HomeMy WebLinkAboutmeasurea-15-16-finalMEASURE A
Essential Health Care Services Tax Ordinance
OVERSIGHT COMMITTEE
10TH REPORT TO THE ALAMEDA COUNTY
BOARD OF SUPERVISORS AND THE PUBLIC
Review of Expenditures July 1, 2015 – June 30, 2016
Fiscal Year 2015/2016
MEASURE A
Essential Health Care Services Tax Ordinance
OVERSIGHT COMMITTEE
10TH REPORT
TO THE ALAMEDA COUNTY BOARD OF SUPERVISORS
AND THE PUBLIC
REVIEW OF EXPENDITURES IN
Fiscal Year (FY) 2015/2016
July 1, 2015 – June 30, 2016
CONTENTS
Measure A Oversight Committee Members ........................................................................................... 1
Executive Summary ..................................................................................................................................................... 3
How The Money Was Spent ............................................................................................................................... 11
Review of FY 15/16 Expenditures: 75% of Measure A Funds
Allocated to Alameda Health System ............................................................................................................... 12
Review of FY 15/16 Expenditures: 25% of Measure A Funds
Allocated by the Alameda County Board of Supervisors ....................................................................... 15
Group 1: Behavioral Health
Behavioral Health and Alcoholand Other Drug (AOD) Community ................................................................. 18
Center for Healthy Schools and Communities (School-Based Behavioral Health Initiative) ........................ 19
Criminal Justice Screening and In-Custody Services ............................................................................................. 23
Detoxification/Sobering Center .................................................................................................................................. 27
La Familia Counseling Services ................................................................................................................................... 29
Mental Health Services for Juvenile Justice Center ................................................................................................. 30
Mental Health Services for Newcomers and Immigrants (CERI) ........................................................................ 31
Safe Alternatives to Violent Environments (SAVE) ................................................................................................ 32
Senior Support Program of Tri-Valley ....................................................................................................................... 33
Group 2: Hospital, Tertiary Care, Other
Administration/Infrastructure Support .................................................................................................................... 36
San Leandro Hospital .................................................................................................................................................... 38
St. Rose Hospital ............................................................................................................................................................ 39
UCSF Benioff Children’s Hospital Oakland .............................................................................................................. 41
Group 3: Primary Care
Alameda County Dental Health .................................................................................................................................. 46
Center for Elders’ Independence ................................................................................................................................ 48
Center for Healthy Schools and Communities (School Health Centers) .......................................................... 49
Connecting Kids to Coverage (CKC) Initiative ........................................................................................................ 52
Fire Station Health Portals ........................................................................................................................................... 55
Fremont Aging and Family Services ........................................................................................................................... 56
Health Enrollment for Children .................................................................................................................................. 59
Health Services for Day Laborers: Community Initiatives (Day Labor Center) ............................................... 60
Health Services for Day Laborers: Multicultural Institute .................................................................................... 62
Health Services for Day Laborers: Street Level Health Project ........................................................................... 64
Increase Hospice Utilization ........................................................................................................................................ 65
Medical Costs for Juvenile Justice Center: Direct Service Planning and Administration ............................... 66
Medical Costs for Juvenile Justice Center: Mind Body Awareness ...................................................................... 67
Medical Costs for Juvenile Justice Center: Niroga Institute .................................................................................. 68
Medical Costs for Juvenile Justice Center: Victims of Crime ................................................................................ 69
Preventive Care Pathways ............................................................................................................................................. 70
Primary Care Community-Based Organizations .................................................................................................... 71
Tiburcio Vasquez Health Center, Inc. ........................................................................................................................ 73
Washington Hospital ..................................................................................................................................................... 75
Group 4: Public Health
ACCMA Community Health Foundation/East Bay Conversation Project ........................................................ 78
Alameda Boys & Girls Club, Inc. ................................................................................................................................ 80
Alameda County Asthma Start ................................................................................................................................... 82
Alameda County Breastfeeding Coalition Childcare Taskforce ........................................................................... 84
Center for Early Intervention on Deafness ............................................................................................................... 85
City of San Leandro ....................................................................................................................................................... 86
Drivers for Survivors, Inc. ............................................................................................................................................ 87
East Oakland Community Project .............................................................................................................................. 88
Eden Youth and Family Center .................................................................................................................................... 89
Emergency Medical Services (EMS) Corps .............................................................................................................. 91
Emergency Medical Services (EMS) Health Coach Program ............................................................................... 92
Emergency Medical Services (EMS) Injury Prevention ......................................................................................... 93
Genesis Worship Center ............................................................................................................................................... 95
HIV Education and Prevention Project of Alameda County OPEND Program ............................................... 96
HIV Education and Prevention Project of Alameda County Syringe Program ................................................. 98
LIFE ElderCare ............................................................................................................................................................. 100
LifeLong Medical Care Emery School Health Center .......................................................................................... 101
LifeLong Medical Care Heart2Heart ....................................................................................................................... 102
Love Never Fails ........................................................................................................................................................... 104
Mandela MarketPlace .................................................................................................................................................. 105
National Health Care Decisions Day ........................................................................................................................ 106
Public Health Prevention Initiative .......................................................................................................................... 107
Senior Injury Prevention Program ........................................................................................................................... 117
Service Opportunities for Seniors (Meals on Wheels) ......................................................................................... 119
Social and Environmental Entrepreneurs, Inc. (Acta Non Verba) ..................................................................... 120
Spectrum Community Services, Inc. Fall Prevention ........................................................................................... 121
Spectrum Community Services, Inc. Senior Nutrition Program ....................................................................... 122
Timelist Group Inc. ...................................................................................................................................................... 123
Youth and Family Opportunity Initiatives .............................................................................................................. 124
Youth UpRising ............................................................................................................................................................. 129
Appendices
Appendix A: Measure A Revenue Received ........................................................................................................ 132
Appendix B: FY 15/16 Budget Information ....................................................................................................... 133
Appendix C: FY 15/16 Measure A Fund Distribution by Provider or Program ................................ 135
Appendix D: Maps: Geographic Distribution of
Providers Funded by Measure A in FY 15/16 .................................................................................................... 140
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)
Keith Davies Alameda County Public Health Commission
Adam Davis Hospital Council of Northern California
Charles Go Supervisor Wilma Chan (District 3)
Dru Howard Supervisor Keith Carson (District 5)
Kuwaza Imara Central Labor Council of Alameda County
Sally Morgan League of Women Voters
Al Murray City of Berkeley
Zachariah Oquenda Supervisor Richard Valle (District 2)
Jaseon Outlaw, Ph.D. Alameda County Mental Health Board
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) City Managers’ Association
(vacant) Supervisor Nate Miley (District 4)
* Olga Borjon resigned in September 2017. Zachariah Oquenda was appointed to
serve the remainder of her term.
ALAMEDA COUNTY HEALTH CARE SERVICES AGENCY STAFF
Colleen Chawla Agency Director
Rebecca Gebhart Finance Director
James Nguyen Administrative Services Officer
Connie Soriano Administrative Specialist II
FY 2015/2016 Measure AExecutive Summary
(July 1, 2015 – June 30, 2016)
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, highlighting accomplishments while deliberating and
communicating concerns to providers, and reviewing and editing the
Measure A report. 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 $137,233,576* in FY 15/16.
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
133,234 individuals, or 8.3% of County residents, remain uninsured
according to the American Community Survey estimates for 2016. 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 $137,233,576 that Measure A generated in FY 15/16,
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.
17%
81%
2%Behavioral Services
Population Health
Management
Provider Delivery
Public Health
Behavioral Health
Primary Care
26%
17%
33%
24%
Hospital, Tertiary Care, Other
the Board of Supervisors
Measure A Funding Approved by
Allocati on of Measure A Funds toAlameda Health System
Total generated: $34.3 million
Total allocated: $32.5 million**
Total: $102.9 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.
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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.
Countywide Benefits
Measure A funds continue to support the health and well-being of large
numbers of County residents. AHS alone served 129,805 County residents
through Measure A in FY 15/16, while the Alameda County Public Health
Department Public Health Prevention Initiative served 129,388.
In addition, Measure A contributes to positive outcomes for residents
throughout the County, with recipient providers located in every
Supervisory District in cities from Fremont to Livermore to Berkeley.
Substantial Return on Investment
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 $13.3 million in matching funds. Thus, every $1 in
Measure A funds to these recipients returned $0.40 in matching funds.
For some recipients, the matching funds represented a return greater than
1:1. Safe Alternatives to Violent Environments (SAVE) obtained almost
$85,000 in matching funds on its $40,000 Measure A allocation. Fremont
Aging and Family Services obtained almost $200,000 in matching funds
on its $52,000 Measure A allocation. Most notably, the School-Based
Behavioral Health Initiative obtained over $6,000,000 in matching funds
on its $617,000 Measure A allocation, while the School Health Centers
obtained almost $12,000,000 in matching funds on an allocation of
roughly $1,250,000.
Exceeding Expectations
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 (4,822 actual vs. 1,200 target, an increase of over 400%)
and providing health care application assistance (933 actual vs. 133 target,
an increase of over 700%). HIV Education and Prevention Project of
Alameda County exceeded its target for one-on-one Overdose Prevention
Education and Naloxone Distribution trainings by 158%.
Fremont Aging and Family Services conducted 729 home visits to
122 clients, compared to a target of 350 home visits to 85 clients. And
LifeLong Heart2Heart reached 865 residents through mobile outreach
compared to a target of 200, and provided 1,696 visits to the hypertension
clinic compared to a target of 500.
AHS alone served
129,805 County
residents through
Measure A in FY 15/16,
while the Alameda
County Public Health
Department Public
Health Prevention
Initiative served
129,388.
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$13.3
million
Client Satisfaction
In surveys, recipients of Measure A-funded services revealed high levels
of satisfaction with their provider and care received. For youth receiving
behavioral health services through the Center for Healthy Schools and
Communities School-Based Behavioral Health Initiative, 96% stated that
they were satisfied with the service they received, and 91% reported that
they got the help they wanted. At Preventive Care Pathways, 100% of
residents rated the medical care they received as good or very good. And
at Tiburcio Vasquez Health Center, Inc., 100% of respondents expressed
that health center staff helped them get services they wouldn’t otherwise
get.
Measurable Success
Provider recipient reporting continues to improve in providing metrics
for client outcomes. Among the measurable results provided, Highland
Hospital’s Outpatient Pharmacy reported that average wait times have
decreased from three to four hours to no more than 30 minutes. At UCSF
Benioff Children’s Hospital Oakland, 100% of children who received
Trauma-Focused Cognitive Behavioral Therapy demonstrated clinical
progress. And at the Health Services for Day Laborers: Community
Initiatives Day Labor Center, 100% of clients who required follow-up care
received the care they needed, and 100% of uninsured clients were signed
up for health coverage.
Innovative Services
Measure A funding supports a wide variety of services that support the
health and well-being of the target population. In addition to traditional
medical and mental/behavioral health service providers, Measure
A recipients in FY 15/16 included the Connecting Kids to Coverage
Initiative, which provides health insurance application assistance;
the Alameda-Contra Costa Medical Association Community Health
Foundation/East Bay Conversation Project and the National Health Care
Decisions Day, which promote understanding and engagement in advance
care planning; and the Alameda County Breastfeeding Coalition Childcare
Taskforce, which promotes and supports breastfeeding through education,
collaboration, and partnership.
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 (38%), behavioral/emotional needs (51%),
and school success (37%) from intake to discharge. Youth participating in
the Mind Body Awareness program at the Juvenile Justice Center revealed
a decrease in stress (87%) and an increase in self-control (83%).
Measure AAllocation MatchingFunds
$34.3
million
The recipients of the
25% of Measure A funds
allocated by the Board
obtained $13.3 million
in matching funds
from public and private
sources.
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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 (2004-2016) and in the foreseeable future.
Furthermore, many families, especially those living in disadvantaged
communities, have not benefitted from the economic recovery in recent
years and face rising housing and living costs, which significantly impact
the health of County residents. In 2015, an estimated 18,000 to 23,000
County residents experienced homelessness, according to the Health Care
for the Homeless Needs Assessment. As the housing and homelessness
crisis continues to grow in Alameda County, Measure A continues to
play a vital role in providing essential health services to many vulnerable
residents, including low income families and seniors.
The Committee urges Alameda County to pay close attention to public
health policy changes that relate to homelessness and housing affordability
that may have significant impacts on health care access or the County’s
safety net. 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.
RECOMMENDATION: Recruitment of Oversight Committee
membership should place an ongoing focus on representing the diverse
make-up of the population served by Measure A.
7
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 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
• 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.
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—
via audit or other method.
• 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.
• 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 population of indigent, uninsured, and low income clients
they serve by race, ethnicity, geography, and language. The Oversight
Committee notes that many Measure A recipients do not understand the
difference between quality and impact objectives and outcomes. Many
8
Measure A recipients also could not provide the specific composition of
the demographics that they serve. The Committee further advocates that
HCSA be sufficiently staffed to successfully implement such a process.
RECOMMENDATION: Organizations that do not provide adequate
information in response to HCSA and Oversight Committee requests may
not be considered for future funding.
RECOMMENDATION: The Board should authorize HCSA to include
evaluations of Measure A programs as part of its initiative to improve
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 put a process in place to improve
the measurable objectives and outcomes reported by providers.
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 continue to hold trainings to
reinforce proper and accurate completion of demographic information
and adherence to Measure A services. Measure A recipients who fail
to complete the reporting form adequately will be required to attend
mandatory training.
RECOMMENDATION: HCSA should continue to work with recipients to
improve the use of Results-Based Accountability performance measures
and ensure that the population and services supported with Measure A
comply with the ordinance.
RECOMMENDATION: HCSA should refine 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.
