753,009 0 Public Health Alameda Boys & Girls Club, Inc. 114,794 0 114,794 114,794 0 114,794 0 Asthma Start 100,000 0 100,000 100,000 0 100,000 0 Center for Early Intervention on Deafness 57,397 0 57,397 57,397 0 57,397 0 City Serve of the Tri-Valley 100,000 0 100,000 100,000 0 100,000 0 Continued on next page 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 105 TOTAL ALLOCATION5 CARRYOVER FROM PREVIOUS FISCAL YEAR2 TOTAL AVAILABLE FUNDS EXPENDED AND/OR ENCUMBERED CARRYOVER TO NEXT FISCAL YEAR2 TOTAL SAVINGS4 Public Health (Continued) Countywide Plan for Seniors: Home-Based Nursing Case Management 500,000 0 500,000 500,000 0 500,000 0 Countywide Plan for Seniors: Hospice and Advance Life Planning 250,000 0 250,000 233,154 16,846 250,000 0 Countywide Plan for Seniors: Injury Prevention & Nutrition Services 797,808 28,916 826,724 751,595 75,129 826,724 0 COVID-19 Crisis Response Services 0 2,945,668 2,945,668 2,016,750 928,918 2,945,668 0 Emergency Medical Services (EMS) Corp 607,791 0 607,791 607,791 0 607,791 0 EMS Ambulance Providers to Serve 5150 Indigent Population 0 1,056,675 1,056,675 252,060 804,615 1,056,675 0 Emergency Preparedness, Mitigation, Response, and Recovery 0 64,070 64,070 64,070 0 64,070 0 Health Services for Persons Who Inject Drugs: HIV Education and Prevention Project of Alameda County (HEPPAC) 310,684 0 310,684 310,684 0 310,684 0 Healthy Homes Department: Fixing to Stay & Group Living Facilities Project 311,511 0 311,511 218,221 0 218,221 93,290 Home Visiting Services 1,850,170 456,921 2,307,091 1,915,292 391,799 2,307,091 0 Homelessness 3-Year Action Plan 500,000 0 500,000 500,000 0 500,000 0 La Clinica de La Raza, Inc.20,000 0 20,000 20,000 0 20,000 0 Latino Men and Boys Program: Spanish Speaking Unity Council of Alameda County, Inc. DBA The Unity Council 200,000 0 200,000 200,000 0 200,000 0 LifeLong Medical Care (Heart 2 Heart)100,000 0 100,000 100,000 0 100,000 0 Needle Exchange Emergency Distribution 25,000 0 25,000 25,000 0 25,000 0 Nutrition Services in West Oakland (City Slicker Farms)0 20,000 20,000 20,000 0 20,000 0 Public Health Prevention Initiative 3,252,820 0 3,252,820 3,038,378 0 3,038,378 214,442 Public Health Prevention Initiative: EMS Injury Prevention 225,077 0 225,077 225,077 0 225,077 0 Public Health Services for Homeless Residents: Abode Services 107,123 0 107,123 91,968 0 91,968 15,155 Roots Community Health Center 20,000 0 20,000 20,000 0 20,000 0 Senior Injury Prevention Program 123,191 0 123,191 123,191 0 123,191 0 Senior Injury Prevention Program: City of San Leandro Senior Services 57,397 0 57,397 57,397 0 57,397 0 Senior Injury Prevention Program: Fremont Aging & Family Services 57,397 0 57,397 57,397 0 57,397 0 Service Opportunity for Seniors (Meals on Wheels)40,000 0 40,000 40,000 0 40,000 0 Tri-Valley Haven for Women 100,000 0 100,000 100,000 0 100,000 0 West Oakland Health Council 20,000 0 20,000 20,000 0 20,000 0 Youth and Family Opportunity Initiatives 2,724,654 0 2,724,654 2,682,200 42,454 2,724,654 0 Board of Supervisors 750,000 744,304 1,494,304 521,000 973,304 1,494,304 0 TOTAL FY 20/214 158,936,217 6,915,656 165,851,873 157,099,677 7,532,805 164,632,482 1,219,391 1. Cherry Hill Detoxification and Sobering Center's carryover balance includes carryover of unexpended funds from the Board-approved original allocation and any unspent funds from subsequent Board-approved allocations. 