HomeMy WebLinkAboutmeasurea-14-15MEASURE A
Essential Health Care Services Tax Ordinance
OVERSIGHT COMMITTEE
9TH REPORT TO THE ALAMEDA COUNTY
BOARD OF SUPERVISORS AND THE PUBLIC
Review of Expenditures July 1, 2014 – June 30, 2015
Fiscal Year 2014/2015
MEASURE A
Essential Health Care Services Tax Ordinance
OVERSIGHT COMMITTEE
9TH REPORT
TO THE ALAMEDA COUNTY BOARD OF SUPERVISORS
AND THE PUBLIC
REVIEW OF EXPENDITURES IN
Fiscal Year (FY) 2014/2015
July 1, 2014 – June 30, 2015
CONTENTS
Measure A Oversight Committee Members ........................................................................................... 1
Executive Summary ..................................................................................................................................................... 3
How The Money Was Spent ............................................................................................................................... 13
Review of FY 14/15 Expenditures: 75% of Measure A Funds
Allocated to Alameda Health System ............................................................................................................... 14
Review of FY 14/15 Expenditures: 25% of Measure A Funds
Allocated by the Alameda County Board of Supervisors ....................................................................... 18
Group 1: Behavioral Health
Abode Services ............................................................................................................................................................... 20
Behavioral Health and Alcohol and Other Drug (AOD) Community ................................................................ 22
Center for Healthy Schools and Communities (School-Based Behavioral Health Initiative) ........................ 23
Criminal Justice Screening and In-Custody Services ............................................................................................. 27
Detoxification/Sobering Center .................................................................................................................................. 30
La Familia Counseling Services ................................................................................................................................... 31
Mental Health Services for Juvenile Justice Center ................................................................................................. 32
Mental Health Services for Newcomers and Immigrants (CERI) ........................................................................ 33
Oakland Police Department ......................................................................................................................................... 34
Options Recovery Services ........................................................................................................................................... 35
Safe Alternatives to Violent Environments (SAVE) ................................................................................................ 36
Senior Support Program of Tri-Valley ....................................................................................................................... 38
The Schreiber Center ..................................................................................................................................................... 39
Tri-Valley Haven for Women ....................................................................................................................................... 40
Group 2: Hospital, Tertiary Care, Other
Administration/Infrastructure Support .................................................................................................................... 42
San Leandro Hospital .................................................................................................................................................... 44
St. Rose Hospital ............................................................................................................................................................ 45
UCSF Benioff Children’s Hospital Oakland .............................................................................................................. 47
Group 3: Primary Care
Alameda County Dental Health .................................................................................................................................. 51
Berkeley Community Health Project (Berkeley Free Clinic) ................................................................................. 53
Center for Elders’ Independence ................................................................................................................................ 55
Center for Healthy Schools and Communities (School Health Centers) ...............................................................56
Fire Station Health Portals ........................................................................................................................................... 60
Fremont Aging and Family Services ........................................................................................................................... 62
Health Enrollment for Children .................................................................................................................................. 65
Health Services for Day Laborers: Community Initiatives (Day Labor Center) ............................................... 66
Health Services for Day Laborers: Multicultural Institute .................................................................................... 68
Health Services for Day Laborers: Street Level Health Project ............................................................................ 70
Hope Hospice .................................................................................................................................................................. 72
Increase Hospice Utilization ........................................................................................................................................ 73
Medical Costs for Juvenile Justice Center: Direct Service Planning and Administration ............................... 74
Medical Costs for Juvenile Justice Center: Mind Body Awareness ...................................................................... 75
Medical Costs for Juvenile Justice Center: Niroga Institute .................................................................................. 76
Medical Costs for Juvenile Justice Center: Victims of Crime ................................................................................ 77
Preventive Care Pathways ............................................................................................................................................. 78
Primary Care Community-Based Organizations .................................................................................................... 79
Roots Community Health Center ............................................................................................................................... 81
Tiburcio Vasquez Health Center, Inc. ........................................................................................................................ 82
Washington Hospital ..................................................................................................................................................... 84
Group 4: Public Health
100 Black Men of the Bay Area ................................................................................................................................... 86
Alameda Boys & Girls Club, Inc. ................................................................................................................................ 88
Alameda County Asthma Start ................................................................................................................................... 90
CAL-PEP .......................................................................................................................................................................... 92
Center for Early Intervention on Deafness ............................................................................................................... 93
City of San Leandro ....................................................................................................................................................... 94
Collaboration Agencies Responding to Disasters (CARD) ................................................................................... 95
Community Health and Wellness Element ............................................................................................................... 96
Emergency Medical Services (EMS) Corps .............................................................................................................. 97
Environmental Health: Improve Field Sanitation Conditions/Nail Salons ........................................................ 99
Genesis Worship Center ............................................................................................................................................. 101
HIV Education and Prevention Project of Alameda County (HEPPAC) .......................................................... 102
Hospital Committee for Livermore-Pleasanton Area dba ValleyCare Health System .................................. 104
LIFE ElderCare ............................................................................................................................................................. 105
Mercy Retirement Center ........................................................................................................................................... 106
Public Health Prevention Initiative .......................................................................................................................... 107
Ryan White Provider RFP: Community Health for Asian Americans (Office of AIDS) ................................ 115
Senior Injury Prevention Program ........................................................................................................................... 116
Service Opportunties for Seniors (Meals on Wheels) .......................................................................................... 118
South Hayward Parish ................................................................................................................................................. 119
Spectrum Community Services, Inc. ....................................................................................................................... 120
SSI Housing Trust ........................................................................................................................................................ 122
Viola Blythe Community Services ............................................................................................................................ 123
West Oakland Youth Center ...................................................................................................................................... 124
Youth and Family Opportunity Initiatives .............................................................................................................. 127
Appendices
Appendix A: Measure A Revenue Received ........................................................................................................ 136
Appendix B: FY 14/15 Budget Information ....................................................................................................... 137
Appendix C: FY 14/15 Measure A Fund Distribution by Provider or Program ................................ 139
Appendix D: Maps: Geographic Distribution of
Providers Funded by Measure A in FY 14/15 .................................................................................................... 144
MEASURE A
OVERSIGHT COMMITTEE MEMBERS
COMMITTEE MEMBER REPRESENTING/NOMINATED BY
John Becker City Managers’ Association
Olga Borjon Supervisor Richard Valle (District 2)
Arthur Chen, M.D. Alameda-Contra Costa Medical Association
Louis Chicoine Supervisor Scott Haggerty (District 1)
Fran David City Managers’ Association
Keith Davies Alameda County Public Health Commission
Adam Davis Hospital Council of Northern California
Dru Howard Supervisor Keith Carson (District 5)
Kuwaza Imara Central Labor Council of Alameda County
Gwendolyn McClain* Alameda County Public Health Commission
Al Murray City of Berkeley
Jaseon Outlaw, Ph.D Alameda County Mental Health Board
George Phillips Supervisor Wilma Chan (District 3)
Rachel Richman Central Labor Council of Alameda County
Ursula Rolfe, M.D. League of Women Voters
(seat in abeyance) Alameda County Taxpayers Association, Inc.
(vacant) Supervisor Nate Miley (District 4)
* Gwendolyn McClain resigned in July 2016. Keith Davies was appointed to serve the
remainder of her term.
ALAMEDA COUNTY HEALTH CARE SERVICES AGENCY STAFF
Rebecca Gebhart, Interim Agency Director
James Nguyen, Interim Finance and Administration Director
Connie Soriano, Administrative Specialist II
FY 2014/15 Measure AExecutive Summary
ABOUT THE MEASURE A OVERSIGHT COMMITTEEOne of the provisions of Measure A required the
establishment of a Citizen Oversight Committee. The
Committee’s role is to annually review Measure A
expenditures for each fiscal year and report to the Alameda County
Board of Supervisors (Board) on whether such expenditures conform
to the purposes set forth in the measure.
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.”
The Oversight Committee spent several months reviewing allocation
reports, convening and deliberating concerns, communicating concerns
to providers, highlighting provider accomplishments, and reviewing and
editing the Measure A report. As part of this process, the Committee used
the report forms returned by most Measure A fund recipients, along with
information from several provider presentations, to review all funding
allocations.
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.
The Oversight Committee did have concerns for
a small number of allocations. These concerns
are noted in this Executive Summary and in the
individual report summaries for the relevant
providers.
History of the Measure
Measure A, the Essential
Health Care Services Initiative,
was passed by 71% of Alameda County
voters in March 2004. In June 2014,
76% of voters passed Measure AA,
which extended the initiative through
2034. Both measures authorize the
County of Alameda to raise its sales tax
by one-half cent to provide additional
financial 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.
A AA
3
Measure A generated $132,429,279* in FY 14/15.
Highlights
Since the full implementation of the Affordable Care Act in 2014, more
than 40,000 newly eligible County residents have been enrolled into the
state’s Medi-Cal program, and more than 64,000 residents have been
enrolled in Covered California. Despite these achievements to increase
the number of individuals who have health insurance, an estimated
158,734 individuals, or 10.1% of County residents, remain uninsured,
according to the American Community Survey data for 2015. Thus,
Measure A revenues continue to play a critical role in helping indigent,
uninsured, and low income residents of Alameda 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 the Health Care Services Agency
(HCSA) to improve the accountability of Measure A recipients by
DISTRIBUTION OF MEASURE A FUNDS
25%
75%
Of the $132,429,279 that Measure A generated in FY 14/15,
AHS received 75% and the remainder of the funds was
distributed by the Board to many health care providers who
provide essential health care services.
14%40%
15%14%
17%
Behavioral Services
Acute
Ambulatory Services
ER/Urgent/TraumaLong-Term Care
Public Health
Behavioral Health
Primary Care
26%
24%
30%
20%
Hospital, Tertiary Care, Other
the Board of Supervisors
Measure A Funding Approved by
Allocati on of Measure A Funds toAlameda Health System
Total generated: $33.1 million
Total allocated: $35.1 million**
Total $99.3 million
* 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.
4
implementing a Results-Based Accountability framework to help
providers report measurable performance data that describes the effort,
quality, and impact of their programs and services.
Large Numbers Served, Wide Geographic Reach
Measure A funds continue to support the health and well-being of large
numbers of County residents. AHS alone served 156,330 County residents
through Measure A in FY 14/15, while the Alameda County Public Health
Department Public Health Prevention Initiative served over 200,000.
In addition, Measure A contributes to positive outcomes for residents
throughout the County, with recipient providers located in every
Supervisory District.
Mental Health/Behavioral Health Services
More than just physical health, a great number of Measure A providers
used their allocation to achieve positive mental and behavioral health
outcomes for the target population. For example, everyone in the Abode
Services Greater HOPE program has been connected with mental health
services and housing support services, with over 75% of clients reporting
decreased psychiatric hospital stays and/or criminal justice involvement.
At the new Schreiber Center, clients receiving therapy and psychiatric
services have shown an overall decrease in symptoms of depression,
reduced side effects of medications, improved communication with
family, increased access to mental health services, and improved care with
current providers following the recommendations of a psychiatrist.
Youth Outcomes
A number of providers reported on improved mental and behavioral
health outcomes for youth. The Center for Healthy Schools and
Communities School-Based Behavioral Health Initiative reported that
students who received group or individual services presented statistically
significant improvements in life functioning (43%), behavioral/emotional
needs (24%), and school success (34%) from intake to discharge. Youth
participating in the Mind Body Awareness program at the Juvenile
Justice Center revealed a significant decrease (20.4%) in perceived
stress, a significant increase in healthy self-regulation (19.6%), and a
significant increase in self-esteem (14.1%) from pre to post testing. A
behavioral health assessment used by half of the community-based
organizations in the Youth and Family Opportunity initiative revealed
significant improvement in client behavioral/emotional needs (34.4%), life
functioning (40.5%), school (39.9%), and child strengths (27.6%).
Program Stabilization
Measure A funds contribute to stabilization of health care service delivery
in the face of cuts from other funding sources. For example, despite
AHS alone served
156,330 County
residents through
Measure A in FY 14/15,
while the Alameda
County Public Health
Department Public
Health Prevention
Initiative served
over 200,000.
5
$26.3
million
significant reductions in County General Funds available to support
behavioral health services, Measure A funds helped Behavioral Health
and Alcohol and Other Drug (AOD) Community organizations maintain
a higher level of access to services for uninsured and health care safety
net populations. Specifically, only a minimal change occurred when
comparing the total number of unique clients served during this year
across the behavioral health system with the number of clients served last
year across providers receiving Measure A funds.
Leveraged Funding
A large number of Measure A recipients leveraged their allocations to
receive matching funds from other sources. For the 25% of Measure
A funds allocated by the Board, recipients leveraged their allocations
to obtain a total of $26.3 million in matching funds. Thus, every $1 in
Measure A funds to these recipients returned $0.75 in matching funds.
For some recipients, the matching funds represented a return greater
than 1:1. Safe Alternatives to Violent Environments (SAVE) obtained over
$80,000 in matching funds on its $30,000 Measure A allocation. Fremont
Aging and Family Services obtained almost $200,000 in matching funds
on its $52,000 Measure A allocation. Most dramatically, the School-Based
Behavioral Health Initiative obtained $6,216,000 in matching funds on its
$617,000 Measure A allocation, while the School Health Centers obtained
over $10,000,000 in matching funds on an allocation of just under
$2,000,000.
Agency Collaboration
Measure A funding encouraged provider collaboration with other
agencies to improve health care outcomes. The Detoxification/Sobering
Center expanded its collaboration with mental health providers, including
John George Psychiatric Hospital, crisis services, Highland Hospital, local
medical clinics, and law enforcement. These partnerships had a significant
positive impact on the clients and families served, allowing for increased
referral capability, increased collaborative consultation and training, and
a warm hand-off for clients to and from multiple levels of the health care
system.
Exceeding Targets
Many Measure A recipients exceeded their target numbers for clients
served, sometimes dramatically. Serving a larger number of clients with
a given allocation translates to a lower per-client cost. For example, La
Familia greatly exceeded its targets for providing information to low
income residents (2,697 actual vs. 1,200 target, an increase of over 100%)
and providing health care application assistance (723 actual vs. 133 target,
an increase of over 500%). Safe Alternatives to Violence (SAVE), having set
a target of providing 160 individual counseling sessions, actually provided
377—an increase of over 100%. Fremont Aging and Family Services
Measure AAllocation MatchingFunds
$35.1
million
The recipients of the
25% of Measure A funds
allocated by the Board
obtained $26,347,012
in matching funds
from public and private
sources.
6
conducted 563 home visits to 140 clients, compared to a target of 350
home visits to 85 clients. And the City of San Leandro Senior Community
Center conducted 740 blood pressure/weight checks, compared to a target
of 360—an increase of almost 100%.
Preventive Care
In addition to providing emergency care and treatment, many Measure
A providers used their funding to offer cost-effective preventive care. An
analysis of health outcomes for children participating in the Alameda
County Dental Health WIC “Dental Days” showed that they had 42%
fewer restorative dental treatment needs compared to children who
did not benefit from the program. Preventive Care Pathways clients
experienced a reduction in emergency room visits to AHS and outside
emergency rooms, as well as improvement in clinical findings related
to diabetes, hypertension, and congestive heart failure. With the timely
diagnostic care offered at Washington Hospital, abnormal findings were
detected and treated earlier, which translated to better patient outcomes.
Service Growth
Many Measure A recipient providers experienced noticeable growth
in service delivery in FY 14/15. For example, as a result of its Measure
A-funded expansion efforts, Roots Community Health Center experienced
an 87% increase in patient visits and a 300% increase in laboratory visits
compared to the same time period pre-expansion. The Senior Support
Program of Tri-Valley In-Home Counseling Program had more referrals in
FY 14/15 than in any other year.
Crisis Services
Measure A goes beyond standard health care delivery to offer services
to those in emergency or crisis situations. Through the Victims of Crime
program, Measure A funding helped enable clients who would normally
have been ignored because of lack of information of available resources,
or limited resources to pay for treatment services, to receive necessary
services on an ongoing basis at no cost to the client or to Alameda County.
In a survey, Mercy Brown Bag Program recipients indicated that 37%
didn’t have enough money to buy food or other necessary items to last the
entire month, 34% had to skip meals, and 76% thought their health would
be negatively affected without this program. Thus, the program helped fill
an important gap in maintaining the health and well-being of the older
adult population.
As a result of its
Measure A-funded
expansion efforts, Roots
Community Health
Center experienced an
87% increase in
patient visits and a
300% increase in
laboratory visits.
7
Concerns
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 (2004-2015) and in the foreseeable future.
While Measure A tax revenues have gradually increased each year since
their lowest levels in 2010, economic indicators reveal that the annual rate
of change from the prior year started to decrease in 2012.
Furthermore, many families living in disadvantaged communities have
not benefited from the improved job and housing markets during the
economic recovery over the past few years and continue to need access to
the essential health care services that Measure A provides.
The Committee urges Alameda County to continue to pay close attention
to policy changes proposed by the 2016 presidential administration that
may have significant impacts on health care access or the County’s safety
net. Moreover, Medi-Cal rate reductions and other funding cuts over
the past several years have continued to decrease the ability of health
providers to offer services to the expanded Medi-Cal and uninsured
populations in the County.
Realizing the full promise of these 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 and a shortage of
providers—particularly in primary and preventive care. 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.
RECOMMENDATION: The Board should make a public announcement
that Measure A funding is open to all organizations so that eligible
organizations become aware of this funding opportunity and learn how to
apply.
Outside the area of health care funding, the Committee recognizes that
the composition of the Committee has improved in reflecting the diverse
make-up of the population served by Measure A. The Committee notes
that this should be an area of ongoing focus as Committee member
selections are made moving forward.
Regarding Measure A funding, the Committee raises the following
concerns.
Note: The Committee believes it is important to present any concerns it
noticed while reviewing Measure A recipient reports. At the same time, the
8
Committee wants to make clear that raising a concern does not necessarily
mean that a problem exists with a recipient’s use of Measure A funds.
For example, the concern may arise because of incomplete or inaccurate
reporting, not because of any inappropriate use of funds.
Reporting and Review Concerns
• As part of its role in providing fiscal oversight, the Committee
recognizes a need for providers and HCSA to work together to evaluate
the long-term impact of Measure A investments in Alameda County.
• The Oversight Committee believes that the interpretation of the statute
must be revised to expand the role of the Committee and appropriately
allocate Measure A funds for administrative staff to oversee the
contracts and ensure the effective use of public funds to all grantees.
• The Committee expresses an ongoing concern that the County
Counsel’s interpretation of the Measure A ordinance limits the
Committee’s ability to review program efficacy and cost-effectiveness.
In addition, the Committee does not have the capacity to review
HCSA’s process of controls and review of how the funding is spent—via
audit or other method.
• 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 specific questions posed by the Committee to specific
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 are not measurable
and/or stated positive outcomes without quantifying the statements.
- For some reports, it is unclear whether the target population
falls within one of the categories listed in the Measure A statute:
“indigent, low income, and uninsured adults, children, families,
seniors, and other residents of Alameda County.”
- In other reports, the provider’s description of the services offered
raises questions as to their relevance to the wording of the Measure
A statute.
RECOMMENDATION: HCSA should receive funding to create a process
for Measure A recipients to verify that they are using Measure A funds to
provide their described programs to the populations listed in the measure.
This process can include HCSA staff providing training to Measure A
recipients on how to effectively collect demographic data to report on the
diverse populations of indigent, uninsured, and low income clients they
serve by race, ethnicity, geography, and language. The Committee further
advocates that HCSA be sufficiently staffed to successfully implement such
a process.
RECOMMENDATION: The Board should authorize HCSA to include
evaluations of Measure A programs as part of its initiative to improve
9
oversight and outcomes in all its programs. This includes identifying
additional funding to ensure that Measure A contracts are included in the
initiative.
RECOMMENDATION: HCSA should hold trainings to reinforce proper
and accurate completion of demographic information and adherence to
Measure A services.
RECOMMENDATION: HCSA should continue to work with recipients
to improve the use of results-based performance measures and ensure that
the population and services supported with Measure A comply with the
ordinance.
RECOMMENDATION: HCSA should update the recipient reporting
form to include a question about service delivery in multiple languages, as
language barriers can potentially impede access to services for members of
the Measure A target population.
RECOMMENDATION: 10% of Measure A recipients should undergo a
formal audit each year to track whether money is being spent in accordance
with the wording and intent of the measure.
RECOMMENDATION: HCSA should put a process in place to improve
the measurable objectives and outcomes reported by providers.
Alameda Health System
The Committee notes the following concerns:
• AHS provides well-stated goals, but objectives are not quantified.
References are made to “True North” metrics without measurable
objectives provided. AHS did not revise its report to include
measurable objectives.
• Several results are described, however very few are quantified other
than a generalization—for example, “improving patient transition from
inpatient services to long-term care, rehabilitation, or the home.”
• The Measure A funding expenditures reported by AHS exceeded the
total Meaure A allocation of $99,321,959. The four reported categories
of expenditures should add up to but not exceed this figure. AHS did
not revise these figures.
• AHS reported that Measure A funds covered 3,484 FTEs, which
seems excessive to reviewers. AHS did not respond to a request for
clarification.
• Measure A accounts for 12.9% of the AHS budget. The number of
individuals served by this funding should be less than the total number
of individuals served by the agency. The provider report suggests
that 94% of 156,330 individuals seen are uninsured and that 100% are
qualified for entitlement benefit programs. This does not correspond
with information provided in presentations from AHS executive staff.
AHS should clarify and correct this information.
10
Although AHS has made some progress, the Committee notes that these
concerns have been raised for at least the last five years.
RECOMMENDATION: A formal audit should be conducted to more
accurately gain an understanding of expenditure of Measure A funds.
Abode Services
Greater HOPE
Based on the provider report, it is unclear how the Measure A funds
increased access to services for vulnerable populations.
HOPE Crisis Outreach Program
The Committee questions the use of Measure A funds to help people
obtain survival gear for living on the streets: tents, sleeping bags, etc. The
Committee wonders whether this money would be better used to fund
housing or efforts to put clients into housing.
Administration/Infrastructure Support
The Direct Service Planning and Administration group does not have
enough resources allocated to carry out a Measure A program evaluation
that would adequately ensure accountability to Alameda County
taxpayers for this annual expenditure of over $120 million. As a first
step, appropriate levels of staffing and expenditures would allow staff to
conduct mandatory audits and subsequent training for at least 10% of
funding recipient programs.
San Leandro Hospital
The provider’s report contains an impressive list of services and
achievements. However, there is no alignment between these
achievements and the clearly stated and quantifiable objectives in the
provider report. In addition, the goals and objectives listed were not
specific to San Leandro Hospital but instead were an exact reprint of the
entire AHS goals and objectives. This causes difficulty in determining the
intent and actual impact of Measure A funds.
For example, the provider reports that all 24,627 individuals served were
served by Measure A, but elsewhere reports that only 54% of individuals
served qualified for Measure A benefits. The budget numbers reported are
for the entire hospital budget and are not specific to the Measure A grant.
The omitted information in the Measure A Funding Summary section has
been requested several times without response.
RECOMMENDATION: A full audit should be performed to determine
accounting for Measure A expenditures.
11
St. Rose Hospital
The objectives included in the provider report are not quantifiably stated
and should be revised. While the provider included excellent quantified
results achieved in serving uninsured and underinsured patients, these
should be revised to match the categories of patients described in the
goals and objectives.
UCSF Benioff Children’s Hospital
The Committee notes that CHO does not list measurable objectives,
which has been raised repeatedly in the last several years. Additionally,
many of the achievements do not give a specific time frame for
achievement—it is unclear what improvement, if any, took place from FY
13/14 to FY 14/15.
All the numbers listed under the Measure A Funding Summary are
identical to the numbers listed in the FY13/14 Measure A report.
RECOMMENDATION: A full audit should be performed to determine
accounting for Measure A expenditures.
Collaboration Agencies Responding to Disasters (CARD)
It is unclear if the Measure A allocation to CARD complies with the
ordinance requirement that funds go to provide “emergency medical,
hospital inpatient, outpatient, public health, mental health, and substance
abuse services to indigent, low income, and uninsured adults, children,
families and seniors, and other residents of Alameda County.”
The project was not completed, with no services deliverables report. The
provider reports that only the “planning phase” was completed before the
agency went out of business. Only $7,500 of the $25,000 was paid out to
CARD, and these Measure A funds went to planning for services that were
never provided.
West Oakland Youth Center (WOYC)
One staff assigned to the WOYC project resigned mid-year. The
supervisor took on the project responsibilities but wasn’t able to bill
against Measure A funding. Therefore, the actual expenditure was $44,244
out of WOYC’s $70,000 allocation.
12
Alameda County
Board of Supervisors
DISTRIBUTION OF MEASURE A FUNDS
HOW THE MONEY WAS SPENT
Alameda Health System
Board of Trustees
25%
75%
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, public health, mental
health, and substance abuse services to address the many health needs of communities throughout the County.
In FY 14/15, Measure A generated $132,429,279 (not including interest earned). The funds were allocated as follows:
Alameda Health System (75%): $99,321,959
Alameda County (non-AHS) (25%): $33,107,320
TOTAL: $132,429,279
In FY 14/15, the Alameda County approved budget totaled $2.786 billion. The Alameda County Health Care Services
Agency approved budget totaled $614.8 million, or 22.1% of the total County budget. Measure A revenues not specifically
designated for AHS accounted for 5.4%.
The following sections in the report provide more detail on how AHS and the Board spent Measure A funds in FY 14/15,
which includes revenue generated in the reporting year as well as unspent funds earned in previous years.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
13
BACkGROUND
Alameda Health System (AHS) is a patient- and family-centered system
of care that promotes wellness, eliminates disparities, and optimizes the
health of its diverse communities.
AHS program objectives are guided by a three-year strategic plan, which
is built on the following pillars:
• Access goals relate to providing care to all County residents by
expanding access to services. Key goals in FY 14/15 included the
following:
- Increasing coordination and referral of specialty care with the
Community Health Clinic Network (CHCN)
- Further integration of San Leandro and Alameda Hospitals into the
system
- Increasing Cardiology, Dermatology, Optometry, and Orthopedic
service lines
- Expanding the Complex Care Program for high risk, high cost,
complex care patients
- Increasing medical home assignments for emergency department
(ED) and specialty clinic patients
- Increasing the utilization rate of the 24-hour nurse advice line
- Reducing the overall length of stay in the various EDs
• Quality Enhancement goals in FY 14/15 further aligned AHS
with patient safety initiatives, such as benchmarks set by the Joint
Commission, Center for Medicare and Medicaid Services (CMS),
and U.S. Centers for Disease Control (CDC). Key goals in FY 14/15
included the following:
- Continued focus on panel management, including increasing
preventive health screenings at outpatient facilities
- Incorporation of Alameda Health Partners, a physician organization
dedicated to streamlining clinical priorities and coordinating and
supporting physicians in delivering high quality, efficient, value-
based care to patients and communities
Allocation: $99,321,959 | Expended/Encumbered: $99,321,959
Individuals served by Measure A: 156,330 (Total individuals served: 156,330)
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, Outside of Alameda County, Homeless or transient
FY 14/15: 75% OF MEASURE A FUNDS ALLOCATED TOAlameda Health System
alamedahealthsystem.org
Matching Funds
AHS leveraged its Measure A allocation
to obtain $17,958,463 in matching
funds through a number of different
intergovernmental transfers provided
by Alameda County, including the
following:
• Medicaid Waiver
• Seniors and Persons with Disabilities
• Rate Range
• DSRIP
Measure AAllocation MatchingFunds
$99,321,959
$17,958,463
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
14
- Continued focus on harm reduction, including reducing sepsis
infection and pressure ulcers at inpatient facilities
- Establishing a new care coordination infrastructure,
multidisciplinary teams, and processes to improve patient flow,
documentation, and avoidable readmissions
• Service Enhancement goals promote an improved patient experience.
Key goals in FY 14/15 included the following:
- Developing processes and implementing best practices designed to
reduce the response time to patient call buttons
- Increasing inclusion of patient preference in his or her treatment
- Conducting patient experience surveys in cooperation with the U.S.
Agency for Healthcare Research and Quality (AHRQ) and Consumer
Assessment of Healthcare Providers and Systems (CAHPS)
- Sharing data, best practices, and findings with the Safety Net
Institute (SNI) to foster shared learning and benchmarking across
California’s public hospitals
- Improving patient transitions from inpatient services to long-term
care, rehabilitation, or the home
- Improving the “fast track” door to discharge process for lower
acuity patients at John George Psychiatric Hospital (JGPH) and
Highland Hospital, for better patient flow and utilization of
provider resources
• Sustainability goals represent a commitment to financial stability,
operational efficiency, and debt reduction. Under the Affordable Care
Act, AHS seeks to offset declining federal funds with new patient
revenues from expanded Medi-Cal, the Health Insurance Exchange,
and new contracts with commercial payers. Key goals in FY 14/15
included the following:
- Developing processes such as Budget Variance and FTE committees
to maintain budget discipline
Service Enhancement
goals included
improving patient
transitions from
inpatient services
to long-term care,
rehabilitation, or
the home.
REvENUE EARNED EACH FISCAL YEAR (FY 04/05 tHROUGH FY 14/15)
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
1009080
Millions of dollars
706050403020100
$71,756,087
$82,401,622
$85,377,759
$86,889,558
$75,929,787
$70,587,890
$79,135,112
$84,405,378
$90,786,904
$95,191,659
$99,321,959
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
15
- Establishing a Revenue Cycle Improvement Project to develop
standardized reporting
- Implementing forecasting software to model service line projections
through 2020
- Developing reconciliation processes and standards to correct
material accounting errors and inaccuracies and ensure financial
integrity
- Improving charge capture, billing, and revenue cycle management
processes across the organization
- Implementing an ongoing cost management initiative aimed at
reducing unnecessary costs and improving efficiency by decreasing
usage of overtime labor and improving core staff scheduling,
redesigning the supply chain, improving purchased service contract
pricing, and implementing flex scheduling
- Developing a managed care contracting department to expand
access to commercially insured patients so patients who want to stay
with AHS can do so without service interruption
- Improving end-to-end revenue cycle functioning
• Workforce Development goals promote a culture of customer service,
innovation, and achievement by attracting, developing, and retaining
competent and compassionate staff. Key goals in FY 14/15 included the
following:
- Establishing Alameda Health Partners, a physician organization
dedicated to coordinating and supporting physicians and
streamlining clinical priorities
- Increasing staff training in population health management
- Evaluating and providing training in communication skills
competencies and customer service for permanent inpatient nurses
and staff members
- Hiring additional physician and support staff to meet patient
demand and expand service offerings
- Working to increase employee engagement and commitment to
organizational goals and patient experience
MEASURE A FUNDING SUMMARY
Measure A is a supplemental revenue source for AHS, reducing the gap
between reimbursement for services from a variety of sources and the
actual cost of providing those services to underinsured and uninsured
persons. Measure A supports all of AHS’s services, with the exception of
that fraction of AHS’s business for which it receives full reimbursement
for the cost of services provided.
Measure A helped AHS achieve the following measurable objectives in
FY 14/15:
• Access: Decrease length of stay for admitted patients to 6.9 hours
(target: 7.8 hours)
• Sustainability: Attain a -8.0% operating margin in fiscal 2015, and 3.3%
in budget 2016 (target: 3.0%)
Measure A Helps
In 2014, Mr. H. came to the Highland
ED 18 times. Primarily homeless, he
had cirrhosis, congestive heart failure,
hepatitis B, kidney disease, and pain.
The complex care management team
twice discharged Mr. H. to skilled
nursing facilities (SNFs), which he
left against medical advice. The team
continued to see him when he was in
the hospital. Over time he seemed more
comfortable talking and building trust.
However, after yet another discharge
and return hospital stay, the team
came up with the idea of hospice. In the
hospice SNF, the team ran interference
between Mr. H. and staff. Shortly
after, Mr. H. asked for help contacting
friends and relatives, and the team has
been helping him fill out applications
for independent housing.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
16
• Quality: Experience a decline in preventable harm of 11% systemwide
and 40% over the past five years
• Service: In hospital surveys, obtain approximately a 12% improvement
in patient responses compared to the prior year
• Workforce Development: In surveys, obtain a 3.88 employee engagement
score and a 3.68 physician engagement score (target score: 4)
CONCERNS
The Committee notes the following concerns:
• AHS provides well-stated goals, but objectives are not quantified.
References are made to “True North” metrics without measurable
objectives provided. AHS did not revise its report to include
measurable objectives.
• Several results are described, however very few are quantified other
than a generalization—for example, “improving patient transition from
inpatient services to long-term care, rehabilitation, or the home.”
• The Measure A funding expenditures reported by AHS exceeded the
total Meaure A allocation of $99,321,959. The four reported categories
of expenditures should add up to but not exceed this figure. AHS did
not revise these figures.
• AHS reported that Measure A funds covered 3,484 FTEs, which
seems excessive to reviewers. AHS did not respond to a request for
clarification.
• Measure A accounts for 12.9% of the AHS budget. The number of
individuals served by this funding should be less than the total number
of individuals served by the agency. The provider report suggests
that 94% of 156,330 individuals seen are uninsured and that 100% are
qualified for entitlement benefit programs. This does not correspond
with information provided in presentations from AHS executive staff.
AHS should clarify and correct this information.
Although AHS has made some progress, the Committee notes that these
concerns have been raised for at least the last five years.
RECOMMENDATION: A formal audit should be conducted to more
accurately gain an understanding of expenditure of Measure A funds.
Measure A helped
AHS experience a
decline in
preventable harm
of 11% systemwide
and 40% over the past
five years.
ALLOCATION OF ALAMEDA HEALTH SYSTEM
MEASURE A FUNDS IN FY 14/15
Highland Hospital
Fairmont Campus
Behavioral Health
Ambulatory
Alameda Hospital
San Leandro Hospital 18%16%
13%
8%
34%
11%
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
17
FY 14/15: 25% OF MEASURE A FUNDS ALLOCATED BYThe Alameda County Board of Supervisors
In FY 14/15, the Board of Supervisors (Board) approved approximately $35.1 million in total Measure A allocations. The
Board allocations are listed by group in the following chart.
Note: Since most of the allocations are approved by the Board before and during each fiscal year based on sales tax revenue
projections, the total allocation amount may not equal the actual revenue received. For more details on Board allocations, see
Appendix B: FY 14/15 Budget Information and Appendix C: FY 14/15 Measure A Fund Distribution by Provider or Program.
The appendices may include allocations that were approved by the Board but not expended by the end of the fiscal year.
MEASURE A FUNDING APPROVED BY THE BOARD OF SUPERVISORS IN FY 14/15
TOTAL MATCHING FUNDS OBTAINED BY LEVERAGING MEASURE A ALLOCATIONS
25.7%
23.9%29.6%
20.7%
Group 4: Public Health
$7,262,669
Group 1: Behavioral Health
$9,035,442
Group 2: Hospital, tertiary Care, Other
$8,400,000Group 3: Primary Care
$10,401,716
Measure A Allocation Matching Funds
$35,099,827
$26,347,012
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
18
FUNDS ALLOCATED BY THE ALAMEDA COUNTY BOARD OF SUPERVISORS
GROUP 1: BEHAVIORAL HEALTH
Abode Services ......................................................................................................................................... 20
Behavioral Health and Alcohol and Other Drug (AOD) Community ......................................................... 22
Center for Healthy Schools and Communities (School-Based Behavioral Health Initiative) ..................... 23
Criminal Justice Screening and In-Custody Services ................................................................................. 27
Detoxification/Sobering Center ................................................................................................................ 30
La Familia Counseling Services ................................................................................................................. 31
Mental Health Services for Juvenile Justice Center .................................................................................. 32
Mental Health Services for Newcomers and Immigrants (CERI) ............................................................... 33
Oakland Police Department ..................................................................................................................... 34
Options Recovery Services ....................................................................................................................... 35
Safe Alternatives to Violent Environments (SAVE) .................................................................................... 36
Senior Support Program of Tri-Valley ....................................................................................................... 38
The Schreiber Center ................................................................................................................................ 39
Tri-Valley Haven for Women ..................................................................................................................... 40
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
19
BACkGROUND
Abode Services works to end homelessness by assisting low income,
unhoused people to secure stable, supportive housing, and by advocating
for the removal of the causes of homelessness.
Abode Service received two Measure A allocations: one for its Greater
HOPE program, and one for its HOPE Crisis Outreach Program.
Greater HOPE
Greater HOPE provides wraparound clinical services and housing to
adults with severe mental illness, long histories of homelessness, and
other barriers such as chronic health conditions.
HOPE Crisis Outreach Program
The HOPE program provides outreach and engagement services to
homeless people in Livermore, mid County, and Fremont. The program
assesses people’s needs and helps connect them to resources including
income, shelter, medical services, mental health and drug and alcohol
services, employment, etc. The team also helps link people to basic
resources like survival gear for living on the streets, IDs, Social Security
cards, food, cell phones, transportation, etc.
Through its street outreach, the HOPE program reaches those with the
most barriers, which often include severe mental health challenges, drug
and alcohol addiction, and/or chronic health conditions. The goal is to
provide services and linkage to referrals and housing that will improve
health and housing outcomes for these clients.