Alameda Health System
In response to questions from the Measure A Oversight Committee,
neither Mr. David Cox, CFO, nor Mr. Terry Lightfoot, Director of Public
Affairs and Community Engagement, were able to:
• Determine what portion of Measure A funds were allocated to
personnel, subcontracted services, non-personnel program and/or
operating expenses, or administrative overhead, separate from their
overall agency budget for these categories.
• Determine what portion of Measure A funds were allocated to the
actual number of staff supported, separate from their entire agency staff
of 3,415.
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• Determine what portion of Measure A funds were allocated to the
actual number of individuals served, separate from the agency total of
43,039 individual patients.
• Explain why in their Measure A allocation report they identified 17%
of their patients as being “uninsured,” whereas in their presentation
of September 2016 monthly metrics to the Oversight Committee only
5.5% were uninsured.
In light of the above collective concerns, it is recommended that
Alameda Health System undergo a full and comprehensive audit to track
Measure A fund allocations during the FY 15/16 period to clarify public
accountability for how the funds were utilized.
San Leandro Hospital
As San Leandro Hospital is part of Alameda Health System, several of the
concerns listed for AHS on page 9 apply to San Leandro Hospital as well.
Specifically, AHS was unable to:
• Determine what portion of Measure A funds were allocated to
personnel, subcontracted services, non-personnel program and/or
operating expenses, or administrative overhead, separate from their
overall agency budget for these categories.
• Determine what portion of Measure A funds were allocated to the
actual number of staff supported, separate from San Leandro’s staff
of 333.
As mentioned previously, it is recommended that Alameda Health
System undergo a full and comprehensive audit to track Measure A fund
allocations during the FY 15/16 period to clarify public accountability for
how the funds were utilized.
Timelist Group Inc.
This provider did not supply any Measure A funding information for FY
15/16. Therefore, the Committee cannot evaluate whether funds were
spent in accordance with the strictures of Measure A.
10
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, and public health,
mental health, and substance abuse services to address the many health needs of communities throughout the County.
In FY 15/16, Measure A generated $137,233,576 (not including interest earned). The funds were allocated as follows:
Alameda Health System (75%): $102,925,182
Alameda County (non-AHS) (25%): $34,308,394
TOTAL: $137,233,576
In FY 15/16, the Alameda County approved budget totaled $2.744 billion. The Alameda County Health Care Services
Agency approved budget totaled $646 million, or 23.5% of the total County budget. Measure A revenues not specifically
designated for AHS accounted for 5.3%.
The following sections in the report provide more detail on how AHS and the Board spent Measure A funds in FY 15/16,
which includes revenue generated in the reporting year as well as unspent funds earned in previous years.
2015-2016 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
11
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:
- Hiring additional providers in primary care
- Adding convenient appointments in primary care
- Building a model of team-based care in primary care
- Assessing operational efficiency and streamlining processes
- Offering e-consults in specialty care
• Sustainability goals:
- Establishing performance benchmarks and operating expense controls
- Improving operational and finance reporting capabilities
- Assessing service line/business profitability
- Completing reimbursement analytics
• Quality goals:
- Developing harm reduction teams to review root causes and
implement proven best practices
- Conducting routine physician peer review, where applicable, for
practice improvement
• Service goals:
- Setting standards for response times to patient call buttons
- Increasing staff efforts to include the patient in decisions about his
or her treatment
• Workforce Development goals:
- Sharing results and ensuring that staff understand what they mean
- Providing instruction and training on how to enlist the support of
team members to improve engagement
Allocation: $102,925,182 | Expended/Encumbered: $102,925,182
Individuals served by Measure A: 129,805 (Total individuals served: 129,805)
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 $18,101,487 in matching
funds through the Seniors and Persons
with Disabilities and Rate Range
intergovernmental transfers provided
by Alameda County.
Measure AAllocation MatchingFunds
$103,652,898
$18,101,487
2015-2016 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
12
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.
In FY 15/16, Measure A helped AHS achieve the following:
• Access (number of days to the third-next-available appointment)
- Primary care: Highland, 31; Eastmont, 41; Hayward, 80; Newark, 50.
- Specialty care: Highland, 43; Eastmont, 53.
• Sustainability
- Operating margin for FY 15/16 was 3.3%, compared to -8% in FY 14/15.
• Quality
- Total harm reduction improved 55.35% from FY 10/11 to FY 15/16
and 23.77% from FY 14/15 to FY 15/16.
• Service
- Patients who reported getting help as soon as they wanted after
pressing the call button improved 6.42% over the prior year.
- Patients who reported that staff took their and their families/
caregivers’ preferences into account in deciding their health care
needs after discharge improved 4.15% over the prior year.
• Workforce Development
- Systemwide scores for employee engagement were 3.95 (2015) and 3.6
(2016), and for physician engagement were 3.68 (2015) and 3.3 (2016).
REvEnuE EARnEd EACH fISCAl YEAR (fY 04/05 tHRougH fY 15/16)
FY 04/05
FY 05/06
FY 06/07
FY 07/08
FY 08/09
FY 09/10
FY 10/11
FY 11/12
FY 12/13
FY 13/14
FY 14/15
FY 15/16
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
$103,652,898
Highlights
Highland Hospital’s Outpatient
Pharmacy has made many significant
improvements in patient care:
• Average wait times have decreased
from three to four hours to no more
than 30 minutes.
• Patients are alerted via text
message or phone call when their
prescriptions are ready.
• A free, same-day delivery service
was launched for eligible patients.
• Pharmacy profits have grown
significantly from approximately
$400k in 2014 to a projected $2.8
million for 2016.
2015-2016 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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CONCERNS
In response to questions from the Measure A Oversight Committee,
neither Mr. David Cox, CFO, nor Mr. Terry Lightfoot, Director of Public
Affairs and Community Engagement, were able to:
• Determine what portion of Measure A funds were allocated to
personnel, subcontracted services, non-personnel program and/or
operating expenses, or administrative overhead, separate from their
overall agency budget for these categories.
• Determine what portion of Measure A funds were allocated to the
actual number of staff supported, separate from their entire agency staff
of 3,415.
• Determine what portion of Measure A funds were allocated to the
actual number of individuals served, separate from the agency total of
43,039 individual patients.
• Explain why in their Measure A allocation report they identified 17%
of their patients as being “uninsured,” whereas in their presentation
of September 2016 monthly metrics to the Oversight Committee only
5.5% were uninsured.
In light of the above collective concerns, it is recommended that
Alameda Health System undergo a full and comprehensive audit to track
Measure A fund allocations during the FY 15/16 period to clarify public
accountability for how the funds were utilized.
Measure A Helps
Ms. M, a homeless patient at
Highland Hospital, was diagnosed
with Clostridium Difficile Infection
(C. Diff), AIDS and Disseminated
MAC, symptoms of diarrhea, weight
loss, and fever. She also reported using
crack cocaine frequently. The Homeless
Coordination Team, Licensed Clinical
Social Worker (LCSW), and AHS
Director of Social Services worked
together to get Ms. M a housing
voucher, assess her goals and needs,
and ultimately provide a referral to
the Cherry Hill Detoxification Center.
The LCSW continued to engage with
Ms. M and discuss other treatment
options. Ms. M was able to secure a
bed at Chrysalis Residential Treatment
Program and was expected to graduate
in January of 2017. ALLOCATION OF ALAMEDA HEALTH SYSTEM
MEASURE A FUNDS IN FY 14/15
Alameda Hospital
Ambulatory
Fairmont Campus
John George Behavioral Health
San Leandro Campus
Professional Services 29%
28%
7%
10%
11%
15%
2015-2016 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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FY 15/16: 25% OF MEASURE A FUNDS ALLOCATED BYThe Alameda County Board of Supervisors
In FY 15/16, the Board of Supervisors (Board) approved approximately $34.3 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 15/16 Budget Information and Appendix C: FY 15/16 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 15/16
TOTAL MATCHING FUNDS OBTAINED BY LEVERAGING MEASURE A ALLOCATIONS
26%
17%33%
24%
group 4: Public Health
$7,978,387
Group 1: Behavioral Health
$8,397,799
group 2: Hospital, tertiary Care, other
$5,400,000Group 3: Primary Care
$10,739,313
Measure A Allocation Matching Funds
$32,515,499
$13,365,906
2015-2016 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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2015-2016 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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FUNDS ALLOCATED BY THE ALAMEDA COUNTY BOARD OF SUPERVISORS
GROUP 1: BEHAVIORAL HEALTH
Behavioral Health and Alcohol and Other Drug (AOD) Community ......................................................... 18
Center for Healthy Schools and Communities (School-Based Behavioral Health Initiative) ..................... 19
Criminal Justice Screening and In-Custody Services ................................................................................. 23
Detoxification/Sobering Center ................................................................................................................ 27
La Familia Counseling Services ................................................................................................................. 29
Mental Health Services for Juvenile Justice Center .................................................................................. 30
Mental Health Services for Newcomers and Immigrants (CERI) ............................................................... 31
Safe Alternatives to Violent Environments (SAVE) .................................................................................... 32
Senior Support Program of Tri-Valley ....................................................................................................... 33
2015-2016 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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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 several mental health and
substance use disorder programs. Funds were roughly evenly distributed
between mental health and alcohol and other drug (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 contract.
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: $775,848 | Expended/Encumbered: $775,848
Individuals served by Measure A: 10,000 (Total individuals served: 36,000)
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
$775,848
$19,961
2015-2016 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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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.
Co-coordinated by CHSC and the Alameda County Behavioral Health
Care Services (BHCS) Agency, the Alameda County School-Based
Behavioral Health Initiative strengthens the use of evidence-based
practices along a continuum of behavioral health supports that includes
prevention, early intervention, and treatment strategies.
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 main objective of the initiative is to implement
and strengthen these programs in the following school districts:
• Emery Unified
• Newark Unified
• New Haven Unified
• Dublin Unified
• Livermore Valley Joint Unified
• Oakland Unified
• Pleasanton Unified
• San Leandro Unified
• Hayward Unified
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
Allocation: $622,356 | Expended/Encumbered: $622,356
Individuals served by Measure A: 2,913 (Total individuals served: 2,913)
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
Jake, a 17-year-old high school senior,
has experienced multiple traumas.
He was placed in foster care after his
parents were incarcerated but left the
foster home due to abuse, leading to
homelessness and substance abuse. At
school, Jake was arrested for carrying
a pocket knife on campus. After his
arrest, Jake was referred to COST. The
COST helped Jack get a job, accessed
funds for transportation to and from
school, and provided academic support.
The COST continues to connect Jake
to services available for transition-age
youth and is working on a permanent
housing solution. Thanks in large part
to the COST support, in June 2016,
Jake graduated from high school.
2015-2016 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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supports prevention efforts at the school sites, as well as early intervention
and treatment services for any student and their family that needs it.
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 services provided by BHCs include the following:
• Assess the social-emotional service needs and infrastructure of a school
district or set of schools and develop a service plan
• Coordinate the work of all partner agencies who deliver behavioral
health services in schools and districts
• Provide and/or coordinate clinical case management, group and
individual counseling, and crisis assessment and intervention to
students
• Provide workshops, parenting groups, mental health and other
appropriate consultation, and linkages to needed school and
community resources to parents/caregivers
MEASURE A FUNDING SUMMARY
The School-Based Behavioral Health Initiative used its Measure A
allocation to support the following activities through the District
Behavioral Health Consultation program.
Prevention Activities
BHCs provided a variety of non-clinical preventative services to students,
families, and teachers and other staff at schools and schools districts.
These services included the following:
• Individual mentorship/drop-ins with youth
• Youth groups
• Individual mentorship/drop-ins with families
• Family groups/workshops
• Teacher/provider consultations
• School/district staff presentations
As a result of Measure A funding, the School-Based Behavioral
Health Initiative also supported the unique needs of the population
of unaccompanied immigrant youth (UIY) in schools through the
development of the UIY Care Team. The UIY Care Team deployed
culturally competent clinicians and case managers to schools and districts
to connect UIY and their caregivers to mental health supports and
other resources. BHCs supported the UIY in their schools/districts by
identifying youth who might be unaccompanied immigrants and alerting
the UIY team so that they could respond appropriately to their health,
mental health, and academic needs. In FY 15/16, BHCs reported serving
or brokering non-clinical support for 118 UIY.
Matching Funds
The School-Based Behavioral Health
Initiative leveraged its Measure A
allocation to obtain $6,016,022 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 AAllocation MatchingFunds
$617,362
$6,016,022
2015-2016 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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Early Intervention and Treatment Strategies
BHCs performed several roles and responsibilities to strengthen the
quality of early intervention and treatment programs in all school
districts:
• In all districts, BHCs served as key point persons for responding to
behavioral health crises at school sites. BHCs either directly provided
crisis response services or coordinated crisis response. In FY 15/16,
BHCs provided crisis assessment services to 471 youth, with a total of
420 hours reported on this work.
• In addition to overseeing Clinical Case Managers in Oakland and
Hayward, BHCs provided direct supervision and/or coordination of
graduate-level social work and MFT interns in the Emery, Newark,
New Haven, San Leandro, and Hayward Unified School Districts.
The Our Kids Our Families Intern Program supervised a total of 16
social work and MFT interns. During FY 15/16, 4,073 students were
provided with 146,318 hours of clinical services through the program.
The program also provided 6,565 hours of support to the families of
students receiving clinical services.
• BHCs also worked to expand the use of therapeutic groups for students
who showed early signs of behavioral health struggles. In FY 15/16,
8,876 hours of group services were provided to these at-risk students.
In addition, BHCs coordinated clinical staff to work with teachers and
other staff to help them support students who were receiving treatment.
As a result, 6,241 hours of support were provided to these teachers and
staff.