2. The Board approved certain allocations to carry over unexpended funds to the next fiscal year. The carryover funds must be used for the same purpose for which the Board approved the original allocation. 3. Savings are unexpended funds that will revert to the general Measure A account for reallocation in future fiscal years. 4. The total allocation includes Measure A Base and Measure A One-Time Allocations approved by the Board for FY 20/21. 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 106 APPENDIX C: FY 20/21 MEASURE A FUND DISTRIBUTION BY PROVIDER OR PROGRAM GROUP 1: BEHAVIORAL HEALTH MEASURE A ALLOCATION FY 20/21 EXPENDED/ENCUMBERED FY 20/21 Behavioral Health Services Alameda County Mental Health Association 31,139 8,751 Bonita House, Inc. 61,310 61,310 Center for Independent Living 2,627 2,627 The Alliance for Community Wellness 54,924 18,308 Total Allocation 150,000 90,996 Center for Healthy Schools and Communities (School-Based Behavioral Health Initiative) City of Hayward 220,000 220,000 Portia Bell Hume Center 143,492 143,492 Emeryville Unified School District 40,178 40,178 Other Program Expenses 929,666 929,666 Total Allocation 1,333,336 1,333,336 Cherry Hill Detoxification and Sobering Center (Horizon Services, Inc.) 2,295,875 1,989,977 Criminal Justice Screening and In-Custody Services 4,306,000 4,306,000 The Alliance for Community Wellness dba La Familia Counseling Services (La Familia) 30,000 30,000 Mental Health Services for Juvenile Justice Center 360,000 360,000 Mental Health Services for Newcomers & Immigrants: Center for Empowering Refugees and Immigrants (CERI) 86,096 86,096 Substance Use Disorder Services Axis Community Health, Inc. 1,429 1,429 Center Point 193,693 137,930 Filipinos Advocates for Justice 30,000 24,585 Horizon Services, Inc. 5,017 - New Bridge 30,000 11,334 Roots Community Health Center 30,000 3,262 Senior Support Program of the Tri-Valley 78,518 59,880 St. Mary's Center 78,519 73,325 Unallocated 2,824 - Total Allocation 450,000 311,745 GROUP 2: HOSPITAL, TERTIARY CARE, OTHER MEASURE A ALLOCATION FY 20/21 EXPENDED/ ENCUMBERED FY 20/21 Alameda Health System 121,160,385 121,160,385 Children’s Hospital & Research Center at Oakland 2,100,000 2,100,000 St. Rose Hospital 5,000,000 5,000,000 Washington Hospital Healthcare Foundation 66,000 66,000 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 107 GROUP 3: PRIMARY CARE MEASURE A ALLOCATION FY 20/21 EXPENDED/ ENCUMBERED FY 20/21 Alameda County Dental Health (Axis Community Health)1 257,580 257,580 Center for Elders' Independence 57,397 57,397 Center for Healthy Schools and Communities (School Health Centers) Alameda Family Services 125,000 125,000 Children's Hospital & Research Center at Oakland 100,000 100,000 City of Berkeley 75,000 75,000 East Bay Agency for Children 50,000 50,000 East Bay Asian Youth Center 50,000 50,000 Fred Finch 50,000 50,000 La Clinica de La Raza, Inc. 400,000 400,000 LifeLong Medical Center 150,000 150,000 Native American Health Center 200,000 200,000 Tiburcio Vasquez Health Center 125,000 125,000 Sunol Glen Unified School District 25,000 25,000 Total Allocation 1,350,000 1,350,000 Direct Medical and Support Services (Oakland) Preventive Care Pathways 229,587 229,587 Roots Community Health Center 250,000 250,000 Total Allocation 479,587 479,587 Health Enrollment for Children 300,000 