MEASURE A FUNDING SUMMARY
Greater HOPE
Measure A funds were used to improve the delivery of services and
documentation and billing of services. Through Measure A funding, the
Allocation: $50,000/$90,000 | Expended/Encumbered: $50,000/$64,975
Individuals served by Measure A: 50/122 (Total individuals served: 50/612)
Populations served: Indigent, Low Income, Uninsured Adults
Services provided: Mental Health, Substance Abuse
Service area: Castro Valley, Fremont, Hayward, Livermore, Newark, Oakland, Union City, Homeless or transient
Abode Services
www.abodeservices.org
Measure A Helps
HOPE Crisis Outreach Program
The HOPE team encountered a
55-year-old homeless man with severe
alcohol addiction and a physical
disability. This man had almost daily
interaction with police, fire, and
paramedics due to drinking heavily,
passing out, or falling out of his
wheelchair. The HOPE team helped
the client get an ID, Social Security
card, and income, as well as complete
his application for housing. The client
moved into his own apartment after
nine months. He has stopped drinking
and smoking. He has established a
primary care provider and stabilized
his health needs. Since becoming
housed, this client has not had a single
encounter with law enforcement or
emergency services.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
20
team received IPS training, hired an employment specialist, and launched
an employment program utilizing the IPS model. Five people are currently
enrolled in the employment program.
Specifically, Abode Services Greater HOPE used its Measure A allocation to
achieve the following:
• Create and implement a Quality Assurance manual
• Train nine staff on Quality Assurance standards (target: 7)
• Review and update 65 clinical files to ensure accuracy (target: 50)
• Develop and implement a tool to track staff productivity
• Develop and implement performance improvement plans for clinicians
with productivity of less than 45%
• Train 11 staff in Assertive Community Treatment
• Hire an Employment Specialist and develop a vocational program
HOPE Crisis Outreach Program
Measure A funds were used to fund the HOPE program’s street outreach
efforts in mid County.
Specifically, the Abode Services HOPE Crisis Outreach Program used its
Measure A allocation to achieve the following:
• Provide 100% of direct services in locations outside clinic offices (target:
75%)
• Link 83% of clients to a primary care provider (PCP) and have them make
at least one visit to a PCP within six months of enrollment (target: 100%)
• House 58% of clients in temporary shelter or transitional housing at
program exit (target: 50%)
• Help 42% of clients obtain permanent housing at program exit, with 2%
of those obtaining permanent housing within six months (target: 25% of
clients obtaining housing, with 50% obtaining housing within six months)
• Help 67% of clients exit the program to a known destination (target: 60%)
• Have 92% of clients who enter the program without health insurance
coverage exit with health insurance coverage (target: 100%)
• Have 67% of clients experience an increase in monthly income from
program intake to program exit (target: 25%)
CONCERNS
Greater HOPE
Based on the provider report, it is unclear how the Measure A funds
increased access to services for vulnerable populations.
HOPE Crisis Outreach Program
The Committee questions the use of Measure A funds to help people
obtain survival gear for living on the streets: tents, sleeping bags, etc. The
Committee wonders whether this money would be better used to fund
housing or efforts to put clients into housing.
Highlights
Greater HOPE
The program served 50 people during
this period and maintained 85%
housing stability. Everyone in the
program was connected with mental
health services and housing support
services. 55% of clients without SSI
benefits were connected to benefit
advocacy services. Over 75% of clients
decreased psychiatric hospital stays
and/or criminal justice involvement.
Matching Funds
Abode Services Greater HOPE
leveraged its Measure A allocation
to obtain matching funds from
Medi-Cal Billing. The HOPE Crisis
Outreach Program obtained matching
funds from Medi-Cal Administrative
Activities (MAA).
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
21
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 and
substance use disorder services under contract with BHCS to meet the
diverse cultural and language needs of County resident populations.
MEASURE A FUNDING SUMMARY
Measure A funds were used to support 26 mental health and substance
use disorder programs. Funds were roughly evenly distributed between
mental health and AOD programs. Providers used Measure A funds to
support expansion in service operations and administrative needs, and to
address cost increases not sufficiently covered by standard cost-of-living
adjustments (COLAs) provided by their contracts.
The use of Measure A funds to mitigate budget cuts allowed providers
to serve approximately the same number of County residents in AOD
programs, despite unavoidable cost increases for insurance, utilities, and
other non-service-related operational expenses. These additional funds
contributed to significant client-level outcomes, such as service continuity,
outreach effectiveness, and client engagement in treatment objectives that
would be put at risk by cutbacks in provider service capacity.
Allocation: $753,250 | Expended/Encumbered: $383,219
Individuals served by Measure A: 9,556 (Total individuals served: 35,393)
Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors
Services provided: Mental Health, Substance Abuse
Service area: Countywide
Behavioral Health and Alcohol and Other Drug (AOD) Community
www.acbhcs.org
Matching Funds
BHCS-contracted CBOs leveraged
their Measure A allocations to obtain
$19,961 in matching funds from Medi-
Cal and the Medi-Cal Administrative
Activities (MAA) program.
Measure AAllocation MatchingFunds
$753,250
$19,961
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
22
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. The Center focuses its programs on five
specific result areas:
• Children are physically, socially, and emotionally healthy.
• Children succeed academically.
• Environments are safe, supportive, and stable.
• Families are supported and supportive.
• Systems are integrated and care is coordinated and equitable.
Co-coordinated by CHSC and the Alameda County Behavioral Health
Care Services (BHCS) Agency, the Alameda County School-Based
Behavioral Health Initiative strives to strengthen and expand school-based
behavioral health practice, finance, evaluation, and policy in Alameda
County. In partnership with school districts and service providers, the
Initiative works to deliver a continuum of school-based behavioral health
supports to students in schools throughout Alameda County.
CHSC and BHCS used their Measure A allocation to enhance two core
programs of the Alameda County School-Based Behavioral Health
Initiative: the Our Kids Our Families Program, and the School District
Consultation program.
• The Our Kids Our Families program, provided at 29 school sites in
the Hayward and Oakland Unified School Districts, is a school-based
behavioral health program that fosters social-emotional wellness
in an educational environment so that children and families feel
connected, safe, and supported in school. The Our Kids Our Families
program supports prevention efforts at the school sites, as well as early
intervention and treatment services for any student and their family
that needs it.
Allocation: $617,362 | Expended/Encumbered: $617,362
Individuals served by Measure A: 3,840 (Total individuals served: 3,840)
Populations served: Indigent, Low Income, Uninsured Adults, Children, Families
Services provided: Mental Health, Substance Abuse
Service area: Ashland, Cherryland, Dublin, Emeryville, Hayward, Livermore, Newark, Oakland, Pleasanton, San Leandro, San Lorenzo, Union
City, Homeless or transient
Center for Healthy Schools and Communities
(School-Based Behavioral Health Initiative)
achealthyschools.org
Measure A Helps
An 8th grade student in New Haven
Unified was having difficulty self-
regulating his emotion and relating to
his peers, and often sought attention
through negative behaviors. He
attended a support group created by
the COST team to give students from
Mexico and Central America the
opportunity to address their thoughts
and feelings regarding their transition
to the United States. Throughout
the group, students were allowed to
address their issues of grief, loss, and
trauma. As the group progressed,
the student was able to build positive
relationships with group members,
increased his sense of empathy, and
became very engaged in conversations
regarding group topics.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
23
• The School District Consultation program places behavioral health
consultants (BHCs) in school districts to provide and enhance
preventive social-emotional supports and mental health services
for students and their families. The BHCs conducted the following
activities:
- Assessed the social-emotional service needs and infrastructure of a
school district or set of schools and developed a service plan
- Coordinated the work of all partner agencies who deliver behavioral
health services in schools and districts
- Provided and/or coordinated clinical case management, group, and
individual counseling to students
- Provided workshops, parenting groups, and mental health and other
appropriate consultation to parents/caregivers; linked parents/
caregivers with needed resources in the school and community; and
supported school and school district efforts to engage and support
families in meaningful and positive ways
- Provided crisis assessment and intervention for students, supported
schools in effective crisis response, and supported school districts in
developing crisis response protocols
- Provided clinical supervision to interns and/or actively participated
in intern recruitment and placement
- Conducted planning to develop service referral and coordination
systems
- Provided behavioral health consultation to district/school staff to
strengthen connections between students and adults
- Conducted psycho-education for administrators, teachers, school
staff, parents, students, and community partners
- Participated in district- or school-wide efforts to create a positive
climate, prevent conflicts and violence, and enhance the community
setting for all members
- Developed or coordinated leadership and other opportunities for
children/youth that allow them to participate meaningfully in their
school
- Expanded partnerships with County, city, and/or community-based
organizations to fill service gaps
- Worked to become more integrated into the school district’s
operational systems
Highlights
Parent surveys reported a high
level of satisfaction. Parents saw
improvements in their children’s
ability to handle school and daily
life, resolve problems, and interact
positively with peers and adults.
Parents also reported having a support
network to assist them in dealing with
their child’s behavioral problems.
The majority of parents reported
that the parent/family engagement
events were useful and informative,
addressed their needs, and increased
their knowledge and parenting skills.
In six of the eight school districts
supported under this program,
considerable progress was made
toward strengthening and expanding
COST in FY 14/15. Three of the districts
now have COST at every site, and
five districts have made considerable
progress in their implementation and
expansion efforts. This is a substantial
increase since the 2009-2010 school
year, where only one of the eight
districts was making a systemwide
effort at implementing COST.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
24
MEASURE A FUNDING SUMMARY
The School-Based Behavioral Health Initiative used its Measure A
allocation to achieve the following objectives through the District
Behavioral Health Consultation program.
Increase access to behavioral health supports for students and their
families in eight school districts in Alameda County
Measure A funding has been instrumental in continuing to expand to
previously underserved school districts in the County, specifically the
following:
• Emery Unified
• Newark Unified
• New Haven Unified
• Dublin Unified
• Livermore Valley Joint Unified
• Pleasanton Unified
• San Leandro Unified
• Hayward Unified
Address the behavioral health support needs of students
As measured by the Community Functioning Evaluation (CFE)
administered to all students receiving early intervention and treatment
services under the School-Based Behavioral Health Initiative, services
delivered and/or coordinated by BHCs yielded positive results. At intake
and discharge, school-based providers and BHCs assessed their clients on
six common problem areas:
• Academic functioning
• Social relationships
• Exposure to violence/challenging environments
• Emotional and behavioral functioning
• Health/basic needs
• Living arrangements and basic functioning
The Our Kids Our Families Intern Program supervised a total of 16 social
work and MFT interns. The intern programs enabled Our Families Our
Kids to increase service capacity and service access for students and their
families.
Strengthen the use of evidence-based practices along a continuum of
behavioral health supports that includes prevention, early intervention,
and treatment
BHCs in all eight school districts are responsible for planning and/or
implementing evidence-based prevention programs that promote social/
emotional learning and development (SEL) learning in students and SEL
application in adults, including the following:
Matching Funds
The School-Based Behavioral Health
Initiative leveraged its Measure A
allocation to obtain $6,216,022 in
matching funds from the following
sources:
• Early Periodic Screening, Diagnosis,
and Treatment (EPSDT) funding,
Hayward: $1,345,957
• Early Periodic Screening, Diagnosis,
and Treatment (EPSDT) funding,
Oakland: $2,133,989
• Tobacco Master Settlement Fund
(TMSF)/CHSC discretionary :
$1,513,112
• Medi-Cal Administrative Activity
(MAA): $500,000
• Mental Health Services Act
Prevention/Early Intervention
Program: $412,866
• City of Oakland, Oakland Unite:
$200,000
• School District funding: $110,098
Measure A
Allocation
Matching
Funds
$617,362
$6,216,022
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
25
• Positive behavioral interventions and supports
• Restorative justice
• Mental health consultation with teachers, staff, parents, and students
In addition, BHCs worked to strengthen the quality of early intervention
and treatment programs in all school districts. BHCs provided and
worked with current providers and interns to expand the use of
therapeutic groups to serve students showing early signs of behavioral
health struggle and students assessed to be “at risk.” BHCs in all districts
either directly provided crisis response services or coordinated crisis
response.
Implement consistent criteria, procedures, and practices for behavioral
health assessments, referrals, and linkages in the schools
BHCs support the implementation of Coordination of Services
Teams (COST) in the schools. COST is an evidence-based model for
coordinating care at a school site. The multidisciplinary COST work
together to do the following:
• Use referrals and data-driven screenings to identify students who are
struggling
• Deliberate strengths and challenges
• Assess supports needed
• Help implement interventions
• Monitor progress and provide appropriate follow-up
• Identify the broader learning support resource needs of the school
• Make recommendations about resource allocation
Highlights
An analysis of students across all
grade levels showed improvement in
relationships with teachers, peers,
and family. Additionally, students who
received group or individual services
presented statistically significant
improvements in life functioning
(43%), behavioral/emotional needs
(24%), and school success (34%) from
intake to discharge.
In a survey conducted among middle
and high school students who had
received behavioral health services,
87% of respondents found those
services to be extremely helpful in
improving their ability to handle daily
life, get along better with friends
and family members, and succeed in
school.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
26
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.
A program of BHCS, Criminal Justice (CJ) Screening/In-Custody Services
provides a full range of mental health services to County jail inmates every
month. Without jail mental health services, mentally ill inmates would go
untreated.
MEASURE A FUNDING SUMMARY
BHCS used its Measure A fund allocation to maintain staff at CJ
Screening/In-Custody Services who provided assessment of all inmates
and improved care by ensuring timely access to medications and reduced
potential medication abuse at Santa Rita Jail. The demand for jail mental
health services continues to remain steady, even though the number of
overall inmates in the jail has decreased. To deliver mental health services
effectively, mental health staff were assigned to various areas of the jail:
intake (booking), inmate housing units, and the clinic. Staff worked in the
intake section of the jail seven days a week, two shifts per day.
Specific services supported by Measure A included the following.
Mental Health Screening
• Initial (Intake). At the time of booking, all inmates are screened
for medical and psychiatric treatment needs. Within 14 days, staff
conduct an additional mental health appraisal. Inmates found to need a
further mental health evaluation are referred to CJMH. The screening
assessment includes an evaluation of the inmate’s current psychiatric
condition, psychiatric history, substance abuse (addictions) history
and current use, psychiatric medication history and current need for
medications, suicide history and current risk factors, and more.
• Post-booking. CJMH clinicians triage and screen all referred inmates
for mental health service needs and recommend appropriate treatment
plans based on the assessment. CJMH provides services onsite in
Allocation: $4,306,000 | Expended/Encumbered: $4,306,000
Individuals served by Measure A: approximately 4,232 (Total individuals served: 4,318)
Populations served: Indigent, Low Income, Uninsured Adults, Families, Seniors
Services provided: Mental Health
Service area: Countywide
Criminal Justice Screening and In-Custody Services
Highlights
Prior to Measure A funding, there
were too few mental health staff
working in the jail to accommodate
the high volume of inmates needing
mental health assessments, services,
and medications. Many had to wait
a long time (two months) to be
seen, if at all. CJMH now has mental
health teams assigned to all the high
risk housing units. They have also
begun providing weekly groups for
inmates in the special population
male housing unit and at Glen Dyer
Detention Facility (GDDF) in Oakland.
They have expanded services at
GDDF. Previously, inmates who
wanted mental health services had
to be transported to Santa Rita Jail in
Dublin and would often wait in holding
cells for most of the day. Now those
needing mental health services are
seen by CJMH clinical staff on site at
GDDF weekly.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
27
special housing units 1, 2, 8, 9, and 24. These onsite services allow
CJMH staff to proactively deliver mental health services to mentally ill
inmates who might otherwise fall through the cracks.
Crisis Intervention
• Onsite. CJMH clinicians respond to urgent calls regarding
seriously distressed inmates and provide crisis counseling, make
recommendations for interventions, initiate interim placements, and/or
make arrangements for psychiatric hospitalization.
• On-call. When there are no mental health staff onsite, a CJMH clinician
is on call and can be reached by pager to assist with urgent mental
health matters.
Management of Inmate Behavioral Problems
CJMH clinicians collaborate with and provide consultation to deputies
and staff to develop and implement plans for appropriate management of
inmate behavioral problems.
Suicide Prevention
CJMH participates with sheriff’s personnel and medical staff in training,
oversight, and procedures designed to prevent inmate suicides. At the
time of booking, all inmates are assessed for suicide risk. In addition,
CJMH conducts a suicide risk assessment on all inmates called to
their attention as a result of inmates expressing suicidal thoughts or
demonstrating self-injurious behaviors. CJMH staff work with inmates
who demonstrate a risk for suicide and address risk factors, develop
relapse prevention strategies, and discuss coping strategies. CJMH takes
preventive action on all inmates expressing suicidal thoughts and/or
demonstrating self-injurious behaviors.
Ongoing Treatment Services, Treatment Planning, Stabilization of
Mental Disorders, and Other Services
All inmates receiving mental health services are seen by CJMH clinicians,
who develop individualized treatment plans to help inmates achieve
mental stability, develop an awareness of their psychological and
behavioral problems, and acquire coping skills while incarcerated.
• Medication support services. When appropriate, CJMH psychiatrists
evaluate inmates and prescribe psychotropic medications to alleviate
symptoms and allow the inmates to achieve an optimal level of
functioning while incarcerated.
• Counseling services. Inmates referred for counseling services receive
an additional post-booking assessment and are provided ongoing
counseling sessions as determined by their treatment plan.
• Misdemeanant incompetents. With regard to misdemeanant
Incompetent to Stand Trial (PC 1370.01) inmates, CJMH staff
collaborate with the courts to provide treatment geared to restoring
competence and/or refer inmates to community programs that can
address competency.
Measure A Helps
A 19-year-old African American youth
ended up in jail due to an incident in
which his behavior escalated and his
parents were fearful someone would
be hurt. In jail, the youth was housed
in administrative segregation due to
his violence when psychotic and off
his medications. The CJMH clinician
was able to support both the youth and
his family while he was in custody.
This collaboration went on for the year
while the youth was in custody. The
clinician was able to help the youth
regarding the loss around his college
scholarship, being diagnosed with a
serious mental illness, his adjustment
to jail, and hope for the future.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
28
• Court-ordered evaluations. CJMH clinicians conduct court-ordered
psychiatric evaluations (PC 4011.6s) to assess the need for acute
inpatient psychiatric care and provide reports back to the courts.
• Inpatient services. CJMH staff or deputies send inmates requiring acute
inpatient hospitalization to acute psychiatric inpatient hospitals. When
inmates are returned to the jail, they are held in the Outpatient Housing
Unit (Infirmary) until CJMH clinicians can assess them, continue their
medications, and clear them for housing.
• Inmates who refuse treatment. All treatment is voluntary. CJMH staff
monitor inmates with serious mental illnesses who refuse treatment
and make an ongoing attempt to engage these inmates in treatment.
• Outreach and teamwork. CJMH clinicians and psychiatrists closely
monitor inmates in Special Housing Units: Ad Seg, Mental, Women’s.
Visits occur weekly, including cell checks for inmates who refuse to be
seen or who are noncompliant with treatment.
• Substance abuse treatment. Inmates have access to programs that
specifically address addiction problems. CJMH clinicians also address
substance abuse as part of their ongoing interventions with inmates.
Mental Health On-Call/Emergency Services
Emergency mental health services are available 24 hours a day by onsite
staff or by mental health professionals who work on call. Access to 24-
hour acute psychiatric hospitalization is available. A CJMH psychiatrist is
on call to accommodate the continuity of psychotropic medications.
Discharge Planning/Continuity of Care
When CJMH staff have advance notice of an inmate’s date of release,
staff make a referral for follow-up outpatient treatment. CJMH staff work
closely with court mental health advocates the Court Advocacy Project
(CAP), the Forensic Assertive Community Treatment (FACT) team, the
Behavioral Health Court (BHC), and community service providers in
coordinating treatment plans and release plans for persons in custody
with serious mental illnesses.
Training
The CJMH Director, the Senior Clinician(s), and other mental health
professionals provide training to sheriff’s personnel and civilian staffs
in mental illnesses and suicide prevention. All new CJMH staff receive
40 hours of initial training. CJMH managers and psychiatrists provide
ongoing training to CJMH line staff on topics related to the practice of
jail psychiatric services. The CJMH Lead Psychiatrist attends the monthly
BHCS Psychiatric Practices Committee and shares information learned
with other CJMH psychiatrists.
Administration of Psychotropic Medications to Patients in a Psychiatric
Emergency
Psychiatrists can legally prescribe psychotropic medication for emergency
situations.
Emergency mental
health services are
available 24 hours
a day by onsite staff
or by mental health
professionals who
work on call.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
29
BACkGROUND
The Detox/Sobering Center works to improve the quality of life for
individuals, families, and the community affected by drug abuse and
mental health issues by providing compassionate, effective prevention,
treatment, and recovery services.
The Detox Center is a social model nonmedical detoxification center
specifically designed for individuals requiring 24-hour/7-day-a-week
monitoring. It offers van transport for individuals needing transportation
to and from medical, psychiatric, treatment, housing, or any other
ancillary service.
The Sobering Center is designed to assist those needing immediate
sobering services from alcohol/drugs. It provides a brief visit of 23 hours
or less with continual monitoring for safe withdrawal, 24 hours per day,
seven days per week. Within the Sobering Center, the Health Center
is staffed with nurse coordinators and health technicians who monitor
withdrawal and assist with medical triage/assessment to ensure safe and
healthy withdrawal. The center also provides TB tests and referrals to
medical/psychiatric services for all individuals as needed.
MEASURE A FUNDING SUMMARY
Measure A provides 100% of the funding to Cherry Hill Detoxification
Services Program/Horizon Services, Inc., the sole provider of the Detox/
Sobering Center.
With this funding, the Detox/Sobering Center achieved the following
measurable outcomes:
• Cherry Hill Sobering Center provided 5,198 units of service.
• The Detox Center provided 2,229 units of service.
• The Health Center provided 985 services to existing clients.
• Law enforcement leadership and officers attended bi-monthly trainings
in groups of 25-30 for training, education, and orientation around the
Detox/Sobering Center’s programs and services.
Allocation: $2,080,800 | Expended/Encumbered: $1,948,778
Individuals served by Measure A: 6,873 (Total individuals served: 6,873)
Populations served: Indigent, Low Income, Uninsured Adults, Seniors
Services provided: Substance Abuse
Service area: Countywide, Homeless or transient
Detoxification/Sobering Center
Measure A Helps
A 45-year-old uninsured, homeless
Latino male arrived at Cherry Hill
for sobering and detox services.
He had been using alcohol and
methamphetamine for 10 years
without treatment and had not taken
his medication for several months.
Based on the Nurse Coordinator’s
recommendation of medical
intervention, Cherry Hill transported
the client to Highland Hospital. After
stabilizing, the client transferred to
the Detox Center, where he began
to open up about his life, including
loss and multiple traumas. After four
days at the Detox Center, the client
expressed interest in ongoing care.
He was successfully transferred to La
Familia, a residential alcohol and drug
treatment center in Oakland.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
30
BACkGROUND
La Familia Counseling Service is an inclusive, Latino community-based,
multicultural organization committed to strengthening the emotional
wellness of individuals and the preservation of families.
MEASURE A FUNDING SUMMARY
Measure A provided 100% of the funding for the targeted La Familia
services. La Familia used its Measure A allocation to achieve the
following:
• Provide individual and family basic needs information and referral
in the areas of housing, job referrals, nutrition, translations, health
referrals, immigration, legal and general orientation, and health
education workshops to low income residents, to help them attain
increased psychosocial and economic stability (target: 1,200 residents;
actual: 2,697)
• Provide case management support—including intake and assessment,
service planning, direct support, and evaluation—for an average of 90
days to families facing multiple challenges (target: 159 families; actual:
79)
• Provide assistance in applying for health coverage through Medi-Cal
and other available options to low income Hayward residents (target:
133 residents; actual: 723)
• Provide workshops/support groups for adults/caregivers on topics
to improve access to medical and mental health resources, nutrition,
parenting, coping skills, academic engagement, and advocacy (target:
105 workshops/support groups; actual 105)
• Provide workshops/support groups to youths to foster healthier
relationships, discuss maladaptive behaviors and risk factors, and
explore personal and social responsibility (target: 40 workshops/
support groups; actual: 56)
Allocation: $100,000 | Expended/Encumbered: $100,000
Individuals served by Measure A: 2,697 (Total individuals served: 2,697)
Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors
Services provided: Mental Health, Substance Abuse
Service area: Ashland, Cherryland, Hayward, San Leandro, San Lorenzo
La Familia Counseling Services
lafamiliacounseling.org
Highlights
La Familia met or exceeded its targets
for almost all of its program objectives.
In two areas, it greatly exceeded its
targets: providing information to
low income residents (2,697 actual
vs. 1,200 target, an increase of over
100%), and providing health care
application assistance (723 actual vs.
133 target, an increase of over 500%).
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
31
BACkGROUND
Alameda County Behavioral Health Care Services (BHCS) offers mental
health services to youth at the Alameda County Juvenile Hall in an effort
to maximize the recovery, resilience, and wellness of those who develop or
experience serious mental health, alcohol, or drug concerns. The services
provided consist of individual therapy, case management, court-ordered
evaluations, crisis intervention, and consultation to Juvenile Hall staff,
probation officers, school staff, and the Juvenile Court.
Youth who are detained in Juvenile Hall by nature of being in a locked
facility away from family and friends experience anxiety, agitation, and
depression in regards to their situation. This is in addition to any pre-
existing mental health conditions that the youth struggle with prior to
being admitted into Juvenile Hall. The goal of BHCS is to mitigate as much
as possible the negative emotional impact of detention.
MEASURE A FUNDING SUMMARY
BHCS used its Measure A allocation to provide mental health services
to youth detained in the Juvenile Hall facility. The funding helped BHCS
attain the following objectives:
• Mitigate the mental health issues of detained youth by offering crisis
intervention and ongoing mental health support while detained.
• Provide court-ordered mental health assessments. Guidance Clinic staff
completed approximately 244 mental health assessments in FY 14/15.
Measure A funding covered approximately 33 of those assessments.
• Offer immediate crisis intervention for suicidal youth to avoid self-
harm. The Guidance Clinic performed 156 crisis interventions to avoid
self-harm and/or hospitalization, of which Measure A funded 21.
Allocation: $360,000 | Expended/Encumbered: $360,000
Individuals served by Measure A: 149 (Total individuals served: 1,097)
Populations served: Indigent, Low Income, Uninsured Children, Families
Services provided: Mental Health, Substance Abuse
Service area: Countywide, Outside of Alameda County
Mental Health Services for Juvenile Justice Center
Highlights
Thanks in part to Measure A funding,
the program achieved the following:
• The program resulted in increased
coping skills among the target
population for managing anxiety,
depression, and trauma symptoms
due to being detained.
• As a result of immediate crisis
intervention, only four clients were
hospitalized in FY 14/15.
Matching Funds
BHCS leveraged its Measure A
allocation to obtain $63,284 in
matching funds from Medi-Cal.
Measure AAllocation MatchingFunds
$360,000
$63,284
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
32
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 Cambodian survivors of the Khmer Rouge
genocide and their families, although they have expanded services to other
refuge and immigrant populations.
MEASURE A FUNDING SUMMARY
CERI used its Measure A allocation to conduct the following outreach
activities:
• Community events (target: 8 events attended by 50 individuals; actual:
monthly events attended by 45 individuals)
• Home and school visits (target: 196 hours; actual: 200)
• Psycho-educational workshops (target: 1 per month; actual: 1 per
month)
• Support groups, including life skills classes, art, and other
nontraditional mental health prevention activities (target: 4 ongoing
groups; actual: 5)
• Cultural workshops for the community and schools (target: 2
workshops; actual: 1)
• Consultation and/or training for community-based organizations
(CBOs) (target: 3 trainings; actual: 3)
• Consultation and/or training for schools, probation officers, child
welfare workers, and health care workers
• Early intervention for individuals and families including short-term,
low intensity interventions (target: 160 hours to at least 4 individuals;
actual: 4 individuals)
Allocation: $78,030 | Expended/Encumbered: $72,359
Individuals served by Measure A: 25 (Total individuals served: 50)
Populations served: Low Income, Uninsured Children, Families
Services provided: Mental Health
Service area: Alameda, Albany, Oakland, San Leandro, Union City
Mental Health Services for Newcomers and Immigrants (CERI)
cerieastbay.org
Matching Funds
CERI leveraged its Measure A
allocation to obtain $75,000 in
matching funds from the Mental
Health Services Act (MHSA), including
Medi-Cal Administrative Activities
(MAA).
Measure AAllocation MatchingFunds
$78,030 $75,000
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
33
Highlights
Having M.E.T. respond to 5150 calls
frees up patrol units to attend to other
types of public safety calls.
M.E.T. takes the pressure off officers
having to make complex mental
health decisions as the clinical mental
health staff are able to assist with their
expertise, knowledge of the system,
and access to the mental health
history of patients.
M.E.T. has the ability to respond faster
to 5150 MH crisis calls because the
information is available on the patrol
car’s computer and the M.E.T. officers
can proactively dispatch themselves to
the call.
M.E.T. provides options to de-escalate
most situations by allowing the
individual to make the choice to speak
with either a clinician or an officer.
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.
The Oakland Police Department Mobile Evaluation Team (M.E.T.)
provides mobile assessment and evaluation services to those in crisis
living in East Oakland. East Oakland was identified by the Oakland Police
Department as having the second-largest percent of crisis calls after the
downtown area, where BHCS already has a mobile crisis team.
M.E.T. strives to avoid the use of involuntary psychiatric hospitalization
when appropriate by providing alternative treatment resources, which
may include consultation, crisis intervention, and referral to brief
treatment and/or diversion to other voluntary crisis services as available.
MEASURE A FUNDING SUMMARY
M.E.T. used its Measure A allocation to achieve the following objectives:
• Respond to six crisis calls per day, which increased to eight calls per day
as the program became established. The Oakland Police Department
responds to 20–25 mental health-related calls a day on average, so
M.E.T. picked up, on average, one-quarter to one-third of the calls.
• Reduce the amount of time a cover officer has to be on the scene of the
5150 crisis call after the M.E.T. arrives. The cover unit was needed on
scene for an average of 15 minutes, with a maximum of 30 minutes and
a minimum of five minutes for some calls.
• Provide alternative resources to individuals in crisis. The result of the
call was recorded on 320 of the 410 calls that M.E.T. responded to. Of
the 320 calls, 58% of individuals were not put on an involuntary hold
(5150) and were instead given resource materials, de-escalated, had a
physical health/medical issue addressed, or refused to accept services.
None of the calls that M.E.T. responded to resulted in an arrest.
Allocation: $250,000 | Expended/Encumbered: $250,000
Individuals served by Measure A: 410 (Total individuals served: 410)
Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors
Services provided: Mental Health, Substance Abuse
Service area: Oakland, Homeless or transient
Oakland Police Department
www.acbchs.com
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
34
BACkGROUND
Options Recovery Services works to break the cycle of addiction that
causes crime, homelessness, and broken families.
MEASURE A FUNDING SUMMARY
Options Recovery Services used its Measure A allocation to achieve the
following:
• Complete renovations to the interior of the Berkeley City Hall Annex
building, including painting, floor repair, new carpet installation, and
new lighting
• Provide ADA accessibility to the building including an exterior
wheelchair ramp and modifications to the front door and restrooms
• Bring the facility into compliance with state Medi-Cal regulations
• Ensure efficient communication and accurate and secure information
management by installing a new phone system, computers, copier, fax,
and Internet access
Allocation: $25,000 | Expended/Encumbered: $20,000
Individuals served by Measure A: 6 (Total individuals served: 100)
Populations served: Indigent, Low Income, Uninsured Adults
Services provided: Substance Abuse
Service area: Berkeley, Oakland
Options Recovery Services
optionsrecovery.org
Options Recovery
Services used its
Measure A allocation
to provide ADA
accessibility to the
building, including an
exterior wheelchair
ramp.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
35
Matching Funds
SAVE leveraged its Measure A
allocation to obtain $86,000 in
matching clinical program funding
from the California Office of
Emergency Services as well as private
foundation funding.
Measure AAllocation MatchingFunds
$30,000
$63,284
BACkGROUND
Safe Alternatives to Violent Environments (SAVE) works to strengthen
every individual and family they serve with the knowledge and support
needed to end the cycle of violence and build healthier lives.
All SAVE services are provided free of charge. At SAVE, the only criteria
for participation in counseling services is that the client has experienced
or is experiencing domestic violence. The drop-in domestic violence
support groups held at SAVE’s community office are open to any woman
struggling with the effects of domestic violence in her life. Any woman
can come to group whenever she needs it. There is no registration process,
and there are no limitations on how often she can come.
Support groups provide a safe place for women to talk about their issues
with each other and the support of a trained facilitator. The information
and sense of community they receive from the group helps to reduce
isolation and see that the blame lies with the abuser.
Counseling staff are all trained in domestic violence and have expertise
in the effects of that particular kind of trauma. They also understand the
types of additional challenges clients who are low income or disabled
or struggling with substance abuse or mental health issues might face.
They work to ensure that they provide a trauma-informed, culturally
appropriate, safe environment in which no client will ever feel judged or
blamed for her choices.
MEASURE A FUNDING SUMMARY
Measure A support is a key source of funds for SAVE counseling services.
SAVE used its Measure A allocation to meet the following objectives:
• Provide individual counseling sessions to participants, with at least 50%
of clients participating in more than one session (target: 160 sessions
to 45 participants; actual: 377 sessions to 59 participants, with 92%
participating in more than one session)
• Develop safety plans in collaboration with clinicians and clients, with
Allocation: $30,000 | Expended/Encumbered: $30,000
Individuals served by Measure A: 59 (Total individuals served: 112)
Populations served: Indigent, Low Income, Uninsured Adults, Children, Families
Services provided: Mental Health
Service area: Fremont
Safe Alternatives to Violent Environments (SAVE)
save-dv.org
Highlights
All SAVE programs supported by
Measure A exceeded their targets,
sometimes dramatically. For example,
having set a target of providing 160
individual counseling sessions, SAVE
actually provided 377—an increase of
over 100%.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
36
65% of clients reporting an increased feeling of safety (target: 20 safety
plans; actual 28, with 100% of clients reporting an increased feeling of
safety)
• Provide a packet of information containing relevant community-based
resources to clients, with 65% of clients reporting increased knowledge
of how to access community resources (target: 20 packets; actual 28,
with 100% of clients reporting increased knowledge of how to access
community resources)
Measure A Helps
A transgender Latina client—born
as male and identifying as female—
with physical disabilities came to
SAVE for counseling. The client did
not feel safe in her environment and
had few financial resources. She had
been expelled from her family and
had no supportive relationships. The
therapist assisted the client with food
and hygiene needs and with calling
shelters. The next morning, the client
moved into the SAVE domestic
violence shelter, where she continued
to receive therapeutic support. The
client was eventually able to find
a sense of purpose and focus in her
recovery. She moved to Washington
state and has become an active member
of the transgender community.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
37
BACkGROUND
Senior Support Program of Tri-Valley provides seniors services and
assistance to foster independence, promote safety and well-being,
preserve dignity, and improve quality of life.
The In-Home Counseling Program makes a difference in the lives of
Tri-Valley seniors by providing counseling services in seniors’ homes.
Staff members receive referrals from case managers, family members,
caregivers, and other concerned members of the community. Counseling
occurs on an individual basis. During sessions, counselors conduct
assessments, including psychosocial, physical, mental health status, and
personal history. Counselors also provide crisis intervention, resources,
and referrals, as needed.
By making this service free of charge, many older adults get the benefit of
much-needed support with their most challenging end-of-life issues. In
many cases, the counselor is the only contact the client has.
MEASURE A FUNDING SUMMARY
Senior Support Program of Tri-Valley depends on Measure A funding to
support its In-Home Counseling program. Measure A funding supported
the following objectives:
• Provide In-Home Counseling services to at least 20 seniors with mental
health issues who are referred from community, staff, family, etc.
• Conduct progress evaluations of clients every six weeks until discharge
• Train and supervise interns to assist with counseling
• Evaluate and adjust the program throughout the year by giving
evaluation surveys to clients at the end of each client’s program
Allocation: $20,000 | Expended/Encumbered: $20,000
Individuals served by Measure A: 46 (Total individuals served: 46)
Populations served: Seniors
Services provided: Mental Health
Service area: Dublin, Livermore, Pleasanton, Sunol
Senior Support Program of Tri-Valley
ssptv.org
Measure A Helps
After a fall four years ago, Mr. J.,
76, did not feel fully recovered and
continued to have bouts of depression,
forgetfulness, foggy thinking, and
inertia. In sessions at the In-Home
Counseling Program, the counselor
assessed that Mr. J. needed more
interactions with family, friends, and
community, and discussed ways he
could reach out more. Mr. J. received
resources for managing his depression,
finding a primary care doctor, and
locating activities in the community.
With each session, Mr. J opened
up more about himself and what he
wanted to create in his life. Mr. J.
has become more outgoing and has
started to reach out to others in the
community.
Highlights
In FY 14/15, the In-Home Counseling
Program had more referrals than in
any other year.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
38
BACkGROUND
The Developmental Disabilities Council advocates for the rights of people
with developmental disabilities to be assisted in the fullest development of
their mental, physical, and spiritual potentials, and the right to community
living in the least restrictive environment.
MEASURE A FUNDING SUMMARY
The Developmental Disabilities Council used its Measure A allocation to
develop a specialty mental health clinic, the Schreiber Center, for adults
with developmental disabilities.
The Schreiber Center, staffed by a full-time clinician and part-time
psychiatrist, is now open, located in the Gail Steele Wellness Center in
Hayward. A referral process was developed in collaboration with the
Regional Center of the East Bay, and extensive outreach and training is
ongoing. Services include assessment for specialty mental health, case
consultation, psychotherapy, and medication support.