• In FY 15/16, BHCs coordinated social and emotional learning (SEL)
initiatives at all eight school districts supported by Measure A
funds. The Emery, Newark, and Hayward school districts received
funding to implement a Positive Behavioral Interventions & Supports
(PBIS) framework in every school. As a result of this work, PBIS was
implemented in 18 of 21 schools in Hayward and four of 13 schools
in Newark. BHCs are also supporting quality improvements of San
Leandro’s PBIS initiative, which was implemented in every school in the
district.
• BHCs also supported other SEL and restorative justice resources in
school districts, such as implementing restorative justice coordinators
at all secondary schools in Hayward and developing Parent Ambassador
and Student Ambassador programs to support engagement in district
planning efforts. BHCs also supported the adoption of SEL curriculums
in the Emery, San Leandro, and Dublin school districts.
• BHCs implemented Coordination of Services Teams (COST) and
other referral mechanisms for behavioral health supports. COST is
an evidence-based model for coordinating care at a school site. The
multidisciplinary COST worked together to identify students who are
struggling through referrals and data-driven screenings; deliberate
strengths and challenges and assess supports needed for each student
who is struggling; support the implementation of interventions that will
Highlights
In surveys of youth receiving
behavioral health services in the
School-Based Behavioral Health
Initiative:
• 96% stated that they were satisfied
with the service they received.
• 91% reported that they got the help
they wanted.
• 94% reported improvements in
their access to an individual who
can help them in a crisis.
• 85% reported improved ability to
cope when things go wrong.
• 85% indicated improved
relationships with friends and other
people.
• 84% reported improvements in
school and/or work.
In surveys of parents whose students
had received services:
• 91% reported a high level of
satisfaction with the services that
their child received.
• 76% and 82% saw improvements
in their children’s ability to handle
school and daily life, respectively.
• 97% who participated in parent/
family engagement workshops
reported that the events were
useful and informative, addressed
their needs, and increased their
knowledge and parenting skills.
2015-2016 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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support the student; monitor progress and provide appropriate follow-
up; identify the broader learning support resource needs of the school;
and make recommendations about resource allocation.
• During FY 15/16, BHCs supported the implementation of COST in 157
schools in 13 school districts, or 56% of all schools in these districts.
COSTs at these schools received over 7,228 student referrals during the
year. Approximately 72% of all students (or 5,170) referred to COST
were connected to critical behavioral health services.
Highlights
The Child and Adolescent Needs
and Strengths (CANS) assessment
administered to students receiving
services showed significant
improvements in:
• life functioning (38%)
• Behavioral/emotional needs (51%)
• School success (37%)
• Child strengths (44%)
Among students who received
individual or group clinical services,
the proportion who experienced
depression decreased from 35% at
intake to 21% at discharge.
2015-2016 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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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 Mental Health (CJMH) 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 criminal
justice screening and to provide ongoing services and assessments on the
housing units at Santa Rita Jail (SRJ) and Glen Dyer Detention Facility
(GDDF). Goals included the following:
• Provide onsite clinical coverage in the Intake, Transfer, and Release
(ITR) area of SRJ seven days a week, two shifts per day
• Provide on-call access to clinicians during times staff is not onsite
• Respond to all mental health crises within the jail in a timely manner
• Assess all inmates placed on suicide watch while in custody
• Provide assessment and monitoring of seriously mentally ill inmates
housed in SRJ and GDDF
• Refer clients to appropriate community services
In FY 15/16, CJMH staff completed the following:
• 5,543 assessments/initial evaluations
• 7,249 individual therapy sessions
• 961 crisis interventions
• 7,986 face-to-face medication interviews
• 4,641 non-face-to-face medication interventions
Allocation: $4,306,000 | Expended/Encumbered: $4,306,000
Individuals served by Measure A: Approximately 4,728 (Total individuals served: 4,728)
Populations served: Indigent, Low Income, Uninsured Adults, Families, Seniors
Services provided: Mental Health
Service area: Countywide
Criminal Justice Screening and In-Custody Services
Measure A Helps
Ms. X, 34, has a long history of
mental health treatment, often from
CJMH while in jail. Through repeated
interventions, CJMH staff were able
to develop a trusting relationship
with Ms. X and encourage her to
engage in treatment. During a recent
incarceration, CJMH staff referred Ms.
X to a re-entry program for inmates
who are not connected to community
mental health services. Although Ms.
X continues to struggle with addiction,
she has been engaged with treatment
and has not returned to custody. Ms.
X was stabilized by CJMH staff so she
was in a much better position to take
advantage of the discharge plans and
referrals provided by CJMH.
2015-2016 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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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
conducts 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
select special housing units. 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.
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.
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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 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.
• Court-ordered evaluations. CJMH clinicians conduct court-ordered
psychiatric evaluations 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
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.
2015-2016 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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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 in 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.
All new CJMH staff
receive 40 hours of
initial training.
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BACkGROUND
The Detoxification/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.
Services provided include the following:
• Residential sobering services including a stay of less than 24 hours
at the Sobering Center for withdrawal management from alcohol
and other drugs of abuse. The Sobering Center serves as a receiving
and substance use crisis center for local law enforcement, hospitals,
families, clinics, and communities. The Sobering Center is accessible to
the community 24 hours per day, every day, including holidays.
• Residential detoxification services including a 3–5 day stay at the
Detoxification Center focused on withdrawal management, client
engagement, and referral to ongoing care. Ongoing care might include
residential substance use treatment, shelters, mental health treatment,
sober living, transitional living, and other community resources. The
Detoxification Center is accessible to the community 24 hours per day,
every day, including holidays.
• Health Center services including tuberculosis skin testing; wound care;
medication management; medical assessment; blood pressure, heart
rate, and pulse check; and crisis medical response.
• Transportation services for clients to and from hospitals, clinics, and
treatment centers. Transportation services are also available for law
enforcement, crisis response teams, and any other community provider
who has a person who is in need of detoxification or sobering services.
• Recovery services including substance use prevention, relapse
prevention, case management, and referral services.
• 12-step meetings including Alcoholics Anonymous and Narcotics
Anonymous. These meetings are closed to the public and are offered
five evenings per week, every week, including holidays.
Allocation: $2,143,224 | Expended/Encumbered: $1,996,448
Individuals served by Measure A: 7,068 (Total individuals served: 7,068)
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 transgendered client (male who
identifies as female) arrived at
Cherry Hill with a co-occurring
mental illness and substance use
disorder. Despite numerous staff
attempts at engagement, the client
left the Sobering Center untreated.
Approximately a month later, the
client returned to Cherry Hill from
a local hospital. Staff were able to
accommodate her needs and make
attempts to engage her during the
detoxification process. Despite many
challenging days, the client was able
to safely detoxify from heroin, stabilize
on her psychiatric medication, and be
referred to residential co-occurring
disorder treatment. Staff received a
letter from the client thanking them for
being accommodating and sensitive to
her needs.
2015-2016 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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MEASURE A FUNDING SUMMARY
Measure A provides over 98% 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:
• Cherry Hill Sobering Center provided 5,014 units of service, with a
total of 5,014 admissions.
• The Detox Center provided 8,775 units of service, with a total of 2,054
admissions.
• The Health Center provided 955 health services.
Cherry Hill Sobering
Center provided
5,014 units of service.
The Detox Center
provided 8,775 units
of service.
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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
La Familia used its Measure A allocation to achieve the following:
• Provide individual and family basic needs information, housing
referrals, job referrals, nutrition, translations, health referrals,
immigration, legal and general orientation, and health education
workshops to low income residents, to help them attain increased
psycho-social and economic stability (target: 1,200 residents; actual:
4,822).
• 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: 39).
• Provide assistance in applying for health coverage through Medi-
Cal and other available options to residents who do not have health
insurance (target: 133 residents; actual: 990).
• 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: 139).
• Provide workshops/support groups to youths to foster healthier
relationships, support community building, and explore personal and
social responsibility (target: 40 workshops/support groups; actual: 48).
La Familia also used its Measure A funding to provide monthly
immigration consultations, Zumba, yoga and meditation, special events
and activities in relation to culture and wellness, and self-enrichment
classes such as ESL.
Allocation: $50,000 | Expended/Encumbered: $50,000
Individuals served by Measure A: 4,822 (Total individuals served: 4,822 )
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 (4,822 actual
vs. 1,200 target, an increase of over
400%), and providing health care
application assistance (990 actual
vs. 133 target, and increase of over
700%). Numbers also increased
substantially in many areas compared
to FY 14/15—for example, information
and referrals increased by 56%, while
health insurance referrals increased by
31% compared to the previous year.
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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 149 mental health assessments in FY 15/16.
Measure A funding covered approximately 14 of those assessments.
• Offer immediate crisis intervention for suicidal youth to avoid self-
harm. The Guidance Clinic performed 167 crisis interventions to avoid
self-harm and/or hospitalization, of which Measure A funded 16.
Allocation: $360,000 | Expended/Encumbered: $360,000
Individuals served by Measure A: 79 (Total individuals served: 847)
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 eight clients
were hospitalized in FY 15/16.
Matching Funds
BHCS leveraged its Measure A
allocation to obtain $59,318 in
matching funds from Medi-Cal.
Measure AAllocation MatchingFunds
$360,000
$59,318
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BACkGROUND
The Center for Empowering Refugees and Immigrants (CERI) is a
grassroots, nonprofit organization dedicated to providing culturally
competent mental health and other social services to refugee and
immigrant families with multiple layers of complex needs, exposure to
violence and trauma both in their current environment and in their native
countries, and weakening intergenerational relationships.
The agency’s focus is on refugees and immigrants from Afghanistan,
Bosnia, Cambodia, and Iran. Presently, the majority of its 200 clients are
Cambodian refugees living in Oakland, about two-thirds are children, and
nearly all are low income.
Over 50% of staff are Cambodian American and speak the Khmer
language. All staff are trained in issues around trauma, refugee, and
immigrant needs for those living in poverty and facing discrimination.
MEASURE A FUNDING SUMMARY
CERI used its Measure A allocation to conduct the following activities:
• Community events (target: 16 events providing outreach to 125
individuals; actual: monthly events attended by 55 individuals)
• Home and school visits (target: 392 hours; actual: 400)
• Psycho-educational workshops (target: 16 workshops)
• Support groups, including life skills classes, art, and other
nontraditional mental health prevention activities (target: 10 groups)
• Cultural workshops (target: 6 workshops; actual: 6)
• Mental health trainings to increase understanding around mental
health and mental health resources (target: 6 trainings; actual: 6)
• Consultation and/or training for schools, probation officers, child
welfare workers, and health care workers
• Mental health early intervention for individuals and families including
referral and linkage to alternative programs as needed (target: 320
hours to at least 10 individuals; actual: 500 hours to 15 individuals)
Allocation: $80,371 | Expended/Encumbered: $80,371
Individuals served by Measure A: 150 (Total individuals served: 180)
Populations served: Low Income, Uninsured Children, Families
Services provided: Mental Health
Service area: Oakland
Mental Health Services for Newcomers and Immigrants (CERI)
cerieastbay.org
Matching Funds
CERI leveraged its Measure A
allocation to obtain $76,556 in
matching funds from the Mental
Health Services Act (MHSA).
Measure AAllocation MatchingFunds
$80,731
$76,556
Highlights
• 100% of CERI’s school-aged youth
are attending some sort of school.
• 16% of adolescents reported
being involved in drug use, gang
involvement, or sexual exploitation,
compared to 40% the previous year.
• CERI made two CPS reports,
compared to five the preceding
year.
• No youth were arrested, compared
to two the preceding year.
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Matching Funds
SAVE leveraged its Measure A
allocation to obtain $84,074 in
matching funds.
Measure AAllocation MatchingFunds
$40,000
$84,074
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.
The SAVE Teen Dating Violence Prevention (TDVP) program provides
an opportunity for youth to discuss and learn topics that can improve
their long-term wellness outcomes. It also helps educators and youth
services providers have a better understanding of how the young people
with whom they work know about healthy relationships, boundaries,
digital safety, warning signs of dating violence, and how/where to
access resources. Given the high risk youth face for being involved in
violent intimate relationships, offering access to this education (which
is often limited to privileged communities) improves overall community
outcomes. The program is designed for and delivered in high school
classrooms.
MEASURE A FUNDING SUMMARY
SAVE used its Measure A allocation to conduct 98 TDVP presentations to
a total of 5,040 students.
Allocation: $40,000 | Expended/Encumbered: $40,000
Individuals served by Measure A: 5,090 (Total individuals served: 8,688)
Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors
Services provided: Public Health
Service area: Fremont, Hayward, Newark, Pleasanton, San Lorenzo, Union City
Safe Alternatives to Violent Environments (SAVE)
save-dv.org
Highlights
In a teacher survey, 100% of teachers
indicated they liked the presentation
and would recommend it to another
educator, compared to a goal of 65%.
In a student survey of questions
regarding teen dating violence, 75% of
students scored at least 80% correct.
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BACkGROUND
Senior Support Program of Tri-Valley provides services and assistance to
seniors 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.
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 used its Measure A allocation to
achieve the following:
• Provide In-Home Counseling services to at least 20 seniors with mental
health issues who are referred from community, staff, family, etc.
100% of clients reported experiencing improvements in mental health
(compared to a target of 80%). 100% also reported improvements in at
least one of the following categories: self-care, isolation, accessing their
support system, and/or experiences with anger/guilt (target: 90%). 92%
of clients would refer a friend to the program.
• Conduct program pre-evaluation with each client to assess mental
health status. Twenty-five evaluations were completed, each of the 25
clients received a customized plan, and 96% of screened clients enrolled
in services.