300,000 Health Services for Day Laborers Multicultural Institute 95,662 95,662 Street Level Health Project 95,662 95,662 Total Allocation 191,324 191,324 Health Services for Unaccompanied Immigrant Youth Alliance for Community Wellness 185,000 185,000 Eden United Church of Christ 75,000 75,000 Oakland Unified School District 15,000 15,000 Other Program Expenses 75,000 75,000 Total Allocation 350,000 350,000 Medical Costs for Juvenile Justice Services Niroga Institute 89,152 89,152 Victims of Crime 90,000 87,134 Direct Service Planning & Administration 261,000 203,725 Unallocated 71,739 - Total Allocation 511,891 380,011 Primary Care Community-Based Organizations Alameda Health Consortium: Asian Health Services 610,521 610,521 Axis Community Health 638,300 638,300 Davis Street Family Resource Center 107,123 107,123 La Clínica de La Raza 1,796,317 1,796,318 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 108 GROUP 3: PRIMARY CARE MEASURE A ALLOCATION FY 20/21 EXPENDED/ ENCUMBERED FY 20/21 LifeLong Medical Center 694,001 694,001 Native American Health Center 269,219 269,219 Tiburcio Vasquez Health Center 869,872 869,872 Tri-City Health Center 591,504 591,504 West Oakland Health Council 176,152 176,152 Total Allocation 5,753,009 5,753,010 GROUP 4: PUBLIC HEALTH MEASURE A ALLOCATION FY 20/21 EXPENDED/ ENCUMBERED FY 20/21 Alameda Boys & Girls Club, Inc. 114,794 114,794 Asthma Start 100,000 100,000 Center for Early Intervention on Deafness 57,397 57,397 City Serve of the Tri-Valley 100,000 100,000 Countywide Plan for Seniors (Home-Based Nursing Case Management) 500,000 500,000 Countywide Plan for Seniors (Hospice & Advance Life Planning) 250,000 233,154 Countywide Plan for Seniors (Injury Prevention, Meals, Nutrition) Afghan Elderly Association 20,439 7,274 Daybreak Adult Care Centers 49,220 49,220 Life ElderCare, Inc. 46,452 46,452 LifeLong Medical Care 24,774 24,774 Mercy Brown Bag 85,000 85,000 Pharm United/Partners In Care 14,300 6,952 Rebuilding Together Oakland 12,387 12,387 Senior Support Program of the Tri-Valley 25,357 25,357 Service Opportunity for Seniors 370,000 370,000 Spectrum Community Services 66,117 66,117 Spectrum Community Services 21,000 21,000 St. Mary's Center 34,062 37,062 Unallocated 28,700 - Total Allocation 797,808 751,595 COVID-19 Crisis Response Services1 Berkeley Food and Housing 3,000 3,000 LifeLong Medical Care 2,013,750 2,013,750 Total Allocation 2,016,750 2,016,750 Emergency Medical Services (EMS) Corp 607,791 607,791 EMS Ambulance Providers to Serve 5150 Indigent Population FALCK - 246,803 Other Program Expenses - 5,258 Total Allocation - 252,060 Emergency Preparedness, Mitigation, Response, and Recovery - 64,070 Health Services for Persons Who Inject Drugs 310,684 310,684 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 109 GROUP 4: PUBLIC HEALTH MEASURE A ALLOCATION FY 20/21 EXPENDED/ ENCUMBERED FY 20/21 Healthy Homes Department: Fixing to Stay & Group Living Facilities Project 311,511 218,221 HIV Education and Prevention Project of Alameda County OPEND 310,684 310,684 Healthy Food Healthy Families Alameda County Community Food Bank 47,500 47,500 Alameda County Deputy Sheriffs' Activities League, Inc. 270,000 270,000 Total Allocation 417,500 402,500 Healthy Homes Department (Fixing to Stay & Group Living Facilities Project) 311,511 197,589 Homelessness 3-Year Action Plan Abode Services 