Since the Schreiber Center’s opening, the program has received over 50
referrals. Of those 50 referrals, 16 have been opened to the Center and 12
are currently receiving therapy and psychiatric services. Nine are pending
assessment.
Allocation: $250,000 | Expended/Encumbered: $250,000
Individuals served by Measure A: 15 (Total individuals served: 15)
Populations served: Low Income Adults
Services provided: Mental Health
Service area: Countywide
Note: In addition to its individual allocation, the Schreiber Center also received Measure A money through the Public Health Prevention
Initiative allocation (see page 107). The funding summary information described here is for the total of both allocations.
The Schreiber Center
acbhcs.org
Highlights
Clients have improved in the
following ways: decreased symptoms
of depression, reduced side
effects of medications, improved
communication with family, increased
access to mental health services, and
improved care with current providers
following the recommendations of a
psychiatrist.
Matching Funds
The Schreiber Center leveraged
its Measure A allocation to obtain
approximately $40,000 in matching
funds from Medi-Cal and Mental
Health Services Act (MHSA) funds.
Measure AAllocation MatchingFunds
$250,000
$40,000
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
39
BACkGROUND
Tri-Valley Haven for Women (TVH) creates homes safe from abuse and
contributes to a more peaceful society. TVH strives to build a world
without violence.
The majority of clients at TVH have experienced domestic violence,
sexual abuse, molestation, or assault at some time in their lives. TVH
professional counseling staff provide intake and assessment and ongoing
counseling services.
Counseling involves validating client experiences, providing education on
domestic violence and sexual abuse, helping clients realize they are not
alone, and providing support in many clinical ways. Clients leave with
a desire to take care of themselves, many for the first time in their adult
lives, and with a positive feeling about their future.
All of these factors help clients live fuller lives and have a positive sense of
self and community rather than living in a state of shame and fear where
they feel alone, hopeless, and worthless.
MEASURE A FUNDING SUMMARY
TVH used its Measure A allocation to meet the following objectives:
• Provide professional counseling sessions to adult and children clients
(target: 200 sessions to 25 unduplicated clients; actual: 224 sessions to
56 clients)
• Based on staff assessment, have clients show improved mental health
(target: 60% of clients served; actual: 91%)
Allocation: $25,000 | Expended/Encumbered: $25,000
Individuals served by Measure A: 56 (Total individuals served: 56)
Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors
Services provided: Mental Health
Service area: Castro Valley, Dublin, Livermore, Oakland
Tri-Valley Haven for Women
trivalleyhaven.org
Measure A Helps
When 12-year-old Ana’s mom took
her to the hospital for stomach pain,
tests revealed that Ana was pregnant.
She’d been raped by her stepfather.
During counseling at TVH, Ana
learned that the rape and sexual abuse
were not her fault in any way. Ana
began to open up to her therapist
and process the trauma in a safe
environment. When the stepfather
went to trial, TVH worked with the
district attorney’s office to ensure Ana
would be protected. TVH’s Linkages
Program helped the family maintain
safe, stable housing. Ana was able to
stay at her middle school, where she is
now getting As in her classes and loves
to play basketball.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
40
FUNDS ALLOCATED BY THE ALAMEDA COUNTY BOARD OF SUPERVISORS
GROUP 2: HOSPITAL , TERTIARY CARE , OTHER
Administration/Infrastructure Support .................................................................................................... 42
San Leandro Hospital ................................................................................................................................ 44
St. Rose Hospital ....................................................................................................................................... 45
UCSF Benioff Children’s Hospital Oakland ................................................................................................ 47
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
41
BACkGROUND
The Alameda County Health Care Services Agency (HCSA) works to
provide fully integrated health care services through a comprehensive
network of public and private partnerships that ensures optimal health and
well-being and respects the diversity of all residents.
The HCSA Administration/Indigent Health department serves to provide
the following:
• Integrated health care services to the residents of Alameda County
within the context of managed care and a private/public partnership
structure
• Direct oversight, administrative, and fiscal support for the County’s
medically Indigent Services Plan and its provider network and all cross-
departmental and cross-jurisdictional services, with an emphasis on
children’s services
• General oversight, administrative, and fiscal support for the Public
Health, Environmental Health, and Behavioral Health Care Services
Departments
• Leadership for implementation of countywide or agency-wide health care
initiatives
• Leadership and assistance to private and publicly operated health care
delivery systems, including implementation of programs that expand
accessibility of needed medical services in the most appropriate and cost-
effective settings, development of insurance alternatives for previously
uninsured County residents, and implementation of programs that
expand accessibility of needed medical services targeting children
MEASURE A FUNDING SUMMARY
The HCSA Administration/Indigent Health department used its Measure
A allocation to provide administrative support for the management
of Measure A including, but not limited to, contract development and
monitoring, management of special projects, budget oversight and
preparation of the annual reports, and staffing of the Measure A Oversight
Committee.
Specifically, HCSA used its Measure A allocation to achieve the following:
• HCSA provided contract and administrative support for 65 Measure A
allocations. Of the 65 contracts, Administration and Indigent Health
Allocation: $400,000 | Expended/Encumbered: $228,437
Note: Recipient does not provide direct services
Administration/Infrastructure Support
acgov.org/health
The HCSA
Administration/
Indigent Health
department used
its Measure A
allocation to provide
administrative
support for the
management of
Measure A.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
42
staff was involved in the contract development of 33 of the executed
contracts. Of the 33 contracts that were developed by Administration
and Indigent Health staff, 90.9% were fully executed within 2.5 months
(which is the average turnaround time to develop a contract, receive
Board approval, and encumber funds).
• Administration and Indigent Health staff provided one Results-Based
Accountability (RBA) training in April 2015 to organizations that
received Measure A base funding. A total of 10 organizations were
trained in RBA, with 25 participants attending.
• Administration and Indigent Health staff monitored 33 Measure A
contracts. The Measure A contract providers had contracts with either
monthly or quarterly reimbursement schedules. Of the 156 invoices
processed, 90.9% were processed within 30 days of receiving the invoice
and progress report.
• Administration and Indigent Health staffed and convened 10 Measure
A Oversight Committee meetings. Of the 10 meetings that were
scheduled, 100% were convened.
• Administration and Indigent Health staff completed the production and
distribution of the FY 13/14 Measure A Final Report.
CONCERNS
The Direct Service Planning and Administration group does not have
enough resources allocated to carry out a Measure A program evaluation
that would adequately ensure accountability to Alameda County
taxpayers for this annual expenditure of over $120 million. As a first
step, appropriate levels of staffing and expenditures would allow staff to
conduct mandatory audits and subsequent training for at least 10% of
funding recipient programs.
Of the 33 contracts
that were developed
by Administration
and Indigent Health
staff, 90.9% were fully
executed within 2.5
months.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
43
BACkGROUND
San Leandro Hospital is a 93-bed community-based hospital that was
acquired by Alameda Health System (AHS) in 2013. It provides inpatient
and outpatient services including medical, surgical, and intensive care,
as well as 24-hour emergency services in its 13-bed, Level II Emergency
Department (ED). The hospital serves central Alameda County, a
community of 265,000 people.
MEASURE A FUNDING SUMMARY
This provider did not supply any Measure A funding summary
information for FY 14/15.
CONCERNS
The provider’s report contains an impressive list of services and
achievements. However, there is no alignment between these
achievements and the clearly stated and quantifiable objectives in the
provider report. In addition, the goals and objectives listed were not
specific to San Leandro Hospital but instead were an exact reprint of the
entire AHS goals and objectives. This causes difficulty in determining the
intent and actual impact of Measure A funds.
For example, the provider reports that all 24,627 individuals served were
served by Measure A, but elsewhere reports that only 54% of individuals
served qualified for Measure A benefits. The budget numbers reported are
for the entire hospital budget and are not specific to the Measure A grant.
The omitted information in the Measure A Funding Summary section
above has been requested several times without response.
Because of these concerns, the Committee recommends a full audit to
determine accounting for Measure A expenditures.
Allocation: $1,000,000 | Expended/Encumbered: $1,000,000
Individuals served by Measure A: 24,627 (Total individuals served: 24,627)
Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors
Services provided: Emergency Medical, Hospital Inpatient, Hospital Outpatient, Public Health, Mental Health
Service area: Countywide, Outside of Alameda County, Homeless or transient
San Leandro Hospital
sanleandroahs.org
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
44
BACkGROUND
St. Rose Hospital (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. These services include the
following:
• Critical access. SRH serves as a critical access point for Alameda
County and is the only Medi-Cal-contracted facility between Oakland
and Fremont. Additionally, SRH serves as a safety-net hospital and
provides health care access to many low income residents who do not
have adequate transportation to the Alameda County Medical Center.
• Hospitalists programs. The Hospitalists assume care of indigent
and uninsured patients who are admitted to SRH. This alleviates the
financial impact of private physicians who request compensation for
lack of reimbursement.
• Women’s services. SRH operates the Women’s Center to meet the
growing demand for OB/GYN services in the community, because
many OB practitioners do not accept Medi-Cal rates. The program
provides immediate and emergency care for pregnant women who
present to the emergency room (ER), often with no history of prenatal
care.
• Cardiac care. SRH is the only Medi-Cal-contracted facility to provide
elective cardiac and percutaneous coronary intervention (PCI) services
in central Alameda County. There has been a 3% increase in procedures
for Medi-Cal beneficiaries in fiscal year 2015 over 2014. SRH routinely
accepts hospital transfers for emergency and elective cardiac care from
non-Medi-Cal providers.
SRH serves approximately 12% of Alameda County’s indigent population.
MEASURE A FUNDING SUMMARY
SRH used its Measure A funds to subsidize the cost of providing care to
the following groups of patients:
• Patients who qualify for charity care
• Uninsured and/or indigent patients
Allocation: $4,000,000 | Expended/Encumbered: $4,000,000
Individuals served by Measure A: 11,132 (Total individuals served: 40,805)
Populations served: Indigent, Low Income Adults, Children, Families, Seniors
Services provided: Emergency Medical, Hospital Inpatient, Hospital Outpatient
Service area: Countywide, Homeless or transient
St. Rose Hospital
strosehospital.org
Measure A Helps
A 61-year-old homeless male
was brought into the emergency
department due to loss of consciousness
with acute gastrointestinal bleeding.
He was undocumented and uninsured.
After being admitted, the patient
wanted to leave the hospital because of
his inability to pay. After discussion
with the physician, he decided to stay.
An upper gastrointestinal endoscopy
revealed gastritis, duodenitis, and an
duodenal ulcer. A blood transfusion
was given. The patient was stabilized
and discharged six days later. Since the
patient did not qualify for insurance,
the hospital made the decision to waive
the hospital bill. The patient has often
returned to St. Rose Hospital to thank
the staff for their kindness.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
45
• Traditional Medi-Cal beneficiaries
• Medi-Cal Managed Care enrollees, including Alameda Alliance
members
• HealthPAC members
SRH used its Measure A allocation to help achieve the following:
• Provide emergency care for uninsured and underinsured patients. The
SRH ER experienced 33,263 visits in FY 14/15, including 73%, or 24,224
visits, from uninsured and underinsured patients.
• Provide hospital admissions for 3,381 uninsured or underinsured
patients, representing 57% of total inpatient admissions.
• Assist in supporting SRH inpatient services to uninsured and
underinsured patients. Hospital-based physicians provided over 11,500
patient encounters for uninsured patients for the year.
CONCERNS
The objectives included in the provider report are not quantifiably stated
and should be revised. While the provider included excellent quantified
results achieved in serving uninsured and underinsured patients, these
should be revised to match the categories of patients described in the
goals and objectives.
Matching Funds
SRH leveraged its Measure A allocation
to obtain $2,000,000 in matching
funds from the intergovernmental
transfer program through the Medi-Cal
program.
Measure AAllocation MatchingFunds
$4,000,000
$2,000,000
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
46
BACkGROUND
UCSF Benioff Children’s Hospital Oakland (CHO) works to protect
and advance the health and well-being of children through clinical care,
teaching, and research.
At CHO, Measure A funding supported three programs/activities:
• The pediatric Emergency Department (ED), specifically to provide
adequate staffing for the large volume of children seen at the ED
• The Center for Child Protection (CCP)
• School-based clinics
Emergency Department
CHO provides highly specialized pediatric emergency services for the
children of Alameda County, 24 hours a day, seven days a week. CHO’s
ED sees a broad array of pediatric disease and injury from the basic to the
most complex. CHO is the leading provider for Alameda County children
in need of acute care. Children with Medi-Cal rely nearly exclusively on
CHO 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. In FY 14/15, CHO’s ED was the
highest volume ED in the San Francisco Bay Area.
CHO’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.
For many children, the ED also functions as the gateway to a regular
medical home, specialty care, or other community programs sponsored by
CHO or other organizations.
Approximately 70% of patients seen in the CHO ED receive Medi-Cal.
This number is higher than almost any other hospital—child or adult—in
Allocation: $3,000,000 | Expended/Encumbered: $3,000,000
Individuals served by Measure A: 33,676 (Total individuals served: 43,118)
Populations served: Indigent, Low Income, Uninsured Children
Services provided: Emergency Medical, Hospital Outpatient, Public Health, Mental Health
Service area: Countywide
UCSF Benioff Children’s Hospital Oakland
childrenshospitaloakland.org
Measure A Helps
A school clinic patient who is now
25 years old was a bright and vibrant
student at Castlemont High School
and won a scholarship for track in
Idaho. She was hesitant to pursue this
opportunity, as she had significant
family pressure to stay in Oakland.
However, with encouragement from
her therapist she was able to leave.
Over her breaks from college she often
came to the clinic for ongoing care
and would discuss the “culture shock”
of living in Idaho coming from East
Oakland. With continued support and
encouragement she completed college,
has completed her Masters of Science
in Criminal Justice, and is living in
Louisiana.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
47
California. Without the CHO ED, children would need to travel farther
and/or receive care that is not specialized to children. With little doubt,
more children would die without the CHO ED.
Center for Child Protection
CHO and Alameda County recognize that they share a responsibility
to provide immediate and comprehensive care for this population of
children, yet there are many challenges to maintaining this responsibility.
CCP serves more than 1,000 clients per year. CCP is a comprehensive
child abuse program within CHO. CCP is the only provider in Alameda
County that has the capacity to offer many of its services.
Because many CCP services are funded by external sources such as
Measure A, there is no charge for eligible clients. This feature is very
important because if CCP needed to charge insurance for these services,
there would be a record of services provided, and many families would not
step forward to divulge such sensitive information.
CCP 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. Non-acute forensic examinations for
children under age 18 and second opinion medical consults are performed
in the CCP outpatient clinic through appointment only.
Clinical case management is provided to children and adolescents who
present to the ED and/or child abuse management clinic following
diagnosis or disclosure of abuse. Comprehensive evidenced-based mental
health services are provided to children, adolescents, and their families
who have been exposed to childhood trauma, including child abuse and/
or witness to violence. For most of these families, there are no alternatives
in Alameda County for many of the services provided by CCP.
School-Based Clinics
CHO runs two school-based health centers: one at Castlemont High
School and one at McClymonds High School. The school health centers
provide a safe and convenient place for students to receive integrated,
comprehensive medical and mental health services. The Youth Uprising/
Castlemont Health Clinic sees students from Castlemont High School
as well as members of the community ages 11–24. The Chappell Hayes
Health Clinic sees students from McClymonds High School as well as
members of the community ages 11–21.
The Castlemont site is now the highest volume school-connected mental
health site in Alameda County. The sites’ School-Based Mental Health
Program has become a national model for the integration of medical
and mental health care, and it has been cited for success at addressing
underlying social stressors related to mental health. The program has
Matching Funds
CHO leveraged its Measure A
allocation to obtain $3,000,000
in matching funds through an
intergovernmental transfer using
supplemental funds from the
California Department of Health Care
Services.
Measure AAllocation MatchingFunds
$1,000,000
$3,000,000
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
48
developed a training and consultation program for school professionals
and mental health providers who work with schools, and it has contracts
to conduct trainings throughout Alameda County and California.
MEASURE A FUNDING SUMMARY
CHO used its Measure A allocation to achieve the following:
Emergency Department
• In FY 14/15, there were a total of 44,508 unique patients to the ED.
• 665 of these visits were trauma cases where the child faced an
immediate life-threatening situation.
• The total average time children spent at the ED shrunk to 3.1 hours.
This compares with 4.1 hours for CHO’s peer group according to
studies conducted by McKesson.
• Measure A funding helped the ED upgrade its space to be more
kid-friendly and purchase state-of-the-art equipment, such as new
monitors and imaging equipment.
• The average time for providing sickle cell patients with proper pain
medication decreased from 90 minutes to 30 minutes, which is among
the top in the nation.
• Over 400 children seen in the ED were referred to and seen at CHO’s
asthma clinic for follow-up care and asthma education.
Center for Child Protection
• In FY 14/15, the CCP served more than 1,000 children.
• The CCP conducted 104 forensic evidentiary examinations,
55 outpatient medical consultations, and 57 inpatient medical
consultations, and provided clinical and psychotherapy services to 556
children.
School-Based Clinics
• In FY 14/15, the two clinics run by CHO had a total of 2,458 encounters
and saw 823 children/adolescents.
CONCERNS
The Committee notes that CHO does not list measurable objectives,
which has been raised repeatedly in the last several years. Additionally,
many of the achievements do not give a specific time frame for
achievement—it is unclear what improvement, if any, took place from FY
13/14 to FY 14/15.
All the numbers listed under the Measure A Funding Summary are
identical to the numbers listed in the FY13/14 Measure A report.
Because of these concerns, the Committee recommends a full audit.
The average time for
providing sickle cell
patients with proper
pain medication
decreased from
90 minutes to
30 minutes, which is
among the top in
the nation.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
49
FUNDS ALLOCATED BY THE ALAMEDA COUNTY BOARD OF SUPERVISORS
GROUP 3: PRIMARY CARE
Alameda County Dental Health ................................................................................................................ 51
Berkeley Community Health Project (Berkeley Free Clinic) ...................................................................... 53
Center for Elders’ Independence ............................................................................................................. 55
Center for Healthy Schools and Communities (School Health Centers) ......................................................56
Fire Station Health Portals ........................................................................................................................ 60
Fremont Aging and Family Services .......................................................................................................... 62
Health Enrollment for Children ................................................................................................................ 65
Health Services for Day Laborers: Community Initiatives (Day Labor Center) .......................................... 66
Health Services for Day Laborers: Multicultural Institute ......................................................................... 68
Health Services for Day Laborers: Street Level Health Project ................................................................. 70
Hope Hospice ........................................................................................................................................... 72
Increase Hospice Utilization ..................................................................................................................... 73
Medical Costs for Juvenile Justice Center: Direct Service Planning and Administration .......................... 74
Medical Costs for Juvenile Justice Center: Mind Body Awareness ........................................................... 75
Medical Costs for Juvenile Justice Center: Niroga Institute ...................................................................... 76
Medical Costs for Juvenile Justice Center: Victims of Crime .................................................................... 77
Preventive Care Pathways ........................................................................................................................ 78
Primary Care Community-Based Organizations ........................................................................................ 79
Roots Community Health Center .............................................................................................................. 81
Tiburcio Vasquez Health Center, Inc. ........................................................................................................ 82
Washington Hospital ................................................................................................................................ 84
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
50
BACkGROUND
The Alameda County Public Health Department works in partnership
with the community to ensure the optimal health and well-being of all
people through a dynamic and responsive process that respects the
diversity of the community and works to provide for present and future
generations.
A program of the Public Health Department, the WIC Oral Health
Collaborative 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 WIC, as well as continuity and referral for
regular follow-up dental care in the community. The services provided
at WIC include dental history interviews to identify risk factors and oral
home care practices, brushing the child’s teeth and applying fluoride,
assessing the child’s mouth, and setting goals for home care behaviors.
For children who need follow-up care beyond the services provided at
the WIC site, the outreach worker collaborates with the family to assess
insurance coverage, obtain a dental appointment with a provider, and
assist with making the initial dental appointment. For families lacking
insurance coverage, the outreach worker arranges insurance assistance
through the Healthy Smiles Dental Treatment program.
MEASURE A FUNDING SUMMARY
Measure A funding helped the WIC Oral Health Collaborative program
achieve the following measurable results:
• Enroll at least 400 infants and toddlers into the Healthy Kids Healthy
Teeth (HKHT) program of preventive dental services and access to
early dental care
• Provide 710 of these children with oral assessments and fluoride
varnish applications
Allocation: $153,662 | Expended/Encumbered: $153,662
Individuals served by Measure A: 2,088 (Total individuals served: 4,833)
Populations served: Indigent, Low Income, Uninsured Adults, Children, Families
Services provided: Public Health
Service area: Alameda, Castro Valley, Fremont, Hayward, Newark, Oakland, San Leandro, San Lorenzo, Union City
Note: In addition to its individual allocation, Alameda County Dental Health also received Measure A money through the Public Health
Prevention Initiative allocation (see page 107). The funding summary information described here is for the total of both allocations.
Alameda County Dental Health
www.acphd.org/dental-administration.aspx
Matching Funds
The WIC Oral Health Program
leveraged its Measure A allocation to
obtain $223,501 in matching federal
funds from the Maternal, Child &
Adolescent Health Program (MCAH)
and Child Health and Disability
Prevention (CHDP).
Measure AAllocation MatchingFunds
$153,662
$223,501
Highlights
An analysis of health outcomes for
children participating in the WIC
“Dental Days” showed that they
had 42% fewer restorative dental
treatment needs compared to children
who did not benefit from the program.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
51
• Ensure that 78% of the families received care through Medi-Cal
• Ensure that a minimum of 150 families and children be assisted in
getting access to dental providers who were willing and able to provide
early care and become a dental home
• Ensure that at least 75% of children enrolled in HKHT visited a dentist
at least once during the year to begin accessing supplemental fluoride
varnish and additional oral health family education services
• Expand operation of WIC “Dental Days” to a fourth site (Fremont) in
addition to Hayward, Eastmont, and Telegraph
• Provide prenatal oral health education to WIC staff who conducted
prenatal classes for 455 prenatal women, and establish an incentive for
women to attend the classes
Measure A Helps
A five-year-old child had severe tooth
decay and needed immediate dental
treatment. The family was hesitant
to accept public health services while
they were experiencing financial
hardship and language barriers. The
outreach worker referred the family
to the Healthy Smiles program and
ensured them that translation services
would be available. The child had
his dental appointment and was
scheduled for follow-up treatment.
The outreach worker kept in close
contact with the family and was able to
enroll other siblings into the Healthy
Smiles program. The child is no
longer suffering from dental pain and
infection, and has a dental home that
provides preventive and restorative
dental services.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
52
Allocation: $50,000 | Expended/Encumbered: $50,000
Individuals served by Measure A: 653 (Total individuals served: 8,207)
Populations served: Indigent, Low Income, Uninsured Adults
Services provided: Public Health, Mental Health
Service area: Countywide, Homeless or transient
BACkGROUND
The Berkeley Free Clinic (BFC) works to empower individuals and
communities by providing accessible, client-centered health services and
information. All services at BFC are provided completely free of charge.
BFC also provides extensive education and referrals to every client.
Every client is screened for health insurance needs and, when applicable,
referred to BFC’s Certified Enrollment Counselors for help exploring
options for health insurance. Providers also work with clients to
determine what social services, like food, housing, and long-term primary
care, might be beneficial to the client. BFC’s Information Resource
Collective provides in-person and over-the-phone referrals for requests
ranging from legal counsel to crisis hotlines to transportation resources
and more.
MEASURE A FUNDING SUMMARY
Every year, the BFC provides thousands of same-day appointments
for acute medical care, STI screens, TB tests, dental care, and
peer counseling. Measure A funding enabled BFC to provide fully
comprehensive care to individuals requiring more significant help than
what BFC is typically able to afford.
Specifically, BFC used its Measure A allocation to achieve the following:
• Provide acute medical care for certain respiratory infections,
dermatological concerns, urinary tract infections, and minor wounds/
burns to 101 clients.
- 94% of clients indicated that they were satisfied or highly satisfied
with the services they received.
- 64% indicated they knew more about how to treat or prevent their
health concern after the visit than they did before.
- 35% reported that if they had not come to BFC, they would have
needed to rely on the emergency room to address their concerns.
Berkeley Community Health Project (Berkeley Free Clinic)
berkeleyfreeclinic.org
Measure A Helps
After her boyfriend cheated on her, ZD
came to BFC for an STD screen. She
received information about symptoms,
treatment, and how long it would take
before an STD showed up on a test.
The BFC counselor who called ZD
with the test results took extra time to
talk with ZD about how she was doing
emotionally. ZD was uninsured, so the
counselor also talked with her about
health insurance. A BFC Certified
Enrollment Counselor helped ZD
navigate the Covered CA system and
sign up for health insurance. She has
a primary care doctor now and feels
much more secure and in control of her
health.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
53
• Provide confidential STI/HIV testing and counseling to 150 clients and
provide referrals to other organizations for STI and HIV management
as needed.
- 100% of clients with a reactive result on a rapid HIV test received a
confirmatory test the same day and a confirmed result within two
weeks.
- 68% indicated that they knew more about their sexual health after
the visit than they did before.
- 100% presenting GC or NSU received treatment the night of their
visit.
• Provide Hepatitis A, B, and C testing and counseling to 72 clients and
provide referrals to other organizations for long-term Hepatitis B or C
management
- 95% of clients indicated that they were satisfied or highly satisfied
with the services they received.
- 76% who were unvaccinated and at high risk for Hepatitis B were
vaccinated.
- 73% indicated that they knew more about how to treat or prevent
their health concern after the visit than they did before.
• Provide Tuberculosis (TB) testing and counseling to 100 clients and
provide referrals to other organizations for long-term TB management.
• Provide 150 free peer counseling sessions and provide referrals to crisis
lines and other resources as needed.
- 94% of clients indicated that they were satisfied or highly satisfied
with the services they received.
• Provide dental screening, cleanings, and/or fillings.
- 41 clients were provided with dental exams and cleanings.
- 40 clients received fillings.
- 98% of clients indicated that they were satisfied or highly satisfied
with the services they received.
100% of clients
with a reactive
result on a rapid
HIV test received
a confirmatory test
the same day and
a confirmed result
within two weeks.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
54
BACkGROUND
The Center for Elders’ Independence (CEI) provides quality, affordable,
integrated health care services to the elderly, which promote autonomy,
quality of life, and the ability of individuals to live in their communities.
CEI’s Program of All-inclusive Care for the Elderly (PACE) is a
comprehensive, community-based long-term care health plan that serves
frail adults age 55 and over with complex medical needs. All enrollees are
Medi-Cal beneficiaries, and most also have Medicare coverage.
MEASURE A FUNDING SUMMARY
CEI used its Measure A allocation to achieve the following objectives:
• Develop an in-house End-of-Life (EOL) and advance care planning
program that incorporates industry best practices and materials using
internal and external resources and personnel
• Develop and/or acquire advance care planning and EOL training
materials and train staff to implement advance care planning and end-
of-life care
• Research the cost of hiring a chaplain to provide emotional and
spiritual support to participants and families in the EOL program, and
offer chaplain services
• Develop a plan for implementing the EOL program, including chaplain
services, for applicable participants
• Develop a plan for collecting data on EOL participation and administer
a survey to participants on their advance care planning/advance
directive (AD) experience
Program services began in FY 15/16.
Allocation: $52,020 | Expended/Encumbered: $52,020
Individuals served by Measure A: N/A (Total individuals served: 675) FY 14/15 Measure A funds were spent on program development; no
direct services were offered as a result of this year’s funding.
Populations served: Indigent, Low Income Adults, Seniors
Services provided: Hospital Inpatient
Service area: Alameda, Albany, Ashland, Berkeley, Castro Valley, Cherryland, Emeryville, Hayward, Oakland, San Leandro, San Lorenzo
Center for Elders’ Independence
cei.elders.org
CEI used its Measure
A allocation to
develop an in-house
EOL and advance
care planning
program that
incorporates industry
best practices and
materials.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
55
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. The Center focuses its programs on five
specific result areas:
• Children are physically, socially, and emotionally healthy.
• Children succeed academically.
• Environments are safe, supportive, and stable.
• Families are supported and supportive.
• Systems are integrated and care is coordinated and equitable.
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. SHCs provide
services in the following areas.
Mental Health and Substance Abuse Services
The SHCs offer school-based counseling on alcohol and drugs including
individual counseling, prevention and early intervention, substance abuse
assessments, and relapse prevention. Behavioral health group counseling
is offered at the SHCs for prevention and early intervention, including
some groups that focus on conflict resolution and/or restorative justice.
The SHCs also offer crisis intervention, family therapy, and referrals as
needed. Other services included case management, individual contact/
meetings, plan development, and collateral with family members and
school staff.
Public Health Prevention and Outpatient Services
The SHCs provide public health prevention and outpatient services
Allocation: $1,924,740 | Expended/Encumbered: $1,924,740
Individuals served by Measure A: 14,446 (Total individuals served: 14,446)
Populations served: Indigent, Low Income, Uninsured Adults, Children, Families
Services provided: Public Health, Mental Health, Substance Abuse
Service area: Countywide, Homeless or transient
Center for Healthy Schools and Communities (School Health Centers)
achealthyschools.org
Measure A Helps
A 17-year-old female was brought to
the SHC because she was crying in
class. She told the therapist that she
had had an upsetting sexual experience
the day before. While undergoing STI
testing, the youth revealed that she
had met a man on the Internet and had
been raped. Police and CPS reports
were filed, and her mother was brought
into the clinic. Staff revealed to the
mother what had happened, because
the student was afraid to tell her. The
mother was extremely supportive and
planned to connect the young woman
to Kaiser for care. She thanked SHC
staff profusely for the support provided
to her and her daughter.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
56
through medical visits with providers and health education/outreach
activities. Medical visits include sports physicals, disease screening,
chronic disease management, medicine management, and other primary
care services. The SHCs also treat injuries, headaches, abdominal pain,
cold/flu symptoms, and other first aid needs.
The SHCs also provide sexual/reproductive health services, including
contraceptive maintenance, contraceptive counseling/family planning
advice, and sexually transmitted infection (STI) counseling.
Finally, dental services are offered at eight SHCs. Most visits are for
screening, assessment, and examinations, and the rest are for preventive
services. Referrals and follow-up care are provided as needed.
Youth and Community Services
The SHCs offer education and outreach activities ranging from health
fairs and other schoolwide events to workshops on parenting or healthy
relationships, The SHC also offer a wide range of nutrition and physical
education activities. SHCs provide leadership development and mentoring
through peer health education programs and youth advisory boards. They
also provide a variety of programming including sports, tutoring, dance,
arts, media, and gardening during lunch or after school.
MEASURE A FUNDING SUMMARY
Measure A funds supported 15 of the 27 SHCs. Measure A provides a
unique, long-term funding stream to the CHSC to offer school-based
health supports for children and youth in Alameda County. Very few other
funding sources exist to provide ongoing, stable, and substantial funding
to finance the growing network and investment in school health services.
The SHCs used their Measure A allocation to achieve the following
objectives.
Provide comprehensive school health services in a safe, accessible
environment on or near the school campus during convenient hours
SHCs continue to expand. In FY 14/15, the SHCs served three elementary,
10 middle, and 18 high schools. During the same period, the number of
clients increased from 5,010 to 14,446 (a 188% increase), and the number
of annual client visits increased from 18,818 to 60,780 visits (a 223%
increase). The SHCs also served more than 1,000 clients from the broader
community, including high school graduates, college students, siblings,
and community members.
SHCs are open during school hours and often after school as well. Nearly
one-quarter of visits were drop-in, demonstrating the flexibility of the
Matching Funds
The School-Based Behavioral Health
Initiative leveraged its Measure A
allocation to obtain $10,278,268 in
matching funds from Medi-Cal and
other third-party billing; the Tobacco
Master Settlement Fund (TMSF); and
other funding from the County, cities,
school districts, the state, the federal
government, and private grants.
Measure AAllocation MatchingFunds
$1,924,740
$10,278,268
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
57
services. In addition, SHC services are available at no cost to clients,
regardless of their insurance status, thus filling a gap for students who are
uninsured or underinsured. Nearly one in five clients were reported to
have no insurance.
Of those clients with data recorded, 26% did not have a primary care
medical home and 28% did not have a regular dental provider.
Without an SHC onsite, many students might have been sent home—
leading them to miss a portion of the school day—rather than having their
health issues addressed on site and being sent back to class.
Provide SHC clients with referrals to necessary health and wellness
services
SHCs offer a full scope of integrated services with easy referrals among
providers. Clients return for multiple visits to the SHCs, demonstrating
the value of integrated and youth-friendly services.
Provide first aid, medical, and health education services
SHCs help clients with a variety of medical concerns. The SHCs provide
vital care for health problems that could interfere with students’ ability to
attend and succeed in school.
SHCs provide education and interventions to encourage healthy
behaviors, such as delayed sexual initiation and contraceptive use.
According to clinic data, female contraceptive use improved significantly
over time.
Provide behavioral health services
Individual and group behavioral health services were provided during 21%
of all visits to 3,015 clients. A sample of clients were tracked over time and
improvements were reported in clients’ presenting problems and observed
strengths.
Provide dental health services
SHCs are increasingly providing vital dental services to their clients.
At the eight sites providing services in FY 14/15, 22% of all visits (1,045
clients) had a dental service provided. Many of the visits resulted in
identification of suspicious areas of decay or urgent needs.
Provide additional nonclinical services such as youth development and
school climate services
SHCs integrate health and education through broader student and
community educational programs. Overall, SHCs had 18,650 contacts
Highlights
Comprehensive health services were
provided at or near Alameda County
schools to an increasing number of
students compared to previous years.
Care provided included primary
medical care, first aid, health
education, behavioral health services,
and dental care at eight school sites,
as well as referrals to additional
sources of care when needed.
SHC evaluation data showed that SHCs
are providing safe places for youth to
get needed care:
• 61% of clients returned for more
than one visit, indicating high
patient satisfaction and that
patients feel welcomed and safe in
the clinics.
• Compared to non-users,
significantly more clients reported
“always” receiving counseling (31%
users vs. 24% non-users) , and
reproductive health services (39%
vs. 25%).
• 87% said, “The SHC helped me get
services I wouldn’t otherwise get.”
• 87% said, “The SHC helped get help
sooner than I normally would.”
• 95% said, “The people who work
there helped me work through my
problem.”
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
58
with adult participants such as family members, school staff, and other
school community members through these events and activities. Eight
of the SHCs have a Youth Advisory Board and 10 have a Peer Health
Education or Peer Mentoring program, where students develop leadership
skills and learn to give classroom presentations on various health issues.
CONCERNS
The provider reported program results, including statistics, for the 27
schools served by SHCs—not for the 15 SHCs specifically funded by
Measure A. The results for these 15 schools might differ considerably
from the average of the 27 SHCs.
Given the sizable allocation of almost $2 million, the provider should
report more precise information to the Oversight Committee.
Highlights
Survey data indicated that SHCs are
helping youth with overall health
and healthy behaviors. Clients who
completed the survey said that the
health center helped them to:
• Exercise more: 71%
• Eat healthier foods: 73%
• Avoid getting into fights: 63%
• Deal with stress/anxiety better: 76%
• Feel like I had an adult I could turn
to if I needed help or support: 89%
• Feel more confident: 88%
• Stop using or use less tobacco,
alcohol, or drugs: 53%
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
59
BACkGROUND
The Alameda Fire Department’s Community Paramedic (CP) program
guides clients towards health and well-being, connects clients with
appropriate services, and intervenes when clients are unable to take an
active role in the management of their health care.
The CP program primarily provides case management, with some medical
evaluation. These efforts include assisting with house cleaning, locating
family members with whom clients had lost contact, and connecting
clients with programs and activities in the community. CPs spend a lot
of time with each client’s family members to educate them on the client’s
chronic conditions and to aid in reaching out for other services.
CP program objectives include the following:
• Enroll post-hospital discharge patients who were admitted for
congestive heart failure, chronic obstructive pulmonary disease,
heart attack, sepsis, and pneumonia, as well as frequent utilizers of
emergency services, into the program
• Assess enrollees’ needs for additional medical, mental health, and social
services
• Help clients secure primary care physicians
• Connect clients with specialists: cardiologists, neurologists,
pulmonologists, etc.
• Secure in-home support services or facilitate an increase in hours
previously allotted to clients
• Assist with establishing physical or occupational therapy services for
clients in their homes
• Connect clients with local resources and outreach programs, such as
the Alameda Food Bank, Meals on Wheels, Alameda Friendly Visitors,
Alameda Point Collaborative, and Mastick Senior Center
• Obtain medical equipment for clients, such as wheelchairs, walkers,
canes, commodes, bedside rails, etc.
• Assist clients with their prescription medications, including medication
education, picking up prescriptions from the pharmacy, and disposing
of medications that had expired or were no longer prescribed
• Perform home safety evaluations for clients, ensuring that smoke/
Allocation: $750,000 | Expended/Encumbered: $187,050
Individuals served by Measure A: 13 (Total individuals served: 13)
Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors
Services provided: Emergency Medical
Service area: Alameda, Homeless or transient
Fire Station Health Portals
Measure A Helps
A 79-year-old woman with special
needs due to her medical condition was
referred to the CP program. She had
MS, chronic back pain, and limited use
of her hands. Because her neurologist
was in San Francisco, she had not
had an appointment in years. She
received County-provided caregiver
support during weekdays, but on
weekends she was alone and struggled
with activities such as preparing food.