• Distribute program post-evaluation survey to clients at the end of each
client’s program, summarize survey findings, identify recommended
program changes, and implement program changes. 100% of clients
reported leaving their homes within 48 hours of counseling (compared
to a target of 50%), 76% reported experiencing three or more personal
contacts per week (target: 60%), and 68% reported feeling engaged in
Allocation: $20,000 | Expended/Encumbered: $20,000
Individuals served by Measure A: 25 (Total individuals served: 25)
Populations served: Seniors
Services provided: Mental Health
Service area: Dublin, Livermore, Pleasanton, Sunol
Senior Support Program of Tri-Valley
ssptv.org
Measure A Helps
Mrs. O, 68, has struggled with lung
cancer for the last five years. She
recently ended a long-term relationship
and had become very depressed. The
In-Home Counselor referred Mrs. O
to Senior Support Program of the Tri-
Valley’s case management team, who
assisted her with shopping, Medicare,
and Social Security. The counselor also
addressed Mrs. O’s depression and
medical needs. Mrs. O discussed her
guilt and grief and clarified where she
wanted to live for the time she had left.
Within the next month, Mrs. O was
told that she had six months to live and
decided to move to Southern California
to be with her daughter.
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one or more enjoyable activities/hobbies weekly (target: 60%).
• Recruit, train, and supervise three interns to assist with counseling.
100% of interns completed orientation and training before meeting
clients. Each intern received over 50 hours of training and supervision.
In addition, 100% of interns received one-on-one and group supervision
weekly and bi-monthly trainings. After completing their internship, two
of the three interns became Licensed Marriage and Family Therapists,
and two became Senior Support Program of the Tri-Valley staff.
Highlights
In several key areas, evaluations
revealed that clients exceeded
program targets. For example:
• 100% indicated improvements
in mental health, compared to a
target of 80%.
• 100% reported leaving the home
within 48 hours of counseling,
compared to a target of 50%.
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FUNDS ALLOCATED BY THE ALAMEDA COUNTY BOARD OF SUPERVISORS
GROUP 2: HOSPITAL , TERTIARY CARE , OTHER
Administration/Infrastructure Support .................................................................................................... 36
San Leandro Hospital ................................................................................................................................ 38
St. Rose Hospital ....................................................................................................................................... 39
UCSF Benioff Children’s Hospital Oakland ................................................................................................ 41
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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 provides 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 report, staffing of the Measure A Oversight
Committee, and development of the next three-year Measure A funding
cycle allocations to community-based organizations and programs that
provide essential health care services.
Allocation: $400,000 | Expended/Encumbered: $252,987
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.
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HCSA used its Measure A allocation to meet the following objectives:
• HCSA provided contract and administrative support for 65 Measure
A allocations (target: at least 10). Of the 65 contracts, Administration
and Indigent Health staff was involved in the contract development of
45 of the executed contracts. Of the 45 contracts that were developed
by Administration and Indigent Health staff, 89% were fully executed
within 2.5 months (target: at least 90%).
• Administration and Indigent Health staff provided Results-Based
Accountability (RBA) and Results Scorecard training in April 2016
to 10 organizations that received Measure A base funding (target: at
least 10 trainings to at least 90% of organizations receiving Measure A
funding).
• Administration and Indigent Health staff monitored 45 Measure A
contracts (target: at least 30). The Measure A contract providers had
contracts with either monthly or quarterly reimbursement schedules.
Of the 220 invoices processed, 87% were processed within 30 days from
receiving the invoice and progress report (target: at least 90%).
• Staff coordinated 10 planning meetings to prepare for scheduled
Measure A Citizen Oversight Committee meetings (target: at least 10).
Of the 10 meetings that were scheduled, 100% were convened (target: at
least 90%).
• Administration and Indigent Health staffed and convened 10 Measure
A Oversight Committee meetings (target: at least 10). Of the 10
meetings that were scheduled, 100% were convened (target: at least
90%).
• Staff oversaw the production of the FY 13/14 Measure A final report
and supported the Citizen Oversight Committee in the development of
the FY 13/14 and FY 14/15 reports.
• Staff developed recommendations for the three-year Measure A base
funding cycle starting in FY 16/17 and ending FY 18/19, and presented
it to the Board of Supervisors for approval.
Highlights
Through the work of the HCSA
Administration/Indigent Health
department, the total annual Measure
A base allocation to provide essential
health care services increased 12.9%,
compared to a target of 5%.
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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
For details on San Leandro Hospital’s expenditures of Measure A funds,
see the AHS entry on page 12.
CONCERNS
As San Leandro Hospital is part of AHS, several of the concerns listed
for AHS on page 12 apply to San Leandro Hospital as well. Specifically,
AHS was unable to:
• Determine what portion of Measure A funds were allocated to
personnel, subcontracted services, non-personnel program and/or
operating expenses, or administrative overhead, separate from their
overall agency budget for these categories.
• Determine what portion of Measure A funds were allocated to the
actual number of staff supported, separate from San Leandro’s staff of
333.
As mentioned previously, it is recommended that AHS undergo a full and
comprehensive audit to track Measure A fund allocations during the FY
15/16 period to clarify public accountability for how funds were utilized.
Allocation: $1,000,000 | Expended/Encumbered: $1,000,000
Individuals served by Measure A: 43,029 (Total individuals served: 43,029)
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
San Leandro Hospital
sanleandroahs.org
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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 that 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. SRH routinely accepts hospital transfers
for emergency and elective cardiac care from non-Medi-Cal providers.
SRH serves approximately 11% of Alameda County’s indigent population.
MEASURE A FUNDING SUMMARY
SRH used its Measure A funds to subsidize the cost of providing care to
uninsured and/or indigent patients. Specifically, SRH used its Measure A
allocation to help achieve the following:
• Conduct over 4,100 patient encounters and provide over $3.5 million in
cost of care to uninsured/indigent patients
• For both traditional and Managed Care Medi-Cal programs, conduct
Allocation: $2,000,000 | Expended/Encumbered: $2,000,000
Individuals served by Measure A: 3,208 (Total individuals served: 32,136)
Populations served: Indigent, Low Income, Uninsured 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
Letter from a patient who had surgery
to address abdominal pain:
“I appreciate all of the assistance that
you have given to me. I have a family
of four. I got sick and was unable to
work. I lost my job as a result of me
being sick. I am unemployed and still
not able to pay for health insurance. I
did not meet the criteria for any other
assistance. I am barely able to feed my
family or take care of any of my living
expenses. I am so thankful for St. Rose
helping me out. St. Rose Hospital is a
life saver to this community.”
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over 27,900 patient encounters and incur over $31 million of costs in
excess of amounts
• Experience 32,234 ER visits, including 73%, or 23,496 visits, from
uninsured and underinsured patients (target: 26,000)
• Provide financial support to hospital-based physicians to take ER calls
and provide services to 12,476 uninsured/underinsured patients (target:
12,800)
• Support SRH inpatient services to 3,181 uninsured and underinsured
patients (target: 3,000)
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. This represents a $1 match
for every $1 in Measure A funds.
Measure AAllocation MatchingFunds
$2,000,000 $2,000,000
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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 15/16, to 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.
CHO maintains an extensive in-house and outpatient rehabilitation
department for pediatric trauma patients. The Trauma Center also
supports an injury prevention program for the hospital and the community.
For many children, the ED also functions as the gateway to a regular
medical home, specialty care, or other community programs.
Allocation: $2,000,000 | Expended/Encumbered: $2,000,000
Individuals served by Measure A: 29,262 (Total individuals served: 22,109)
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
Issis, 14, came to the CHO ED with
vaginal pain and discharge following
a sexual assault. Issis’s mother told
the CHO social worker that she had
observed changes in Issis such as
resistance toward attending church
and increased emotional responses, as
well as missing allergy and depression
medication. She also reported that
Issis had attempted suicide on two
occasions. The social worker provided
information about the criminal justice
process and victim rights as well as
ongoing clinical case management
to ensure that a police report was
generated, a forensic interview was
conducted, and a forensic medical
exam was authorized. CCP therapists
were contacted and immediately begin
providing therapeutic services.
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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
California. Without the CHO ED, children would need to travel further
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. Both sites are integrated
into full-service youth and/or family centers that promote youth
development and serve as national models for adolescent health care.
Youth Uprising/Castlemont Clinic—which operates a full-time
comprehensive team of six therapists and a psychiatrist, as well as
comprehensive medical services—is the hub for teachers, parents, and
students to coordinate therapy, care, support, and help. The Castlemont
site is now the highest volume school-connected mental health site in
Alameda County.
Matching Funds
CHO leveraged its Measure A
allocation to obtain $1,000,000
in matching funds through an
intergovernmental transfer using
supplemental funds from the
California Department of Health Care
Services.
Measure AAllocation MatchingFunds
$2,000,000
$1,000,000
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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 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 15/16, there were a total of 47,107 visits to the ED.
• 534 of these visits were trauma cases where the child faced an
immediate life-threatening situation.
• The average length of stay for patients discharged from the ED was
reduced to 2.87 hours, compared to 3.1 hours the previous year (target:
<3 hours).
Center for Child Protection
• In FY 15/16, the CCP served more than 2,000 children and their
families.
• 452 of these children and families received intensive behavioral health
services.
• The CCP conducted 97 forensic evidentiary examinations, 55
outpatient medical consultations, and 60 inpatient medical
consultations, and provided clinical and psychotherapy services to 205
children.
• 35 children participated in Camp CCP, where children receive intensive
group psychotherapy services integrated with socialization experiences.
• At least 90% of the individual psychotherapy clients successfully
engaged in treatment after the initial assessment/onset of treatment
(target: >90%).
• 35 children were referred for group psychotherapy.
• 100% had successful engagement in and completion of the group
psychotherapy program.
• 100% of children who received Trauma-Focused Cognitive Behavioral
Therapy demonstrated clinical progress (target: 100%).
School-Based Clinics
• In FY 15/16, the two clinics run by CHO had a total of 6,735 encounters
and saw 947 unique patients.
• 83% of patients reported they were satisfied or very satisfied with the
services they received (target: >80%).
• 83% of patients reported that they agree or strongly agree that the
school clinics helped them with their problem (target: >80%).
Highlights
CHO met or exceeded its targets in all
areas. 100% of children who received
trauma-focused Cognitive Behavioral
Therapy demonstrated clinical
progress, and 83% of school clinic
patients agreed or strongly agreed
that the clinics helped them with their
problem.
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FUNDS ALLOCATED BY THE ALAMEDA COUNTY BOARD OF SUPERVISORS
GROUP 3: PRIMARY CARE
Alameda County Dental Health ................................................................................................................ 46
Center for Elders’ Independence ............................................................................................................. 48
Center for Healthy Schools and Communities (School Health Centers) ................................................... 49
Connecting Kids to Coverage (CKC) Initiative ............................................................................................ 52
Fire Station Health Portals ........................................................................................................................ 55
Fremont Aging and Family Services .......................................................................................................... 56
Health Enrollment for Children ................................................................................................................ 59
Health Services for Day Laborers: Community Initiatives (Day Labor Center) .......................................... 60
Health Services for Day Laborers: Multicultural Institute ......................................................................... 62
Health Services for Day Laborers: Street Level Health Project ................................................................. 64
Increase Hospice Utilization ..................................................................................................................... 65
Medical Costs for Juvenile Justice Center: Direct Service Planning and Administration .......................... 66
Medical Costs for Juvenile Justice Center: Mind Body Awareness ........................................................... 67
Medical Costs for Juvenile Justice Center: Niroga Institute ...................................................................... 68
Medical Costs for Juvenile Justice Center: Victims of Crime .................................................................... 69
Preventive Care Pathways ........................................................................................................................ 70
Primary Care Community-Based Organizations ........................................................................................ 71
Tiburcio Vasquez Health Center, Inc. ........................................................................................................ 73
Washington Hospital ................................................................................................................................ 75
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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 Women, Infants, and Children (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. The focus of the
service is to families of children (ages 9 to 15 months) who participate in
Dental Days at WIC at the Eastmont, Telegraph, Hayward, and Fremont
sites. Since siblings often accompany the caregiver at the Dental Days, all
services are offered to them as well.
In addition, the County Public Health Department collaborates with
the City of Berkeley Public Health Department to screen and provide
preventive dental services including cleaning, sealants, fluoride varnish,
and one-on-one oral health instruction to students at 11 schools.
Allocation: $157,580 | Expended/Encumbered: $157,580
Individuals served by Measure A: 2,206 (Total individuals served: 4,680)
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
Alameda County Dental Health
www.acphd.org/dental-administration.aspx
Matching Funds
The WIC Oral Health Program
leveraged its Measure A allocation to
obtain $222,326 in matching federal
funds from the Maternal, Child, and
Adolescent Health Program (MCAH)
and Child Health and Disability
Prevention (CHDP).
Measure AAllocation MatchingFunds
$157,580
$222,326
Highlights
The program met or exceeded all of its
targets for both the WIC Dental Days
and the school-based program.
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MEASURE A FUNDING SUMMARY
Measure A funding helped the WIC Oral Health Collaborative program
achieve the following:
• Provide dental education to 1,022 parents/guardians through WIC
Dental Days (target: at least 1,000)
• Provide oral health assessments to 1,014 infants/children through WIC
Dental Days (target: at least 900)
• Provide fluoride varnish to 832 infants/children through WIC Dental
Days (target: at least 800)
• Screen 1,204 students at the school-based program (target: at least
1,050)
• Provide sealants to 100% of eligible students screened at the school-
based program (target: 100%)
• Provide preventive dental services and referral to a dental home to
100% of children and students at WIC Dental Days and the school-
based program (target: 100% at each)
• Enroll 79% of assessed children into the Healthy Kids Healthy Teeth
(HKHT) program and link them to dental providers (target: at least
75%)
Measure A Helps
At a WIC Dental Day, a Community
Health Outreach Worker (CHOW)
met a four-year-old boy who was newly
enrolled in Medi-Cal. The father stated
that his son had been complaining
of toothaches. The CHOW referred
the child to the Registered Dental
Hygienist (RDH), who completed a
dental screening and detected severe
tooth decay. The CHOW enrolled the
child into the HKHT program and
scheduled a next-day appointment
with an HKHT provider. The efficient
and effective outreach and care
coordination efforts by the CHOW
and RDH helped ensure that the boy
received the needed dental treatment
services to obtain and maintain good
oral health.