250,000 250,000 East Bay Innovations 250,000 250,000 Total Allocation 500,000 500,000 Home Visiting Services Brighter Beginnings 465,000 473,368 Children's Hospital Oakland & Research Center at Oakland 693,681 694,602 Native American Health Center, Inc. 101,489 129,167 Tiburcio Vasquez Health Center 590,000 618,155 Total Allocation 1,850,170 1,915,292 La Clinica de La Raza, Inc. 20,000 20,000 Latino Men and Boys Program (Spanish Speaking Unity Council of Alameda County, Inc.) 200,000 200,000 LifeLong Medical Care 100,000 100,000 Needle Exchange Emergency Distribution 25,000 25,000 Nutrition Services in West Oakland: City Slicker Farms 20,000 20,000 Public Health Prevention Initiative Axis Community Health, Inc. 50,000 50,000 CAL-PEP 58,507 58,506 Center for Oral Health 154,016 152,114 City of Berkeley 377,638 387,430 East Oakland Boxing Association 56,272 56,272 HIV Education and Prevention Project of Alameda County 109,221 115,032 Lotus Bloom 36,577 45,721 Mandela Partners 112,371 112,371 Niroga Institute, Inc. 166,374 109,323 Tides Center 131,495 131,365 Other Program Expenses 1,775,273 1,587,089 Total Allocation 3,027,744 2,805,223 Public Health Prevention Initiative: EMS Injury Prevention - Adult Day Services Network of Alameda County 26,018 26,018 City of Fremont 136,892 136,892 Senior Support Program of the Tri-Valley 26,018 26,018 St. Mary's Center 26,024 26,024 United Seniors of Oakland and Alameda County 10,125 10,125 Total Allocation 225,077 225,077 Public Health Services for Homeless Residents: Abode Services 107,123 100,446 Roots Community Health Center 20,000 20,000 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 110 GROUP 4: PUBLIC HEALTH MEASURE A ALLOCATION FY 20/21 EXPENDED/ ENCUMBERED FY 20/21 Senior Injury Prevention Program Afghan Elderly Association 9,212 9,212 City of Fremont 57,397 57,397 City of San Leandro 57,397 57,397 Daybreak Adult Care Centers 21,317 21,317 Life ElderCare, Inc. 20,152 20,152 LifeLong Medical Care 11,083 11,083 Rebuilding Together Oakland 5,383 5,383 Senior Support Program of the Tri-Valley 11,395 11,395 Spectrum Community Services 28,577 28,577 St. Mary's Center 16,072 16,072 Total Allocation 237,985 237,985 Service Opportunity for Seniors 40,000 40,000 Tri-Valley Haven for Women 100,000 100,000 West Oakland Health Council 20,000 20,000 Youth and Family Opportunity Initiatives Alameda Family Services 114,794 114,794 Berkeley Youth Alternatives 114,794 114,794 City of Fremont 172,191 172,191 East Bay Agency for Children 103,500 103,500 East Bay Asian Youth Center 114,794 114,794 Eden Youth and Family Center 20,000 20,000 Fremont Unified School District 114,794 114,794 Health Initiatives for Youth 114,794 114,794 La Clinica de La Raza, Inc.50,000 50,000 Lincoln 168,000 168,000 New Haven Unified School District 114,794 114,794 Newark Unified School District 114,794 114,794 Pleasanton Unified School Distirct 19,131 19,131 The Alliance for Community Wellness dba La Familia Counseling Services (La Familia)192,191 192,191 Youth Radio 114,794 114,794 Other Program Expenses 1,081,289 1,081,289 Total Allocation 2,724,654 2,724,654 1. Carryover from previous fiscal year without any new allocation is reported as "0" under allocation column. 