Thanks to the CPs, her caregiver hours
were increased to include weekends. A
neurologist was found whose office is
ten minutes from her house. A medical
alert system was set up, so the client
can call for help if she falls when she is
alone.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
60
carbon monoxide detectors were functioning properly and eliminating
any potential trip or fall hazards
• Refer clients to the Alameda Fire Department Senior Fall Prevention
Program, which provided many clients with grab rails and smoke
detectors—with no cost to the client in some cases
MEASURE A FUNDING SUMMARY
The CP program used its Measure A allocation to work on establishing
pathways for referrals and case management through meetings and phone
calls with various medical and social service providers within the County.
CPs worked with discharge planners and physicians from Alameda
Hospital to receive referred post-discharge and frequent utilizer patients,
and to clarify discharge instructions, medications, and follow-up plans.
Using its Measure A funding, the CP program achieved the following:
• Enrolled five clients into the post-discharge program.
• Enrolled 11 clients into the frequent utilizers program.
• Provided 15 total combination referral/assistance efforts. CPs not
only referred clients to other health and social services in the County,
they also helped clients develop a plan for returning to employment,
reconnect with family members, and rekindle the desire to resume past
healthy hobbies.
• Provided 49 total combination face-to-face visits and assessments. CPs
visited clients in their homes, in the emergency department, and at a
local clinic. CPs performed medical, bio-psych-social, and home safety
assessments. CPs also performed medication reconciliation for each
client.
The CP program
used its Measure A
allocation to work on
establishing pathways
for referrals and case
management with
medical and social
service providers
within the County.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
61
BACkGROUND
The City of Fremont’s Human Services Department (HSD) supports a
vibrant community through services that empower individuals, strengthen
families, encourage self-sufficiency, enhance neighborhoods, and foster a
high quality of life for all residents.
Aging and Family Services (AFS), a Division of the HSD, provides both
a Multi-Service Senior Center and a Senior Support Services team of
caring professionals from diverse backgrounds—social work, nursing,
gerontology, psychology, and public health—who serve seniors and their
families with dignity and respect.
The AFS Health Promoter Program improves both the physical and
mental health of older adults by increasing access to health services,
supporting healthy behavior changes, monitoring medications, and
providing health education classes. The program offers these services
at home and at community congregate sites to older adults in Southern
Alameda County, with a focus on low income, Afghan refugee women
over the age of 50 years.
Within the Health Promoter Program, Afghan Health Promoters develop
relationships with Afghan seniors, provide emotional support, offer health
education, and coordinate referrals for health and social services.
The Health Promoter Program is made up of four program areas:
• Linkages. The Linkages program provides information, referral, and
assistance to participants. Health Promoters assist participants access
an array of services and entitlement programs. Additionally, they help
with translation, completing forms, transportation, housing, and other
community services as needed.
• Medication assistance and counseling. The City of Fremont’s Public
Nurse reviews participants’ medications, evaluates their knowledge
and usage of their medications, and provides training and feedback
as needed. When necessary, the nurse calls participants’ doctors and
pharmacists for clarification or to express concerns. Health promoters
Allocation: $52,020 | Expended/Encumbered: $52,020
Individuals served by Measure A: 31 (Total individuals served: 31)
Populations served: Indigent, Low Income, Uninsured Seniors
Services provided: Public Health, Mental Health
Service area: Fremont, Hayward, Newark, Union City
Fremont Aging and Family Services
www.fremont.gov/217/Aging-Family-Services
Measure A Helps
Rahima, an 81-year-old Afghan
woman, suffers from hypertension and
heart and vascular problems, and has
been diagnosed with serious mental
illness (SMI). She takes multiple
medications including psychotropic
medication. She was referred to the
Happy, Healthy Me program as she
was isolated and not getting out
of the house. Her initial goal was
to attend AEA’s Healthy Aging
Program at least once a month, which
she quickly exceeded by going two
to three times a month. While at the
program, her depression lifted and her
SMI symptoms decreased. When her
SMI symptoms increase, the health
promoter and Rahima’s doctor monitor
her to get her back on track.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
62
assist with translation and how to use medication.
• Happy, Healthy Me (HHM). HHM is a chronic condition self-
management program that helps participants identify problems
and healthy goals. The program utilizes a mix of cognitive behavior
techniques, motivational interviewing, and problem-solving
techniques.
• Health education groups. The program offers two health education
groups. The first is the Stanford Chronic Disease Self-Management
Program. Three health promoters have been trained as leaders, and
the group is offered at least once a year. The second is the Diabetes
Education Group. One health promoter has been trained by the
Alameda County Public Health Department to lead the group. Other
health promoters assist.
MEASURE A FUNDING SUMMARY
Measure A funding helped the Health Promoter Project meet its overall
program objective to improve both the physical and mental health of
older adults through increasing access to health services, supporting
healthy behavior changes, monitoring medications, and providing health
education classes.
Measure A helped the Health Promoter Project achieve the following
measurable objectives.
General
• Provide health promotion services to Afghan clients (target: 100; actual:
152)
• Ensure clients receive care from a primary care physician (target: 90;
actual: 151)
• Provide socialization from Health Promoters (target: 100; actual: 152)
• Have clients complete a wellness screen (target: 60; actual: 89)
• Conduct home safety evaluations (target: 40; actual: 89)
Service Linkage
• Conduct home visits to clients (target: 350 home visits to 85 clients;
actual: 563 home visits to 140 clients)
• Provide health education from Health Promoters (target: 100; actual:
152)
• Refer clients to City of Fremont case management and/or counseling
services (target: 25; actual: 36)
• Provide eligibility assistance and support to access supportive services
to clients (target: 100; actual: 111)
• Help clients access other community services (target: 50; actual: 72)
Matching Funds
Fremont Aging and Family Services
leveraged its Measure A allocation to
obtain $197,980 in matching funds
from the City of Fremont General Fund
and the Alameda County Public Health
Department.
Measure AAllocation MatchingFunds
$52,020
$197,980
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
63
Medication Management
• Provide medication review, education, and counseling (target: 50;
actual: 51)
• Utilize the “teach back” methodology to show an increased knowledge
of medication among clients (target: 50; actual: 51)
• Improve medication compliance within six months for clients identified
as having deficits in medication compliance (target: 30; actual: 41)
Happy, Healthy Me
Ensure the following:
• Clients develop a Wellness Action Plan (target: 40; actual: 36)
• Clients participate in their Action Plan (target: 30; actual: 34)
• Clients show improvement after six months (target: 30; actual: 34)
Health Education Groups
• Offer one 15-hour Chronic Disease Self-Management Program class for
Afghan participants (target: 15 participants; actual: 16)
• Achieve participants showing an increase in their ability to manage
chronic conditions (target: 12; actual: 16)
• Offer one six-week diabetes class for participants (target: 12
participants; actual: 18)
Highlights
In almost all areas, the Health
Promoters program exceeded its
targets, sometimes dramatically. For
example, the program conducted 563
home visits to 140 clients, compared
to a target of 350 home visits to 85
clients.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
64
BACkGROUND
The Alameda County Health Care Services Agency Health Insurance
Enrollment Assistance department provides information, referrals, and
application assistance to low income County residents and families who
are eligible for the following benefit programs: Medi-Cal, Covered CA,
Kaiser Child Health Plan, Health PAC, CalFresh, and CalWorks.
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. This assistance
is particularly important with the new requirements associated with the
implementation of the Affordable Care Act in January 2014.
In 2014, the Health Insurance Enrollment Assistance program expanded
services in the San Leandro Unified School District. The goal was to offer
health insurance assistance in a familiar setting to families served by the
district, who otherwise would not follow through with applying for or
renewing their County benefits. The school district gave the department
space to come in weekly to support families.
MEASURE A FUNDING SUMMARY
Thanks in part to Measure A funding, the program provided benefit
program application assistance to approximately 6,000 Alameda County
residents.
Allocation: $300,000 | Expended/Encumbered: $300,000
Individuals served by Measure A: 1,260 (Total individuals served: 1,260)
Populations served: Indigent, Low Income, Uninsured Adults, Children, Families
Services provided: Emergency Medical, Hospital Inpatient, Hospital Outpatient, Public Health, Mental Health, Substance Abuse
Service area: Countywide
Health Enrollment for Children
achealthcare.org/about/project-updates/childrens-health-insurance-enrollment
Matching Funds
The Health Insurance Enrollment
Assistance department leveraged
its Measure A allocation to obtain
$150,000 in matching funds from
Medi-Cal Administrative Activities
(MAA).
Measure AAllocation MatchingFunds
$300,000
$150,000
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
65
BACkGROUND
The Health Service for Day Laborers Community Initiatives/Day Labor
Center (DLC) program works to enable low income migrant clients in the
East Bay, including at-risk youth and re-entry clients, reach self-sufficiency
through employment and community integration programs.
Through partners Samuel Merritt University in Oakland, California
State East Bay’s Initiative for Community Wellness in Hayward, Davis
Street Clinic in San Leandro, and the Alameda County Healthcare for the
Homeless Van, the DLC Healthcare Portal Project provides referrals for
safety net health care services to hundreds of under- and unemployed,
mostly migrant clients in Southern Alameda County. The DLC develops
culturally competent material for its clientele and trains Peer Health
Educators to provide outreach and information services to this population.
The DLC provides services in the following areas:
• Mental health. The DLC provides workshops and informational
meetings to help address workers’ mental health needs and issues
related to domestic violence and sexual assault.
• Alcohol and drug. The DLC provides workers with weekly meetings to
address alcohol and drug use and abuse.
• Hospital and inpatient services. The DLC portal services use hospital
services for extreme and/or emergency cases only, including lab and
other specialty services as needed.
• Public health prevention. The DLC offers Zumba classes for women
workers, develops and monitors individual health plans for weight and
diabetes management and prevention, and provides HIV prevention
education and screening.
• Outpatient services. In addition to ancillary services provided by the
Davis Street Clinic and/or St. Rose Hospital sites, the County provides
DLC workers with dental services three months out of the year.
• Youth and community services. The DLC was one of the founding
organizations of the South County Unaccompanied Minor and Migrant
Family Collaboration, which highlights the needs of unaccompanied
Allocation: $86,700 | Expended/Encumbered: $86,700
Individuals served by Measure A: 350 (Total individuals served: 500)
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: Ashland, Cherryland, Fairview, Fremont, Hayward, Oakland, San Leandro, San Lorenzo, Union City
Health Services for Day Laborers: Community Initiatives (Day Labor Center)
http://www.alameda.networkofcare.org/mh/services/agency.aspx?pid=HaywardDayLaborCenter_344_2_0
Measure A Helps
Hugo, 18, came from Guatemala
without his parents. His situation in
Guatemala was dangerous, and his
family thought he would be safer in
America. Hugo came to Hayward with
an uncle who took him in and brought
him to the DLC. DLC staff helped
Hugo with his paperwork and made an
appointment for him to talk to a lawyer
about his immigration situation. The
lawyer was able to help Hugo stay
in America for now. Hugo attends
Tennyson High School, where the DLC
director coaches the soccer team. Hugo
hopes to graduate this year, and the
DLC is going to help him go to Chabot
College.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
66
minors in Alameda County and coordinates needed services to this
clientele. The DLC provides services to the indigent population and
youth from the surrounding neighborhood, including job skills training
and community volunteer service opportunities.
• Socialization. The DLC maintains a community garden and has an
18-team soccer league to address the workers’ ailments of depression,
isolation, and loneliness due to being separated from their families in
their home countries.
MEASURE A FUNDING SUMMARY
Measure A funds provide approximately two-thirds of the support needed
to sustain the DLC Healthcare Portal Project.
Measure A funding helped the DLC achieve the following objectives:
• Offer health-related navigation and referral services specific to the
health care needs of approximately 500 workers within the working-age
day labor population at the DLC, including 71 new clients
• Provide over 1,000 primary health care referrals for health care
screenings and/or episodic care visits for issues including eye
irritations, blurry vision, urination pain, toothaches, swollen joints,
high blood sugar, GERD, hearing problems, persistent cough, allergies,
gastritis, flu-like symptoms, high cholesterol, mental health concerns,
and abdominal pains
• Conduct 400 follow-up assessments with and offer recommendations
to clients referred into the health care system
• Communicate the information and issues obtained in client follow-up
assessments to allied community-based organizations, policy makers,
and governmental agencies to assist in improving health care services
for the day labor population
• Hold six semi-annual meetings with appropriate staff from both the
clinic and Center to review and evaluate the services provided
• Advocate for the day labor population and their health care needs—
including hours of operation, types of services needed, and/or cost
structures—with local clinics by participating in Supervisor Valle’s
Tennyson Corridor Initiative, which proposes to construct a new family
community center at the current DLC site
• Train and work with six Peer Health Educators to provide health
education and outreach services to the day labor population
• Conduct external outreach to the working-age day labor population at
five locations, and maintain a partnership between local clinics and the
Center to ensure day labor workers become integrated as part of the
local health care system
• Provide ongoing monthly community health, safety, and wellness
presentations and/or trainings to unemployed and/or underemployed
day labor workers
• Identify and register almost 100 individuals who may be eligible for
health coverage, including Medi-Cal and Alameda County’s HealthPac
Matching Funds
The DLC leveraged its Measure
A allocation to obtain $94,000 in
matching funds from foundation
sources.
Measure AAllocation MatchingFunds
$86,700 $94,000
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
67
BACkGROUND
The Multicultural Institute (MI) accompanies immigrants in their
transition from poverty and isolation to prosperity and participation.
MI’s core constituencies are Latino immigrant families and other youth
and adults lacking access to critical services. Its programs are focused on
historically disadvantaged groups in neighborhoods in Alameda and other
counties.
MI focuses its efforts in the following areas:
• Street conditions. MI staff bring its services to day laborers seeking
work in West Berkeley every day. The program works with local officials
and businesses to ensure that the area is safe, there is access to trash
receptacles and bathrooms, and no harassment of workers occurs.
• Job placement assistance. MI provides no-fee job-matching services for
day laborers to receive jobs at a fair minimum wage.
• Referrals and individualized follow-up for health services. The
community MI serves encounters various issues when accessing
medical services. MI’s case management and referral system assists
individuals in overcoming language barriers. MI provides navigation
in the health system and is a place where individuals can obtain
information on services needed.
• Skill-building. MI offers different vocational trainings such as skills
needed to operate a business, Spanish-language GED preparation
courses, and computer skills.
• Community-building and healthy pastimes. Sponsoring events like
street cleaning and shared meals helps break down isolation and leads
to new ways of working together.
MEASURE A FUNDING SUMMARY
Measure A funding helped MI achieve the following objectives:
• Provide health care referrals and patient navigation support to day
laborer and other low income clients
Allocation: $86,700 | Expended/Encumbered: $86,700
Individuals served by Measure A: 1,603 (Total individuals served: 1,814)
Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors
Services provided: Public Health, Mental Health
Service area: Berkeley, Oakland, Homeless or transient
Health Services for Day Laborers: Multicultural Institute
mionline.org/
Measure A Helps
Guapo, 34, approached MI staff after
working on a tree service job. He had
gauze over his left eye, which was
red. He explained that a tree branch
had poked and severely scraped his
eye. He had not gone to the hospital
or to a clinic because he had no
health insurance or money. MI staff
immediately referred Guapo to the
Alameda County Health Care for
the Homeless (ACHCH) mobile van.
ACHCH staff quickly assessed his
medical situation and sent him to San
Leandro Kaiser. Guapo received free
same-day services and follow-ups.
Doctors said if he would have waited
any longer he was at high risk of losing
his eyesight.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
68
- Target: Provide outreach to 700 unduplicated clients and 70 one-on-
one consultations, with 90% of contacts reporting that their health
care needs were met
- Actual: Outreach to 1,332 clients, 297 consultations held, and 93% of
contacts reporting that their health care needs were met
• Provide health education and public health promotion on various
topics
- Target: Host or co-sponsor eight health care trainings or workshops
attended by 150 participants, with 70% indicating an increase in
knowledge about the topics
- Actual: 11 trainings/workshops held attended by 240 participants,
with 70% indicating an increase in knowledge
• Provide health care treatment and services through partnerships with
providers and/or contracted services
- Target: 400 screenings or visits, with 70% of contacts indicating that
they would not have had access to such services if it weren’t for MI
and its partners
- Actual: 248 screenings/visits provided, with 85% of contacts
indicating that they would not have had access to services otherwise
• Offer a food distribution program
- Target: Provide weekly distribution of Alameda County Food Bank
groceries for 900 unduplicated clients, representing about 320
unduplicated households, with 60% of households reporting that
without MI they would not have had access to food
- Actual: Groceries distributed to 804 clients representing 320
households, with 87% indicating that they would not have had food
otherwise
Matching Funds
MI leveraged its Measure A allocation
to obtain $71,394 in matching funds
from the City of Berkeley and $20,021
from the Metropolitan Transportation
Commission (MTC).
Measure A
Allocation
Matching
Funds
$86,700 $91,415
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
69
BACkGROUND
Street Level Health Project is an Oakland-based grassroots organization
dedicated to improving the health and well-being of underserved urban
immigrant communities in the Bay Area. The Street Level community
center is an entry point to the health care and social service system
for those most often overlooked and neglected, namely the uninsured,
underinsured, and recently arrived. Street Level develops trusting
relationships with isolated immigrants, offers them a place to build a
healthy and vibrant community, and empowers them to advocate for the
well-being of themselves and their families.
Street Level Health Project offers accessible health care services to low
income immigrant workers who would often otherwise delay or avoid
seeking care due to barriers such as cost, immigration status, language,
lack of insurance, or discrimination. Services are free and are provided on
a drop-in basis, with no appointment required.
In FY 14/15, 87% of Street Level patients lacked insurance coverage.
Ninety-two percent were immigrants, 93% spoke a language other than
English, and 61% reported speaking no English.
MEASURE A FUNDING SUMMARY
Measure A funds allowed Street Level to offer a free, thrice-weekly drop-
in health screening clinic to low income immigrant workers, as well as to
offer drop-in mental health consultations and referrals in Spanish during
health screening clinic hours.
Measure A funds also allowed Street Level to provide Mam (a Mayan
language) and Mongolian interpretation to patients and clients.
Interpretation was provided within the clinic and during street outreach
with day laborers.
Allocation: $86,700 | Expended/Encumbered: $86,700
Individuals served by Measure A: 500 (Total individuals served: 1,600)
Populations served: Indigent, Low Income, Uninsured Adults, Families
Services provided: Public Health, Mental Health
Service area: Countywide, Homeless or transient
Health Services for Day Laborers: Street Level Health Project
streetlevelhealth.org
Measure A Helps
Feliciano, a 39-year-old Mam-speaking
Guatemalan day laborer, had high
risk of heart failure. He went to the
hospital for a pacemaker, but was
hesitant about the operation and left
the hospital against medical advice.
Over the following month, Street
Level staff had eight case management
encounters with Feliciano to review
questions, fears, and doubts. When his
symptoms began to worsen, Feliciano
decided he was ready for the operation.
The surgery was completed without
complication, and Feliciano was able to
resolve his bills and enroll in regular
coverage with assistance from Street
Level’s onsite staff. He also was able to
recover over $1,000 at Street Level’s
wage theft clinic.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
70
In addition, Measure A funding helped Street Level Health Project achieve
the following:
• Provide health care screening and episodic care to clients across
multiple languages (target: 750 clients, with 95% receiving same-day
services; actual: 738 clients, with 98% receiving same-day services)
• Offer health care referrals (target: 1,000 referrals; actual: 1,354)
• Provide mental health prevention workshops/trainings (target: 10;
actual 10)
• Offer mental health consultations/referrals annually to low income
communities in Alameda County (target: 125; actual: 213)
• Provide nutritionist/herbalist consultations (target: 100; actual: 157)
• Distribute free healthy fruit and produce food bags to low income
households (target: 5,000 bags to 400 workers/families; actual: 7,896
bags to 701 families)
• Provide referrals to local grassroots community organizations that
provide legal, educational, and social services (target: 850 referrals;
actual: 895)
• Collaborate with community-based organizations, health care agencies,
and/or governmental agencies to promote the health and wellness
of immigrants and refugees (target: collaboration with 12 outside
agencies; actual: 22)
• Leverage financial support from private foundations by submitting
grant applications for the Wellness and Prevention or Health Access
Program (target: 4 applications, with 50% being approved; actual: 11
applications, with 80% being approved)
• Collaborate with students enrolled in the health field and health
care-related schools to train future multilingual health care providers,
providing them with experience working with uninsured low income
communities (target: 20 students; actual: 44)
Matching Funds
Street Level Health Project leveraged
its Measure A allocation to obtain a
total of $142,500 in matching funds
from the following sources:
• San Francisco Foundation
• Frances K. and Charles D. Field
Foundation
• Kaiser Permanente
• California Endowment
• Latino Community Foundation
Measure A
Allocation
Matching
Funds
$86,700
$142,500
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
71
BACkGROUND
Hope Hospice is dedicated to helping patients and clients live each day to
the fullest with dignity, hope, and courage. Every end-of-life experience
is patient-centered; based on individual choice; and lightened by hope,
comfort, and dignity.
MEASURE A FUNDING SUMMARY
Measure A funding helped Hope Hospice increase access to mental health
and public health services to senior adults with life-limiting illnesses.
Services were offered to seniors who were formerly in hospice care yet
no longer eligible to receive hospice, or who did not meet the Centers for
Medicare and Medicaid services (CMS) criteria for admission to hospice.
Specifically, Hope Hospice used it Measure A allocation to achieve the
following:
• Make outreach calls to all discharged and ineligible hospice patients,
with the exception of patients who moved out of Alameda County
(target: 30 patients; actual: 55).
• Provide outreach services for up to six months to discharged and/
or ineligible hospice patients who elected to enroll in the Transitions
Program. Outreach services performed during this period totaled
354. For the Transitions cohort admitted within the six-month period,
outreach services totaled 140.
• Have patients and/or caregivers indicate that they were satisfied with
the service. Satisfaction surveys reflected a 100% satisfaction level.
• Have patients experience fewer falls and returns to the hospital. In the
same surveys, patients reported zero falls, and 6% were admitted to the
hospital.
Other services provided through the Measure A funds included
management of volunteer workers who were sent to the residents’ homes
providing a variety of services. Volunteer services included haircuts,
respite care, minor home repairs, errand running, cooking and cleaning,
therapeutic massage, art and music services, and pet therapy.
Allocation: $10,000 | Expended/Encumbered: $10,000
Individuals served by Measure A: 11 (Total individuals served: 45)
Populations served: Low Income Adults, Families, Seniors
Services provided: Public Health
Service area: Castro Valley, Dublin, Hayward, Livermore, Pleasanton, San Leandro
Hope Hospice
hopehospice.com
Measure A Helps
Mrs. Smith, who had dementia, had
been a hospice patient at Hope Hospice.
Her health had improved and she was
discharged to the Transitions program.
After her spouse died in hospice, Mrs.
Smith continued to receive Transitions
care, including weekly companionship
visits from a volunteer. Mrs. Smith did
not remember her volunteer from week
to week but always enjoyed pleasant
conversations with her. She received
haircuts provided by Hope Hospice
volunteers and a visit from a volunteer
harpist. Her family received education
packets sent each month providing tips
on keeping their loved one safe and
maintaining a positive approach to her
daily living.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
72
BACkGROUND
The Alameda County “Getting the Most out of Life” (GMOL) program is
designed to reduce suffering and improve quality of care for terminally ill
residents of Alameda County through advance health care planning and
hospice utilization.
GMOL services go beyond education of end-of-life care and resources.
The program aims to demonstrate social change, collect data, motivate
behavior change, and create general public awareness around end of life.
GMOL seeks to accomplish the following:
• Increase knowledge of end-of-life planning resources in disadvantaged
and multilingual communities
• Increase hospice awareness by tracking an increase in hospice
utilization in Alameda County
• Train care providers, social workers, and public health workers to
increase hospice utilization of their clients
• Track the number of completed advance care health directives through
trainings and/or outreach efforts
MEASURE A FUNDING SUMMARY
Each of the GMOL affiliate programs—Comfort Homesake, Hospice
Providers Coalition, Care Partners, and the Clinical Partnership—used
Measure A funds to work toward GMOL’s overall program goals by
offering specific services that further its mission.
Measure A funding helped the GMOL program achieve the following:
• Complete over 31 outreach and radio media events educating more
than 2,800 County residents from disadvantaged and multilingual
communities about available end-of-life resources
• Track 14 major hospice organizations to show increases in hospice
admissions and patient deaths in hospice care
• Train 110 In-Home Support Service (IHSS) staff to have meaningful
end-of-life conversations with IHSS consumers
• Assist County residents in completing 65 advance health care directives
Allocation: $200,000 | Expended/Encumbered: $151,187
Individuals served by Measure A: 500 (Total individuals served: 2,000)
Populations served: Indigent, Low Income, Uninsured Adults, Families, Seniors
Services provided: Emergency Medical, Hospital Inpatient, Hospital Outpatient, Public Health, Mental Health
Service area: Countywide
Increase Hospice Utilization
gettingthemostoutoflife.org/about-variant-2
Measure A funding
helped GMOL train
110 IHSS staff to have
meaningful end-of-
life conversations
with IHSS consumers.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
73
BACkGROUND
The Alameda County Health Care Services Agency (HCSA) works to
provide fully integrated health care services through a comprehensive
network of public and private partnerships that ensures the optimal health
and well-being and respects the diversity of all residents.
HCSA oversees certain programs that provide services at the Alameda
County Juvenile Justice Center (JJC). Included in these programs are
services provided by the JJC Health Services Director. The JJC Health
Services Director performs the following:
• Plan, organize, direct, and evaluate the operations of all health services
programs for minors in the Alameda County juvenile justice system,
including the Guidance Clinic, Children’s Hospital contract, HCSA-
contracted services for youth in JJC and Camp Sweeney, and Behavioral
Health Care Services (BHCS)-contracted services for youth
• Serve as the primary liaison to the Juvenile Court and Probation
Department for juvenile health services operations, collaborations, and
re-entry planning
• Coordinate service systems to ensure compliance with legislative
mandates and minimum standards as well as state and federal rules
• Increase collaboration with Probation to enable better access to BHCS
services to youth on probation
MEASURE A FUNDING SUMMARY
This Measure A allocation covered the cost of the JJC Health Services
Director. The position was vacant as of October 2015 as a result of the
then-Director taking a new position within BHCS. In the first three
months of FY 14/15, this Director continued some of the initiatives from
the previous fiscal year while preparing to move to the new position. The
measurable results for the first three months of the fiscal year included:
• Begin work on a request for proposals (RFP) for new services to
Probation youth for a program called Parenting With Love and Limits
• Continue development of a database for tracking psychotropic
medications for youth in JJC and Camp Sweeney
Allocation: $261,000 | Expended/Encumbered: $261,000
Individuals served by Measure A: 0 (Total individuals served: 0) The position funded by this allocation does not provide any direct services.
Populations served: Children
Services provided: Mental Health
Service area: Countywide
Medical Costs for Juvenile Justice Center: Direct Service Planning and Administration
JJC’s Measure A
allocation covered the
cost of the JJC Health
Services Director.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
74
BACkGROUND
Founded in 2000 by a group of formerly incarcerated youth, Mind
Body Awareness (MBA) delivers mindfulness-based mental health
programming to at-risk, gang-involved, and incarcerated youth in three
Bay Area counties. MBA’s mission is to help youth transform harmful
behavior and live meaningful lives through the practices of mindfulness
meditation and emotional awareness. MBA also engages in customized
curriculum development and training for service providers working
with at-risk youth regionally and nationally. The heart of MBA’s work is
to provide the most at-risk youth in the most difficult environments—
probation detention facilities, youth detention camps, and at-risk
schools—with concrete tools to reduce stress, impulsivity, and violent
behavior and increase self-esteem, self-regulation, and overall well-being.
MEASURE A FUNDING SUMMARY
Measure A funding helped MBA achieve the following:
• Provide mindfulness classes across four units at the Alameda County
Juvenile Justice Center (ACJJC) as well as Camp Sweeney. Classes took
place once or twice per week, for 1.5 hours, for 48 weeks. A total of 307
classes were scheduled, with 238 held. Each class served an average of
4.2 youth.
• Offer at least one team-taught (co-facilitated by more than one
instructor) class, with a goal of eventually team-teaching all classes.
Approximately 48% of classes were team-taught in FY 14/15.
• Provide a minimum of one paid instructor per class. MBA met this
objective for 100% of classes taught.
• Meet with the guidance clinic director from Alameda County
Behavioral Health Care Services (BHCS), Probation leadership, and
ACJJC mental health staff to collaborate about reinforcing services.
• Complete an evaluation of services that included statistically validated
pre and post self-report survey measures to evaluate stress and self-
regulation and a shorter weekly program evaluation form.
Allocation: $57,222 | Expended/Encumbered: $57,222
Individuals served by Measure A: 160 (Total individuals served: 277)
Populations served: Indigent, Low Income, Uninsured Children
Services provided: Public Health, Mental Health, Substance Abuse
Service area: Countywide
Medical Costs for Juvenile Justice Center: Mind Body Awareness
mbaproject.org
Matching Funds
MBA leveraged its Measure A
allocation to obtain over $40,500 in
matching funds.
Measure AAllocation MatchingFunds
$57,222 $40,500
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
75
BACkGROUND
Niroga Institute fosters health, well-being, and social and emotional
learning by bringing Transformative Life Skills (TLS) or dynamic
mindfulness to at-risk and underserved individuals, families, and
communities. TLS develops self-transforming life skills through mindful
movement, breathing techniques, and meditation.
MEASURE A FUNDING SUMMARY
Niroga Institute used its Measure A allocation to achieve the following:
• 13 TLS classes per week year-round, serving nine youth per class and
more than 115 youth per week
• Three all-day immersion retreats in three units, serving an average of
eight youth each
• 10 classes per week during intersession, four times per year, serving an
average of 10 youth each
• One staff class per week, serving an average of seven staff each
Allocation: $80,800 | Expended/Encumbered: $80,800
Individuals served by Measure A: 310 (Total individuals served: 310)
Populations served: Indigent, Low Income, Uninsured Children, Adults (ages 16–24)
Services provided: Mental Health
Service area: Countywide
Medical Costs for Juvenile Justice Center: Niroga Institute
niroga.org
Highlights
In evaluation surveys, the vast majority
of participants expressed positive
outcomes such as an increase in
self-control, decrease in stress, and
healthy habits from Niroga Institute
activities: over 80% from weekly youth
TLS sessions and daylong immersions,
and 75% from staff classes.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
76
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.
The Victim Compensation Program offers the following:
• Crisis support referrals and follow-up to outside agencies
• Optimum compensation assistance through the investigation and
utilization of other applicable financial resources and recovery
• Support in navigating the client’s immediate access to critical needs
services: medical, mental health, pharmaceutical, etc.
• Swift processing of emergency claims to alleviate client financial
suffering and hardship
• Increased expansion of covered financial services and benefits, and
evaluation of their effectiveness in addressing the client’s needs
• Increased community outreach to help educate clients about the
existence of the program and its available economic services and
resources
MEASURE A FUNDING SUMMARY
The Victim Compensation Program used its Measure A allocation to hire
staff, which enabled the program to expedite the processing of claims
submitted by the Guidance Clinic originating in the Alameda County
Family Justice Center, Camp Sweeney, school-based health centers in
Alameda County, and/or Crisis Service Response Teams.
Allocation: $144,000 | Expended/Encumbered: $90,000
Individuals served by Measure A: 2,457 (Total individuals served: 3,354)
Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors
Services provided: Emergency Medical, Hospital Inpatient, Hospital Outpatient, Public Health, Mental Health
Service area: Alameda, Berkeley, Castro Valley, Dublin, Emeryville, Fremont, Hayward, Livermore, Newark, Oakland, Piedmont, Pleasanton,
San Leandro, San Lorenzo, Union City, Outside of Alameda County
Medical Costs for Juvenile Justice Center: Victims of Crime
alcoda.org/victim_witness/california_victim_compensation_program
Highlights
Measure A funding helped enable
clients who would normally have been
ignored because of lack of information
about available resources, or limited
resources to pay for treatment
services, to receive necessary services
on an ongoing basis at no cost to the
client or to Alameda County.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
77
BACkGROUND
Preventive Care Pathways offers “Pathways to Wellness” to the general
population by providing medical and health care services for at-risk and
indigent patients as well as individuals re-entering the community from
the prison system. Preventive Care Pathways also produces and presents
educational videos and literature.
The Preventive Care Pathways clinic is easily accessible and conveniently
located in North Oakland. It provides same-day and urgent appointments
and referrals to specialty clinics. A pharmacy, chiropractic care, and
imaging services are onsite, which is a convenience for most patients
who may have transportation issues or limited funds. This accessibility to
services results in reduced emergency room visits and early detection of
chronic disease, cardiovascular disease, Hepatitis C , and cancer.
MEASURE A FUNDING SUMMARY
Preventive Care Pathways used its Measure A allocation to achieve the
following objectives:
• Become a Covered California Certified Enrollment Entity (CEE). The
CEE application was completed in November 2015.
• Have staff approved and trained as Covered California Enrollment
Counselors
• Designate one staff person to participate in the Covered CA CEE
Alameda Partnership Meetings. Designated staff has attended all
meetings in FY 14/15.
• Strategize how best to coordinate enrollment efforts as Alameda
County works toward building a No Wrong Door approach to
enrollment.
• Recruit one full-time equivalent (FTE) of each: nurse practitioner,
medical assistant, and administrative assistant. One FTE medical
assistant was hired in January 2015.
• Provide direct medical service visits to low income County residents.
Services were provided to 3,424 residents, an average of 428 per month.
The target was 150–350 services per month.
Allocation: $200,000 | Expended/Encumbered: $200,000
Individuals served by Measure A: 3,424 (Total individuals served: 3,700)
Populations served: Indigent, Low Income, Uninsured Adults, Seniors
Services provided: Emergency Medical, Mental Health
Service area: Countywide, Homeless or transient
Preventive Care Pathways
healthcare.gov/coverage/preventive-care-benefits
Highlights
Thanks in part to Measure A funding,
Preventive Care Pathways clients
experienced a reduction in emergency
room visits to Alameda Health System
and outside emergency rooms, as well
as improvement in clinical findings
related to diabetes, hypertension, and
congestive heart failure.
Matching Funds
Preventive Care Pathways leveraged
its Measure A allocation to obtain
$105,750 in matching funds.
Measure AAllocation MatchingFunds
$200,000
$105,750
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
78
BACkGROUND
The Alameda Health Consortium 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.
The Alameda Health 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 our
communities.
• Racial and ethnic health disparities must be eliminated in order to have
healthy communities.
The Consortium’s outpatient services are provided at community health
center locations throughout Alameda County and are not hospital-
based. The health centers see patients regardless of income, insurance,
or immigration status. In addition to providing medical care, the health
centers provided a wide range of support services to improve the lives of
patients served. More than 20 different languages are spoken across the
health centers.
The Consortium is made up of eight member health centers:
• Asian Health Services
• Axis Community Health
• La Clinica
• LifeLong Medical Care
• Native American Health Center
Allocation: $5,734,272 | Expended/Encumbered: $5,734,272
Individuals served by Measure A: 22,449 (Total individuals served: 184,024)
Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors
Services provided: Hospital Inpatient, Mental Health
Service area: Countywide
Primary Care Community-Based Organizations
Measure A Helps
When Salvador lost his job, he also
lost his employer-sponsored coverage
through Kaiser. One year earlier,
Salvador had been diagnosed as pre-
diabetic. When Salvadro went to pick
up his wife’s medication for the last
time at Kaiser, the pharmacist told
him that he and his wife could receive
care at LifeLong Medical Care and
might be eligible to enroll in a special
program that would cover the cost
of their medications. Salvador now
regularly goes to the LifeLong clinic for
eye exams and other tests. Twice a year
he consults with nutritionists there.
They’ve told him he must continue to
eat healthy and exercise to avoid full-
scale diabetes.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
79
• Tiburcio Vasquez Health Center
• Tri-City Health Center
• West Oakland Health Center
MEASURE A FUNDING SUMMARY
The eight Alameda Health Consortium member health centers used
their Measure A allocation to ensure that low income uninsured
Alameda County residents received access to affordable health care at
community health centers under the Health Program of Alameda County
(HealthPAC). The funds enabled the health centers to provide essential
medical services to HealthPAC enrollees, as well as health insurance
enrollment assistance for the uninsured.
Specifically, Measure A funding helped Consortium member community
health centers achieve the following:
• 22,449 low income Alameda County residents received access to quality
services at very low cost through HealthPAC.
• Over 19,000 patients received some type of medical service visit.
• For dental services alone, patients made over 9,000 visits that included
cleanings, examinations, and fluoride treatments.
• In terms of mental health, Measure A funds supported over 2,000
mental health visits.
• Over 185,000 laboratory tests were given to patients during visits.
• Measure A funds supported the transition of 20,000 HealthPAC
patients now eligible for Medi-Cal under the Affordable Care Act.