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Measure A Helps
A CEI chaplain recalls a senior who
was vacillating about continuing
dialysis and getting sicker. The senior
explained that he was miserable and
was ready to be done. The CEI team
called his family together to honor his
wishes. The senior went on to hospice
in skilled nursing and quickly passed
peacefully. The chaplain states that the
senior had intellectual rigor and an
eclectic set of beliefs. His family was
very grateful for the spiritual support
he received at the end of his life.
BACkGROUND
The Center for Elders’ Independence (CEI) provides high 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. All of CEI’s participants are frail, low income adults over
age 55 who qualify for Medi-Cal. Most are also Medicare beneficiaries.
CEI’s Life Care Planning program enables seniors to live with dignity
through the end of their lives. The program ensures that seniors’ wishes
are carried out and that costly and unnecessary medical treatments,
hospitalizations, and emergency room services are reduced or avoided.
MEASURE A FUNDING SUMMARY
CEI used its Measure A allocation to achieve the following:
• Convene a Life Care Plan Committee and hold 18 meetings
• Hire a chaplain
• Train 12 nurses, six social workers, and six doctors on having end-of-
life conversations with participants
• Develop a process for tracking conversations in CEI’s electronic health
record system
As a result of these efforts:
• 93% of participants had a Life Care Plan conversation with their
provider.
• 12.3% of participants completed Advance Care Directives that outline
each participant’s preferences for health care interventions should their
capacity to decide become compromised.
• 58 participants received chaplaincy services.
• 85% of participants who completed a Life Care Plan had their wishes
met at the time of their death or change in condition.
Allocation: $53,581 | Expended/Encumbered: $53,581
Individuals served by Measure A: 649 (Total individuals served: 649)
Populations served: Indigent, Low Income Adults, Seniors
Services provided: Emergency Medical, Hospital Inpatient, Hospital Outpatient
Service area: Alameda, Albany, Ashland, Berkeley, Castro Valley, Cherryland, Emeryville, Fairview, Hayward, Oakland, Piedmont, San Leandro,
San Lorenzo, Outside of Alameda County
Center for Elders’ Independence
cei.elders.org
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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.
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:
• Medical/health education
• Behavioral health
• Oral health
• Youth enrichment and school community support
• Insurance enrollment
In FY 15/16, the number of SHCs increased to 28, with some serving
multiple schools. During the same period, the number of clients increased
to 14,790 (a 140% increase over a decade), and the number of annual client
visits increased to 63,345 (a 146% increase). The SHCs also served more
than 3,000 clients from the broader community, including high school
graduates, college students, siblings, and community members.
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. Sixteen percent of clients reported having no insurance.
MEASURE A FUNDING SUMMARY
Measure A provides a unique, long-term funding stream to the CHSC
to offer school-based health supports for children and youth in Alameda
Allocation: $1,256,750 | Expended/Encumbered: $1,256,750
Individuals served by Measure A: 14,790 (Total individuals served: 14,790)
Populations served: Indigent, Low Income, Uninsured Adults, Children
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
Jonathan, 16, arrived in the U.S.
this past year. During a visit to his
school’s SHC, Jonathan reported pain
in his right knee from an injury he
suffered a few years ago. The Nurse
Practitioner noticed significant
inflammation and limited movement
and referred Jonathan to Children’s
Hospital for an MRI. Initially,
Children’s Hospital denied services
because of questions about the referral
and Jonathan’s insurance coverage.
SHC staff provided many hours of
medical case management to show
medical necessity, get pre-approved
service authorization, and schedule the
appointment. Ultimately, Jonathan
received the MRI. Staff also intervened
to have a $3,000 charge removed after
proving that Jonathan’s insurance
covered the procedure.
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County. Very few other funding sources exist to provide ongoing, stable,
and substantial funding to finance the growing network of and investment
in school health services.
Medical/Health Education Services
Physical health services provided during SHC visits included general
health counseling, nutrition counseling, injury treatment, and physical
activity counseling. In addition, the SHCs provided 2,109 non-HPV
immunization visits and 3,385 other health screening contacts with youth
in non-clinical settings.
Reproductive health services included contraceptive counseling/ family
planning advice and maintenance as well as HIV, chlamydia, and other STI
screening/counseling. The SHCs also provided 1,033 HPV immunization
visits.
The SHCs also provided the following services to youth outside of clinical
visits:
• Health fairs/outreach: 214 sessions reaching 26,196 youth
• Reproductive health education: 1,055 sessions reaching 17,665 youth
• Nutrition education (e.g., gardening/cooking): 129 sessions reaching
2,175 youth
• Tobacco and alcohol/drug use education: 43 sessions reaching 963
youth
• Other classroom presentations/interventions: 357 sessions reaching
9,463 youth
• First aid supply distribution: 415 sessions reaching 5,416 youth
• Peer health education group/peer counseling/mentoring: 238 sessions
reaching 2,442 youth
Behavioral Health Services
Individual behavioral health services included individual therapy,
assessment and intake, psychosocial screening, individual contact/
meetings, plan development, collateral with family members and school
staff, and case management. Behavioral health group counseling was also
provided.
SHCs made 5,304 contacts with youth, including the following:
• Screening for trauma, ninth and other grades: 45 sessions reaching
1,753 youth
• School safety/climate: 33 sessions reaching 1,710 youth
• Social skills/communication/anger management/conflict resolution:
115 sessions reaching 1,175 youth
• Self-esteem/image/empowerment: 44 sessions reaching 666 youth
• Restorative justice: 128 sessions reaching 2,901 youth
• Crisis intervention/grief support: 118 sessions reaching 228 youth
Matching Funds
The School-Based Behavioral Health
Initiative leveraged its Measure A
allocation to obtain $11,712,315 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
$1,256,750
$11,712,315
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Oral Health Services
At the 10 SHC sites providing dental services, 1,341 clients had a dental
service provided for screening exams and cleanings, and also for case
management and restorative treatment. In addition, 2,489 students were
provided dental screenings during school-wide screenings in eight SHCs.
Youth Enrichment and School Community Supports
The SHCs provided a variety of youth enrichment activities and
community supports. For example, eight SHCs made 2,801 contacts for
job training/career exploration and 2,663 contacts for youth advisory
boards, leadership, research, and advocacy groups.
The SHCs also provided the following services:
• Physical activity/recreation/dance/yoga: 148 sessions reaching 1,877
youth
• School-wide assemblies or special events: 34 sessions reaching 5,222
youth
• Acculturation support for newcomers, unaccompanied youth, etc.: 116
sessions reaching 1,376 youth
Insurance Enrollment
During FY 15/16, 24 SHCs conducted application assistance to educate
and enroll families in health coverage and other benefits programs. These
SHCs provided the following:
• 6,341 families with information about health insurance and benefits
eligibility or referral to an offsite location for application assistance
• 532 families with onsite application assistance to enroll in Medi-Cal,
HealthPAC, or Covered California coverage
• 229 families with onsite application assistance to enroll in CalFresh,
CalWORKs, or other public benefits
The SHCs also conducted insurance screening/enrollment with 401 youth.
Of those clients with data recorded, 26% did not have a primary care
medical home and 28% did not have a regular dental provider.
Highlights
SHC evaluation data shows that SHC
provide safe places for youth to get
needed care:
• 99% of students reported that the
people who work at the SHC made
it feel like a safe place.
• 98% reported that the people who
work at the SHC were easy to talk
to and helped them work through
their problem.
• 97% indicated that the SHC helped
them get care sooner than they
normally would.
• 96% indicated that they received
care from the SHC that they
normally wouldn’t have received
otherwise.
• 62% of clients returned for more
than one visit, indicating high
patient satisfaction.
Evaluation data indicates that SHCs
helped students:
• Eat healthier foods and/or exercise
more: 89%
• deal with stress/anxiety better:
94%
• Feel like they had an adult they
could turn to if they needed help or
support: 97%
• Feel less irritable or have fewer
angry outbursts: 91%
• Stop using or use less tobacco,
alcohol, or drugs: 91%
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Matching Funds
The CKC Initiative leveraged its
Measure A allocation to obtain
$61,330 in matching funds from the
Alameda County Center for Healthy
Schools and Communities (CHSC)
General Fund.
Measure AAllocation MatchingFunds
$316,435
$61,330
BACkGROUND
Since 2013, the Center for Healthy Schools and Communities (CHSC) has
administered Alameda County’s Connecting Kids to Coverage Schools
(CKC) Initiative. Implemented in the Oakland, Hayward, and San Leandro
school districts, the initiative aims to eliminate common barriers to health
insurance enrollment and retention by leveraging school districts as
channels for reaching uninsured families.
The CKC Initiative centralizes enrollment assistance in school district-
based Central Family Resource Centers so that families can apply for
and renew their health care coverage and public benefits in a “one-stop
shop,” minimizing visits to multiple County offices. The initiative is a
collaboration among the Alameda County Social Services Agency, the
Alameda County Health Care Services Agency (HCSA), three of the
County’s largest school districts, and two community-based organizations.
A majority of consumers accessing assistance are Latino and Spanish-
speaking and reside in Oakland, the largest school district participating
in the initiative. Most families have qualified for two or more affordable
coverage programs, indicating that the “one-stop shop” model is of
particular value for these families. The CKC “one-stop shop” model is
particularly important for the working poor, whose demanding and
inflexible work schedules and difficulty accessing reliable or efficient
transportation can prevent them from making or attending appointments
at different public agency locations for each family member.
The CKC Initiative utilizes three primary strategies to reach its target
populations:
• Trainings or presentations for school site staff, community-based
partners, or other school-based resources to increase the number of
people on school sites who are referring families in need to the CKC
Family Resource Centers for health benefit enrollment assistance.
• Outreach events hosted at school sites to educate parents and students
about health insurance eligibility guidelines and enrollment assistance
resources at the CKC Family Resource Centers.
Allocation: $316,435 | Expended/Encumbered: $316,435
Individuals served by Measure A: 2,710 (Total individuals served: 2,710)
Populations served: Indigent, Low Income, Uninsured Adults, Children, Families
Services provided: Public Health
Service area: Hayward, Oakland, San Leandro
Connecting Kids to Coverage (CKC) Initiative
www.whhs.com
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• Targeted outreach calls to families whose Medi-Cal applications are up
for renewal or have already fallen off. Center staff conducts outreach
calls to these families to schedule enrollment assistance appointments
at the school district site.
MEASURE A FUNDING SUMMARY
The CKC Initiative used its Measure A funding to achieve the following.
Trainings or Presentations
• 17 trainings or presentations were provided to school staff, partners, or
other groups around health coverage and health and wellness resources
at schools in Oakland. Approximately 350 people attended these
trainings.
• Seven trainings or presentations were provided in San Leandro, with
122 people in attendance.
• East Bay Agency for Children recruited and trained six parents from
the school districts to become Family Health Advocates in the Oakland
Unified School District. The role of the Family Health Advocates
was to conduct peer outreach to parents in their schools and to host
enrollment events to provide information about health insurance
eligibility and enrollment opportunities in the County.
• Family Health Advocates organized and led six enrollment events,
where 79 parents received information and scheduled appointments for
assistance.
• In San Leandro, Parent Facilitators led 14 enrollment events, with 309
people attending these trainings.
School Site Outreach Events
• In Oakland, there were 11 school site outreach events, with 208 people
attending these events at their schools.
• In San Leandro, there were 34 school site outreach events, with 2,167
attending the outreach events.
Targeted Outreach
• Approximately 13,589 outreach calls were made to families to
inform them of their Medi-Cal eligibility status and to schedule
enrollment assistance appointments at CKC Family Resource Centers.
Approximately 60% of these calls were to families in Oakland, 35%
were to families in Hayward, and 5% were to families in San Leandro.
Outreach workers administered phone calls in English, Spanish,
Mandarin, and Cantonese.
• Approximately 1,907 families made appointments at the CKC Family
Resource Centers to receive application assistance as a result of the
outreach events, trainings, and targeted phone calls. The average family
size was 3.1 individuals per family.
• Outreach efforts reached over 6,000 individuals in the County.
• Of the families who had appointments, 36% completed and submitted
their applications for health insurance or other benefits with the
Highlights
• In a consumer satisfaction survey,
72% of respondents said they would
rate the centers “excellent” or
“very good.”
• 98% of respondents said that they
would recommend the center to
other parents.
• 60% of respondents said that
multiple members of their
family were assisted with health
insurance applications by CKC—and
one in three said that their family
members qualified for different
programs.
• 70% of people who received health
insurance enrollment assistance
also received assistance with
applying to other public benefits or
getting other family support.
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support of the CKC centers. Fifty-four percent (54%) of families still
had active cases with the CKC centers.
Health Insurance
• 2,710 Alameda County residents were assisted with applications and
enrollment in Covered California, Medi-Cal, HealthPac, or other health
insurance benefits programs. Fifty percent of the individuals assisted
were children under the age of 18.
Other Public Benefits
• 1,199 Alameda County residents were assisted with applications and
enrollment in CalFresh. 60% of these CalFresh applications were for
children.
• 28 individuals were assisted with CalWorks applications.
2,710 Alameda
County residents
were assisted with
applications and
enrollment in
Covered California,
Medi-Cal, HealthPac,
or other health
insurance benefits
programs.
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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.
A program of HCSA, the Firehouse Clinic provides a new access point for
comprehensive primary and preventative care to communities in critical
need of health care services, including behavioral health care services. In
addition, the Firehouse Clinic provides insurance enrollment assistance,
connection to a medical home, referrals, and emergency department and
hospital discharge follow-up. The clinic also provides health education
and outreach services to the community.