2020–2021 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT | 111 MAP 1 ALAMEDA COUNTY PUBLIC HEALTH PROGRAMS FUNDED BY MEASURE A IN FY 20/21 #PROVIDER CITY 1 Brighter Beginnings Oakland 2 California Prostitutes Education Project Oakland 3 Center for Oral Health Oakland 4 City of Berkeley Berkeley 5 East Oakland Boxing Association Oakland 6 HIV Education and Prevention Project of Alameda County Oakland #PROVIDER CITY 7 Lotus Bloom Oakland 8 Mandela Partners Oakland 9 Niroga Institute Oakland 10 Tiburcio Vasquez Health Center Hayward 11 Tides Center (Hope Collaborative) Oakland 12 UCSF Benioff Children's Hospital Oakland Oakland MAP 1 ALAMEDA COUNTY PUBLIC HEALTH PROGRAMS FUNDED BY MEASURE A IN FY 20/21 NOTE: Unincorporated areas, including Ashland, Castro Valley, Cherryland, Fairview, San Lorenzo, and Sunol, shown lined. Cities shown in color. MAP 2 ALAMEDA COUNTY BEHAVIORAL HEALTH CARE SERVICES ALCOHOL AND OTHER DRUG PROVIDERS FUNDED BY MEASURE A IN FY 20/21 #PROVIDER CITY 1 Axis Community Health, Inc. Pleasanton 2 Filipino Advocates for Justice Oakland 3 Horizon Services, Inc. Hayward 4 Native American Health Center, Inc. Oakland 5 New Bridge Foundation, Inc. Berkeley 6 Senior Support Program of the Tri-Valley Pleasanton 7 St. Mary's Center Oakland #PROVIDER CITY Uplift Family Services (formerly EMQ Families First) - Administrative Services Office Campbell Uplift Family Services School Sites: 8 Itliong Veracruz Middle School Union City 9 Cesar Chavez Middle School Union City 10 James Logan High School Union City 11 Horner Jr. High School Fremont 12 Newark Jr. High School Newark 13 Newark Memorial High School Newark 14 Thornton Jr. High School Fremont MAP 2 ALAMEDA COUNTY BEHAVIORAL HEALTH CARE SERVICES ALCOHOL AND OTHER DRUG PROVIDERS FUNDED BY MEASURE A IN FY 20/21 NOTE: Unincorporated areas, including Ashland, Castro Valley, Cherryland, Fairview, San Lorenzo, and Sunol, shown lined. Cities shown in color. MAP 3 ALAMEDA COUNTY BEHAVIORAL HEALTH CARE SERVICES MENTAL HEALTH COMMUNITY-BASED ORGANIZATION PROVIDERS FUNDED BY MEASURE A IN FY 20/21 #PROVIDER CITY 1 Abode Services, Inc. Fremont 2 Bonita House, Inc. Oakland 3 Center for Empowering Refugees and Immigrants Oakland 4 Center for Independent Living Berkeley 5 Mental Health Association of Alameda County Oakland 6 The Alliance for Community Wellness (La Familia Counseling Service) Hayward MAP 3 ALAMEDA COUNTY BEHAVIORAL HEALTH CARE SERVICES MENTAL HEALTH COMMUNITY-BASED ORGANIZATION PROVIDERS FUNDED BY MEASURE A IN FY 20/21 NOTE: Unincorporated areas, including Ashland, Castro Valley, Cherryland, Fairview, San Lorenzo, and Sunol, shown lined. Cities shown in color. MAP 4 SCHOOL HEALTH CENTERS FUNDED BY MEASURE A IN FY 20/21 #PROVIDER CITY 1 Alameda High School-Based Health Center Alameda 2 Barbara Lee Health & Wellness Center San Leandro 3 Berkeley High School Health Center Berkeley 4 Berkeley Technology Academy Health Center Berkeley 5 Chappell Hayes Health Center Oakland 6 Elmhurst/Alliance Wellness Center Oakland 7 Emeryville Health Center Emeryville 8 Encinal High School-Based Health Center Alameda 9 Fremont Tiger Clinic Oakland 10 Frick Health and Wellness Center Oakland 11 Fuente Wellness Center (REACH Ashland Youth Center)San Leandro 12 Havenscourt Health Center Oakland 13 Hawthorne Health Center Oakland 14 Hayward High Health Center Hayward #PROVIDER CITY 15 Island Health & Wellness Center Alameda 16 Logan Health Center Union City 17 Madison Health Center Oakland 18 Rising Harte Wellness Center Oakland 19 