Actual visits for Each Consortium Health Center
total Patients
Primary Care,
Specialty Visits Dental Visits
Mental Health
Visits Total Visits
Asian Health Services 336 936 - 20 956
Axis Community Health 1,877 5,026 - 181 5,207
La Clinica de la Raza 7,374 19,672 1,967 744 22,383
LifeLong Medical Care 1,361 3,765 584 257 4,606
Native American Health Center 604 1,011 1,388 161 2,560
Tiburcio Vasquez Health Center 4,455 11,165 2,316 854 14,335
Tri-City Health Center 2,387 7,649 1,941 146 9,736
West Oakland Health Center 620 1,567 928 - 2,495
Total 19,014 50,791 9,124 2,363 62,278
Measure A funding
helped Consortium
member community
health centers ensure
that 22,449 low
income Alameda
County residents
received access to
quality services at
very low cost.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
80
BACkGROUND
Roots Community Health Center works to provide culturally competent,
comprehensive health care, mental health, and wraparound services with
the goal of eliminating health disparities in Oakland. Roots Community
Center accomplishes its mission by providing top quality care; conducting
community-based participatory research; and offering opportunities for
rehabilitation, education, training, and employment to reduce poverty and
dependency in the community.
Roots implements its programs and services while honoring the “roots” of
culture, heritage, and tradition by providing access to preventive, primary,
and urgent care; remaining community-aware and community-responsive;
and establishing partnerships to ensure a more efficient continuum of care
in Oakland.
MEASURE A FUNDING SUMMARY
Roots Community Health Center used its Measure A funds to support
increased capacity and expand access to medical outpatient services
for indigent, low income, and uninsured adults, children, families, and
seniors, including the reentry population, those with unstable housing,
and those with limited English proficiency throughout Alameda County.
Roots increased access to medical services in two ways:
• Increased clinic capacity through the construction and renovation of
three new examination rooms and the expansion of administrative
offices at Roots Community Health Center. Patient visits included
routine, episodic/urgent, and preventive care. The expansion also
facilitated the movement of patients from illness-based episodic care to
ongoing primary and preventive care.
• Increased the capacity of Roots Community Health Alliance to provide
primary and specialty care services by developing new agreements
and partnerships with 18 community partners, and by providing Roots
Alliance members assistance with various stages of electronic health
records adoption, implementation, and meaningful use.
Allocation: $100,000 | Expended/Encumbered: $100,000
Individuals served by Measure A: 367 (Total individuals served: 9,180)
Populations served: Indigent, Low Income Uninsured Adults, Children, Families, Seniors
Services provided: Public Health, Mental Health, Substance Abuse
Service area: Alameda, Oakland, San Leandro, Homeless or transient
Roots Community Health Center
rootsclinic.org
Highlights
As a result of its Measure A-funded
expansion efforts, Roots Community
Health Center experienced an 87%
increase in patient visits and a
300% increase in laboratory visits
compared to the same time period
pre-expansion.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
81
BACkGROUND
Tiburcio Vasquez Health Center, Inc. (TVHC) is dedicated to promoting
the health and well-being of the community by providing accessible
high quality care. TVHC’s individual and organizational commitment
is to ensure this human right through quality service, advocacy, and
community empowerment.
Through its Logan and Tennyson school health centers, TVHC offers
health education, case management, and parent engagement programs.
Providing health education and youth leadership development services
helps to ensure that youth receive comprehensive intervention and
support. These programs include the following:
• Youth empowerment programs build leadership and advocacy skills—
two competencies often linked to an increase in school attendance and
performance, meaningful relationships with caring adults, and overall
improvements in health.
• The Hip-Hop Elements program is a forum for any Logan student
interested in creative expression through hip-hop. The program focuses
on several areas of hip-hop, including the art of being a Disc Jockey
(DJ), Graffiti Art, Break Dancing, Master of Ceremony (MC)/Spoken
Word, Poetry, etc.
• The Youth Advisory Board (YAB) provides a platform for youth to give
input into health center policy and function. YAB members accomplish
this by providing feedback to health center staff and serve as an
important evaluation tool for the center’s services. YAB also serves as a
means for youth to actively promote health to the high school campus.
They accomplish this by developing school-wide “health tips” that
air on the school PSA system, hosting workshops, and organizing an
annual health fair.
• At the CAFÉ (Club de Aprendizaje Para Una Familia Estable) Parent
Engagement Program, parents learn about health care reform.
Participants also receive free dental screenings.
• The school-based Health Educators provide one-on-one health education
counseling sessions. Reducing barriers to access shifts culture and
behavior, thereby improving the overall health of young people.
Allocation: $60,000 | Expended/Encumbered: $60,000
Individuals served by Measure A: 1,349 (Total individuals served: 6,749)
Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors
Services provided: Public Health, Mental Health, Substance Abuse
Service area: Ashland, Cherryland, Hayward, Union City
Tiburcio Vasquez Health Center, Inc.
tvhc.org
Measure A Helps
A student at Tennyson High School
was a newcomer to the U.S. The
student needed access to health care
and behavioral health care. The
student’s caregiver did not have any
verifiable documents that would
allow for a consent to treatment for
the youth. The TVHC site manager
contacted an eligibility specialist at
TVHC’s main site in Hayward. The
specialist directed the site manager
to the proper forms that would cover
liability and allow the youth to receive
necessary services. The youth was seen
later in the week, and the caregiver
expressed thanks to TVHC staff for
finding a way to get the necessary
paperwork completed and on file.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
82
MEASURE A FUNDING SUMMARY
TVHC’s Measure A funding supports a continuum of care model that
incorporates health education, case management services, and youth
and parent leadership development programs that operate out of health
centers at Logan and Tennyson High Schools and the mobile health clinic
at Hayward High.
Measure A funding helped TVHC achieve the following objectives:
• The Health Educator(s) and Youth Leaders coordinated a multiracial
young women and young men’s empowerment program that met
weekly, reaching a total of 30 youth.
• Health Educators assisted with individualized family planning
education, pregnancy testing, and counseling for approximately 60
students.
• The program impacted over 5,000 students by addressing three critical
health issues most prevalent on the campuses it serves: teen violence,
substance abuse, and sexual health.
• The centers conducted 900 individual case management sessions
covering sexual health education and pregnancy options counseling and
linking students to the medical services provided at the clinic.
• CAFÉ, the Spanish-speaking parent empowerment group, reached
approximately 60 Spanish-speaking parents through weekly structured
parent education and empowerment classes. 90 parents graduated from
the program.
• Teams of Health Educators and Peer Health Educators provided
presentations about the health center and a range of health topics to
roughly 1,500 students.
• 60 students received training to become Peer Educators. Students were
introduced to a variety of topics to share with their peers.
• Students used the outreach and health promotion strategies learned
in their weekly workshops to promote pregnancy prevention on their
respective campuses. Their presentations led to over 300 students
registering as new patients at TVHC.
• TVHC helped train and develop 15 YAB members.
The program
impacted over
5,000 students by
addressing three
critical health issues
most prevalent on
the campuses it
serves: teen violence,
substance abuse, and
sexual health.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
83
BACkGROUND
The Washington Hospital Healthcare Foundation works to enhance the
Washington Hospital Healthcare System by increasing public awareness
and providing financial support. The Washington Hospital Healthcare
System strives to meet the health care needs of district residents through
medical services, education, and research.
MEASURE A FUNDING SUMMARY
Washington Hospital used its Measure A allocation to increase access
to hospital outpatient services for adults, seniors, and other residents
of Alameda County by providing free mammography screening
examinations to indigent, low income, and uninsured patients referred
to Washington Hospital by local health centers. The service included the
mammogram procedure, interpretation of results by the radiology group,
consultation with the patient, and arrangements for follow-up care as
needed.
Washington Hospital provided mammograms to 82 patients, of whom 18
had abnormal findings detected.
Allocation: $34,000 | Expended/Encumbered: $25,070
Individuals served by Measure A: 82 (Total individuals served: 88,537)
Populations served: Indigent, Low Income, Uninsured Adults, Seniors
Services provided: Emergency Medical, Hospital Outpatient, Public Health
Service area: Ashland, Cherryland, Fremont, Hayward, Newark, Sunol, Union City, Homeless or transient
Washington Hospital
www.whhs.com
Highlights
With the timely diagnostic care that
this program offers, abnormal findings
were detected and treated earlier,
which should translate to a better
outcome for the patient.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
84
FUNDS ALLOCATED BY THE ALAMEDA COUNTY BOARD OF SUPERVISORS
GROUP 4: PUBLIC HEALTH
100 Black Men of the Bay Area ................................................................................................................ 86
Alameda Boys & Girls Club, Inc. ................................................................................................................ 88
Alameda County Asthma Start .................................................................................................................. 90
CAL-PEP .................................................................................................................................................... 92
Center for Early Intervention on Deafness ............................................................................................... 93
City of San Leandro ................................................................................................................................... 94
Collaboration Agencies Responding to Disasters (CARD) ......................................................................... 95
Community Health and Wellness Element ............................................................................................... 96
Emergency Medical Services (EMS) Corps ................................................................................................ 97
Environmental Health: Improve Field Sanitation Conditions/Nail Salons ................................................. 98
Genesis Worship Center ......................................................................................................................... 101
HIV Education and Prevention Project of Alameda County (HEPPAC) .................................................... 102
Hospital Committee for Livermore-Pleasanton Area dba ValleyCare Health System ............................. 104
LIFE ElderCare ......................................................................................................................................... 105
Mercy Retirement Center ....................................................................................................................... 106
Public Health Prevention Initiative ......................................................................................................... 107
Ryan White Provider RFP: Community Health for Asian Americans (Office of AIDS) ............................. 115
Senior Injury Prevention Program .......................................................................................................... 116
Service Opportunties for Seniors (Meals on Wheels) ............................................................................. 118
South Hayward Parish ............................................................................................................................ 119
Spectrum Community Services, Inc. ....................................................................................................... 120
SSI Housing Trust .................................................................................................................................... 122
Viola Blythe Community Services ........................................................................................................... 123
West Oakland Youth Center .................................................................................................................... 124
Youth and Family Opportunity Initiatives ............................................................................................... 127
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
85
BACkGROUND
100 Black Men works to develop programs designed to improve the
quality of life for African Americans and other people of color. The Bay
Area chapter was established in 1988, and represents one of 116 chapters
located in the United States, England, and the Caribbean.
All 100 Black Men chapter activities are guided by the organization’s
“Four for the Future” plan, which focuses on four areas that are critical
to ensuring the future of the Black community: 1) mentoring across a
lifetime and leadership development, 2) education, 3) health and wellness,
and 4) economic empowerment. 100 Black Men of the Bay Area places an
emphasis on nurturing the Bay Area’s marginalized youth.
The 100’s Youth Movement program strives to improve the overall health
and well-being of marginalized children through structured physical
fitness training, wholesome food choices, character development, and
mentoring. Through these activities, Youth Movement helps children
improve their health, develop long-term goals, and overcome obstacles to
lifetime success and achievement. Youth Movement builds confidence and
resiliency skills and reinforces the values of commitment and hard work,
upon which youth can draw for achievement in academics and other areas
throughout their lives. Youth Movement services low income children and
families who may be at risk for developing serious chronic conditions, and
who may face challenges accessing the health care system.
A large cadre of volunteers is needed to make the Youth Movement
program a success. Athletic training clinics are held on Saturdays each
year from January through May. The day begins with a healthy breakfast
followed by a half-hour Life Skills workshop that addresses topics such as
nutrition/eating habits, conflict resolution, and “how to say no.”
MEASURE A FUNDING SUMMARY
Measure A funding supported the 100 Black Men of the Bay Area’s Youth
Movement Program to provide public health services, including nutritious
Allocation: $25,000 | Expended/Encumbered: $25,000
Individuals served by Measure A: 273 (Total individuals served: 750)
Populations served: Low Income Children
Services provided: Public Health, Mental Health
Service area: Alameda, Berkeley, Hayward, Oakland, San Leandro
100 Black Men of the Bay Area
100blackmenba.org
Measure A Helps
Testimony from a volunteer parent:
“I am a single mom of an eight-year-
old girl and a 14-year-old boy. I did
not expect the Youth Movement
track and field program to contribute
to their overall well-being in the
ways that it has. My son has been
able to benefit from the program’s
mentoring, which has helped him
learn self-discipline and character
development. Youth Movement has
helped him build confidence, which
shows up every day in big and small
activities. My daughter also enjoys the
friendships she makes and the hands-
on opportunities the program provides.
I believe the program’s biggest impact
has been healthier physical and mental
health for my family.”
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
86
meals and health and physical fitness programs to low income children
and youth, ages 4 to 18 years old, who live in Oakland, Alameda, San
Leandro, Hayward, and Berkeley. Measure A funding enabled 100 Black
Men of the Bay Area to improve the quality of its nutrition curriculum
and to provide stipends to its hard-working volunteers.
Specifically, 100 Black Men of the Bay Area used its Measure A allocation
to achieve the following:
• Assess 273 youth for fitness measures including aerobic capacity and
upper-body strength (target: 250)
• Have 91% of girls and 94% of boys with poor baseline aerobic capacity
levels achieve appropriate fitness levels within six months (target: 90%)
• Engage 500 youth in the Saturday clinics and 750 in the annual Tommie
Smith Youth Track Meet (target: 500)
• Offer after-school athletic training four days per week (target: four)
• Offer three clinics and eight track meets (target: 20 total)
• Have an estimated 88% of youth stay in the program throughout the
year (target: 80%)
• Recruit and train 22 volunteer coaches throughout Alameda County,
and provide first aid/CPR to seven volunteers
• Recruit Youth Movement participants through the Oakland Unified
School District’s African American Male Achievement program and
Martin Luther King, Jr. Elementary School in Berkeley
• Secure training facilities through joint-use agreements from Alameda
County schools and Park & Rec Departments
• Maintain the existing three track and field clubs and work to organize a
new club
• Host and sponsor two youth cross-country meets in Alameda County
(target: three)
• Host and sponsor eight youth track and field meets (target: four)
Highlights
In almost all areas, 100 Black Men
of the Bay Area met or exceeded
its target outcomes for the Youth
Movement program.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
87
BACkGROUND
Founded in 1949, the Alameda Boys & Girls Club provides high impact,
affordable youth development programs and services for over 65,000
youth, ages 6–18. The Club strives to inspire and enable all youth,
especially those who need it the most, to realize their full potential as
productive, responsible, and caring citizens. The Club offers a variety
of life-enhancing and life-changing programs in the areas of health
and fitness, education and technology, performing and visual arts, and
leadership and life skills.
Seventy-eight percent of youth attending the Alameda Boys & Girls Club
come from families that live at or below the poverty line.
MEASURE A FUNDING SUMMARY
Alameda Boys & Girls Club used its Measure A allocation to serve youth
in the following programs:
• Health Clinic services. Club youth serviced by the Health Clinic
received beneficial vision, dental, and respiratory screenings and
treatment to improve their physical well-being. This improved health
decreased their school absences.
- 387 youth were served.
- Four informational events/workshops were held with 470 youth in
attendance.
- 182 youth were screened, representing 70% of overall club youth.
• Mental health services. Services offered included individual and family
counseling, as well as small group Life Skills workshops. Participants
demonstrated a decrease in confrontational incidents and improvement
in pursuit of healthy lifestyles, such as not smoking and avoiding drugs
and alcohol.
- 173 youth were served in individual counseling.
- 695 youth participated in 17 six-week Life Skills workshops.
- 715 youth participated in daily programming, with 77.5% developing
a healthy eating habit and 90% demonstrating responsible decision-
making.
Allocation: $104,040 | Expended/Encumbered: $104,040
Individuals served by Measure A: 3,000 (Total individuals served: 3,000)
Populations served: Low Income, Uninsured Children
Services provided: Public Health, Mental Health, Substance Abuse
Service area: Alameda, Oakland
Alameda Boys & Girls Club, Inc.
alamedabgc.org
Measure A Helps
Ja’Nylah, 16, faced the common peer
pressure to participate in dangerous
and illegal activities such as sex,
alcohol, and drugs. She was able to
combat these pressures and stand
up for her own beliefs through the
self-confidence and healthy habits she
learned in the Life Skills SmartGirls
workshops. Being in a supportive
environment with female peers, she
learned how to become the person
she wanted to be, not who others
thought she should be. Ja’Nylah states,
“Becoming president of our girls group
taught me to understand that there are
people that want me to succeed, and
demonstrate important skills needed in
everyday life.”
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
88
• Get Cooking nutrition and healthy cooking program. Students
participating in health, nutrition, and fitness programs reported an
increase in stamina, better weight management, and higher energy
levels. They influenced their parents and families to be more healthy
and fit as well.
- 258 youth participated.
- Four informational events/workshops were held.
- 85.5% of youth showed improvement in eating.
• Get Growing sustainable garden.
- 301 youth participated.
- Four informational events/workshops were held.
- 84% of youth showed improvement in learning a new gardening skill.
• Physical fitness and recreation.
- 1,630 youth participated in gym fitness or outdoor recreational
activities.
- Four informational events/workshops were held.
- 87.5% of youth showed improvement in physical fitness scores.
Students participating
in health, nutrition,
and fitness programs
reported an increase
in stamina, better
weight management,
and higher energy
levels. They
influenced their
parents and families
to be more healthy
and fit as well.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
89
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 provides in-home case management to families of children
and adolescents with asthma. The program provides asthma education
related to disease, symptoms, medication, and its use. The program
develops a care plan for the family, inspects their home for asthma
triggers, and teaches the family how to remediate them; advocates with
landlords; and partners with Code Enforcement as needed to take care
of issues managing their child’s asthma such as pillow and mattress
encasings, non-bleach-based mold cleaner, vacuums, etc. Families are
linked to any needed services such as food, housing, medical home,
and insurance. The program also partners with schools to case manage
children that are missing school due to asthma and the District Attorney
for those that are truant due to asthma.
Eighty-three percent of the children served were insured by Medi-Cal and
from low income families. Asthma Start is the only program in the County
doing in-home asthma case management.
MEASURE A FUNDING SUMMARY
Measure A funds one-third of the Asthma Start budget.
Asthma Start used its Measure A allocation to achieve the following:
• Increase caregiver knowledge of asthma (target: 90% of caregivers
passing an asthma post test with a score of 90% or better; actual: 95%)
• Help children maintain or reduce asthma symptoms to the lowest level
(target: 95% of children; actual: 99%)
Allocation: $100,000 | Expended/Encumbered: $100,000
Individuals served by Measure A: 31 (Total individuals served: 36)
Populations served: Indigent, Low Income, Uninsured Children, Families
Services provided: Public Health
Service area: Alameda, Ashland, San Leandro, San Lorenzo
Note: In addition to its individual allocation, Asthma Start also received Measure A money through the Public Health Prevention Initiative
allocation (see page 107). The funding summary information described here is for the total of both allocations.
Alameda County Asthma Start
acphd.org/asthma.aspx
Measure A Helps
An 11-year-old girl was referred
to Asthma Start after she had gone
into the clinic for three urgent care
appointments related to her asthma.
Asthma Start connected the family
to Healthy Homes, who helped with
installing a handrail, painting the
bathroom, installing double-paned
windows and a threshold, removing
carpet and replacing it with laminate
flooring in the child’s bedroom, and
adding tile in the bathroom. After
these changes to the home, the mother
reported that her daughter was doing
very well with her asthma. She had not
had any recent symptoms or need for
Albuterol, and she had not needed to
go to the emergency room, hospital, or
urgent care.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
90
• Help caregivers reduce at least one identified asthma trigger (target:
95% of caregivers; actual: 100%)
• Reduce instances of children requiring hospitalization or emergency
department visits post-case management (target: 20% or less of
children; actual: 3% needing hospitalization, 15% needing emergency
department visits)
• Increase caregiver confidence in managing their child’s asthma (target:
95% of caregivers reporting increased confidence; actual: 100%)
• Ensure children have a medical home and insurance before discharge
(target: 100% of children; actual: 100%)
Matching Funds
Asthma Start leveraged its Measure
A allocation to obtain $10,000 in
matching funds from Targeted Case
Management (TCM) and Medi-Cal
Administrative Activities (MAA).
Measure A
Allocation
Matching
Funds
$100,000
$10,000
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
91
BACkGROUND
CAL-PEP provides accessible health education, disease prevention, risk
reduction, and support services to people at high risk for or currently
living with HIV/AIDS.
MEASURE A FUNDING SUMMARY
Measure A funding helped CAL-PEP meet some of the basic needs of
their clients. Basic needs include transportation, food bags, and gift cards.
In addition, CAL-PEP used its Measure A allocation to achieve the
following:
• Increase awareness of CAL-PEP partner services among HIV-positive
African American clients (target: 50 clients: actual: 66)
• Conduct Targeted Prevention Activities (TPAs) in high risk venues
where African American positive and high risk negative individuals
congregate
• Distribute partner services information and safer sex materials to all
TPA contacts
• Refer high risk negative partners to HIV testing, primary care substance
abuse treatment, and other services as needed
• Have CLEAR clients increase risk-reduction skills (target: 8 clients;
actual: 9)
• Screen and enroll HIV-positive African American clients into CLEAR
(target: 10 clients; actual: 10)
• Have CLEAR participants complete a pre- and post-test assessment to
measure their risk behavior at intake and discharge
• Have HIV high risk partners or social networks of HIV-positive clients
increase their knowledge of their HIV status (target: 50 partners/social
networks; actual: 49)
• Conduct events to increase knowledge of HIV status, risk-reduction
skills, and communication among HIV-positive African Americans and
their negative sexual partners (target: 5 events; actual: 5)
Allocation: $258,621 | Expended/Encumbered: $258,621
Individuals served by Measure A: 226 (Total individuals served: 226)
Populations served: Indigent, Low Income, Uninsured Adults, Seniors
Services provided: Substance Abuse
Service area: Countywide, Homeless or transient
CAL-PEP
calpep.org
Measure A Helps
A 49-year-old African American
bisexual male was enrolled into CAL-
PEP’s CLEAR program. He was
recently released from jail and had
stopped taking his HIV medication.
He lives in a homeless encampment,
smokes crack, drinks alcohol, and has
sex with women and men when under
the influence. In the CLEAR program,
the client was linked to primary care
and onsite mental counseling services.
Additionally, the client participated
in the onsite PWP groups. With the
support of CLEAR services, the client’s
confidence and outlook improved. He is
currently on medications, is housed at
the EOCP Crossroads shelter, recently
stopped using crack, and reports that
he always uses condoms with his HIV-
negative partner.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
92
BACkGROUND
The Center for Early Intervention on Deafness (CEID) works to maximize
the communication potential of young children through early education,
family support, and community audiology services.
As one of the few audiology providers in the area that accepts Medi-Cal
patients, CEID provides a critical service to an underserved population.
It provides Spanish translation and coordinates translation services for
patients who speak other languages. Patients receive the service as well as
the follow-up information necessary to continue to monitor their or their
child’s hearing health care needs.
MEASURE A FUNDING SUMMARY
Measure A funding helped CEID provide the following services:
• Newborn hearing screenings (target: 120 patients)
• Audiological evaluations for children and adults (target: 300 patients)
• Hearing aids and accessory dispensing for children and adults (target:
150 patients)
• Community hearing screenings (target: 100 community members)
• Training for pediatric residents (target: 75 residents)
Allocation: $57,020 | Expended/Encumbered: $57,020
Individuals served by Measure A: 438 (Total individuals served: 756)
Populations served: Indigent, Low Income Adults, Children, Families, Seniors
Services provided: Public Health
Service area: Alameda, Albany, Berkeley, Castro Valley, Dublin, Emeryville, Fremont, Hayward, Livermore, Newark, Oakland, Pleasanton, San
Leandro, San Lorenzo, Homeless or transient
Center for Early Intervention on Deafness
ceid.org
Matching Funds
CEID leveraged its Measure A
allocation to obtain $5,000 in
matching funds from Alameda County
District 2 Supervisor Valle.
Measure A
Allocation
Matching
Funds
$57,020
$5,000
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
93
BACkGROUND
The San Leandro Recreation and Human Services Department strongly
emphasizes the importance of health and wellness. The department strives
to educate the public about how they can achieve improved health and
wellness and continually provides or partners in programs that support
health and wellness in the community.
The department has developed program guidelines and expectations
regarding healthy eating and physical activity.
MEASURE A FUNDING SUMMARY
The part-time staff provided by Measure A allowed Recreation and
Human Services to maintain quality senior services, grow programs, and
continue to offer critical health and wellness services to San Leandro
seniors.
Measure A funding supported a comprehensive health and wellness
framework by allowing the City of San Leandro to offer critical programs
to seniors. The City of San Leandro set an attendance objective of 50%
of Senior Community Center members participating in programs and
services formulated to promote health and wellness.
Specific target and actual numbers are as follows:
• Blood pressure/weight checks (target: 360, actual: 740)
• Mercy Brown Bag program—Grocery bag of nutritional food monthly
to eligible seniors (target: 576; actual: 611)
• Health education classes (target: 6 classes; actual: 15)
• Pull Up a Chair exercise class (target: 120 participants; actual: 128)
• Fall prevention class (target: 6,750 participants; actual: 6,888)
• Referral to additional health and wellness programs and services
(target: 395 seniors accessing other programs; actual: 1,667)
Allocation: $52,020 | Expended/Encumbered: $52,020
Individuals served by Measure A: 10,548 (Total individuals served: 69,429)
Populations served: Seniors
Services provided: Public Health
Service area: San Leandro, San Lorenzo
City of San Leandro
sanleandro.org
Highlights
Recreation and Human Services
exceeded all of its targets for senior
services, sometimes dramatically.
For example, the Senior Community
Center conducted 740 blood
pressure/weight checks, compared to
a target of 360—an increase of almost
100%. The program experienced a
96% success rate at delivering a bag
of nutritional food to 48 seniors
twice per month, and increased
awareness of high blood pressure and
weight level risk factors in 100% of
clients. Over 300 seniors attended fall
prevention classes every month.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
94
BACkGROUND
In partnership with traditional disaster relief agencies, CARD prepares
local community groups to participate in coordinated response and
recovery efforts for vulnerable and underserved populations in Alameda
County. CARD services are for everyone and anyone, particularly for
individuals with Access and Functional Needs (AFN).
MEASURE A FUNDING SUMMARY
As a result of Measure A funding, CARD engaged in planning activities
that fully included the preparedness and planning needs of vulnerable
communities with the partnership of the agencies that serve them.
Specifically, CARD used its Measure A funds to conduct the following
activities: Preplanning for three community-based events, research, social
media planning, curriculum selection, and partnership planning.
While CARD successfully completed the planning portion of this
contract, CARD’s Board voted to cease operations. CARD is in the process
of decommissioning as a nonprofit corporation.
CONCERNS
It is unclear if the Measure A allocation to CARD complies with the
ordinance requirement that funds go to provide “emergency medical,
hospital inpatient, outpatient, public health, mental health, and substance
abuse services to indigent, low income, and uninsured adults, children,
families and seniors, and other residents of Alameda County.”
The project was not completed, with no services deliverables report. The
provider reports that only the “planning phase” was completed before the
agency went out of business. Only $7,500 of the $25,000 was paid out to
CARD, and these Measure A funds went to planning for services that were
never provided.
Allocation: $25,000 | Expended/Encumbered: $7,500
Individuals served by Measure A: N/A (Total individuals served: 14,862)
Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors
Services provided: Other (Emergency Preparedness)
Service area: Countywide
Collaboration Agencies Responding to Disasters (CARD)
CARDcanhelp.org
As a result of Measure
A funding, CARD
was able to engage
in planning activities
that fully included the
unique preparedness
and planning
needs of vulnerable
communities with
the partnership of
the agencies that
serve them.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
95
BACkGROUND
The Alameda County Community Development Agency works to
enhance the quality of life of County residents and plan for the future
well-being of the County’s diverse communities; to balance the physical,
economic, and social needs of County residents through land use
planning, environmental management, neighborhood improvement, and
community development; and to promote and protect agriculture, the
environment, economic vitality, and human health.
The purpose of the Element is to develop the foresight and the regulatory
authority necessary to ensure that County land use and other policies
are not incompatible with health, but rather that they support healthy,
equitable, and ecological community development. It summarizes all of
those actions that the County has or will take in support of the community
vision, thereby providing an opportunity for improved collaboration and
coordination of efforts taking place in Ashland and Cherryland.
The following objectives were identified as part of this project and are
aligned with the Element’s vision and purpose:
• Residents invested in a vision for their community
• A shift in focus to the environment in which projects are developed
• A healthy community image
• A planning model that could be replicated in other unincorporated
communities or cities within Alameda County
MEASURE A FUNDING SUMMARY
Thanks in part to Measure A funding, the Ashland and Cherryland
Community Health and Wellness Element was approved by the Alameda
County Board of Supervisors in December 2015.
Allocation: $17,697 | Expended/Encumbered: $17,697
Individuals served by Measure A: 38,604 (Total individuals served: 38,604)
Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors
Services provided: Public Health
Service area: Ashland, Cherryland
Community Health and Wellness Element
acgov.org/cda
The Ashland
and Cherryland
Community Health
and Wellness Element
was approved by the
Alameda County
Board of Supervisors
in December 2015.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
96
BACkGROUND
The Emergency Medical Services (EMS) Corps works to increase the
number of underrepresented Emergency Medical Technicians (EMTs)
through youth development, mentoring, and job training.
The EMS Corps targets young men of color from underserved
communities. A majority of the youth that are selected to participate
in the EMS Corps are recruited from a variety of community-based
organizations.
The EMS Corps is part of a national network of programs and
organizations that serves boys and men of color. The EMS Corps provides
opportunities for young men of color to pursue a career in EMS and
creates pathways for careers in health care. The program’s wraparound
support services prepare young men of color for careers by providing
them with professional development and exposure to health care
professionals through a group mentoring model.
MEASURE A FUNDING SUMMARY
The EMS Corps used its Measure A allocation to support the following:
• Two annual five-month-long cohorts of approximately 80 youth from
low income communities
• An EMT training course consisting of 136 hours of instruction, 24
hours of supervised clinical experience, and 10 documented patient
contacts
• EMT instructors, equipment, and training materials
• CPR training
• Mental health services that included 90 hours of individual
psychotherapy sessions and weekly group counseling
• Health and wellness and self-care reform
• Life coaching, mentorship, case management, life coaching, tutoring,
community service, and a stipend for 40 EMS Corps students
Allocation: $604,942 | Expended/Encumbered: $604,242
Individuals served by Measure A: 80 (Total individuals served: 80)
Populations served: Indigent, Low Income, Uninsured Adults, Children
Services provided: Emergency Medical, Public Health, Mental Health
Service area: Countywide
Emergency Medical Services (EMS) Corps
acphd.org/ems-corps.aspx
Measure A Helps
When he first came into the EMS
Corps, John was a high school dropout
and had spent time in the Juvenile
Justice System. Once he realized that
he would get out what he put into the
program, John excelled. He graduated
from the EMS Corps and passed the
National Registry exam. John now
works for Cherry Hill detox center
as a health care technician. He also
coordinates community outreach
events for the EMS Corps, serves as a
peer coach in the Life Coaching class,
and tutors and mentors incoming
students. John was recently accepted
into the Merritt College Fire Academy.
He credits his success in life to the
EMS Corps.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
97
Program results included the following:
• 36 of the 40 EMS Corps students are employed, 28 as EMTs.
• 18 are pursuing higher education.
• 12 EMS Corps graduates enrolled in the Fire Academy.
• Eight graduates are enrolled in the Health Coach program through the
Alameda Health Pipeline Partnership.
• Seven EMS Corps alumni volunteer in the EMS Corps as mentors,
tutors, and skills instructors.
36 of the 40 EMS
Corps students
are employed,
28 as EMTs.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
98
BACkGROUND
Alameda County Environmental Health Services (EHS) promotes
the health, safety, and well-being of the public through promotion of
environmental quality. EHS uses enforcement authority, education,
and cooperation to promote awareness of environmental protection,
environmental justice, and pollution prevention. EHS carries out this
mission in partnership with a wide variety of other government, nonprofit,
and for-profit organizations.
The Alameda County Environmental Health Department (ACEH) created
a Healthy Nail Salon Recognition (HNSR) program and technician
certification with the California Healthy Nail Salon Collaborative. The
program serves businesses in seven cities: Alameda, Albany, Berkeley,
Fremont, Hayward, Oakland, and Pleasanton.
The HNSR program achieves its goals through the following activities:
• Assisting salon owners and workers in identifying the highest risk nail
salon products and practices and in selecting preferable products,
practices, and protective equipment to improve worker, client, and
community safety
• Identifying or creating reliable information sources for salon workers/
owners
• Offering a rebate to cover all or most of the cost of purchasing and
installing appropriate air purification equipment
• Providing recognition (certificate and use of logo) to salons to promote
themselves as Healthy Nail Salons
• Providing online and branding tools for customers/clients to find and
patronize Healthy Nail Salons
• Providing training and training certificates to empower workers with
better information and a way to demonstrate to prospective employers
that they know Healthy Nail Salon criteria
Allocation: $25,000 | Expended/Encumbered: $12,547
Individuals served by Measure A: 325 salons (Total individuals served: 325 salons)
Populations served: Low Income Adults, Children
Services provided: Public Health
Service area: Countywide, Outside of Alameda County
Environmental Health: Improve Field Sanitation Conditions/Nail Salons
acgov.org/aceh/healthynail/index.htm
The HNSR program
assists salon owners
and workers in
identifying the
highest risk nail
salon products
and practices and
selecting preferable
alternatives.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
99
MEASURE A FUNDING SUMMARY
Measure A funding helped the ACEH/HNSR program achieve the
following:
• Hold one formal workshop for salon owners, with 24 attendees
representing 12 salons
• Send mailers to 325 salons in Alameda County
• Respond to three media requests
• Participate in six stakeholder meetings
• Review 18 applications
• Perform 14 site audits with technical assistance
• Conduct 10 onsite trainings for workers at nine salons, with 31
attendees
• Provide six recognitions and four equipment reimbursements
• Offer translation services at the owner workshop and at three salons
• Respond to one complaint by phone
• Contact 13 salons to participate in an outcomes survey organized and
carried out on behalf of the California Healthy Nail Salon Collaborative
Measure A funding
helped the ACEH/
HNSR program send
mailers to 325 salons
in Alameda County.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
100
BACkGROUND
The Genesis Worship Center feeding program provides food to those in
need once per week, four times per month.
MEASURE A FUNDING SUMMARY
Genesis Worship Center used its Measure A allocation to provide meals
to 548 clients in December 2014 and 622 clients in January 2015. The
target was 100 clients per week.
Allocation: $5,000 | Expended/Encumbered: $5,000
Individuals served by Measure A: 1,170 (Total individuals served: 7,700)
Populations served: Low Income Adults, Children, Families, Seniors
Services provided: Public Health
Service area: Oakland
Genesis Worship Center
genesiswc.com
Highlights
Genesis Worship Center exceeded its
target of feeding 100 clients per week
in both months for which it used its
Measure A allocation.
Matching Funds
Genesis Worship Center leveraged its
Measure A allocation to obtain $4,000
in matching funds from the church.
Measure A
Allocation
Matching
Funds
$5,000 $4,000
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
101
BACkGROUND
The HIV Education and Prevention Project of Alameda County (HEPPAC)
works to stop the further spread of preventable diseases among increased-
risk populations in the communities it serves. HEPPAC strives to reduce
the impact of harm by addressing external barriers and increasing access
to basic needs services.
Many HEPPAC clients would go untreated because their only options are
emergency departments, where there are long wait times and the fear of
being stigmatized for their substance use and/or chronic homeless status.
MEASURE A FUNDING SUMMARY
Measure A supported HEPPAC’s client population by providing critical
wound care and clinical services to extremely low income, marginalized
active injection drug users and high risk youth and young adults engaging
in unprotected sex with multiple partners.
HEPPAC used its Measure A allocation to achieve the following:
• Administer care for soft tissue damage due to injection drug use by a
qualified medical professional at the Casa Segura clinic and syringe
exchange locations (target: 100 wound care visits, 50 unduplicated
clients; actual: 142 visits, 73 unduplicated clients)
• Provide wound care follow-up services to intravenous drug users
(IDUs) at both the Casa Segura clinic and syringe exchange program
(target: 12 visits; actual: 13)
• Maintain two syringe drop box locations by collecting used syringes in
the box weekly and collecting any loose syringes in the immediate area
(target: collect 5,000 syringes; actual: 3,041 at drop box, 2,015 loose
syringes collected)
• Conduct outreach to the IDUs accessing the drop box location to make
them aware of the drop box and provide them with information on how
Allocation: $26,000 | Expended/Encumbered: $26,000
Individuals served by Measure A: 646 (Total individuals served: 1,615)
Populations served: Indigent, Low Income, Uninsured Adults, Seniors
Services provided: Public Health, Substance Abuse
Service area: Alameda, Berkeley
Note: In addition to its individual allocation, HEPPAC also received Measure A money through the Public Health Prevention Initiative allocation
(see page 107). The funding summary information described here is for the total of both allocations.
HIV Education and Prevention Project of Alameda County (HEPPAC)
casasegura.org
Measure A Helps
T., a 37-year-old African American
homeless male, accesses HEPPACs
mobile outreach services at least every
other week. T. was informed of his
positive HCV status over 13 years
ago and never followed up or sought
further care. He was enrolled into
Medicare, but his assigned medical
home was in Fremont. Because he is
based in Oakland, he never accessed
the home. HEPPAC provided
confirmatory HCV screening services
and connected him with a health
benefits enrollment specialist to change
his assigned medical home to LifeLong
Medical services. At LifeLong, they are
addressing T.’s chief medical concerns
and preparing him for possible HCV
treatment services.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
102
to properly dispose of used syringes and reduce the risk of HIV and
HCV (target: 100 IDU clients; actual: 146)
• Encourage PWIDs receiving abscess/wound care services to participate
in at least one of the following: HIV or HCV testing and counseling
services (target: 100 PWIDs, with 52% participating in at least one
service)
• Demonstrate increased knowledge among PWIDs of their HIV and/or
HCV status (target: 156 PWIDs)
• Refer all PWIDs and/or their sexual and/or needle-sharing partners
who test positive for HIV and/or HCV and/or an STI to primary care
services as needed
HEPPAC used its
Measure A allocation
to demonstrate
increased knowledge
among PWIDs of
their HIV and/or
HCV status.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
103
BACkGROUND
ValleyCare Health System works to care, to educate, and to discover.