The clinic model in South Hayward, the first site, aims to reduce wait
times for patients seen at community clinics by guaranteeing primary
care appointments within 72 hours and providing extended hours. It is
anticipated that during the first two years of operation, over 5,000 new
patients will be seen at the Hayward site, the majority of whom will
consist of low income, uninsured, and indigent residents.
MEASURE A FUNDING SUMMARY
The Firehouse Clinic used its Measure A allocation to achieve the
following:
• Provide full-service primary and preventative medical care and public
health services each week to a minimum of 1,255 clients through 1,346
visits
• Provide 291 medical case management and referrals for specialty care
to clients
• Provide counseling services onsite for 83 patients experiencing mild to
moderate conditions
• Develop and implement a process to screen and enroll 55 eligible
uninsured clients for appropriate health coverage
Allocation: $1,201,271 | Expended/Encumbered: $1,201,271
Individuals served by Measure A: 530 (Total individuals served: 1,255)
Populations served: Indigent, Low Income, Uninsured Adults, Seniors
Services provided: Public Health
Service area: Alameda, Berkeley, Castro Valley, Dublin, Fremont, Hayward, Livermore, Newark, Oakland, San Leandro, San Lorenzo, Union City,
Outside of Alameda County
Fire Station Health Portals
Measure A Helps
A 33-year-old Hispanic male came to
the clinic for anxiety and depression.
He reported lethargy, fatigue, difficulty
sleeping, and difficulty performing
daily tasks including work. He was
skeptical of psychiatric medications
and concerned about side effects.
Through an honest dialog of available
options, the patient decided to try a
course of SSRI oral medications daily
as well as Behavioral Health (BH)
counseling through the clinic. The
patient was followed up with regularly
and reported a significant difference
in symptoms after a few weeks of
treatment. The patient is currently
continuing his medication and BH
counseling and is asymptomatic for
anxiety and depression. He has stated,
“I can actually smile again.”
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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 Afghan Health Promoter Program predominately serves frail
Afghan seniors and their families living in central and southern Alameda
County. It is a program of the Afghan Elderly Association (AEA), which
has been caring for the health and welfare of Afghan elders in the Bay
Area since 1995.
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 assist
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’ medication, 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
conduct in-home reviews of medications, evaluating knowledge of
medications and use. They provide medication assistance as needed.
• 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
Allocation: $52,020 | Expended/Encumbered: $52,020
Individuals served by Measure A: 27 (Total individuals served: 163)
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
Ahmad had to stop working due to
health problems such as diabetes,
prostrate, hypertension, stress, anxiety,
and depression. With no income, he
was having a difficult time finding a
place to live. At another organization,
he applied for the Cash Assistance
Program for Immigrants (CAPI) but
was denied. An AEA Health Promoter
assessed Ahmad’s application and
felt they had reason to appeal. After
completing and submitting the
required paperwork, Ahmad was
given a court date. At the hearing,
Ahmad was granted 1.5 years of back
pay. Once Ahmad received an initial
payment, the Health Promoter was able
to work with him on securing housing
and other needed services.
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techniques. Problems and mid-range goals are established and a health
plan is developed utilizing short-term action steps.
• Health education groups. The program offers three 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. The third is the Matter of Balance (MOB) group,
an evidence-based class that promotes fall prevention. Four health
promoters have been trained as leaders.
MEASURE A FUNDING SUMMARY
Measure A helped the Health Promoter Project achieve the following.
General
• Provide health promotion services to Afghan clients (target: 125; actual:
163)
• Ensure clients receive care from a primary care physician (target: 100;
actual: 161)
• Provide socialization from Health Promoters (target: 100; actual: 162)
• Have clients complete a wellness screen (target: 60; actual: 69)
• Conduct home safety evaluations (target: 40; actual: 75)
Service Linkage
• Conduct home visits to clients (target: 350 home visits to 85 clients;
actual: 729 home visits to 122 clients)
• Provide health education from Health Promoters (target: 50; actual: 80)
• Refer clients to City of Fremont case management and/or counseling
services (target: 25; actual: 28)
• Provide eligibility assistance and support to access supportive services
to clients (target: 100; actual: 112)
• Help clients access other community services (target: 50; actual: 65)
Medication Management
• Provide medication review, education, and counseling (target: 50;
actual: 91)
• Utilize “teach back” methodology to show an increased knowledge of
medication among clients (target: 50; actual: 80)
• Improve medication compliance within six months for clients identified
as having deficits in medication compliance (target: 30; actual: 74)
Happy, Healthy Me
Ensure the following:
• Clients complete a Partners-in-Health (PIH) screen (target: 45; actual:
46)
• Clients complete a six-month PIH reassessment (target: 45; actual 36)
• Clients participate in their Action Plan (target: 30; actual: 35)
Matching Funds
Fremont Family and Aging 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
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• Clients show improvement after nine months (target: 30; actual: 32)
• Clients show improved blood pressure, pulse rate, or blood sugar scores
after nine months (target: 15; actual: 13)
Health Education Groups
• Offer one 16-hour MOB class for Afghan participants (target: 10
participants; actual: 16)
• Achieve participants showing an increase in their knowledge regarding
falls and fall prevention (target: 10; actual: 10)
• Offer one six-week diabetes class for participants (target: 12
participants; actual: 6)
Highlights
In almost all areas, the Health
Promoters program exceeded its
targets, sometimes dramatically. For
example, the program conducted 729
home visits to 122 clients, compared
to a target of 350 home visits to 85
clients.
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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 component 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.
MEASURE A FUNDING SUMMARY
The Health Insurance Enrollment Assistance department used its Measure
A allocation to achieve the following:
• 5,989 Alameda County residents received application assistance.
• The Health Insurance Technician (HIT) assistance toll-free line
received 2,008 calls.
Allocation: $300,000 | Expended/Encumbered: $300,000
Individuals served by Measure A: 5,851 (Total individuals served: 5,851)
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
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BACkGROUND
The Day Labor Center (DLC) works to empower low income individuals
and families and their children, including immigrants and refugees,
through economic and leadership development, community education,
policy and advocacy, and immigration services, to attain their basic rights
and protections, essential services, and access to full participation in
society.
Through the services of partners Samuel Merritt University in Oakland,
California State East Bay’s Initiative for Community Wellness in Hayward,
and the Alameda County Healthcare for the Homeless Van, the DLC
Healthcare Portal Project provides referrals for safety net health care
services, including episodic visits and emergency care when needed, to
hundreds of under- and unemployed, mostly migrant clients in southern
Alameda County. The DLC continues to develop culturally competent
material for its clientele and to train 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 meetings to help 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,
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.
Allocation: $149,301 | Expended/Encumbered: $149,301
Individuals served by Measure A: 175 (Total individuals served: 300)
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
Matching Funds
The DLC leveraged its Measure
A allocation to obtain $80,000 in
matching funds from foundation
sources.
Measure AAllocation MatchingFunds
$149,301
$80,000
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• 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
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 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 three-quarters of the support
needed to sustain the DLC Healthcare Portal Project.
Measure A funding helped the DLC achieve the following:
• Distribute over 1,450 flyers about the health care services offered by
the DLC at sites where workers congregate, and follow up with text
messages and phone calls
• Register 45 new individuals as clients at the DLC
• Provide 580 health services to over 150 clients
• Train six clients to become Peer Health Educators (target: 6), including
46 hours of training
• Perform 554 health and/or dental assessments and complete 219
follow-up assessments (target: 750 assessments and 125 follow-up
assessments)
• Identity 115 clients as having no health insurance and set up
appointments with an eligibility worker for all identified clients
• Hold eight meetings of DLC staff and partner agencies to review and
evaluate the monitoring system for chronic conditions, attended by an
average of seven participants at each meeting (target: 4 meetings)
• Hold six meetings with staff from various school districts in southern
Alameda County to identify undocumented immigrant youth (UIY) and
inform them of/refer them to health care and other support services
• Refer seven UIY for health or dental services
• Identify seven UIY as having no insurance and refer them to an
eligibility worker
Highlights
100% of clients, including UIY, who
required follow-up care received
the care they needed, and 100% of
uninsured clients were signed up for
health coverage.
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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 brings its services to day laborers seeking
work in West Berkeley. 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 follow-up for educational, health, and legal services.
The community MI serves encounters various issues when accessing
medical and legal 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 business
entrepreneurship, 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:
• Provide health care referrals and patient navigation support to day
laborer and other low income clients
Allocation: $89,301 | Expended/Encumbered: $89,271
Individuals served by Measure A: 650 (Total individuals served: 906)
Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors
Services provided: Hospital Outpatient, Public Health
Service area: Berkeley, Oakland, Homeless or transient
Health Services for Day Laborers: Multicultural Institute
mionline.org/
Measure A Helps
One morning, day laborer Jose
approached MI program staff looking
very sick. He is diabetic and needs to
take medication regularly to keep it
controlled. Staff determined that Jose
hadn’t taken his medication in months
and referred him to the Alameda
County mobile health van. The
examining nurse made an appointment
at Highland Hospital, because Jose
needed immediate assistance. Due
to extremely high sugar levels, Jose
couldn’t go himself. He was weak,
couldn’t walk straight, felt disoriented,
and had blurred vision, so MI staff
drove him to the hospital. MI and
mobile clinic staff keep monitoring
Jose’s case, have connected him to
a nutritionist, and gave him a free
glucometer.
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- Target: Provide outreach to 700 unduplicated clients and 100 one-
on-one consultations, with 90% of contacts reporting that the health,
public health, and/or referral services were well performed and that
their health care needs were met, and 80% reporting that they would
not know where to access health services without MI’s assistance.
- Actual: Outreach to 650 clients and 143 consultations held. 100%
of contacts reported that the health, public health, and/or referral
services were well performed, 90% reported that their health care
needs were met, and 97% reported that they would not know where
to access health services without MI’s assistance.
• Provide health education and public health promotion on various
topics
- Target: Host or co-sponsor a minimum of eight health care trainings
or workshops attended by 150 participants, as well as eight street-
based health education sessions attended by 150 participants, with
70% reporting that the workshops were well facilitated, they liked the
workshop, and/or they found it interesting or informative, and 70%
also indicating an increase in knowledge.
- Actual: 14 health care trainings/workshops held attended by
192 participants, and 12 street-based health education sessions
attended by 137 participants. 95% and 99% reported that the health
care workshops and street-level sessions, respectively, were well
facilitated, they liked the workshop, and/or they found it interesting
or informative. 95% and 89%, respectively, indicated an increase in
knowledge.
• Provide health care treatment and services through partnerships with
providers and/or contracted services
- Target: Arrange a minimum of 250 screenings or treatments to a
minimum of 100 individuals, with 70% of contacts indicating that the
services delivered were well done, they would not have had access to
such services if it weren’t for MI and its partners, and the health care
needs that originally brought them to MI were addressed.
- Actual: 223 screenings/visits provided to 103 individuals. 99%
indicated that the services delivered were well done, 93% indicated
they would not have had access to such services if it weren’t for MI
and its partners, and 98% reported that the health care needs that
originally brought them to MI were addressed.
93% of individuals
receiving health
care treatment and
services indicated
they would not
have had access to
such services if it
weren’t for MI and its
partners.
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BACkGROUND
Street Level Health Project is an Oakland-based health center dedicated
to improving the health and well-being of underserved urban immigrant
communities in the Bay Area. The Street Level Health Access Program
is a critical entry point to the health care and social service system for a
marginalized population that may be excluded from the Affordable Care
Act. Many of the community members that access Street Level face a
multitude of barriers that include issues related to language and literacy
skills, legal status, unemployment, and lost work opportunities due to long
wait times at Federally Qualified Health Centers.
MEASURE A FUNDING SUMMARY
Measure A funding helped Street Level Health Project achieve the
following:
• Provide health care screening and episodic care to 810 clients across
multiple languages (target: 750 clients)
• Offer 1,478 health-related navigation and referral services across 55
local health care agencies (target: 1,300 referrals)
• Distribute 4,678 free healthy fruit and produce food bags to 909 low
income households (target: 5,000 bags to 400 workers/families)
• Provide 575 referrals to local grassroots community organizations that
provide social services (target: 850 referrals)
• Recruit and train 57 prospective and current health care providers to
provide them with experience working with uninsured low income
communities (target: 25)
• Provide medical service on the same day to 99% of clients who check in
to the clinic (target: 95%)
• Provide information on how to access services to 93% of clients who
screen positively for unmet mental health needs (target: 80%)
• Refer 80% of clients who have no health care coverage to the enrollment
worker (target: 75%)
Allocation: $89,301 | Expended/Encumbered: $89,301
Individuals served by Measure A: 2,110 (Total individuals served: 2,357)
Populations served: Indigent, Low Income, Uninsured Adults, Seniors
Services provided: Public Health
Service area: Countywide, Homeless or transient
Health Services for Day Laborers: Street Level Health Project
streetlevelhealth.org
Measure A Helps
Danny suffers from substance use,
mental health needs, and income
barriers. He contacted Street Level
Health after being detained during a
DMV visit for outstanding tickets. He
was taken into custody and placed on
house arrest with an ankle monitor.
Danny reported feeling depressed
and informed staff of past PTSD
and mental health treatment, and
he received both a health screening
and a mental health evaluation.
Based on the evaluation, Danny was
referred and provided transportation
to Sausal Creek Outpatient Clinic,
where he received a month’s supply of
medication. In addition, Danny was
set up with a care plan that health
navigators will pursue once he is
stabilized.
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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 increased education about and
utilization of advanced health care planning, palliative care, and hospice
services.
GMOL offers services that go beyond general education of advanced care
planning and hospice services. The program aims to demonstrate a social
change, collect data, motivate behavior change, and create general public
awareness around end of life.
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 help support and contribute to GMOL’s overall
mission by providing their program services.