Roosevelt Health Center Oakland 20 San Lorenzo High Health Center San Lorenzo 21 Shop 55 Wellness Center Oakland 22 Seven Generations SBHC (Skyline High School)Oakland 23 TechniClinic Oakland 24 Tennyson Health Center Hayward 25 Seven Generations SBHC (United for Success/Life Academy)Oakland 26 West Oakland Middle School Health Center Oakland 27 Youth Heart Health Center (La Escuelita Education Complex)Oakland 28 Youth Uprising/Castlemont Health Center Oakland MAP 4 SCHOOL HEALTH CENTERS FUNDED BY MEASURE A IN FY 20/21 NOTE: Unincorporated areas, including Ashland, Castro Valley, Cherryland, Fairview, San Lorenzo, and Sunol, shown lined. Cities shown in color. MAP 5 HEALTHPAC PROVIDER NETWORK FUNDED BY MEASURE A IN FY 20/21 #PROVIDER CITY Alameda Health System (site locations listed below) 1 Alameda Hospital Alameda 2 Eastmont Wellness Oakland 3 Fairmont Hospital San Leandro 4 Hayward Wellness Hayward 5 Highland Hospital Oakland 6 John George Psychiatric Pavilion San Leandro 7 Newark Wellness Newark 8 San Leandro Hospital San Leandro Asian Health Services (site locations listed below) 9 Asian Medical Center Oakland 10 Frank Kiang Medical Center Oakland 11 Rolland & Kathryn Lowe Medical Center Oakland Axis Community Health (site locations listed below) 12 Axis Community Health - Hacienda Pleasanton 13 Axis Community Health - Livermore Livermore 14 Axis Community Health - Pleasanton Pleasanton Bay Area Community Health (site locations listed below) 15 Bay Area Community Health - Irvington Fremont 16 Bay Area Community Health - Liberty Fremont 17 Bay Area Community Health - Main Street Fremont 18 Bay Area Community Health - Mowry I Fremont 19 Bay Area Community Health - Mowry II Fremont Davis Street Community Center Inc 20 Davis Street Family Resource Center San Leandro #PROVIDER CITY La Clinica de la Raza (site locations listed below) 21 Clinica Alta Vista Oakland 22 San Antonio Neighborhood Health Center Oakland 23 Transit Village Oakland LifeLong Medical Care (site locations listed below) 24 Ashby Health Center Berkeley 25 Downtown Oakland Clinic Oakland 26 Howard Daniel Clinic Oakland 27 LifeLong Medical Care - East Oakland Oakland 28 Over 60 Health Center Berkeley 29 West Berkeley Family Practice Berkeley Native American Health Center 30 Seven Directions Oakland St. Rose Hospital 31 St. Rose Hospital (ER/IP)Hayward Tiburcio Vasquez Health Center (site locations listed below) 32 Tiburcio Vasquez Firehouse Clinic Hayward 33 Tiburcio Vasquez Hayward Hayward 34 Tiburcio Vasquez San Leandro San Leandro 35 Tiburcio Vasquez Union City Union City West Oakland Health Center (site locations listed below) 36 Albert J. Thomas Medical Clinic Oakland 37 East Oakland Health Center Oakland 38 West Oakland Health Center Oakland 39 William Byron Rumford Medical Center Berkeley The Health Program of Alameda County, also known as HealthPAC (and formerly known as CMSP or ACE), is a County program that provides affordable health care to uninsured people living in Alameda County. Services are provided through 39 sites, which are operated by one of the 11 HealthPAC providers that include Alameda Health System (dba Alameda County Medical Center). MAP 5 HEALTHPAC PROVIDER NETWORK FUNDED BY MEASURE A IN FY 20/21 NOTE: Unincorporated areas, including Ashland, Castro Valley, Cherryland, Fairview, San Lorenzo, and Sunol, shown lined. Cities shown in color.