MEASURE A FUNDING SUMMARY
ValleyCare used its Measure A allocation to provide quality, nutritious
meals to low income children ages 18 months to six years living in
Livermore. Meals were provided through ValleyCare’s nonprofit, hospital-
based food service establishment.
Specifically, ValleyCare used its Measure A allocation to achieve the
following:
• Conduct four trainings monthly to instruct staff on the nutritional
benefits and proper preparation of fresh fruits and vegetables, with
100% of staff completing at least one training
• Use 90% of purchased food to prepare healthy meals
• Have 50% of Head Start program participants complete the food
education curriculum
Allocation: $15,000 | Expended/Encumbered: $4,536
Individuals served by Measure A: 175 (Total individuals served: 175)
Populations served: Low Income Children
Services provided: Public Health
Service area: Livermore
Note: The provider submitted its report late for Committee review. Therefore, this summary may reflect incomplete information.
Hospital Committee for Livermore-Pleasanton Area dba ValleyCare Health System
valleycare.com
ValleyCare used its
Measure A allocation
to provide quality,
nutritious meals to
low income children
ages 18 months to
six years living in
Livermore.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
104
Measure A Helps
After Mrs. Q., 83, fell and was
hospitalized, she was very interested
in giving the fall prevention program
a try. At the beginning, her scores
rated her at very high risk of another
fall. Student nurses taught Mrs. Q.
the recommended exercises, which
she faithfully did every day. Mrs. Q’s
furniture arrangement also posed a
hazard. The students helped her move
some items out of high traffic areas,
and the program paid for Mrs. Q to
have grab bars professionally installed
in her shower. Mrs. Q.’s follow-up
assessments have rated her as low
risk of future falls. She is even back to
taking her daily outside walk.
BACkGROUND
LIFE ElderCare empowers seniors to live with independence and
interdependence by nourishing mind, body, and spirit. LIFE ElderCare’s
fall prevention program includes individualized exercise programs,
medication screening and education, and environmental assessments and
minor home modifications.
MEASURE A FUNDING SUMMARY
LIFE ElderCare used its Measure A funds to increase access to home-
based public health services for low income, at-risk seniors in Central and
Southern Alameda County through a person-centered, multifaceted fall
prevention program. The program achieved the following objectives:
• 87 seniors (age 60+) enrolled in the program.
• 77% of seniors participating in the program demonstrated fewer (or if 0,
no more than 0) falls in the three months after they enrolled than in the
three months prior to enrollment.
• 100% of enrollees received an initial strength and balance assessment by
a certified fitness instructor.
• 100% of enrollees had an individualized exercise plan designed for and
taught to them by trained, screened nursing students.
• 100% of enrollees received medication screening and education on
medication management.
• 100% of enrollees received a home hazard assessment and education
and assistance in reducing clutter and fall hazards.
• 100% of those enrollees who needed minor home modifications
received them.
• 72% of enrollees expressed more confidence about not falling after
participating in the program.
• 58% of enrollees had improved times on the Single Leg Stand test post-
program vs. pre-program.
• 53% of enrollees had improved scores on the Berg & Tinetti Balance
Tests post-program vs. pre-program.
• 53% of enrollees had improved scores on the Timed Up & Go test post-
program vs. pre-program.
Allocation: $12,400 | Expended/Encumbered: $12,400
Individuals served by Measure A: 26 (Total individuals served: 202)
Populations served: Low Income Seniors
Services provided: Public Health
Service area: Ashland, Castro Valley, Cherryland, Fremont, Hayward, Newark, San Leandro, San Lorenzo, Union City
LIFE ElderCare
lifeeldercare.org
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
105
BACkGROUND
The Mercy Brown Bag Program coordinates the distribution of over a
million pounds of free nutritious groceries to low income older adults
in Alameda County to improve the quality of their lives by combating
the negative effects of hunger, malnutrition, isolation, and a sense of
uselessness.
Seniors who come to central locations to get their food are given
information about other essential services and volunteer opportunities in
their area, while having an environment in which to exercise and socialize.
MEASURE A FUNDING SUMMARY
The Mercy Brown Bag Program used its Measure A allocation to
distribute two nutritiously balanced bags of groceries each month to a
minimum of 3,000 senior households, representing a minimum of 5,500
grocery bags to 4,000 individual seniors.
Allocation: $40,000 | Expended/Encumbered: $40,000
Individuals served by Measure A: 5,427 (Total individuals served: 5,427)
Populations served: Low Income Seniors
Services provided: Public Health
Service area: Countywide
Mercy Retirement Center
eldercarealliance.org/mercy-retirement-care-center
Highlights
In a survey, Mercy Brown Bag Program
recipients indicated the following:
• 37% didn’t have enough money to
buy food or other necessary items
to last the entire month.
• 34% had to skip meals.
• 76% thought their health would be
negatively affected either somewhat
(22%) or a great deal (54%) without
this program.
Thus, the program helped fill an
important gap in maintaining the
health and well-being of the older
adult population.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
106
Measure A Helps
HOPE COLLABORATIVE
From client Abdu Abdulalim:
“After leaving Eritrea as a war refugee
and moving to California, ten years
ago I bought this food market, Three
Amigos. Recently I met the HOPE
Collaborative, which transforms corner
stores into healthy markets. Since then,
I have increased the store’s healthy food
offerings by carrying fresh produce.
HOPE volunteers have come to the
store for work days, replacing tobacco
and alcohol signs with colorful posters
promoting healthy foods. They are
designing a mural promoting healthy
foods and beverages for the outside
of the store. HOPE taught me which
alcohol and tobacco products are most
harmful and helped me understand
why I should sell less of these
products.”
BACkGROUND
The Alameda County Public Health Department 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 Measure A Prevention Initiative aims to reduce health disparities via
three priority areas:
• Chronic Disease & Injury Prevention
• Health Inequities & Community Capacity-Building
• Obesity Prevention & School Health
The programs that make up these three priority areas are not designed
to operate as standalone efforts but rather are complementary to other
departmental programs and strategies.
These priority areas encompass the following programs and organizations.
Chronic Disease & Injury Prevention
• Diabetes
• Project New Start
• Asthma Start (see the separate “Asthma Start” entry on page 90)
• Healthy Kids Healthy Teeth (see the separate “Alameda County Dental
Health” entry on page 51)
Health Inequities & Community Capacity-Building
• Immunization
• HIV Prevention: HEPPAC (see the separate “HIV Education and
Prevention Project of Alameda County (HEPPAC)” entry on page 102)
• HIV Prevention: CAL-PEP
• Lotus Bloom
• Niroga
• Healthy Retail Project
• HOPE Collaborative—A Project of the Tides Center
• Mandela Marketplace
• Developmental Disabilities Council—Older Adult System of Care (see
the separate “Schreiber Center” entry on page 39)
Allocation: $3,151,570 | Expended/Encumbered: $3,151,570
Individuals served by Measure A: 202,475 (Total individuals served: 236,257)
Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors
Services provided: Public Health
Service area: Countywide
Public Health Prevention Initiative
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
107
• Child Health Disability Prevention Program
• Home Visiting and Family Support
• City and County Neighborhood Initiative (CCNI): Sobrante Park and
West Oakland
Obesity Prevention & School Health
• Healthy Living Program for Children at Madison Park Business and Art
Academy
• Berkeley School-Linked Health Services Program
• Nutrition Services
• East Oakland Boxing Association
MEASURE A FUNDING SUMMARY
The Public Health Prevention Initiative programs used Measure A funding
to help achieve the following objectives.
Chronic Disease & Injury Prevention
Diabetes
• Provide 16 hours of self-management education to adults with type 2
diabetes in a variety of languages.
• Offer local support groups serving 996 clients per year.
• Send out a monthly newsletter to 350 past participants per month.
• Reduce A1c, a test that shows how well a person is controlling his or
her diabetes, in 71% of clients (target: 75%).
• Reduce blood pressure in 53% of clients (target: 50%).
• Reduce weight in 64% of clients (target: 75%).
• Increase physical activity in 82% of clients (target: 50%).
• Achieve 92% of clients starting to read food labels, count carbohydrates,
and practice portion control (target: 75%).
Project New Start
• Partner at least 75–90 formerly involved gang youth with sponsoring
agencies committed to supporting each youth’s lifestyle change through
tattoo removal.
• Remove visible gang-related and/or drug-related tattoos from the
face, neck, forearms, hands, and, when appropriate, below the knee
areas of participants to improve employment, social, and educational
possibilities for youth.
• Participate in collaborations to reduce youth violence in Alameda
County.
Health Inequities & Community Capacity-Building
Immunization
• Promote the elimination of vaccine-preventable diseases by
implementing the California Immunization Registry program (CAIR) in
Alameda County.
Measure A Helps
DIABETES
The California Thoroughbred
Horsemen’s Foundation asked the
diabetes program to provide diabetes
education for the workers at Berkeley’s
Golden Gate Fields. The foundation
has a small onsite clinic with a medical
provider two mornings a week.
Since the program’s usual eight-
week diabetes course would not fit
the workers’ schedules, the program
suggested a monthly diabetes class
and support group. In addition, the
clinic’s minimal services limited
access to care and did not offer a
continuity of diabetes care that is
critical in preventing complications.
What’s more, many of the workers
were uninsured and were not aware
of HealthPAC. CCNI set up onsite
enrollment for Medicaid, HealthPAC,
and Covered California.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
108
• Support medical providers who strive to improve their immunization
rates and prevent diseases for their patients.
• Through CAIR, ensure that a child who has received immunization
from multiple sites has one source of immunization coverage truth.
• Also through CAIR, ensure that users have rapid access to complete
and up-to-date immunization records, helping eliminate missed
opportunities to immunize and minimize unnecessary immunizations.
• Allow staff to focus not only on recruiting and retaining providers
that serve underinsured children in the County, but also to increase
the numbers of records in the Immunization Registry and use the
Immunization Registry for specific reminder and recall projects.
• Recruit health care providers to join the registry.
• Provide training and technical assistance on registry use for medical
office staff.
• Set up data exchanges with medical providers’ Electronic Health
Record systems.
• Build and support a network of immunization providers and support
vaccination efforts in needed areas.
• Identify populations who would benefit from immunization-related
projects to prevent communicable diseases.
HIV Prevention: CAL-PEP
• Conduct Targeted Prevention Activities (TPAs) in high risk
communities and other venues where African American positive and
high risk negative individuals congregate.
• Distribute partner services information and safer sex materials to all
TPA contacts.
• Enroll 10 clients in the CLEAR program.
• Have 80% of participants take a pre and post test to measure their risk
behavior at intake and discharge.
• Conduct five HCPI events designed to increase knowledge of current
HIV status, risk reduction skills, and partner communication among
African American HIV-positive participants and their negative sexual
partners.
• Provide HIV testing to drug using and sexual partners of HIV-positive
individuals.
Lotus Bloom
• Build parent/resident leadership in two neighborhoods, Castlemont
and San Antonio, to further expand health, nutrition, and wellness
Immunization
• Provide education and support to over 40 providers/medical groups
meeting the Stage 1 Meaningful Use attestation requirement for the
Medicare and Medicaid EHR Incentive Program.
• Send out over 4,000 recall postcards reminding patients they are due
for their immunizations.
Measure A Helps
HIV PREVENTION: HEPPAC
Client A., 49, accessed HEPPAC
during mobile outreach providing
syringe exchange and harm reduction
supply distribution at a homeless
encampment in East Oakland.
HEPPAC staff referred A. for follow-
up risk reduction counseling services.
A. accessed the syringe exchange three
more times after his initial visit and
received HIV/HCV testing. When A.
tested positive for HCV, HEPPAC
referred him to ACA enrollment,
HCV treatment, housing, and mental
health and substance use treatment
services for methadone. A. successfully
enrolled in ACA and obtained linkages
to specialty care for his HCV and a
medical home that addresses his overall
health needs. He is now stably housed,
medically insured, and maintaining
methadone substance treatment.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
109
• Promote the elimination of vaccine-preventable diseases by
implementing CAIR in Alameda County to eliminate both missed
opportunities to immunize and unnecessary immunizations.
• Increase the number of providers who use CAIR in Alameda County to
120 organizations, and the number of Alameda County patient records
in CAIR to 49,430.
Niroga
• Select, train, and place IHF graduates in the community where they are
needed the most; extend evaluation to organizational and community
impacts; complete data analysis and reporting; and formalize policy
recommendations.
• Provide a one-day Transformative Life Skills training for approximately
25 Alameda County Public Health Department – Community Health
Services staff to incorporate strategies and techniques with clients.
• Provide 25 hours of healing yoga/meditation/stress reduction
classes and preparation of materials to the diabetes prevention and
management classes, diabetes prevention and management supports
groups, and hypertension prevention and management classes.
• Provide healing yoga therapy/stress reduction/meditation sessions to
the Ethnic Health Institute Health Ministry Program’s hypertension and
prevention management clients.
• Create a healing yoga therapy educational tool for asthma prevention
and management.
Mandela Marketplace
• Expand regional food interests in the Ashland, Cherryland, Livermore,
Tri Cities, and Hayward areas.
• Deliver 15+ fruits and vegetables twice a week on consignment,
ensuring that the store has a mix of produce items that are always fresh.
• Develop a healthy retail intervention model, including store selection,
recruitment, and enrollment process; store and store owner
assessment; technical assistance to store owner on healthy retail;
community engagement; product guidelines; sales tracking and
inventory management systems; store owner and staff training; healthy
foods procurement; and marketing.
Child Health Disability Prevention Program (CHDP)
• Screen 6,964 children using the Ages and Stages Questionnaire (ASQ)
and Modified Checklist for Autism in Toddlers (MCHAT) in Help Me
Grow pediatric sites and clinics.
• Refer 1,396 children who scored of concern to the Help Me Grow
phone line for follow-up, which could include referral to entitlement
services such as the Regional Center of the East Bay or Alameda County
Behavioral Health; referral for family navigation services; referrals to
play groups or community-based programs; and provision of child
development guidance and resources.
• Institutionalize universal developmental screening as indicated by an
Matching Funds
Public Health Prevention Initiative
providers leveraged their Measure
A allocations to obtain $815,221 in
matching funds from the following
sources:
• Medi-Cal Administrative Activities
(MAA)
• Targeted Case Management (TCM)
• Children’s Health and Disability
Prevention (CHDP)
• Maternal, Child, and Adolescent
Health (MCAH)
• The Centers for Disease Control
(CDC)
• The U.S. Department of Agriculture
(USDA)
• Cal Endowment
Measure AAllocation MatchingFunds
$3,151,570
$815,221
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
110
increase in the number of CHDP providers who employ a standardized
tool for developmental and mental health screening.
• Provide resources to parents that focus on how to access needed
services for children who are identified with any developmental
concerns.
• Increase the number of low income, Medi-Cal or uninsured children
screened at nine, 18, and 24 months of age. Identify and refer those at
risk for developmental delay.
• Identify children with special health care needs and facilitate
appropriate referrals to California Children’s Services (CCS) and other
programs.
• Increase access to primary and specialty care for low income, Medi-
Cal, or uninsured children through education, training, and support to
pediatric sites serving these children.
• Enable pediatric health care professionals and parents to act as
partners in the “medical home” to coordinate all medical services and
community supports necessary to achieve maximum potential for the
child.
• Recruit and train new Alameda County pediatricians in early childhood
mental health and developmental screening.
• Assist CHDP providers with developing business practices to
incorporate early childhood developmental and mental health
screening into well-child exam appointments.
Home Visiting and Family Support
• Provide 424 in-home, in-person interpretation sessions in 16 languages
by pairing interpreters with home visitors who visit pregnant women
and families with young children on a weekly or semi-monthly basis.
• Assign interpreters to certain cases wherever possible to strengthen the
relationship between the interpreter and the client.
• Arrange for interpreters to accompany clients to health care provider
visits when possible.
City/County Neighborhood Initiative (CCNI): Sobrante Park
• Conduct monthly meetings of the Sobrante Park Resident Action
Council (RAC) and the Neighborhood Crime Prevention Council
(NCPC), attended by an average of 33 residents.
• Successfully lobby the Board of Supervisors (BOS) to select Sobrante
Park as one of six Violence Prevention Initiative (VPI) sites. As a VPI
site, Sobrante Park will receive additional attention and resources
from the BOS to coordinate existing violence prevention efforts in the
neighborhood, align and leverage resources, and communicate about
violence prevention to the wider community.
• Hold annual events such as the Sobrante Park Time Banking Health
Fair, which served 300 residents this year with over 40 vendors offering
health education workshops.
• Conduct three meetings of the Sobrante Park Leadership Council
(SPLC), which brings together leaders of 14 community institutions.
CHDP screened
6.964 children
and referred 1,396
children of concern
to the Help Me Grow
phone line for
follow-up.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
111
• Collaborate with partners including mental health specialists,
community health educators/promoters, traditional healers, and
community capacity-builders to create a cross-ethnic approach named
“Healing Violence with Culture, Traditional Medicine, and Meaningful
Engagement.”
• Connect participants to hands-on community improvement and
violence prevention projects.
City/County Neighborhood Initiative (CCNI): West Oakland
• Conduct a door-to-door survey to reassess community priorities for
action. 53 residents responded to the survey.
• Relaunch the West Oakland RAC, which held monthly meeting to
discuss community priorities for action.
• Through the West Oakland Mini-Grant Committee, distribute $18,625
to 11 distinctive resident grant applicants.
• Train youth at McClymonds High School’s Alternatives in Action
program to co-facilitate focus groups with local youth to assess their
opinions about community issues and priorities for action.
• Through the West Oakland Youth Mini-Grant Committee, distribute
$6,000 to six grant applicants.
• Provide logistic and programmatic support for the West Oakland Youth
Center, which began offering youth activities and mentoring at the site.
Approximately 400 residents attended the six-week “Friday Night Live”
program, participating in activities such as sports activities, cooking
workshops, connections to community resources, giveaways, and
games.
Obesity Prevention & School Health
Healthy Living Program for Children at Madison Park Business and
Art Academy
• Work to ensure children do the following:
- Increase consumption of fruits and vegetables for snacks.
- Drink water between meals and during physical activity.
- Discover fun ways to be physically active.
- Set goals for eating healthier snacks and being physically active.
• Provide a healthy snack once a week, along with a workbook.
Berkeley School-Linked Health Services (SLHS) Program
• Support stronger linkages between Ph.D. programs to build more
productive inter- and intra-agency collaborations, with a focus on those
that address educational attainment.
• Collaborate with the Berkeley Unified School District (BUSD) and other
agencies to develop and implement a coordinated, multiagency service
delivery model that links students, families, and school staff to needed
resources, with a special focus on attendance and truancy.
• Serve as a consultant, specifically in the areas of physical health, to
school administration and elementary school staff and families.
Measure A Helps
CCNI: SOBRANTE PARk
In FY 14/15, residents worked together
to increase safety and reduce blight at
the Edes Avenue throughway. This
throughway had become a neglected
and dangerous dumpsite, earning the
nickname “Death Alley.” Thirteen
residents formed a core group to tackle
the Edes throughway, mobilizing 145
additional residents in clean-up and
beautification activities. CCNI staff
and the residents obtained $4,000 in
in-kind donations and $500 in cash
donations to support their work. As
a result of their efforts, Edes is no
longer “Death Alley.” The dumping
has essentially stopped, and it is safe
to walk on the street. Edes Avenue has
new trees, plants, and vegetation.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
112
• Facilitate data sharing to analyze health-related absenteeism.
• Distribute messaging campaign flyers, banners, and articles, including
700 attendance teacher toolkits and 3,000 stickers.
• Conduct attendance surveys at all 11 district elementary schools.
• Successfully advocate for a BUSD RN position and an increase in
nursing services within BUSD.
• Support oral health screenings at the 11 elementary schools for second
and fifth graders. 1,065 children were screened, and over 290 children
received dental sealants.
• Conduct 16 Public Health family visits at their homes.
• Participate in eight 504/IEP/SST meetings with school staff and
families.
• Participate in eight SARB and five SART elementary meetings.
• Provide over 15 school-linked referrals/case consultations with fellow
PHNs.
Nutrition Services
• Engage in environmental change and policy advocacy for nutrition/
food access, obesity prevention, and physical activity promotion
activities currently unallowable by USDA funds and expansion to
geographic areas and sites outside of USDA-allowed service areas.
• Provide subcontracts to community-based organizations (CBOs)
working on food access issues.
• Support the Oakland Food Policy Council, specifically the direct
support of collaboratives working for a just, fair, and equitable food
system.
• Support an epidemiologist in the CAPE unit for data collection,
analysis, and report development.
• Support the CHS Health Care Program Administrator working on
County collaborations and overseeing the Food 2 Families program,
as well as the Ashland Cherryland Food Policy Council and Mandela
Marketplace.
• Support the Soda Free Summer campaign including social media, video
contests, and collateral materials.
• Support of Safe Routes to School Program funded by CalTrans.
• Participate in East Oakland Building Healthy Communities, Outcome 4
Access to Healthy Foods.
• Participate in food systems/food Policy Collaboratives including HOPE,
Oakland Food Policy Council, Berkeley Food Policy Council, and Place
Matters Land Use and Transportation workgroup.
• Monitor contracts of CBOs conducting nutrition and physical activity
promotion efforts under Measure A.
East Oakland Boxing Association (EOBA)
• Offer cooking classes two days per week and sports nutrition classes
once per month for 200 East Oakland youth .
• Facilitate two health and nutrition presentations for at least 50 EOBA
youth and parents.
EOBA offered
cooking classes two
days per week and
sports nutrition
classes once per
month for 200 East
Oakland youth.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
113
• Have all youth participate in daily physical activity and maintain
awareness of the importance of being active to improve their health.
• Provide gardening classes three days per week for East Oakland youth
focused on access to fresh organic vegetables and fruits, environmental
stewardship, physical activity, stress reduction, life/work skills, and
leadership.
• Create three educational YouTube videos through the EOBA Urban
Fresh Gardeners program.
• Participate in a minimum of two offsite community events and three
workshops at EOBA promoting healthy eating, gardening, and/or
physical activity.
• Increase the amount of free fresh produce available to EOBA youth,
their families, and the community to help improve the overall health
and well-being of the community.
Measure A Helps
EOBA
Twins Monica and Sofia are fifth
graders at Encompass Academy. They
have attended EOBA for over a year.
When the twins started at EOBA, their
in-school behavior was out of control.
They would have temper tantrums in
class, sometimes lashing out physically
against their peers and even teachers.
This behavior was not without
reason—both girls had lived through
traumatic experiences at home. At
EOBA, staff drew upon various
methods of mitigating Monica and
Sofia’s behaviors. The girls learned that
they had adults who cared about their
progress, and whom they could trust.
Their teachers report drastically fewer
behavioral issues at school, and more
positive attitudes from both twins.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
114
BACkGROUND
Community Health for Asian Americans (CHAA) is committed to
improving the quality of life for marginalized communities, with special
focus on Asian and Pacific Islander (API) communities in the Bay Area.
The CHAA Burmacare program helps Burmese clients access HIV and
other services. Due to language and cultural issues, these clients were
previously not in care for their HIV and other needs. Their community
speaks an indigenous dialect that is not well known even to translation
services. This adds to cultural issues that isolate the clients due to beliefs
and stigma around HIV and AIDS, along with underlying substance use
that is also stigmatized and therefore hidden within the community.
Through this program, clients are able to engage with providers about
their medical care and access services like mental health and substance
abuse. Clients are also able to access dental care as well as apply for
medical and financial benefits.
MEASURE A FUNDING SUMMARY
CHAA used its Measure A allocation to achieve the following:
• Ensure that 25 HIV-positive immigrant and refugee clients are covered
by and maintain their Medi-Cal benefits and additional social benefits
such as housing, immigration, financial assistance, and so on
• Provide clinical case management supervision to the community health
outreach worker and health navigator for their work with HIV-positive
clients enrolled in Burmacare
• Hire a Licensed Behavioral Clinician to work with the case manager to
ensure appropriate care, especially for alcohol and drug treatment and
tobacco cessation
Allocation: $50,000 | Expended/Encumbered: $50,000
Individuals served by Measure A: 22 (Total individuals served: 22)
Populations served: Low Income Adults, Families
Services provided: Public Health, Mental Health, Substance Abuse
Service area: Oakland
Ryan White Provider RFP: Community Health for Asian Americans (Office of AIDS)
chaaweb.org
CHAA used its
Measure A allocation
to ensure that
25 HIV-positive
immigrant and
refugee clients are
covered by and
maintain their Medi-
Cal benefits and
additional social
benefits.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
115
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 senior and family involvement in the planning
and delivery of services.
AAA’s Senior Injury Prevention Program (SIPP) has the following goals:
• Secure and maintain maximum independence and dignity in a home
environment of older and functionally impaired persons capable of self-
care with appropriate supportive services
• Remove individual and social barriers to economic and personal
independence for older persons
• Provide a range of services designed to meet the needs of all consumers
who need services, including those who are independent, semi-
dependent, and very dependent
The SIPP providers include the following:
• Daybreak Adult Care Centers
• Rebuilding Together Oakland
• Senior Support Program of the Tri-Valley
• St. Mary’s Center
• Spectrum
• LIFE ElderCare
MEASURE A FUNDING SUMMARY
SIPP providers served 1,399 new seniors in FY 14/15, compared to a
target of 1,010 new seniors.
Measure A funding helped SIPP provide the following:
• Fall risk screening, assessment, and education. A health care
professional or paraprofessional used a validated screening tool to
Allocation: $115,000 | Expended/Encumbered: $115,000
Individuals served by Measure A: 2,606 (Total individuals served: 2,606)
Populations served: Low Income Adults, Seniors
Services provided: Public Health
Service area: Countywide
Senior Injury Prevention Program
acphd.org/ipp/sipp.aspx
Measure A Helps
LIFE ELDERCARE
Samir, 76, enjoys the exercises LIFE
ElderCare helps with in his home
each week. LIFE ElderCare’s Unitek
College nursing students have given
him specific tips on how to make his
home safer, helped to compile his
meds into a foldable he can take to his
doctors, and told him about the role
good hydration and nutrition play in
avoiding falls. Thanks to his exercise,
on evidence-based assessments, Samir
has progressed to a 10 on some of the
exercises a 7 on others. He no longer
has to rely on his walker to get about
his house the way he did prior to
enrolling.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
116
screen and assess the fall risk of older adults. Appropriate education
on fall-risk reduction, evidence-based physical activities, medication
management, and minor home modification referrals was made to meet
the client’s needs (target for all providers: 602; actual: 730).
• Minor home modifications. The program made residential
modifications that were necessary where risk for falls and other risk
factors could be reduced or minimized by minor home adaptations
(target for all providers: 58 assessments/modifications; actual: 80).
• Physical activity sessions. The program used individual and group
exercises using evidenced-based models to improve strength and
balance to reduce fall risk (target for all providers: 50; actual: 108).
• Individual/group medication management. The program educated
individual groups of older persons, in addition to their families,
friends, caregivers, and community individuals, on the safe disposal of
medications and other health measures for managing their medication
properly (target for all providers: 196; actual: 289).
Highlights
In all areas, the SIPP providers
exceeded their targets, in some cases
dramatically. For example, the target
for individual and group physical
activity sessions was 50, while the
actual number of sessions was 108—
an increase of over 100%.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
117
BACkGROUND
Service Opportunity for Seniors (SOS) Meals on Wheels assists
homebound seniors who are in need of supplemental balanced
nutrition through a daily home-delivered meal service to prevent early
institutionalization.
Meals on Wheels delivers meals to seniors who are released from the
hospital to recuperate at home and to homebound seniors with no
capability to purchase or cook their food. The nutrition services include
procurement, preparation, serving, and transporting meals; a wellness
check; and nutrition education.
MEASURE A FUNDING SUMMARY
Meals on Wheels used its Measure A allocation to deliver 70,000 meals
and provide wellness checks to 700 homebound seniors in Castro Valley
and Oakland.
Allocation: $116,000 | Expended/Encumbered: $116,000
Individuals served by Measure A: 703 (Total individuals served: 1,953)
Populations served: Indigent, Low Income, Uninsured Seniors
Services provided: Hospital Outpatient, Public Health
Service area: Castro Valley, Oakland
Service Opportunties for Seniors (Meals on Wheels)
sosmow.org
Highlights
90% of homebound seniors rated
their delivered meals as good, very
good, or excellent. 90% also reported
that receiving meals from Meals on
Wheels improved their health.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
118
BACkGROUND
South Hayward Parish works to engage people of faith in the endeavor and
partnership of building and maintaining a just and nurturing community.
South Hayward Parish provides two days’ worth of food assistance to low
income families in an area that is considered a food desert by distributing
food donated and purchased through the Alameda County Community
Food Bank. Two-thirds of the food distributed is fresh produce. In many
cases, the food provided by the service is the only fresh produce that the
clients receive. In addition, South Hayward Parish provides nutrition
workshops for promoting healthier eating habits and cooking methods. It
also promotes any available services that can assist clients in need.
MEASURE A FUNDING SUMMARY
South Hayward Parish used its Measure A allocation to provide a total of
38,994 meals to 6,499 unduplicated clients over a 63-day period.
Allocation: $10,000 | Expended/Encumbered: $10,000
Individuals served by Measure A: 6,499 (Total individuals served: 27,476)
Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors
Services provided: Public Health
Service area: Castro Valley, Hayward, Union City
South Hayward Parish
southhaywardparish.org
Measure A Helps
One nutrition workshop focused on
introducing children to the kitchen.
The children participating in this
workshop were taught how to make a
simple healthy breakfast for the family.
The children were also taught basic
food safety procedures such as the
importance of personal hygiene when
handling food. The workshop provided
a fun learning opportunity for
children, helped introduce them to the
importance of food and the necessary
safety precautions required, and
supported an improved family diet. The
workshop was beneficial to the families
and gave the children incentive to go
home and prepare a healthy meal for
their families.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
119
BACkGROUND
Spectrum Community Services assists low income, disadvantaged, and
elderly residents of Alameda County as they attempt to achieve and
maintain self-sufficiency and improve the quality of their lives. Spectrum
employs multiple strategies to implement this mission, offering individuals
and families programs that remedy crisis, maintain and improve health
and functionality, and develop skills and the capacity to help themselves.
Spectrum’s Fall Risk Reduction Program (FRRP) uses a multipronged
approach to address the physical, behavioral, and environmental factors
that contribute to falls. FRRP employs strategies that educate about fall
prevention; offers guidance regarding home safety modifications and
environmental changes that can prevent falls; and offers exercise classes
to build strength, stamina, mobility, balance, and fall prevention skills.
Each program component focuses on empowering seniors to implement
solutions and to become more confident of their control over their own
lives.
The program emphasizes social interaction, giving isolated seniors the
opportunity to develop new friendships and improve conditions like
depression.
MEASURE A FUNDING SUMMARY
Measure A funding sustains Spectrum’s FRRP, enabling it to provide
services to seniors at no cost. The program used its Measure A allocation
to achieve the following objectives:
• Provide sessions focused on fall prevention education and strength/
mobility/balance-building exercises at seven locations (target: 15
seniors per location each week; actual: 33 seniors per location)
• Conduct an evaluation of participants every six months to collect
information regarding whether they fell, the cause of any falls, and their
confidence on a number of fall-related topics (target: 50 participants;
actual: 325)
• Evaluate participants on improvement in strength and mobility every
six months, with the following results:
Allocation: $50,000 | Expended/Encumbered: $50,000
Individuals served by Measure A: 567 (Total individuals served: 567)
Populations served: Indigent, Low Income, Uninsured, Adults, Families, Seniors
Services provided: Public Health, Mental Health
Service area: Alameda, Ashland, Castro Valley, Cherryland, Fremont, Hayward, Newark, Oakland, San Leandro, San Lorenzo, Union City
Spectrum Community Services, Inc.
spectrumcs.org
Measure A Helps
After experiencing a stroke, John,
86, went through rehabilitation and
recovered many of his motor skills.
However, John’s health insurance only
covered 12 weeks of physical therapy,
after which he did not participate in
any kind of exercise program. Because
of this inactivity, John was lacking
in lower body strength and suffered
from poor balance and low mobility.
During 2014, John had four falls.
John joined the FRRP program and
attends class 1-2 times per week. He
has gained enough lower body strength
to lift himself out of a chair without an
assistive device. In 2015, John had one
fall, which is a 75% reduction from the
previous year.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
120
- Flexibility: 45% improved, 46% maintained
- Endurance: 44% improved, 43% maintained
- Strength: 56% improved, 41% maintained
- Mobility: 29% improved, 56% maintained
• Conduct one-on-one consultations with 26 participants who
experienced a fall to identify possible causes and recommend home
modifications and home exercises to prevent future falls
• Conduct outreach demonstrations and presentations of the Fall
Prevention Program at health fairs and workshops (target: 2 health fairs
and 3 workshops; actual: 5 health fairs and 4 workshops)
Highlights
Spectrum’s FRRP met or exceeded
its targets in all areas, sometimes
dramatically. For example, while
targeting 15 seniors per location
at their exercise sessions, actual
attendance was 33 seniors per
location—more than a 100% increase.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
121
SSI Housing Trust
BACkGROUND
The Alameda County Health Services Agency (HCSA) helps poor,
disabled Alameda County residents receive disability income and
mitigates the negative impact of long processing times by stabilizing their
health and living situations while their applications are pending.
The HCSA SSI housing trust seeks to achieve the following:
• Connect clients to outpatient mental health and primary care
• Obtain health insurance benefits for clients
• Obtain disability income for clients
• Improve housing stability for clients
This increase in housing stability improves clients’ ability to access care,
enables them to work with disability advocates, and helps improve their
mental health.
MEASURE A FUNDING SUMMARY
Measure A funds were used to establish a revolving fund to increase
housing stability for clients. When clients are approved for disability
benefits, the fund is replenished from the client’s retroactive benefits.
Overall the program provided disability advocacy services, including
care coordination, to 2,081 individuals, of whom 1,214 were approved for
disability benefits and 867 still had claims pending at the end of the fiscal
year. These awards in disability income resulted in clients receiving almost
$25 million in ongoing income since the date of their approvals.
Calendar year 2013 was the pilot year to prove the concept. The project
began to transition to full scale in January of 2014. The leftover funds from
FY 12/13 and FY 13/14 were rolled over to FY 14/15.
Allocation: $0 | Expended/Encumbered: $601,319)
Individuals served by Measure A: 647 (Total individuals served: 2,081)
Populations served: Indigent, Low Income, Uninsured Adults, Other residents: Disabled and Chronically Homeless
Services provided: Public Health, Mental Health
Service area: Countywide
Note: This provider received its allocation in FY 12/13 but expended it in FY 14/15.
Matching Funds
The SSI trust program leveraged
its Measure A allocation to obtain
$2,380,000 in matching funds from
public funding sources.
Measure A
Allocation
Matching
Funds
$601,319
$2,380,000
Highlights
Clients entering the program receive
a maximum of $336/month in
income. Through this fund, while
their disability application is pending,
client income nearly doubles to $654/
month. Upon approval for disability
benefits, client income nearly triples
to $865/month.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
122
BACkGROUND
The Viola Blythe Community Service Center works to support and
advocate for social and human services to any person in immediate need.
MEASURE A FUNDING SUMMARY
Viola Blythe used its Measure A allocation to increase access to quality
nutritional food and provide clothing to low income families. Specifically,
Measure A funding helped the Viola Blythe Center achieve the following:
• Distribute 6,511 pounds of food including fresh meat, dairy, and
produce
• Provide 133 children with new clothing for back to school
Allocation: $5,000 | Expended/Encumbered: $5,000
Individuals served by Measure A: 2,023 (Total individuals served: 2,052)
Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors
Services provided: Public Health
Service area: Fremont, Newark, Union City, Homeless or transient
Viola Blythe Community Services
violablythe.org
Viola Blythe used its
Measure A allocation
to distribute 6,511
pounds of food to low
income families.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
123
BACkGROUND
The Alameda County Public Health Department (ACPHD) and the City
of Oakland joined together in 2003 to fight growing poverty, violence,
and chronic disease in Oakland through the City/County Neighborhood
Initiative (CCNI). They chose to focus activities on two Oakland
neighborhoods that were experiencing high crime rates, but that also
had identified resources such as strong neighborhood associations and
institutions.
One of these neighborhoods is the Hoover Historic District in West
Oakland, where the West Oakland Youth Center (WOYC) is located.
CCNI partners include resident groups, community-based organizations,
and the Oakland Unified School District. It is funded by the ACPHD,
Alameda County Measure A/AA and City of Oakland Measure Y/Z.
MEASURE A FUNDING SUMMARY
Along with ACPHD and City of Oakland Measure Y, Measure A provides
funding to the CCNI. The most significant outcome of these funding
efforts was the opening of the West Oakland Youth Center (WOYC) in a
building that had sat vacant for many years. The WOYC provides physical
space and youth-focused programs and has become a major resource for
West Oakland youth and the community.