Measure A funding helped the GMOL program achieve the following:
• Provide a minimum of two trainings per month, complete over 131
Advance Care Directives, and provide advance care planning and
hospice resources at various community events/fairs
• Organize National Health Decision Day April 2016 that reached over
160 participants
• Provide outreach to over 20,000 IHSS recipients and provide over
24 trainings to two Adult Protective Services staff, six Public Health
Nurses, the Office of the Public Guardian, 83 social workers, and 66
chore providers, resulting in 22 hospice referrals
• Conduct monthly meetings that brought together over 25 service
providers that provide services to residents in/outside of Alameda
County
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
Highlights
The number of advance care
documents completed rose from
31 in FY 14/15 to 131 in FY 15/16.
In an evaluation, 90% of respondents
said that they felt more comfortable
starting a conversation about advance
health care planning after completing
the program.
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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.
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.
MEASURE A FUNDING SUMMARY
This Measure A allocation is meant to cover the cost of the JJC Health
Services Director. During FY 15/16, the position was unfilled.
Allocation: $261,000 | Expended/Encumbered: $261,000
Individuals served by Measure A: 79 (Total individuals served: 847)
Populations served: Children
Services provided: Mental Health
Service area: Countywide
Medical Costs for Juvenile Justice Center: Direct Service Planning and Administration
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BACkGROUND
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 provide 1,059 youth encounters on
mindfulness-based group programs to 245 youth in five 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 per
class.
Allocation: $58,939 | Expended/Encumbered: $58,939
Individuals served by Measure A: 194 (Total individuals served: 242)
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 $40,000 in
matching funds.
Measure AAllocation MatchingFunds
$58,939 $40,000
Highlights
• 95% of participants reported that
they felt the class was a safe place
to share.
• 95% reported that they felt
connected with their instructors.
• 93% reported that they would
recommend MBA classes to a
friend.
• 90% reported improvement in
stress and the ability to regulate
their emotions.
• 87% reported improvement in
positive coping skills.
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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 social emotion learning and stress resilience
through mindful movement, breathing techniques, and meditation.
MEASURE A FUNDING SUMMARY
Niroga Institute used its Measure A allocation to provide the following at
the Alameda County Juvenile Justice Center (JJC):
• 12–13 TLS classes per week year-round, serving an average of seven
youth per class and 90 youth per week
• Three all-day immersion retreats in three units, serving an average of
eight youth each
• Two staff classes per week, serving an average of seven staff each
Allocation: $ 83,224 | Expended/Encumbered: $83,224
Individuals served by Measure A: 4,023 (Total individuals served: 4,023)
Populations served: Indigent, Low Income, Uninsured Children
Services provided: Mental Health
Service area: Countywide
Medical Costs for Juvenile Justice Center: Niroga Institute
niroga.org
Highlights
• 100% of youth who responded
to an evaluation survey reported
that the teachers were effective
in delivering the curriculum and
impacting their behavior.
• In the weekly classes, 50%–87%
of youth who responded reported
shifts from stressed to relaxed,
from anxious to calm, and from
distracted to focused.
• 87% reported a decrease in stress.
• 83% reported an increase in self-
control.
• For the all-day immersion, 100%
of youth who responded reported
shifts from stressed to relaxed,
from anxious to calm, and from
distracted to focused.
• For staff participating in the staff
class, 83% of staff reported a
decrease in stress and increase in
well-being.
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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.
The Victim Compensation Program offers the following:
• Contacts to individuals whose compensation claim was “zero awarded”
(no expenses paid) for a determination as to why the client did not
submit a loss request or bill for payment consideration
• 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 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.
Staff contacted claimants who were approved but did not use funds for
covered medical, mental health, relocation, wage loss, or other services.
Allocation: $90,000 | Expended/Encumbered: $90,000
Individuals served by Measure A: 2,760 (Total individuals served: 2,760)
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
Of the total 1,186 “zero awarded”
claimants, staff successfully contacted
72% to determine why a loss request
or bills were never submitted for
payment and to provide information
to those who were unaware that
they were approved for payment of
benefits.
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BACkGROUND
Preventive Care Pathways offers “Pathways to Wellness” to the general
population by providing medical services for at-risk and indigent patients,
producing and presenting educational videos and literature for health
education, and providing health care services for individuals re-entering
the community from the prison system.
MEASURE A FUNDING SUMMARY
Preventive Care Pathways used its Measure A allocation to achieve the
following:
• Provide 2,318 medical service visits to low income residents (target:
1,500)
• Screen 320 patients for Hepatitis C (target: 30)
• Provide treatment to 36 patients who tested positive for Hepatitis C
• Coordinate four health fairs and/or workshops attended by 280
participants
• Provide Covered California or Medi-Cal application assistance to 522
residents (target: 30)
• Attend two Covered California CEE Alameda County Partnership
Meetings (target: 2)
Allocation: $214,322 | Expended/Encumbered: $214,322
Individuals served by Measure A: 2,598 (Total individuals served: 2,598)
Populations served: Indigent, Low Income, Uninsured Adults, Seniors
Services provided: Emergency Medical, Public Health, Mental Health
Service area: Countywide, Homeless or transient
Preventive Care Pathways
healthcare.gov/coverage/preventive-care-benefits
Matching Funds
Preventive Care Pathways leveraged
its Measure A allocation to obtain
$106,670 in matching funds.
Measure AAllocation MatchingFunds
$214,322
$106,670
Highlights
• In an evaluation survey, 100% of
residents rated the medical care
they received as good or very good.
• 75% said they would recommend
Preventive Care Pathways/James
A. Watson Wellness Center to
someone they know.
• 80% of residents received
application assistance and were
approved for Medi-Cal.
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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, dental, and
behavioral health 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 Alameda Health Consortium’s eight member health centers are the
following:
• Asian Health Services
• Axis Community Health
• La Clinica
• LifeLong Medical Care
Allocation: $5,870,494 | Expended/Encumbered: $5,870,494
Individuals served by Measure A: 21,216 (Total individuals served: 190,152)
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
A 50-year-old patient, out of work,
uninsured, and undocumented, was
experiencing stress, severe migraines,
and blurriness of vision. He went to
emergency rooms for health care, and
one referred him to Tri-City Health
Center. He subsequently met with a
diabetes case manager and a registered
dietician. The patient says, “I take 30-
40 minute walks every morning. Now
my diabetes is in control. I went from
Hb-1Ac of 12.5 to 8 in four months.
I really appreciate Tri-City Health
Center. They changed my life. I like
the model of community clinics and we
need to make sure they are around.”
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• Native American Health Center
• Tiburcio Vasquez Health Center
• Tri-City Health Center
• West Oakland Health Council
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 have access to affordable health care at
community health centers under the Health Program of Alameda County
(HealthPAC). The funds enable 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:
• 18,266 low income Alameda County residents made a total of 60,585
service visits at very low cost through HealthPAC.
• An additional 5,525 appointment offerings were provided to HealthPAC
enrollees.
• 21,216 low income residents were enrolled in HealthPAC at one of the
health centers.
• Providers saw 27,629 more patients across the system compared to the
prior fiscal year.
• Additional sites opened in Pleasanton, Oakland, Berkeley, Hayward,
and Fremont, improving access to care.
• Communication channels improved between hospitals and the primary
care clinics as part of the Care Transition Program.
• Integrated Behavioral Health Care coordinators were trained and
deployed across the eight health centers.
Actual visits for Each Consortium Health Center
total Patients
Primary Care,
Specialty Visits Dental Visits
Mental Health
Visits Total Visits
Asian Health Services 331 966 - 18 1,031
Axis Community Health 1,778 5,055 - 154 5,209
La Clinica de la Raza 6,440 13,882 1,874 1,586 18,503
LifeLong Medical Care 1,292 3,548 596 259 4,439
Native American Health Center 654 1,128 1,560 80 2,769
Tiburcio Vasquez Health Center 4,798 11,918 3,043 602 15,563
Tri-City Health Center 2,377 8,085 2,505 203 11,389
West Oakland Health Center 596 974 702 2 1,682
Total 18,266 45,556 10,280 2,904 60,585
18,266 low income
Alameda County
residents made
a total of 60,585
service visits at very
low cost through
HealthPAC.
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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.
TVHC has over 40 years of history providing youth-based programs and
nearly 20 years of experience running school-based health centers. These
programs include the following:
• The teen pregnancy prevention program has contributed to reducing
teen pregnancy rates in the New Haven Unified School District.
Students receive individual counseling regarding family planning
education, pregnancy prevention options, and STI/HIV education.
• Through the Health Educators and Peer Health Educators programs,
students provide presentations about the health center on a wide
range of health topics to their fellow students at Logan and Tennyson
High Schools. These presentations provide information on a range
of topics including pregnancy prevention, substance abuse, and
healthy relationships. Peer Health Educators also conduct classroom
presentations that meet requirements for sexual health education as
part of the school’s science/life skills classes.
• Café, the Spanish-speaking parent empowerment group, maintains a
group of over 90 parents at weekly workshops at Harder Elementary
and Tennyson and Hayward High Schools. Topics include natural
health nutrition, how to navigate the education system, immigration
laws, health care reform, college readiness, financial education, effective
communication, Internet 101, LGBTQ awareness, and diabetes
prevention.
MEASURE A FUNDING SUMMARY
TVHC’s Measure A funding helps support a continuum of care model
that incorporates health education, case management, youth and parent
leadership development programs, medical care, and behavioral health at
Allocation: $60,000 | Expended/Encumbered: $60,000
Individuals served by Measure A: 175 (Total individuals served: 2,354)
Populations served: Indigent, Low Income, Uninsured Adults, Children, Families
Services provided: Public Health, Mental Health
Service area: Hayward, Union City
Tiburcio Vasquez Health Center, Inc.
tvhc.org
Highlights
• 100% of evaluation survey
respondents expressed that health
center staff helped them get
services they wouldn’t otherwise
get.
• 100% strongly agreed or agreed that
staff helped them get help sooner
than they normally would.
• 97% replied that they were satisfied
or very satisfied with the school
health center.
• 100% agreed or strongly agreed
that health center staff is easy to
talk to; listen carefully to what
they have to say; care about what
they have been through; make the
health center feel like a safe place;
and help them work through their
problem.
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three school health center sites including Tennyson, Logan, and Hayward
High Schools.
Measure A funding helped TVHC achieve the following:
• Provide medical services to 34% of the student body at each school
health center site
• Provide oral health screenings to the student body at each school health
center site
• Provide behavioral health-related services, referrals, and linkages at all
campuses served by a school health center
• Provide an average of 16–35 hours per week of health education, health
promotion, and youth development services at each site
• Coordinate and/or participate in at least one family or community
health-related event or activity at each school health center
• Train over 60 students to become Peer Educators
• At Logan High School:
- Register 600 new patients (target: 1,000)
- Engage 3,000 students in health education and outreach activities
(target: 1,000)
- Reduce the client no-show rate from 30% to 13% (target: 10%)
• At Tennyson High School:
- Have 325 ninth graders participate in peer health education (target:
150)
- Provide family planning sessions to 312 youth (target: 300)
- Provide a weekly multiracial empowerment program for at-risk
youth attended by 40 youth (target: 30)
- Maintain the client no-show rate at 27% (target: 10%)
Highlights
• 97% reported that the health center
helped them do better at school,
get better grades, or get into fewer
trouble situations.
• 99% expressed the health center
helped them stay in school.
• 97% responded that being part of
the group program helped them be
more confident.
• 100% agreed or strongly agreed that
groups helped them learn skills
that will help them in their future.
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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 provide free
mammography screening examinations to indigent, low income, and
uninsured patients referred to Washington Hospital by local partner
health centers.
The service included the mammography procedure, interpretation of
results by the radiology group, and consultation with the patient and
referral to Highland Hospital for further evaluation when needed.
Washington Hospital provided mammograms to 52 patients, of whom 15
had abnormal findings detected. Of this number, seven were called back
for additional evaluation and eight required a six-month follow up to
evaluate necessary next steps.
Allocation: $33,000 | Expended/Encumbered: $21,205
Individuals served by Measure A: 52 (Total individuals served: 52)
Populations served: Indigent, Low Income, Uninsured Adults
Services provided: Hospital Outpatient, Public Health
Service area: Countywide, Homeless or transient
Washington Hospital
www.whhs.com
Measure A Helps
A 38-year-old woman was referred
to Washington Hospital for a
mammography screening exam after
a community health center nurse
practitioner discovered that the
patient was not conducting breast
self-examinations at home. The
mammogram revealed three masses
requiring additional screening and a
biopsy. Washington Hospital referred
the patient to Highland Hospital in
Oakland for further treatment. This
patient gained access to the health
care system and was quickly and
appropriately cared for by medical
professionals. By coordinating care
between three different health care
entities, the mammography program
provided potentially life-saving
diagnostic care and treatment.