Within the framework of the scope of services funded by Measure A,
related outcomes fall into the following five categories:
• Strategic planning
• Partnership development
• Community and youth engagement
• Planning for youth programs and services, including piloting potential
programs
• Operations-related functioning
Allocation: $70,000 | Expended/Encumbered: $70,000
Individuals served by Measure A: 800 (Total individuals served: 1,000)
Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors
Services provided: Public Health, Mental Health
Service area: Oakland
West Oakland Youth Center
westoaklandyouthcenter.org
Highlights
With support of Measure A, through
the work of the CCNI and WOYC, youth
and adults in the West Oakland Hoover
District have a physical building that
provides safe spaces and resources
that can benefit their health and well-
being.
During the summer of 2014, the CCNI
collaborated with the WOYC on a
series of summer family engagement
activities called Friday Night Live.
Approximately 500 residents attended
the six-week program, participating
in activities such as sports activities,
cooking workshops, connections to
community resources, giveaways, and
games.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
124
Strategic Planning
Activities supported by Measure A included the following:
• Participate in 12 planning sessions with partners including ACPHD
staff, YMCA, St. Mary’s Senior Center, McClymonds High School,
Oakland Unified School District, City of Oakland, Alternatives in
Action, Attitudinal Healing Connection-Oakland, People’s Grocery, and
Supervisor Carson’s office
• Create and implement a strategic plan
Partnership Development
The goal was to establish a cooperative network of agencies, community-
based organizations. and local neighborhood groups that would work
together for improving the health of youth. Partners included YMCA, St.
Mary’s Senior Center, East Bay Asian Local Development Corporation,
Hoover Elementary School, One West, McClymonds High School,
Attitudinal Healing Connection, West Oakland Youth MiniGrant
Committee, and West Oakland MiniGrant Committee.
Activities supported by Measure A included the following:
• Hold three working sessions to create a neighborhood assets map
that includes churches, local community organizations, and small
neighborhood groups chosen for outreach and relationship-building
so that they could contribute their resources to creating youth-focused
programs at the WOYC
• Create a plan for WOYC Steering Committee membership roles and
responsibilities
• Have partners meet to choose their level of participation
Community and Youth Engagement
The WOYC building has its main entrance located in a high traffic area
near Hoover Elementary School where groups of youth congregate.
Neighboring residents have reported possible criminal activities in the
building’s vicinity. These factors required thoughtful and respectful
approaches to community dialogues on a regular, consistent basis. Youth
who frequented the area were invited to participate in discussions, both
formally held and in ongoing dialogues in their “territories.”
Related actions included forming a Youth Action Board (YAB) in
partnership with Alternatives in Action. The youth met weekly for three
months to plan youth-friendly and relevant programs and services.
The West Oakland MiniGrant Committee also served as a vehicle for
developing youth leaders who have interests in civic participation.
Young people in the West Oakland Hoover District neighborhood had
several opportunities to engage in the WOYC. They helped plan and
implement six Friday Night Live events, which included use of the WOYC
Highlights
In June 2014, over 1,000 residents
took part in Juneteenth activities.
Forty vendors provided activities and/
or resources, and over 100 participants
received diabetes, blood glucose,
blood pressure, and HIv/AIDS health
screenings, as well as free clothing.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
125
building and facilities. Several community events cosponsored with
CCNI, including Juneteenth and Health Fair, brought approximately 400
participants to these gatherings.
Youth Program and Services Development and Pilots
Activities supported by Measure A included the following:
• Hold over 40 planning sessions related to designing the types of
programs that are relevant and most important to youth in the
community
• Create a preliminary program and service schedule with offerings in
employment skill building, information on educational opportunities,
and life mentoring
• Partner with the Laney College Culinary program to establish a satellite
facility at WOYC
• Explore partnerships with Alternatives in Action and the Robinson
Baker YMCA for mentoring and tutoring
Operations-Related Functions
CCNI staff spent approximately 16 hours per week over a five-month
period on operations, including working with City of Oakland staff to
complete the furnishings and obtaining media and culinary equipment,
computers, and other objects that would allow for services and programs.
These tasks required navigating City of Oakland’s bureaucracy and
building cooperative relationships with staff to complete the transactions.
CONCERNS
One staff assigned to the WOYC project resigned mid-year. The
supervisor took on the project responsibilities but wasn’t able to bill
against Measure A funding. Therefore, the actual expenditure was $44,244
out of WOYC’s $70,000 allocation.
Highlights
Youth were engaged in civic actions
and helped influence policy makers
regarding funds for community
resources and public policies that
influence their health. Youth also had
greater access to information about
the governmental, social, and public
health services available to them.
In addition, community residents
joined together in neighborhood
associations to address crime and
improve their physical environments.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
126
BACkGROUND
The Center for Healthy Schools and Communities 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.
The goal of the countywide Youth and Family Opportunity (YFO)
initiative is to strengthen the capacity of “anchor” community-based
organizations (CBOs) to provide a continuum of high quality, accessible
school-linked health and wellness supports to youth and families
experiencing poor health and educational outcomes.
The CBOs involved in the YFO initiative include the following:
• Alameda Family Services
• Alternatives in Action (AIA)
• Berkeley Youth Alternatives (BYA)
• City of Fremont: Human Services Agency
• East Bay Asian Youth Center (EBAYC)
• Eden Youth and Family Center
• Fremont Family Resource Center
• La Familia
• Newark Unified School District
• REACH Ashland Youth Center
• Union City Kid Zone
• Youth Radio
Mental Health Services
The funded CBOs offer a broad array of mental health services, including
individual and group counseling, case management, mental health,
alcohol and drug assessment, and referrals. For example:
• Alameda Family Services provides an array of mental health services
to youth and families, including case management for youth, parenting
skills classes, teacher consultations, and more.
• AIA provides critical wraparound services and supports to address
Allocation: $2,548,980 | Expended/Encumbered: $2,548,980
Individuals served by Measure A: 12,817 (Total individuals served: 12,817)
Populations served: Indigent, Low Income, Uninsured Adults, Children, Families
Services provided: Mental Health, Substance Abuse
Service area: Countywide
Youth and Family Opportunity Initiatives
achealthyschools.org/youth-development.html
Highlights
Measure A funding enabled the CBOs
participating in the YFO initiative to
achieve a wide variety of outcomes
for a large number of youth and
their families. A behavioral health
assessment used by half of the
CBOs revealed that clients indicated
significant improvement in the
following areas:
• Behavioral/emotional needs: 34.4%
• Life functioning: 40.5%
• School: 39.9%
• Child strengths: 27.6%
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
127
students’ holistic needs. Services include empowerment groups on
topics such as violence prevention, restorative justice and conflict
resolution techniques, relationship-building, trauma recovery, anti-
oppressive education, and social justice principles.
• BYA provides culturally competent psychosocial, mental, and
emotional health services to low income and poverty-level children
and youth ages 6–18. Participants are underinsured, undernourished,
and underdiagnosed, and live in families where there is a parent who is
either underemployed or unemployed.
• EBAYC provides case management, after-school learning, parent
engagement, intake sessions, individual advising, home visits, teacher/
administrator consultations, and more.
• Fremont Family Resource Center provides counseling and behavioral
health services for individuals and groups.
• Newark Unified School District uses both a schoolwide anti-bullying
curriculum and individual counseling to create a safe and positive
environment for children to flourish academically and emotionally.
• Youth Radio offers intensive individual case management services to all
youth participants. Case managers work with youth to navigate a wide
range of challenges and opportunities, including health care system
navigation, family reunification, and school enrollment.
Community Youth and Family Services
The CBOs offer programs including after-school services, arts/culture/
media, case management, community outreach, insurance enrollment,
information and referrals, gang prevention, and leadership development.
For example:
• BYA uses curriculum such as the Alive & Free Violence Prevention
Curriculum, G.R.O.W. Workshops, and Youth Council and Mentoring.
BYA also hosts job fairs/job sessions with Oakland Unified School
District, Security Guard Training, OSHA 10 Training, Goodwill
Industries, and East Bay Innovations.
• Eden Youth and Family Center provides youth with paid career and
employability competency workshops to improve behavioral health in
terms of intrinsic motivation, locus of control, and self-esteem.
• Fremont Family Resource Center offers services in family financial
stability including an integrated program to support low income
individuals/families to build assets and become financially self-
sufficient.
• La Familia offers workshops and services that address needs such as
immigration, conversational English, and chronic disease education.
La Familia also addresses youth health and wellness needs through a
variety of services such as case management, youth support groups,
interactive workshops for youth, and summer camps. La Familia
also offers a diabetes series in partnership with the Alameda County
Diabetes Program.
Matching Funds
The participating CBOs leveraged the
YFO initiative Measure A allocation
to obtain an additional $2,688,610 in
matching funds from the following
sources:
• Medi-Cal Administrative Activities
(MAA)
• Alameda County funding: Probation
Department, Social Services
Administration
• Local and national foundations
• Federal grants
• Cities
Measure A
Allocation
Matching
Funds
$2,548,980 $2,688,610
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
128
• Newark Unified School District works to support family wellness
by hosting workshops directed at families most often underserved,
including Latino Literacy communication skills workshops, culturally
responsive parenting classes, and educational engagement workshops.
• REACH Ashland Youth Center offers a variety of programs for youth
directed at increasing a sense of connection and belonging as well as
widening their access to health access. Through its partners, REACH
Ashland Youth Center also offers career and employment workshops,
as well as recreation and fitness programming.
• Union City Kids Zone facilitates behavioral health prevention
groups and workshops including Psycho Education and Social Skills,
Acculturation Group for new immigrants, Girls Empowerment, and
Mindfulness. Union City Kids Zone also offers a variety of youth
development activities.
Wraparound Services
In addition to the formal services offered to youth and families described
above, CBOs also offer wraparound services and may serve as the safety
net for a family who is just short of extreme crisis. Wraparound services
are a way for staff to support young people to increase their self-esteem,
set goals, and have an accountability structure outside the formal
counseling setting. In addition to working directly with youth and parents,
staff advocate on their clients’ behalf with probation, schools, and other
public services to ensure that clients have completely accessed all the
services available to them.
• AIA wraparound services include home visits; coordinating meetings
with principals, teachers, and health service providers; meeting with
probation and families; attending school/legal/mental health/medical
consultations; and/or attending appointments.
• Alameda Family Services staff facilitate teacher consultation/IEPs and
participate in Mental Health Service Teams for Transitional Aged
Youth.
• BYA provides home and office visits to check in with parents and
guardians. Staff regularly meet with school officials and Alameda
County Probation staff and participate in IEP meetings on behalf of
youth and parents. BYA hosts outreach events within the community
to educate youth and families of color about health coverage and
opportunities to engage in wellness activities. BYA staff meet with
probation staff to coordinate referrals and set meetings with youth,
probation, and counselors. BYA staff provide home visits and office
visits when indicated to allow for discussions with parents and
guardians.
• EBAYC staff provide individual advising, home visits, teacher/
administrator consultations, IEP meetings, school attendance review
team meetings, coordination of services team meetings, and more.
• Eden Family Youth Center partners on a number of collaboratives and
pilot programs to provide seamless wraparound services to youth.
Measure A Helps
REACH AYC
A patient at AYC’s clinic experienced
behavioral issues that compromised
her safety. She was illiterate and had
previously experienced homelessness
and psychosis. Clinic staff made sure
the client received comprehensive
medical care and behavioral health
care services. Staff collaborated with
other providers to discuss how best
to proceed. The team scheduled a
neuropsychological assessment to
better understand her needs and
how to move forward. She is now on
waiting lists for ongoing therapy to
address attachment issues and multiple
traumas. She has also connected with
REACH AYC’s literacy program
to improve her reading skills and
Soulciety, an employment program,
which helped her create her first
resume.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
129
• Fremont Family Resource Center provides support to families during
IEP meetings, School Attendance Review Board (SARB) meetings,
and teacher/principal consults. The program provides school-based
behavioral health services to students and case management services to
their families.
• La Familia offers monthly Medi-Cal enrollment and Cal-Fresh clinics.
• Newark Unified School District staff facilitate teacher/parent
consultations and meet regularly with parents and administrators.
Staff have hosted workshops on parent empowerment, community
organizing, community health advocacy, adolescent development,
communicating with school officials, positive communication, and the
importance of eating healthy and exercise.
• REACH AYC partners with schools and community providers to
provide recreation and fitness, arts and creativity, and career and
employment services; community-based behavioral health and case
management; and medical/dental services.
• Union City Kids Zone offers support for families with hardships by
connecting them with partnered service providers and referrals to
local resources. They also offer home visits, connections to therapists,
workshops to students and parents, translations for parents,
information on college readiness, college scholarship application
assistance, and teacher/student consultations.
• Youth Radio’s Direct Service staff provide comprehensive wraparound
services to young people, including healthy food service and academic
and career advising. Youth Radio staff also provide support at court
hearings, broker communication with probation officers and court
officers, write letters of support, and engage with teachers and guidance
counselors.
MEASURE A FUNDING SUMMARY
Through the Measure A YFO initiative grant, 2,817 clients were served
during FY 14/15.
Client results were obtained across a variety of service areas, including the
following:
• Youth-focused individual and group counseling, case management,
mental health, alcohol and drug assessment, and referrals
- 9,534 youth were seen in groups.
- 2,631 youth received individual services.
• Family-focused individual and group counseling, case management,
mental health services, alcohol and drug assessment, and referrals
- 3,389 families were served in groups.
- 1,425 families received services one on one.
• Youth leadership development and enrichment activities for improving
personal growth, health and wellness, academic achievement, and
creating career opportunities.
- 2,253 youth benefited from these services.
Union City Kids
Zone offers support
for families with
hardships by
connecting them
with partnered
service providers
and referrals to local
resources.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
130
• Family engagement in schools focusing on health and wellness, work
readiness, and life skills
- 4,796 families benefited from these services.
• Community events focusing on raising awareness of free and affordable
health care services
- 347 community events were held.
- 25,473 contacts were made at the events.
The member CBOs used their YFO Initiative Measure A allocation to
achieve the following.
Alameda Family Services
• In a survey administered to 65 adult clients, 97% of survey participants
reported that staff treated them well, and 80% reported that services
greatly improved their stability and/or life skills.
Alternatives in Action
• Students in the program completed probation, school attendance
increased, grades improved, and family engagement increased.
• AIA administered a student survey that revealed the following results:
- 98% said being in the program made them feel good about
themselves.
- 98% of students felt like they belonged in the program and felt safe in
the program.
- 98% said the program helped them feel more confident about what
they can do.
- 98% said the program helped them believe they can finish high
school.
- 97% said the program helped them learn how to be healthy.
- 97% said they are better at saying “no” to things they know are
wrong.
- 98% said they are more of a leader.
Berkeley Youth Alternatives
• Youth demonstrated an overall increase in resilience based on a pre-
and post-program 14-point resilience scale.
• 56% of youth achieved academic improvement, and 88% remained in
school.
City of Fremont: Human Services Agency
• 68% of school-based students improved in functioning.
• Post-evaluation ratings showed 146% improvement in thriving and/or
self-sufficiency.
• In a survey of more than 100 teachers, administrators, counselors, and
other school staff, the majority of respondents were most satisfied with
consultation services, stabilization of youth on campus, positive impact
of crisis management on campus, and engagement of parents.
Measure A Helps
AIA
A student at McClymonds was
struggling with issues around
peer pressure and popularity. Her
academics suffered, she started using
marijuana and was staying out all
hours of the night, and she attended
her own Community Impact Project
panel under the influence of marijuana.
AIA program staff referred her to
needed resources and also used a
restorative approach to connect her
back to her peers and the community.
With the care management structure
put in place by AIA, staff consistently
addressed behavior, built relationships
with this student to guide her through
this time, and developed opportunities
for her to give back to her community.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
131
East Bay Asian Youth Center
• Chronic absenteeism at Garfield Elementary School and Roosevelt
Middle School decreased by over 50% since the establishment of an
EBAYC/school-coordinated attendance promotion partnership.
Eden Youth and Family Center
• Through participation in monthly support groups and volunteer
commitments, participants found peer support, exposure to healthy
life alternatives, increased self-esteem, positive outcomes in career and
social development, and safe separation from their past lives.
• Participants in the youth employment program began receiving an
income, which helped them pay bills and buy clothing and improved
their attitudes.
• Many of the youth participants increased their attendance and grades.
La Familia
• Pre and post evaluations showed a statistically significant increase in
self-esteem.
• Counseling clients also showed improvements in school academics
based on GPA and school attendance.
Newark Unified School District
• Administrators reported that student attendance improved.
• Parents reported feeling more confident when communicating needs to
the school.
• Families reported that their child was doing better in school and that
family communication improved.
REACH Ashland Youth Center
Based on a youth survey administered in June 2015:
• 91-95% respondents stated that REACH AYC is fun, they would
recommend REACH AYC to a friend, they felt safe at REACH AYC,
and staff treated them with kindness and respect.
• 54% of respondents talked with a staff person about a personal
challenge they were facing, and 80% said it was either helpful or very
helpful.
• 87% agreed that participating in REACH AYC helped improve their
grades.
• 91% agreed that participating in REACH AYC helped them work harder
in school.
• 81% said that participating in REACH AYC helped them have better
school attendance.
Youth Radio
• 100% of participants agreed that they can use the skills they learned at
Youth Radio in their lives.
• 98% agreed that they can do well on many different professional tasks.
• 94% of Media Ed students reported increased skills producing their
own media content.
54% of Reach AYC
survey respondents
talked with a staff
person about a
personal challenge
they were facing,
and 80% said it was
either helpful or very
helpful.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
132
• 97% of participants rated their experience at Youth Radio as good or
excellent.
• 72% reported increased confidence in critical thinking about the
media, time management, writing, presenting to groups, and taking a
leadership role on a community issue.
• 80% reported increased frequency in thinking positively about
themselves throughout the day.
• Over 80% of participants are on track to graduate high school.
• Over 70% of college-age participants are on track to enroll in college.
• 307 jobs were created.
Over 80% of Youth
Radio participants are
on track to graduate
high school. Over
70% of college-age
participants are
on track to enroll
in college.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
133
APPENDICES
APPENDIx A: MEASURE A REVENUE RECEIVED
APPENDIx B: FY 14/15 BUDGET INFORMATION
APPENDIx C : FY 14/15 MEASURE A FUND DISTRIBUTION BY PROVIDER OR PROGRAM
APPENDIx D : MAPS: GEOGRAPHIC DISTRIBUTION OF PROVIDERS FUNDED BY MEASURE A IN FY 14/15
Map 1 Alameda County Public Health Programs
Map 2 Alameda County Behavioral Health Care Services
Alcohol and Other Drug Providers
Map 3 Alameda County Behavioral Health Care Services
Mental Health Community-Based Organization Providers
Map 4 School Health Centers
Map 5 HealthPAC Provider Network
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
135
APPENDIX A
MEASURE A REVENUE RECEIVED
FY 04/05 through FY 14/15
tOtAL REvENUE EARNED (FY 04/05 tHROUGH FY 14/15)
$1.42 BILLION
REvENUE EARNED EACH FISCAL YEAR (FY 04/05 tHROUGH FY 14/15)
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
Alameda County Board of Supervisors$357 MILLION
Alameda Health System Board of Trustees$1,064 MILLION
130 1401201101009080
Millions of dollars
706050403020100
$71,756,087 $23,918,696
$82,401,622 $27,467,208
$85,377,759 $28,459,253
$86,889,558 $28,963,185
$75,929,787 $25,309,929
$70,587,890 $23,529,297
$79,135,112 $26,378,371
$84,405,378 $28,135,126
$90,786,904 $30,262,301
$95,191,659 $31,730,553
25%
75%
$99,321,959 $33,107,320
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
136
APP
E
N
D
I
x
B
:
F
Y
1
4
/
1
5
B
UD
G
E
T
I
NF
O
R
M
A
T
I
O
N
TOT
A
L
ALL
O
C
A
T
I
O
N
CAR
R
Y
O
V
E
R
FRO
M
P
RE
V
I
O
U
S
FIS
C
A
L
YE
A
R
1
TOT
A
L
AVA
I
L
A
B
L
E
FUN
D
S
Ex
PE
N
D
E
D
AN
D
/OR
ENC
U
M
B
E
R
E
D
CAR
R
Y
O
V
E
R
TO N
ExT
FIS
C
A
L
Y
EA
R
1
TOT
A
L
SAV
I
N
G
S
2
Gr
o
u
p
1
:
B
e
h
a
v
i
o
r
a
l
H
e
a
l
t
h
Ab
o
d
e
S
e
r
v
i
c
e
s
90
,
0
0
0
0
90
,
0
0
0
64
,
9
7
5
0
64
,
9
7
5
25
,
0
2
5
Al
a
m
e
d
a
C
o
u
n
t
y
B
e
h
a
v
i
o
r
a
l
H
e
a
l
t
h
C
a
r
e
S
e
r
v
i
c
e
s
(
B
H
C
S
)
C
o
m
m
u
n
i
t
y
-
B
a
s
e
d
Or
g
a
n
i
z
a
t
i
o
n
s
(
C
B
O
s
)
75
3
,
2
5
0
0
75
3
,
2
5
0
38
3
,
2
1
9
0
38
3
,
2
1
9
37
0
,
0
3
1
Ce
n
t
e
r
f
o
r
E
m
p
o
w
e
r
i
n
g
R
e
f
u
g
e
e
s
a
n
d
I
m
m
i
g
r
a
n
t
s
78
,
0
3
0
0
78
,
0
3
0
72
,
3
5
9
0
72
,
3
5
9
5,
6
7
1
Ce
n
t
e
r
f
o
r
H
e
a
l
t
h
y
S
c
h
o
o
l
s
a
n
d
C
o
m
m
u
n
i
t
i
e
s
(S
c
h
o
o
l
-
B
a
s
e
d
B
e
h
a
v
i
o
r
a
l
H
e
a
l
t
h
I
n
i
t
i
a
t
i
v
e
)
61
7
,
3
6
2
0
61
7
,
3
6
2
61
7
,
3
6
2
0
61
7
,
3
6
2
0
Ch
e
r
r
y
H
i
l
l
S
o
b
e
r
i
n
g
a
n
d
D
e
t
o
x
i
f
i
c
a
t
i
o
n
C
e
n
t
e
r
3
2,
0
8
0
,
8
0
0
2,
0
6
4
,
3
4
2
4,
1
4
5
,
1
4
2
1,
9
4
8
,
7
7
8
64
,
3
4
2
2,
0
1
3
,
1
2
0
13
2
,
0
2
2
Cr
i
m
i
n
a
l
J
u
s
t
i
c
e
S
c
r
e
e
n
i
n
g
a
n
d
I
n
-
C
u
s
t
o
d
y
S
e
r
v
i
c
e
s
4,
3
0
6
,
0
0
0
0
4,
3
0
6
,
0
0
0
4,
3
0
6
,
0
0
0
0
4,
3
0
6
,
0
0
0
0
La
F
a
m
i
l
i
a
C
o
u
n
s
e
l
i
n
g
S
e
r
v
i
c
e
88
,
0
0
0
0
88
,
0
0
0
88
,
0
0
0
0
88
,
0
0
0
0
Me
n
t
a
l
H
e
a
l
t
h
S
e
r
v
i
c
e
s
f
o
r
J
u
v
e
n
i
l
e
J
u
s
t
i
c
e
C
e
n
t
e
r
36
0
,
0
0
0
0
36
0
,
0
0
0
36
0
,
0
0
0
0
36
0
,
0
0
0
0
Oa
k
l
a
n
d
P
o
l
i
c
e
D
e
p
a
r
t
m
e
n
t
1,4
25
0
,
0
0
0
0
25
0
,
0
0
0
89
,
8
7
5
16
0
,
1
2
5
25
0
,
0
0
0
0
Th
e
S
c
h
r
e
i
b
e
r
C
e
n
t
e
r
25
0
,
0
0
0
0
25
0
,
0
0
0
25
0
,
0
0
0
0
25
0
,
0
0
0
0
Se
n
i
o
r
S
u
p
p
o
r
t
S
e
r
v
i
c
e
s
o
f
t
h
e
T
r
i
-
V
a
l
l
e
y
10
,
0
0
0
0
10
,
0
0
0
10
,
0
0
0
0
10
,
0
0
0
0
Gr
o
u
p
2
:
H
o
s
p
i
t
a
l
,
ter
t
i
a
r
y
C
a
r
e
,
O
t
h
e
r
Ad
m
i
n
i
s
t
r
a
t
i
o
n
/
I
n
f
r
a
s
t
r
u
c
t
u
r
e
S
u
p
p
o
r
t
40
0
,
0
0
0
0
40
0
,
0
0
0
22
8
,
4
3
7
0
22
8
,
4
3
7
17
1
,
5
6
3
Sa
n
L
e
a
n
d
r
o
H
o
s
p
i
t
a
l
1,
0
0
0
,
0
0
0
0
1,
0
0
0
,
0
0
0
1,
0
0
0
,
0
0
0
0
1,
0
0
0
,
0
0
0
0
St
.
R
o
s
e
H
o
s
p
i
t
a
l
4,
0
0
0
,
0
0
0
0
4,
0
0
0
,
0
0
0
4,
0
0
0
,
0
0
0
0
4,
0
0
0
,
0
0
0
0
UC
S
F
B
e
n
i
o
f
f
C
h
i
l
d
r
e
n
'
s
H
o
s
p
i
t
a
l
O
a
k
l
a
n
d
3,
0
0
0
,
0
0
0
0
3,
0
0
0
,
0
0
0
3,
0
0
0
,
0
0
0
0
3,
0
0
0
,
0
0
0
0
Gr
o
u
p
3
:
P
r
i
m
a
r
y
C
a
r
e
Al
a
m
e
d
a
C
o
u
n
t
y
D
e
n
t
a
l
H
e
a
l
t
h
15
3
,
6
6
2
0
15
3
,
6
6
2
15
3
,
6
6
2
0
15
3
,
6
6
2
0
Ce
n
t
e
r
f
o
r
E
l
d
e
r
s
'
I
n
d
e
p
e
n
d
e
n
c
e
52
,
0
2
0
0
52
,
0
2
0
52
,
0
2
0
0
52
,
0
2
0
0
Ce
n
t
e
r
f
o
r
H
e
a
l
t
h
y
S
c
h
o
o
l
s
a
n
d
C
o
m
m
u
n
i
t
i
e
s
(
S
c
h
o
o
l
H
e
a
l
t
h
C
e
n
t
e
r
s
)
1,
9
2
4
,
7
4
0
0
1,
9
2
4
,
7
4
0
1,
9
2
4
,
7
4
0
0
1,
9
2
4
,
7
4
0
0
Fir
e
S
t
a
t
i
o
n
H
e
a
l
t
h
P
o
r
t
a
l
s
1
75
0
,
0
0
0
1,
9
1
2
,
6
7
5
2,
6
6
2
,
6
7
5
2,
0
8
4
,
8
8
3
57
7
,
7
9
2
2,
6
6
2
,
6
7
5
0
Fr
e
m
o
n
t
A
g
i
n
g
a
n
d
F
a
m
i
l
y
S
e
r
v
i
c
e
s
52
,
0
2
0
0
52
,
0
2
0
52
,
0
2
0
0
52
,
0
2
0
0
He
a
l
t
h
E
n
r
o
l
l
m
e
n
t
f
o
r
C
h
i
l
d
r
e
n
30
0
,
0
0
0
0
30
0
,
0
0
0
30
0
,
0
0
0
0
30
0
,
0
0
0
0
He
a
l
t
h
S
e
r
v
i
c
e
s
f
o
r
D
a
y
L
a
b
o
r
e
r
s
26
0
,
1
0
0
0
26
0
,
1
0
0
26
0
,
1
0
0
0
26
0
,
1
0
0
0
In
c
r
e
a
s
e
H
o
s
p
i
c
e
U
t
i
l
i
z
a
t
i
o
n
:
G
e
t
t
i
n
g
t
h
e
M
o
s
t
o
u
t
o
f
L
i
f
e
P
r
o
g
r
a
m
20
0
,
0
0
0
0
20
0
,
0
0
0
15
1
,
1
8
7
0
15
1
,
1
8
7
48
,
8
1
3
Me
d
i
c
a
l
C
o
s
t
s
f
o
r
J
u
v
e
n
i
l
e
J
u
s
t
i
c
e
C
e
n
t
e
r
50
3
,
0
2
2
0
50
3
,
0
2
2
26
2
,
1
3
6
0
26
2
,
1
3
6
24
0
,
8
8
6
Pr
e
v
e
n
t
i
v
e
C
a
r
e
P
a
t
h
w
a
y
s
31
2
,
0
8
0
0
31
2
,
0
8
0
31
2
,
0
8
0
0
31
2
,
0
8
0
0
Pr
i
m
a
r
y
C
a
r
e
C
o
m
m
u
n
i
t
y
-
B
a
s
e
d
O
r
g
a
n
i
z
a
t
i
o
n
s
5,
7
3
4
,
2
7
2
0
5,
7
3
4
,
2
7
2
5,
7
3
4
,
2
7
2
0
5,
7
3
4
,
2
7
2
0
Ro
o
t
s
C
o
m
m
u
n
i
t
y
C
e
n
t
e
r
50
,
0
0
0
0
50
,
0
0
0
50
,
0
0
0
0
50
,
0
0
0
0
Co
n
t
i
n
u
e
d
o
n
n
e
x
t
p
a
g
e
137
TOT
A
L
ALL
O
C
A
T
I
O
N
CAR
R
Y
O
V
E
R
FRO
M
P
RE
V
I
O
U
S
FIS
C
A
L
YE
A
R
1
TOT
A
L
AVA
I
L
A
B
L
E
FUN
D
S
Ex
PE
N
D
E
D
AN
D
/OR
ENC
U
M
B
E
R
E
D
CAR
R
Y
O
V
E
R
TO N
ExT
FIS
C
A
L
Y
EA
R
1
TOT
A
L
SAV
I
N
G
S
2
Gr
o
u
p
4
:
P
u
b
l
i
c
H
e
a
l
t
h
Al
a
m
e
d
a
B
o
y
s
&
G
i
r
l
s
C
l
u
b
,
I
n
c
.
10
4
,
0
4
0
0
10
4
,
0
4
0
10
4
,
0
4
0
0
10
4
,
0
4
0
0
Ala
m
e
d
a
C
o
u
n
t
y
A
s
t
h
m
a
S
t
a
r
t
10
0
,
0
0
0
0
10
0
,
0
0
0
10
0
,
0
0
0
0
10
0
,
0
0
0
0
Ca
l
i
f
o
r
n
i
a
P
r
e
v
e
n
t
i
o
n
a
n
d
E
d
u
c
a
t
i
o
n
P
r
o
j
e
c
t
(
C
A
L
-
P
E
P
)
27
,
0
0
0
0
27
,
0
0
0
27
,
0
0
0
0
27
,
0
0
0
0
Ce
n
t
e
r
f
o
r
E
a
r
l
y
I
n
t
e
r
v
e
n
t
i
o
n
o
n
D
e
a
f
n
e
s
s
52
,
0
2
0
0
52
,
0
2
0
52
,
0
2
0
0
52
,
0
2
0
0
Ci
t
y
o
f
S
a
n
L
e
a
n
d
r
o
52
,
0
2
0
0
52
,
0
2
0
52
,
0
2
0
0
52
,
0
2
0
0
EM
S
C
o
r
p
s
60
4
,
9
4
2
0
60
4
,
9
4
2
60
4
,
2
4
2
0
60
4
,
2
4
2
70
0
He
a
l
t
h
y
N
a
i
l
S
a
l
o
n
P
r
o
j
e
c
t
1,5
25
,
0
0
0
0
25
,
0
0
0
12
,
5
4
7
12
,
4
5
3
25
,
0
0
0
0
Me
r
c
y
R
e
t
i
r
e
m
e
n
t
a
n
d
C
a
r
e
C
e
n
t
e
r
40
,
0
0
0
0
40
,
0
0
0
40
,
0
0
0
0
40
,
0
0
0
0
Pu
b
l
i
c
H
e
a
l
t
h
P
r
e
v
e
n
t
i
o
n
I
n
i
t
i
a
t
i
v
e
3,
1
5
1
,
5
7
0
0
3,
1
5
1
,
5
7
0
3,
1
5
1
,
5
7
0
0
3,1
5
1
,
5
7
0
0
Ry
a
n
W
h
i
t
e
P
r
o
v
i
d
e
r
:
C
o
m
m
u
n
i
t
y
H
e
a
l
t
h
f
o
r
A
s
i
a
n
A
m
e
r
i
c
a
n
s
50
,
0
0
0
0
50
,
0
0
0
50
,
0
0
0
0
50
,
0
0
0
0
Se
n
i
o
r
I
n
j
u
r
y
P
r
e
v
e
n
t
i
o
n
P
r
o
g
r
a
m
11
5
,
0
0
0
0
11
5
,
0
0
0
11
5
,
0
0
0
0
11
5
,
0
0
0
0
SS
I
H
o
u
s
i
n
g
T
r
u
s
t
1
0
60
1
,
3
1
9
60
1
,
3
1
9
60
1
,
3
1
9
0
60
1
,
3
1
9
0
Yo
u
t
h
a
n
d
F
a
m
i
l
y
O
p
p
o
r
t
u
n
i
t
y
I
n
i
t
i
a
t
i
v
e
s
1
2,
5
3
8
,
7
8
0
74
3
,
4
3
9
3,
2
8
2
,
2
1
9
3,
0
7
5
,
9
9
4
20
6
,
2
2
5
3,2
8
2
,
2
1
9
0
Bo
a
r
d
o
f
S
u
p
e
r
v
i
s
o
r
s
1
75
0
,
0
0
0
26
7
,
7
4
5
1,
0
1
7
,
7
4
5
64
7
,
1
4
4
37
0
,
6
0
1
1,0
1
7
,
7
4
5
0
TO
T
A
L
F
Y
1
4
/
1
5
6
35
,
1
8
5
,
7
3
0
5,
5
8
9
,
5
2
0
40
,
7
7
5
,
2
5
0
36
,
3
8
9
,
0
0
1
1,
3
9
1
,
5
3
8
37
,
7
8
0
,
5
3
9
99
4
,
7
1
1
1.
T
h
e
B
o
a
r
d
o
f
S
u
p
e
r
v
i
s
o
r
s
a
p
p
r
o
v
e
d
c
e
r
t
a
i
n
a
l
l
o
c
a
t
i
o
n
s
t
o
c
a
r
r
y
o
v
e
r
u
n
e
x
p
e
n
d
e
d
f
u
n
d
s
t
o
t
h
e
n
e
x
t
f
i
s
c
a
l
y
e
a
r
.
T
h
e
c
a
r
r
y
o
v
e
r
f
u
n
d
s
m
u
s
t
b
e
u
s
e
d
f
o
r
t
h
e
s
a
m
e
p
u
r
p
o
s
e
f
o
r
w
h
i
c
h
t
h
e
B
o
a
r
d
a
p
p
r
o
v
e
d
t
h
e
o
r
i
g
i
n
a
l
al
l
o
c
a
t
i
o
n
.
2.
S
a
v
i
n
g
s
a
r
e
u
n
e
x
p
e
n
d
e
d
f
u
n
d
s
t
h
a
t
r
e
v
e
r
t
t
o
t
h
e
g
e
n
e
r
a
l
M
e
a
s
u
r
e
A
a
c
c
o
u
n
t
f
o
r
r
e
a
l
l
o
c
a
t
i
o
n
i
n
f
u
t
u
r
e
f
i
s
c
a
l
y
e
a
r
s
.
3.
O
n
J
u
l
y
8
,
2
0
1
4
,
t
h
e
B
o
a
r
d
o
f
S
u
p
e
r
v
i
s
o
r
s
a
p
p
r
o
v
e
d
t
h
e
r
e
a
l
l
o
c
a
t
i
o
n
o
f
$
2
,
0
0
0
,
0
0
0
f
r
o
m
t
h
e
S
o
b
e
r
i
n
g
a
n
d
D
e
t
o
x
i
f
i
c
a
t
i
o
n
C
e
n
t
e
r
t
o
S
t
.
R
o
s
e
H
o
s
p
i
t
a
l
.
4.
O
a
k
l
a
n
d
P
o
l
i
c
e
D
e
p
a
r
t
m
e
n
t
F
u
n
d
s
n
o
t
u
s
e
d
i
n
F
Y
1
4
/
1
5
w
i
l
l
b
e
c
a
r
r
i
e
d
o
v
e
r
t
o
F
Y
1
5
/
1
6
(
B
o
a
r
d
L
e
t
t
e
r
a
p
p
r
o
v
e
d
o
n
6
/
2
/
1
5
)
.
5.
H
e
a
l
t
h
y
N
a
i
l
S
a
l
o
n
o
n
e
-
t
i
m
e
f
u
n
d
s
n
o
t
u
s
e
d
i
n
F
Y
1
4
/
1
5
w
i
l
l
b
e
c
a
r
r
i
e
d
o
v
e
r
t
o
F
Y
1
5
/
1
6
.
(
B
o
a
r
d
L
e
t
t
e
r
a
p
p
r
o
v
e
d
o
n
4
/
2
1
/
1
5
)
6.
T
h
e
t
o
t
a
l
a
l
l
o
c
a
t
i
o
n
i
n
c
l
u
d
e
s
M
e
a
s
u
r
e
A
B
a
s
e
a
n
d
M
e
a
s
u
r
e
A
O
n
e
-
T
i
m
e
A
l
l
o
c
a
t
i
o
n
s
a
p
p
r
o
v
e
d
b
y
t
h
e
B
o
a
r
d
o
f
S
u
p
e
r
v
i
s
o
r
s
f
o
r
F
Y
1
4
/
1
5
.
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
138
APPENDIx C:
FY 14/15 MEASURE A FUND DISTRIBUTION
BY PROVIDER OR PROGRAM
MEASURE A ALLOCATION FY 14/15
ExPENDED/ENCUMBERED FY 14/15
GROUP 1: BEHAVIORAL HEALTH
Abode Services 140,000 114,975
Alameda County Behavioral Health Care Services Community-Based Organizations
Adolescent Treatment Centers, Inc. 9,885 0
Alameda County Mental Health Association 36,411 26,668
Alameda Family Services 4,559 0
Asian Community Mental Health Board 9,296 9,296
Axis Community Health, Inc. 6,978 6,742
Berkeley Addiction Treatment Services, Inc. 5,192 5,171
Bi-Bett Corporation 2,774 0
Bonita House, Inc. 55,567 55,567
Building Opportunities for Self-Sufficiency (BOSS) 30,743 5,526
Carnales Unidos Reformando Adictos, Inc. 22,676 25,007
Center for Independent Living 2,381 2,381
Community Health for Asian Americans 2,432 2,343
Crisis Support Services of Alameda County 32,155 32,155
East Bay Community Recovery Project 31,547 30,697
East Bay Community Recovery Project 4,072 3,912
Haart 2,407 0
Horizon Services, Inc. 13,314 10,076
La Familia Counseling Service 7,344 6,132
La Familia Counseling Service 3,229 2,527
La Familia Counseling Service 1,384 480
La Familia Counseling Service 1,540 1,156
La Familia Counseling Service 14,105 14,105
Latino Commission on Alcohol and Drug Abuse of Alameda County 7,345 7,345
Latino Commission on Alcohol and Drug Abuse of Alameda County 3,229 3,229
Latino Commission on Alcohol and Drug Abuse of Alameda County 14,105 0
Latino Commission on Alcohol and Drug Abuse of Alameda County 1,383 0
Latino Commission on Alcohol and Drug Abuse of Alameda County 1,540 1,540
Magnolia Women's Recovery Programs, Inc. 4,142 4,485
Magnolia Women's Recovery Programs, Inc. 2,287 1,914
Native American Health Center, Inc. 3,138 3,138
New Bridge Foundation, Inc. 46,107 -
Second Chance, Inc. 50,076 50,076
Southern Alameda County Committee for Raza 49,778 49,778
St. Mary's Center 4,043 -
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
139
MEASURE A ALLOCATION FY 14/15
ExPENDED/ENCUMBERED FY 14/15
GROUP 1: BEHAvIORAL HEALtH (CONtINUED)
West Oakland Health Council, Inc. 24,400 21,774
Unallocated 241,686 -
total Allocation 753,250 383,219
Center for Empowering Refugees and Immigrants (CERI) 78,030 72,359
Center for Healthy Schools and Communities (School-Based Behavioral Health Initiative) 617,362 617,362
Cherry Hill Sobering and Detoxification Center 2,080,800 1,948,778
Criminal Justice Screening and In-Custody Services 4,306,000 4,306,000
La Familia Counseling Service 100,000 100,000
Mental Health Services for Juvenile Justice Center 360,000 360,000
Oakland Police Department 250,000 89,875
Options Recovery Services 25,000 20,000
Safe Alternatives to violent Environments (SAvE) 30,000 30,000
the Schreiber Center 250,000 250,000
Senior Support Program of Tri-Valley 20,000 20,000
tri-valley Haven for Women 25,000 25,000
MEASURE A ALLOCATION FY 14/15
ExPENDED/ENCUMBERED FY 14/15
GROUP 2: HOSPITAL, TERTIARY CARE, OTHER
Direct Service Planning and Administration 400,000 228,437
San Leandro Hosptial 1,000,000 1,000,000
St. Rose Hospital 4,000,000 4,000,000
UCSF Benioff Children's Hospital Oakland 3,000,000 3,000,000
MEASURE A ALLOCATION FY 14/15
ExPENDED/ENCUMBERED FY 14/15
GROUP 3: PRIMARY CARE
Alameda County Dental Health 153,662 153,662
Berkeley Community Health Project (Berkeley Free Clinic) 50,000 50,000
Center for Elders' Independence 52,020 52,020
Center for Healthy Schools and Communities (School Health Centers)
Alameda Family Services 200,656 200,656
City of Berkeley 127,828 127,828
City of Fremont 32,278 32,278
East Bay Asian Youth Center 72,828 72,828
La Clinica de La Raza, Inc. 291,312 291,312
LifeLong Medical Center 109,242 109,242
Native American Health Center 109,242 109,242
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
140
MEASURE A ALLOCATION FY 14/15
ExPENDED/ENCUMBERED FY 14/15
GROUP 3: PRIMARY CARE (CONtINUED)
Tiburcio Vasquez Health Center 208,080 208,080
UCSF Benioff Children's Hospital Oakland 145,656 145,656
University of California, San Francisco 159,800 159,800
Evaluation and Other Expenses 467,818 467,818
total Allocation 1,924,740 1,924,740
Fire Station Health Portals 750,000 2,084,883
Fremont Aging and Family Services 52,020 52,020
Health Enrollment for Children 300,000 300,000
Health Services for Day Laborers
Health Services for Day Laborers: Community Initiatives (Day Labor Center) 86,700 86,700
Health Services for Day Laborers: Multicultural Institute 86,700 86,700
Health Services for Day Laborers: Street Level Health Project 86,700 86,700
total Allocation 260,100 260,100
Hope Hospice 10,000 10,000
Hospice: Getting the Most out of Life Program 200,000 151,187
Medical Costs for Juvenile Justice Services 447,100 447,100
Medical Costs for Juvenile Justice Center: Direct Service Planning and Administration 261,000 74,114
Medical Costs for Juvenile Justice Center: Mind Body Awareness Project 57,222 57,222
Medical Costs for Juvenile Justice Center: Niroga Institute 40,800 40,800
Medical Costs for Juvenile Justice Center: Victims of Crime 144,000 90,000
total Allocation 503,022 262,136
Preventive Care Pathways 312,080 312,080
Primary Care Community-Based Organizations
Alameda Health Consortium
Asian Health Services 620,078 620,078
AXIS Community Health Center 648,293 648,293
La Clínica de La Raza 1,824,440 1,824,440
LifeLong Medical Center 704,866 704,866
Native American Health Center 273,434 273,434
Tiburcio Vasquez Health Center 883,490 883,490
Tri-City Health Center 600,763 600,763
West Oakland Health Council 178,908 178,908
total Allocation 5,734,272 5,734,272
Roots Community Center 50,000 50,000
tiburcio vasquez 60,000 60,000
Washington Hospital 34,000 34,000
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
141
MEASURE A ALLOCATION FY 14/15
ExPENDED/ENCUMBERED FY 14/15
GROUP 4: PUBLIC HEALTH
100 Black Men of the Bay Area 25,000 25,000
Alameda Boys & Girls Club, Inc. 104,040 104,040
Alameda County Asthma Start 100,000 100,000
California Prevention & Education Project (CAL-PEP) 27,000 27,000
Center for Early Intervention on Deafness 57,020 57,020
City of San Leandro Senior Services 52,020 52,020
Collaboration Agencies Responding to Disasters (CARD) 25,000 7,500
Community Health and Wellness Element 25,000 25,000
EMS Corps
Bay Area Youth EMT Program 100,000 92,927
Berkeley Youth Alternatives 50,000 50,000
Other Program Expenses 454,942 461,315
total Allocation 604,942 604,242
Environmental Health: Improve Field Sanitation Conditions/Nail Salons 25,000 12,547
Genesis Worship Center 5,000 5,000
HIv Education and Prevention Project of Alameda County (HEPPAC) 26,000 26,000
Hospital Committee for Livermore-Pleasanton Area dba valleyCare Health System 15,000 15,000
LIFE ElderCare 12,400 12,400
Mercy Retirement and Care Center 40,000 40,000
Public Health Prevention Initiative
Community-Designed Initiative:
Mandela Market Place 40,800 40,000
Niroga Institute, Inc. 35,700 38,200
Tides Center (HOPE Collaborative) - 21,000
Other Program Costs - -
Dental Health:
Center for Oral Health 133,055 130,606
Emergency Medical Services:
Daybreak Adult Care Centers 23,581 23,581
Senior Support Program of the Tri-Valley 23,581 23,581
St. Mary's Center 23,586 23,586
United Seniors of Oakland & Alameda 7,283 7,283
City of Fremont 176,088 176,088
Total 463,673 483,924
Health Inequities and Community Capacity-Building
Health Inequities and Community Capacity-Building-Office of Director/CAPE:
Attitudinal Healing Connection, Inc. 69,360 69,360
FHS- Healthy Passage System of Care:
Lucile Packard Children's Hospital Stanford 40,401 -!
HIV Prevention:
California Prevention and Education 45,778 45,778
Community Health for Asian Americans 50,000 50,000
HIV Education and Prevention Project of Alameda County 41,616 41,616
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
142
MEASURE A ALLOCATION FY 14/15
ExPENDED/ENCUMBERED FY 14/15
GROUP 4: PUBLIC HEALtH (CONtINUED)
Office of Director/CAPE 99,960 99,960
Total 347,114 306,713!
Obesity Prevention and School Health
Community-Designed Initiative:
City of Berkeley 175,568 69,360
East Oakland Boxing Association 51,000 -
Lotus Bloom 33,150 45,778
Nutrition Services:
Earth Island 10,200 50,000
Total 269,918 165,138
Alcohol and Other Drugs Primary Prevention
CHS: Eden Youth and Family Center 20,000 20,000
Total 20,000 20,000
Subtotal Program Expenses 2,050,865 2,175,794
Other Program Expenses 1,100,705 975,776
total Allocation 3,135,037 2,278,231
Ryan White Provider: Community Health for Asian Americans 50,000 50,000
Senior Injury Prevention Program 115,000 115,000
Service Opportunity for Seniors (Meals on Wheels) 116,000 116,000
South Hayward Parish 10,000 10,000
Spectrum Community Services, Inc. 50,000 50,000
SSI Housing Trust (GA Clients) - 601,319
Viola Blythe Community Services 5,000 5,000
West Oakland Youth Center 70,000 44,244
Youth and Family Opportunity Initiatives
Alameda Family Services 178,384 178,384
Alternatives in Action (AIA) 260,100 260,100
Berkeley Youth Alternatives (BYA) 104,040 104,040
City of Fremont 429,100 429,100
Dublin Unified School District 16,666 16,666
East Bay Asian Youth Center (EBAYC) 104,040 104,040
La Clinica de la Raza 191,040 191,040
La Familia 156,060 156,060
Livermore Unified School District 16,666 16,666
Newark Unified School District 104,040 104,040
New Haven Unified School District 104,040 104,040
Pleasanton Unified School District 16,666 16,666
REACH Ashland Youth Center 744,003 744,003
Seneca Family of Agencies 40,000 40,000
Unity Council 142,424 142,424
Westcoast 77,100 77,100
Youth Radio 104,040 104,040
Professional and specialized services 287,585
total Allocation 2,538,780 3,075,994
2014-2015 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
143
Ma
p
1
ala
Med
a
C
o
u
n
t
y
pub
l
i
C
H
e
a
l
t
H pro
g
r
a
Ms
F
u
n
d
e
d
b
y
M
e
a
s
u
r
e
a
i
n
F
y 1
4
/
1
5
#
Pr
o
v
i
d
e
r
Ci
t
y
1
At
t
i
t
u
d
i
n
a
l
H
e
a
l
i
n
g
C
o
n
n
e
c
t
i
o
n
,
I
n
c
.
Oa
k
l
a
n
d
2
Ba
y
A
r
e
a
Y
o
u
t
h
E
M
T
P
r
o
g
r
a
m
Oa
k
l
a
n
d
3
Be
r
k
e
l
e
y
Y
o
u
t
h
A
l
t
e
r
n
a
t
i
v
e
s
Be
r
k
e
l
e
y
4
Ce
n
t
e
r
f
o
r
O
r
a
l
H
e
a
l
t
h
Oa
k
l
a
n
d
5
Ca
l
i
f
o
r
n
i
a
P
r
e
v
e
n
t
i
o
n
a
n
d
E
d
u
c
a
t
i
o
n
Oa
k
l
a
n
d
6
Ci
t
y
o
f
B
e
r
k
e
l
e
y
Be
r
k
e
l
e
y
7
Ci
t
y
o
f
F
r
e
m
o
n
t
Fr
e
m
o
n
t
8
Co
m
m
u
n
i
t
y
H
e
a
l
t
h
f
o
r
A
s
i
a
n
A
m
e
r
i
c
a
n
s
Oa
k
l
a
n
d
9
Da
y
b
r
e
a
k
A
d
u
l
t
C
a
r
e
C
e
n
t
e
r
s
Oa
k
l
a
n
d
10
Ea
r
t
h
I
s
l
a
n
d
Be
r
k
e
l
e
y
11
Ea
s
t
O
a
k
l
a
n
d
B
o
x
i
n
g
A
s
s
o
c
i
a
t
i
o
n
Oa
k
l
a
n
d
#
Pr
o
v
i
d
e
r
Ci
t
y
12
Ed
e
n
Y
o
u
t
h
a
n
d
F
a
m
i
l
y
C
e
n
t
e
r
Ha
y
w
a
r
d
13
Hi
g
h
e
r
G
r
o
u
n
d
N
e
i
g
h
b
o
r
h
o
o
d
D
e
v
e
l
o
p
m
e
n
t
Oa
k
l
a
n
d
14
HI
V
E
d
u
c
a
t
i
o
n
a
n
d
P
r
e
v
e
n
t
i
o
n
P
r
o
j
e
c
t
o
f
A
l
a
m
e
d
a
C
o
u
n
t
y
Oa
k
l
a
n
d
15
Lo
t
u
s
B
l
o
o
m
Oa
k
l
a
n
d
16
Lu
c
i
l
e
P
a
c
k
a
r
d
C
h
i
l
d
r
e
n
'
s
H
o
s
p
i
t
a
l
S
t
a
n
f
o
r
d
Fr
e
m
o
n
t
17
Ma
n
d
e
l
a
M
a
r
k
e
t
P
l
a
c
e
Oa
k
l
a
n
d
18
Ni
r
o
g
a
I
n
s
t
i
t
u
t
e
,
I
n
c
.
Oa
k
l
a
n
d
19
Se
n
i
o
r
S
u
p
p
o
r
t
o
f
t
h
e
T
r
i
-
V
a
l
l
e
y
Pl
e
a
s
a
n
t
o
n
20
St
.
M
a
r
y
’
s
C
e
n
t
e
r
Oa
k
l
a
n
d
21
Ti
d
e
s
C
e
n
t
e
r
Oa
k
l
a
n
d
22
Un
i
t
e
d
S
e
n
i
o
r
s
o
f
O
a
k
l
a
n
d
a
n
d
A
l
a
m
e
d
a
Oa
k
l
a
n
d
Map 1
alaMeda County publiC HealtH prograMs
Funded by Measure a in Fy 14/15
NO
T
E
:
U
n
i
n
c
o
r
p
o
r
a
t
e
d
a
r
e
a
s
,
i
n
c
l
u
d
i
n
g
A
s
h
l
a
n
d
,
C
a
s
t
r
o
V
a
l
l
e
y
,
C
h
e
r
r
y
l
a
n
d
,
Fa
i
r
v
i
e
w
,
S
a
n
L
o
r
e
n
z
o
,
a
n
d
S
u
n
o
l
,
s
h
o
w
n
l
i
n
e
d
.
C
i
t
i
e
s
s
h
o
w
n
i
n
c
o
l
o
r
.
Ma
p
2
al
a
Med
a
C
ou
n
t
y
be
Ha
Vio
r
a
l
H
ea
l
t
H
C
ar
e
se
r
ViCes
al
CoHol
an
d
ot
Her
dr
u
g
pr
o
Vid
e
r
s
Fun
d
e
d
by
M
ea
s
u
r
e
a in
F
y 1
4
/
1
5
#
Pr
o
v
i
d
e
r
Ci
t
y
1
Ad
o
l
e
s
c
e
n
t
T
r
e
a
t
m
e
n
t
C
e
n
t
e
r
s
,
I
n
c
.
Oa
k
l
a
n
d
2
Al
a
m
e
d
a
F
a
m
i
l
y
S
e
r
v
i
c
e
s
A
l
a
m
e
d
a
3
Ax
i
s
C
o
m
m
u
n
i
t
y
H
e
a
l
t
h
,
I
n
c
.
P
l
e
a
s
a
n
t
o
n
4
Be
r
k
e
l
e
y
A
d
d
i
c
t
i
o
n
T
r
e
a
t
m
e
n
t
S
e
r
v
i
c
e
s
,
I
n
c
.
B
e
r
k
e
l
e
y
5
Bi-
B
e
t
t
C
o
r
p
o
r
a
t
i
o
n
O
a
k
l
a
n
d
6
Ca
r
n
a
l
e
s
U
n
i
d
o
s
R
e
f
o
r
m
a
n
d
o
A
d
i
c
t
o
s
F
r
e
m
o
n
t
7
Co
m
m
u
n
i
t
y
H
e
a
l
t
h
f
o
r
A
s
i
a
n
A
m
e
r
i
c
a
n
s
O
a
k
l
a
n
d
8
Ea
s
t
B
a
y
C
o
m
m
u
n
i
t
y
R
e
c
o
v
e
r
y
P
r
o
j
e
c
t
O
a
k
l
a
n
d
9
Fi
l
i
p
i
n
o
A
d
v
o
c
a
t
e
s
f
o
r
J
u
s
t
i
c
e
O
a
k
l
a
n
d
#
Pr
o
v
i
d
e
r
Ci
t
y
10
Ho
r
i
z
o
n
S
e
r
v
i
c
e
s
,
I
n
c
.
H
a
y
w
a
r
d
11
Hu
m
a
n
i
s
t
i
c
A
l
t
e
r
n
a
t
i
v
e
s
t
o
A
d
d
i
c
t
i
o
n
O
a
k
l
a
n
d
12
La
t
i
n
o
C
o
m
m
i
s
s
i
o
n
o
n
A
l
c
o
h
o
l
a
n
d
D
r
u
g
O
a
k
l
a
n
d
13
Ma
g
n
o
l
i
a
W
o
m
e
n
'
s
R
e
c
o
v
e
r
y
P
r
o
g
r
a
m
s
,
I
n
c
.
O
a
k
l
a
n
d
14
Na
t
i
v
e
A
m
e
r
i
c
a
n
H
e
a
l
t
h
C
e
n
t
e
r
,
I
n
c
.
O
a
k
l
a
n
d
15
Ne
w
B
r
i
d
g
e
F
o
u
n
d
a
t
i
o
n
,
I
n
c
.
B
e
r
k
e
l
e
y
16
Se
c
o
n
d
C
h
a
n
c
e
,
I
n
c
.
N
e
w
a
r
k
17
St
.
M
a
r
y
'
s
C
e
n
t
e
r
O
a
k
l
a
n
d
18
We
s
t
O
a
k
l
a
n
d
H
e
a
l
t
h
C
o
u
n
c
i
l
,
I
n
c
.
O
a
k
l
a
n
d
Map 2
alaMeda County beHaVioral HealtH Care serViCes
alCoHol and otHer drug proViders
Funded by Measure a in Fy 14/15
NO
T
E
:
U
n
i
n
c
o
r
p
o
r
a
t
e
d
a
r
e
a
s
,
i
n
c
l
u
d
i
n
g
A
s
h
l
a
n
d
,
C
a
s
t
r
o
V
a
l
l
e
y
,
C
h
e
r
r
y
l
a
n
d
,
Fa
i
r
v
i
e
w
,
S
a
n
L
o
r
e
n
z
o
,
a
n
d
S
u
n
o
l
,
s
h
o
w
n
l
i
n
e
d
.
C
i
t
i
e
s
s
h
o
w
n
i
n
c
o
l
o
r
.
Ma
p
3
al
a
Med
a
C
ou
n
t
y
be
Ha
Vio
r
a
l
H
ea
l
t
H
C
ar
e
se
r
ViCes
ME
N
T
A
L
H
E
A
L
T
H
C
O
M
M
U
N
I
T
Y
-
B
A
S
E
D
O
R
G
A
N
I
Z
A
T
I
O
N
P
R
O
V
I
D
E
R
S
Fun
d
e
d
by
M
ea
s
u
r
e
a in
F
y 1
4
/
1
5
#
Pr
o
v
i
d
e
r
Ci
t
y
1
Al
a
m
e
d
a
C
o
u
n
t
y
M
e
n
t
a
l
H
e
a
l
t
h
A
s
s
o
c
i
a
t
i
o
n
O
a
k
l
a
n
d
2
As
i
a
n
C
o
m
m
u
n
i
t
y
M
e
n
t
a
l
H
e
a
l
t
h
S
e
r
v
i
c
e
s
O
a
k
l
a
n
d
3
Bo
n
i
t
a
H
o
u
s
e
,
I
n
c
.
O
a
k
l
a
n
d
4
Bu
i
l
d
i
n
g
O
p
p
o
r
t
u
n
i
t
i
e
s
f
o
r
S
e
l
f
-
S
u
f
f
i
c
i
e
n
c
y
B
e
r
k
e
l
e
y
5
Ce
n
t
e
r
f
o
r
I
n
d
e
p
e
n
d
e
n
t
L
i
v
i
n
g
B
e
r
k
e
l
e
y
6
Cr
i
s
i
s
S
u
p
p
p
o
r
t
S
e
r
v
i
c
e
s
o
f
A
l
a
m
e
d
a
C
o
u
n
t
y
O
a
k
l
a
n
d
7
So
u
t
h
e
r
n
A
l
a
m
e
d
a
C
o
u
n
t
y
C
o
m
m
i
t
e
e
f
o
r
R
a
z
a
(
L
a
F
a
m
i
l
i
a
Co
u
n
s
e
l
i
n
g
S
e
r
v
i
c
e
)
H
a
y
w
a
r
d
Map 3
alaMeda County beHaVioral HealtH Care serViCes
MENTAL HEALTH COMMUNITY-BASED ORGANIZATION PROVIDERS
Funded by Measure a in Fy 14/15
NO
T
E
:
U
n
i
n
c
o
r
p
o
r
a
t
e
d
a
r
e
a
s
,
i
n
c
l
u
d
i
n
g
A
s
h
l
a
n
d
,
C
a
s
t
r
o
V
a
l
l
e
y
,
C
h
e
r
r
y
l
a
n
d
,
Fa
i
r
v
i
e
w
,
S
a
n
L
o
r
e
n
z
o
,
a
n
d
S
u
n
o
l
,
s
h
o
w
n
l
i
n
e
d
.
C
i
t
i
e
s
s
h
o
w
n
i
n
c
o
l
o
r
.
Ma
p
4
sCH
oo
l
H
ea
l
t
H
C
en
t
e
r
s
F
un
d
e
d
by
M
ea
s
u
r
e
a in
F
y 1
4
/
1
5
#
Pr
o
v
i
d
e
r
Ci
t
y
1
Al
a
m
e
d
a
H
i
g
h
S
c
h
o
o
l
-
B
a
s
e
d
H
e
a
l
t
h
C
e
n
t
e
r
Al
a
m
e
d
a
2
Be
r
k
e
l
e
y
H
i
g
h
S
c
h
o
o
l
H
e
a
l
t
h
C
e
n
t
e
r
Be
r
k
e
l
e
y
3
B-
T
e
c
h
H
e
a
l
t
h
C
e
n
t
e
r
Be
r
k
e
l
e
y
4
Ch
a
p
p
e
l
l
H
a
y
e
s
H
e
a
l
t
h
C
e
n
t
e
r
Oa
k
l
a
n
d
5
El
m
h
u
r
s
t
/
A
l
l
i
a
n
c
e
W
e
l
l
n
e
s
s
C
e
n
t
e
r
Oa
k
l
a
n
d
6
En
c
i
n
a
l
H
i
g
h
S
c
h
o
o
l
-
B
a
s
e
d
H
e
a
l
t
h
C
e
n
t
e
r
Al
a
m
e
d
a
7
Fr
e
m
o
n
t
T
i
g
e
r
C
l
i
n
i
c
Oa
k
l
a
n
d
8
Fr
i
c
k
M
i
d
d
l
e
S
c
h
o
o
l
-
B
a
s
e
d
H
e
a
l
t
h
C
e
n
t
e
r
Oa
k
l
a
n
d
9
Fu
e
n
t
e
W
e
l
l
n
e
s
s
C
e
n
t
e
r
(
R
E
A
C
H
A
s
h
l
a
n
d
Y
o
u
t
h
C
e
n
t
e
r
)
Sa
n
L
e
a
n
d
r
o
10
Ha
v
e
n
s
c
o
u
r
t
C
a
m
p
u
s
H
e
a
l
t
h
C
e
n
t
e
r
Oa
k
l
a
n
d
11
Ha
w
t
h
o
r
n
e
H
e
a
l
t
h
C
e
n
t
e
r
Oa
k
l
a
n
d
12
Ha
y
w
a
r
d
H
i
g
h
S
c
h
o
o
l
M
o
b
i
l
e
H
e
a
l
t
h
V
a
n
Ha
y
w
a
r
d
13
Is
l
a
n
d
/
B
A
S
E
H
i
g
h
S
c
h
o
o
l
-
B
a
s
e
d
H
e
a
l
t
h
C
e
n
t
e
r
Al
a
m
e
d
a
#
Pr
o
v
i
d
e
r
Ci
t
y
14
Lo
g
a
n
H
e
a
l
t
h
C
e
n
t
e
r
Un
i
o
n
C
i
t
y
15
Ma
d
i
s
o
n
H
e
a
l
t
h
C
e
n
t
e
r
Oa
k
l
a
n
d
16
Ris
i
n
g
H
a
r
t
e
W
e
l
l
n
e
s
s
C
e
n
t
e
r
Oa
k
l
a
n
d
17
Ro
o
s
e
v
e
l
t
H
e
a
l
t
h
C
e
n
t
e
r
Oa
k
l
a
n
d
18
Sa
n
L
o
r
e
n
z
o
H
i
g
h
H
e
a
l
t
h
C
e
n
t
e
r
Sa
n
L
o
r
e
n
z
o
19
Sh
o
p
5
5
W
e
l
l
n
e
s
s
C
e
n
t
e
r
Oa
k
l
a
n
d
20
Sk
y
l
i
n
e
H
i
g
h
S
c
h
o
o
l
H
e
a
l
t
h
C
e
n
t
e
r
Oa
k
l
a
n
d
21
Te
c
h
n
i
C
l
i
n
i
c
Oa
k
l
a
n
d
22
Te
n
n
y
s
o
n
H
e
a
l
t
h
C
e
n
t
e
r
Ha
y
w
a
r
d
23
Un
i
t
e
d
f
o
r
S
u
c
c
e
s
s
/
L
i
f
e
A
c
a
d
e
m
y
H
e
a
l
t
h
C
e
n
t
e
r
Oa
k
l
a
n
d
24
We
s
t
O
a
k
l
a
n
d
M
i
d
d
l
e
S
c
h
o
o
l
H
e
a
l
t
h
C
e
n
t
e
r
Oa
k
l
a
n
d
25
Yo
u
t
h
H
e
a
r
t
H
e
a
l
t
h
C
e
n
t
e
r
(
L
a
E
s
c
u
e
l
i
t
a
E
d
u
c
a
t
i
o
n
C
o
m
p
l
e
x
)
Oa
k
l
a
n
d
26
Yo
u
t
h
U
p
r
i
s
i
n
g
/
C
a
s
t
l
e
m
o
n
t
H
e
a
l
t
h
C
e
n
t
e
r
Oa
k
l
a
n
d
Map 4
sCHool HealtH Centers Funded by Measure a in Fy 14/15
NO
T
E
:
U
n
i
n
c
o
r
p
o
r
a
t
e
d
a
r
e
a
s
,
i
n
c
l
u
d
i
n
g
A
s
h
l
a
n
d
,
C
a
s
t
r
o
V
a
l
l
e
y
,
C
h
e
r
r
y
l
a
n
d
,
Fa
i
r
v
i
e
w
,
S
a
n
L
o
r
e
n
z
o
,
a
n
d
S
u
n
o
l
,
s
h
o
w
n
l
i
n
e
d
.
C
i
t
i
e
s
s
h
o
w
n
i
n
c
o
l
o
r
.
Ma
p
5
HEA
L
T
H
PA
C
P
RO
V
I
D
E
R
N
ET
W
O
R
k
FU
N
D
E
D
BY
M
EA
S
U
R
E
A
IN
F
Y
1
4
/
1
5
#
Pr
o
v
i
d
e
r
Ci
t
y
AL
A
M
ed
A
H
eAL
tH
S
ySte
M
1
Ea
s
t
m
o
n
t
W
e
l
l
n
e
s
s
C
e
n
t
e
r
Oa
k
l
a
n
d
2
Fa
i
r
m
o
n
t
H
o
s
p
i
t
a
l
Sa
n
L
e
a
n
d
r
o
3
Hi
g
h
l
a
n
d
H
o
s
p
i
t
a
l
Oa
k
l
a
n
d
4
Ne
w
a
r
k
W
e
l
l
n
e
s
s
Ne
w
a
r
k
5
Ha
y
w
a
r
d
W
e
l
l
n
e
s
s
Ha
y
w
a
r
d
6
Sa
n
L
e
a
n
d
r
o
H
o
s
p
i
t
a
l
Sa
n
L
e
a
n
d
r
o
7
Al
a
m
e
d
a
H
o
s
p
i
t
a
l
Al
a
m
e
d
a
8
Jo
h
n
G
e
o
r
g
e
P
a
v
i
l
i
o
n
Sa
n
L
o
r
e
n
z
o
ASiAn
H
e
AL
tH S
e
r
v
i
CeS
9
Ro
l
a
n
d
a
n
d
kat
h
r
y
n
L
o
w
e
M
e
d
i
c
a
l
C
e
n
t
e
r
Oa
k
l
a
n
d
10
As
i
a
n
H
e
a
l
t
h
D
e
n
t
a
l
C
l
i
n
i
c
Oa
k
l
a
n
d
11
As
i
a
n
H
e
a
l
t
h
S
e
r
v
i
c
e
s
Oa
k
l
a
n
d
12
Fr
a
n
k
kia
n
g
M
e
d
i
c
a
l
C
e
n
t
e
r
Oa
k
l
a
n
d
Ax
i
S C
o
MM
un
i
t
y
H
e
AL
tH
13
Ax
i
s
C
o
m
m
u
n
i
t
y
H
e
a
l
t
h
-
P
l
e
a
s
a
n
t
o
n
Pl
e
a
s
a
n
t
o
n
14
Ax
i
s
C
o
m
m
u
n
i
t
y
H
e
a
l
t
h
-
L
i
v
e
r
m
o
r
e
Liv
e
r
m
o
r
e
LA C
Lín
i
CA
d
e
L
A rA
zA
15
Ca
s
a
d
e
l
S
o
l
Oa
k
l
a
n
d
16
Cl
i
n
i
c
a
A
l
t
a
V
i
s
t
a
Oa
k
l
a
n
d
17
La
C
l
i
n
i
c
a
d
e
l
a
R
a
z
a
Oa
k
l
a
n
d
18
La
C
l
i
n
i
c
a
D
e
n
t
a
l
Oa
k
l
a
n
d
19
La
C
l
i
n
i
c
a
D
e
n
t
a
l
/
C
h
i
l
d
r
e
n
'
s
Oa
k
l
a
n
d
20
Sa
n
A
n
t
o
n
i
o
N
e
i
g
h
b
o
r
h
o
o
d
Oa
k
l
a
n
d
#
Pr
o
v
i
d
e
r
Ci
t
y
Li
f
e
L
o
n
g
M
e
d
i
CA
L
C
e
n
t
e
r
21
Be
r
k
e
l
e
y
P
r
i
m
a
r
y
C
a
r
e
A
c
c
e
s
s
Be
r
k
e
l
e
y
22
Ho
w
a
r
d
D
a
n
i
e
l
C
l
i
n
i
c
Oa
k
l
a
n
d
23
Lif
e
L
o
n
g
D
e
n
t
a
l
C
a
r
e
Be
r
k
e
l
e
y
24
Lif
e
L
o
n
g
M
e
d
i
c
a
l
C
a
r
e
D
O
C
Oa
k
l
a
n
d
25
Ov
e
r
6
0
H
e
a
l
t
h
C
e
n
t
e
r
Be
r
k
e
l
e
y
26
Ea
s
t
O
a
k
l
a
n
d
Oa
k
l
a
n
d
27
We
s
t
B
e
r
k
e
l
e
y
F
a
m
i
l
y
P
r
a
c
t
i
c
e
Be
r
k
e
l
e
y
nA
ti
v
e
A
Mer
i
CA
n
H
e
AL
tH C
e
n
t
e
r
28
Na
t
i
v
e
A
m
e
r
i
c
a
n
H
e
a
l
t
h
C
e
n
t
e
r
Oa
k
l
a
n
d
St. ro
Se H
oSP
it
AL
29
St
.
R
o
s
e
H
o
s
p
i
t
a
l
Ha
y
w
a
r
d
tib
u
r
Cio
vA
S
qu
e
z
H
e
AL
tH C
e
n
t
e
r
,
inC.
30
Ti
b
u
r
c
i
o
V
a
s
q
u
e
z
,
L
o
g
a
n
H
e
a
l
t
h
Un
i
o
n
C
i
t
y
31
Ti
b
u
r
c
i
o
V
a
s
q
u
e
z
,
H
a
y
w
a
r
d
Ha
y
w
a
r
d
32
Ti
b
u
r
c
i
o
V
a
s
q
u
e
z
,
U
n
i
o
n
C
i
t
y
Un
i
o
n
C
i
t
y
33
Ti
b
u
r
c
i
o
V
a
s
q
u
e
z
,
S
a
n
L
e
a
n
d
r
o
Sa
n
L
e
a
n
d
r
o
Tr
i
-
C
i
Ty
H
e
a
l
TH
C
e
n
Ter
34
Tr
i
-
C
i
t
y
H
e
a
l
t
h
C
e
n
t
e
r
-
L
i
b
e
r
t
y
Fr
e
m
o
n
t
35
Tr
i
-
C
i
t
y
H
e
a
l
t
h
C
e
n
t
e
r
-
M
a
i
n
Fr
e
m
o
n
t
36
Tr
i
-
C
i
t
y
H
e
a
l
t
h
C
e
n
t
e
r
-
M
o
w
r
y
Fr
e
m
o
n
t
37
Tr
i
-
C
i
t
y
H
e
a
l
t
h
C
e
n
t
e
r
-
S
t
a
t
e
Fr
e
m
o
n
t
We
St oA
kLA
nd
H
e
AL
tH C
o
u
n
CiL
38
Al
b
e
r
t
J
.
T
h
o
m
a
s
M
e
d
i
c
a
l
C
l
i
n
i
c
Oa
k
l
a
n
d
39
Ea
s
t
O
a
k
l
a
n
d
H
e
a
l
t
h
C
e
n
t
e
r
Oa
k
l
a
n
d
40
We
s
t
O
a
k
l
a
n
d
H
e
a
l
t
h
C
e
n
t
e
r
Oa
k
l
a
n
d
41
Wi
l
l
i
a
m
B
y
r
o
n
R
u
m
f
o
r
d
M
e
d
i
c
a
l
Be
r
k
e
l
e
y
*
T
h
e
H
e
a
l
t
h
P
r
o
g
r
a
m
o
f
A
l
a
m
e
d
a
C
o
u
n
t
y
,
a
l
s
o
k
n
o
w
n
a
s
H
e
a
l
t
h
P
A
C
(
a
n
d
f
o
r
m
e
r
l
y
k
n
o
w
n
a
s
C
M
S
P
o
r
A
C
E
)
,
i
s
a
C
o
u
n
t
y
p
r
o
g
r
a
m
t
h
a
t
p
r
o
v
i
d
e
s
a
f
f
o
r
d
a
b
l
e
h
e
a
l
t
h
c
a
r
e
t
o
un
i
n
s
u
r
e
d
p
e
o
p
l
e
l
i
v
i
n
g
i
n
A
l
a
m
e
d
a
C
o
u
n
t
y
.
S
e
r
v
i
c
e
s
a
r
e
p
r
o
v
i
d
e
d
t
h
r
o
u
g
h
o
n
e
o
f
t
h
e
n
i
n
e
c
o
m
m
u
n
i
t
y
-
b
a
s
e
d
c
l
i
n
i
c
s
t
h
a
t
a
r
e
p
a
r
t
o
f
t
h
e
n
e
t
w
o
r
k
o
r
t
h
r
o
u
g
h
t
h
e
A
l
a
m
e
d
a
H
e
a
l
t
h
Sy
s
t
e
m
(
d
b
a
A
l
a
m
e
d
a
C
o
u
n
t
y
M
e
d
i
c
a
l
C
e
n
t
e
r
)
.
Map 5
HEALTHPAC PROVIDER NETWORk
Funded by Measure a in Fy 14/15
NO
T
E
:
U
n
i
n
c
o
r
p
o
r
a
t
e
d
a
r
e
a
s
,
i
n
c
l
u
d
i
n
g
A
s
h
l
a
n
d
,
C
a
s
t
r
o
V
a
l
l
e
y
,
C
h
e
r
r
y
l
a
n
d
,
Fa
i
r
v
i
e
w
,
S
a
n
L
o
r
e
n
z
o
,
a
n
d
S
u
n
o
l
,
s
h
o
w
n
l
i
n
e
d
.
C
i
t
i
e
s
s
h
o
w
n
i
n
c
o
l
o
r
.