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FUNDS ALLOCATED BY THE ALAMEDA COUNTY BOARD OF SUPERVISORS
GROUP 4: PUBLIC HEALTH
ACCMA Community Health Foundation/East Bay Conversation Project .................................................. 78
Alameda Boys & Girls Club, Inc. ................................................................................................................ 80
Alameda County Asthma Start ................................................................................................................. 82
Alameda County Breastfeeding Coalition Childcare Taskforce ................................................................. 84
Center for Early Intervention on Deafness ............................................................................................... 85
City of San Leandro ................................................................................................................................... 86
Drivers for Survivors, Inc. .......................................................................................................................... 87
East Oakland Community Project ............................................................................................................. 88
Eden Youth and Family Center .................................................................................................................. 89
Emergency Medical Services (EMS) Corps ................................................................................................ 91
Emergency Medical Services (EMS) Health Coach Program ..................................................................... 92
Emergency Medical Services (EMS) Injury Prevention ............................................................................. 93
Genesis Worship Center ........................................................................................................................... 95
HIV Education and Prevention Project of Alameda County OPEND Program ........................................... 96
HIV Education and Prevention Project of Alameda County Syringe Program ........................................... 98
LIFE ElderCare ......................................................................................................................................... 100
LifeLong Medical Care Emery School Health Center .............................................................................. 101
LifeLong Medical Care Heart2Heart ....................................................................................................... 102
Love Never Fails ...................................................................................................................................... 104
Mandela MarketPlace ............................................................................................................................ 105
National Health Care Decisions Day ....................................................................................................... 106
Public Health Prevention Initiative ......................................................................................................... 107
Senior Injury Prevention Program .......................................................................................................... 117
Service Opportunities for Seniors (Meals on Wheels) ............................................................................ 119
Social and Environmental Entrepreneurs, Inc. (Acta Non Verba) ........................................................... 120
Spectrum Community Services, Inc. Fall Prevention .............................................................................. 121
Spectrum Community Services, Inc. Senior Nutrition Program .............................................................. 122
Timelist Group Inc. ................................................................................................................................. 123
Youth and Family Opportunity Initiatives ............................................................................................... 124
Youth UpRising ....................................................................................................................................... 129
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BACkGROUND
The ACCMA Community Health Foundation, a 501(c)3 charitable
subsidiary of the Alameda-Contra Costa Medical Association (ACCMA),
works with the ACCMA to promote quality of and access to health care
through medical student scholarships and community health programs in
Alameda and Contra Costa Counties.
The East Bay Conversation Project (EBCP) is a community-wide coalition
of hospitals, physicians, hospice agencies, nursing homes, county health
care agencies, faith-based organization, senior advocacy organizations,
fiduciaries, attorneys, business organizations, and other interested
individuals dedicated to promoting understanding of and engagement in
advance care planning.
MEASURE A FUNDING SUMMARY
EBCP used its Measure A allocation to increase access to appropriate
inpatient and outpatient medical services for low income and uninsured
County residents by educating them about advance care planning.
Specifically, Measure A funding helped EBCP achieve the following:
• Support and enhance a diverse coalition that represents community,
business, faith-based, health care, public health, and patient advocacy
organizations and individuals committed to promoting advance
care planning in Alameda County. Ten coalition meetings were held
attended by 140 members, and the number of community organizations
that participated in the meetings rose to 91 by the end of FY 15/16.
• Participate in or support 37 outreach activities to educate and engage
the community in advance care planning. These activities included
video presentations, interactive discussions led by EBCP volunteers,
educational forums specifically targeted to faith-based leaders, and
other community events. These activities reached a total of 1,580
community members.
Allocation: $37,840 | Expended/Encumbered: $14,624
Individuals served by Measure A: 215 (Total individuals served: 5,536)
Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors
Services provided: Public Health
Service area: Countywide, Outside of Alameda County
ACCMA Community Health Foundation/ East Bay Conversation Project
www.accma.org / www.eastbayacp.org
Matching Funds
ACCMA Community Health Foundation
and EBCP leveraged their Measure
A allocation to obtain $37,840 in
matching funds from community
foundations.
Measure AAllocation MatchingFunds
$37,840 $37,840
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• Conduct free quarterly training programs for 60 individual champions
desiring to get detailed training on the value of advance care planning,
how to engage in it, and how to encourage others to engage in it.
• Receive over 4,000 unique visits to the EBCP website, which serves as
a focal point of information and guidance on advance care planning for
the target audience, as well as a resource to help advance care planning
advocates engaged in outreach activities.
Highlights
• 100% of coalition participants
reported that coalition meetings
were engaging and informative.
• 100% of advocates responded that
their knowledge of and ability to
discuss advance care planning had
increased after training.
• 92% of residents contacted via
outreach responded that they were
more likely to engage in advance
care planning.
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BACkGROUND
Founded in 1949, the Alameda Boys & Girls Club provides high impact,
affordable youth development programs and services for 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 is open to all youth from all schools and backgrounds, every
day and evening after school and during school vacations. It specifically
targets low income and at-risk youth to provide them with equality of
opportunity and prepare them for a great future. Seventy-two percent of
youth attending the Alameda Boys & Girls Club are living in poverty.
MEASURE A FUNDING SUMMARY
Measure A helps support the Alameda Boys & Girls Club Live Healthy
program. Live Healthy is a year-round program serving over 500 youth
and teen members that incorporates healthy cooking and gardening
programs with physical fitness and recreation programming.
Specifically, Alameda Boys & Girls Club used its Measure A allocation to
achieve the following:
• Increase access to medical and mental health services to low income
youth
- 422 youth received dental, vision, and/or respiratory screenings
(target: 270).
- 450 dental, vision, and respiratory screening visits were conducted
(target: 360).
- 4 health education events and/or workshops were conducted with
484 youth attending (target: 4 events/workshops with 320 youth
attending).
- 317 unduplicated youths were served through mental counseling
sessions (target: 300).
- 40 mental health visits were provided (target: 30).
Allocation: $107,161 | Expended/Encumbered: $107,161
Individuals served by Measure A: 3,812 (Total individuals served: 3,812)
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
Highlights
• In most areas, Alameda Boys &
Girls Club exceeded its targets,
sometimes dramatically. For
example, 450 dental, vision, and
respiratory screening visits were
conducted compared to a target of
360, while 905 unduplicated youths
participated in Healthy Habits
programming compared to a target
of 240.
• 100% of youth completing a
satisfaction survey reported that
they liked the health education
workshop.
• 79% of youth would recommend
the workshop to a friend.
• 97% of Passport to Manhood
workshop participants would
recommend the workshop to a
friend.
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• Increase access to culturally competent public health and mental health
services to low income youth through Life Skills workshops
- 4 Passport to Manhood workshops were conducted serving 46 boys
(target: 4 workshops serving 40 boys).
- 10 SmartGirls workshops were conducted serving 178 girls (target: 8
workshops serving 80 girls).
- 905 unduplicated youths participated in Healthy Habits
programming (target: 240).
• Increase access to culturally competent public health services to youth
through a comprehensive culinary, nutrition, and health education
program
- 241 unduplicated clients participated in cooking programming
(target: 250).
- 1 hands-on/informational cooking event/workshop was conducted
for all Club youth (target: 1).
• Increase access to culturally competent public health services to youth
through a dynamic, garden-based nutrition and ecology education
program
- 291 unduplicated clients participated in gardening programming
(target: 250).
- 1 hands-on/informational gardening event/workshop was conducted
for all Club youth (target: 1).
• Increase access to culturally competent public health services to youth
through a low and high impact recreation and sports program
- 1,675 unduplicated youths participated in physical fitness and
recreation programming (target: 1,000).
- 4 hands-on/informational sports and recreation events were
conducted for all Club youth (target: 1).
Highlights
• 91% of SmartGirls workshop
participants would recommend the
workshop to a friend.
• 86% of youth would recommend
the Alameda Boys & girls Club to a
friend.
• 100% of youth learned a new skill
for maintaining their physical
health.
• 90% of youth learned a skill for
maintaining their mental health.
• 98% of youth learned something
new about developing positive
relationships.
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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 the disease, symptoms, and medication and its use. The
program develops a care plan for the family, looks at their home for
asthma triggers, and partners with Healthy Homes and Code Enforcement
as needed to advocate with landlords to remediate triggers or safety issues.
Families are given supplies to assist in managing their child’s asthma
such as pillow and mattress encasings, non-bleach-based mold cleaner, a
vacuum, etc. Families are also 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,
participates in School Attendance Review Boards, and works with the
District Attorney when a child is truant due to asthma.
Eighty-nine percent of the children served are 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
Asthma Start used its Measure A allocation to achieve the following:
• Open 290 cases in a 12-month period and close 295 cases, of which 231
were closed successfully (target: open 250 cases)
• Increase caregiver knowledge of asthma (target: 95% of caregivers
passing an asthma post test with a score of 80% or better; actual: 100%)
• 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: 54 (Total individuals served: 64)
Populations served: Indigent, Low Income, Uninsured Children
Services provided: Public Health
Service area: Alameda, Ashland, San Leandro, San Lorenzo
Alameda County Asthma Start
acphd.org/asthma.aspx
Measure A Helps
Asthma Start worked with a single
mother who has two children with
asthma. The Asthma Coordinator
discovered that their unit had bedbugs
and worked with Environmental
Health to exterminate them. Asthma
Start gave the mother mattress and
pillow encasings to assist with dust
mite allergies. The water heater in
the kitchen was not enclosed, so the
children could get into it. The program
worked with the property owner to
enclose the water heater. The property
owner also fixed a leak and cleaned up
mold caused by the leak. Since that
time, the children have not missed
school due to asthma and the mother
feels less anxious about managing their
asthma.
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• Help caregivers reduce at least one identified asthma trigger (target:
95% of caregivers; actual: 99%)
• Reduce instances of children requiring hospitalization or emergency
department visits post case management (target: 20% or less of
children; actual: 5% needing hospitalization, 13% 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 $83,000 in
matching funds from Targeted Case
Management (TCM) and a Kaiser
Community Benefit grant.
Measure A
Allocation
Matching
Funds
$100,000
$83,000
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BACkGROUND
Alameda County Breastfeeding Coalition (ACBC) includes breastfeeding
experts and advocates from public health, WIC, hospitals, clinics, child
care organizations, health plans, community groups, and mothers
and fathers interested in redefining breastfeeding as the norm for
infant feeding; creating an environment that promotes and supports
breastfeeding through education, collaboration, and partnership; and
promoting breastfeeding integration throughout the health care system by
bridging resources and services for families in Alameda County.
MEASURE A FUNDING SUMMARY
Measure A funding helped ACBC meet its objective of ensuring ongoing
the quality and safety of child care center feeding practices by developing
and promoting excellent reference materials and reproducible media in
partnership with national, state, and local experts.
Specifically, ACBC used its Measure A allocation to achieve the following:
• Develop and broadcast a one-hour training webinar featuring experts
in promotion of breastfeeding and management of breast milk in child
care settings. Over 30 child care providers participated in the webinar
and hundreds more are estimated to have accessed the recording
posted on the ACBC website.
• Develop and distribute a Breastfeeding Friendly Childcare Toolkit with
easy-to-read guidelines, handouts, and magnets for child care and early
childhood education providers. 950 copies of the toolkit in English,
Spanish, and Chinese were distributed throughout Alameda County
child care centers, Head Start programs, and other child care sites.
In addition, the toolkit was shared with communities across the state
working to support breastfeeding-friendly child care centers.
• Launch the initiative with a promotion event August 5, 2015 during
World Breastfeeding Week. 30 child care providers and community
members attended the event.
Allocation: $6,900 | Expended/Encumbered: $6,781
Individuals served by Measure A: 2,200 (Total individuals served: 2,200)
Populations served: Low Income Children, Families
Services provided: Public Health
Service area: Countywide, Outside of Alameda County
Alameda County Breastfeeding Coalition Childcare Taskforce
californiabreastfeeding.org/coalition-information/communitycoalitions/members/alameda/
Highlights
• Since posting the webinar and
toolkit on the coalition website,
over 1,500 visits (1,132 unique
visits) have accessed the materials.
• 100% of child care providers who
engaged in the training resources
stated they would implement
breast milk storage and feeding
guidelines.
• The Breastfeeding Friendly Childcare
Toolkit and training webinar
were recognized by the California
Breastfeeding Coalition as a Gold
Nugget Award program supporting
Employment and Child Care.
• Los Angeles County requested
permission to replicate the Toolkit
with the addition of their local
resources for a campaign across Los
Angeles County.
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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.
MEASURE A FUNDING SUMMARY
The funding that CEID received through Measure A helped CEID to hire
staff that is bilingual in Spanish and English. CEID also recently hired a
new part-time audiologist that is fluent in Cantonese and Mandarin.
Additionally, Measure A funding provided CEID the opportunity to offer
onsite pediatric resident training. Residents learn how to properly read
an audiogram, speak with parents about their child’s hearing, and observe
CEID teachers and therapists working with students. This training is
not available elsewhere and has a definite positive impact on the ability
of physicians to support their patients with appropriate diagnoses,
timely referrals, meaningful explanations and information, and effective
treatments.
Specifically, Measure A funding helped CEID achieve the following:
• Conduct 124 newborn hearing screenings (target: 150)
• Perform 408 audiological evaluations for children, youth, and adults
(target: 300)
• Dispense hearing aids and ear molds to 170 residents (target: 150)
• Hold three community hearing screenings
• Train 69 pediatric residents (target: 75)
Allocation: $53,581 | Expended/Encumbered: $53,581
Individuals served by Measure A: 783 (Total individuals served: 1,168)
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
Highlights
• 98% of families of newborn patients
reported that they were satisfied
with the services they received.
• 97% of families reported increased
knowledge about auditory
development and hearing health
following their visit to CEID.
• 100% of parents/guardians of
newborns who were identified for
follow-up care were referred for
evaluation and diagnostic services.
• 97% of patients and/or guardians
who completed a survey reported
increased knowledge about their
hearing level and related services
following their visit to CEID.
• 98% of patients who received a
referral for hearing aids received
hearing aids.
• 97% of patients reported that their
quality of life (access to sound in
environments and communication)
improved.
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Measure A Helps
Sharon, 67, and her father Bill, 92,
are regular participants at the San
Leandro Senior Community Center.
Sharon has cholesterol and blood
pressure issues, while Bill has heart
disease with a pacemaker to address
low pulse. Sharon says: “It keeps my
dad active and mobile at 92 years of
age. If he didn’t take the classes, I don’t
believe he would have maintained his
level of mobility. It’s helped me, too; it
keeps me fit and strong. I feel strongly
if you do not exercise and move around
that your health would decline. It’s a
caring community where people follow
up on each other if a familiar face is
missing.”
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
Measure A funding supports a comprehensive health and wellness
framework by allowing the City of San Leandro to offer the following
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.
Specifically, the City of San Leandro used its Measure A allocation to
achieve the following:
• Hold 13 health checks, including blood pressure and weight checks,
serving 741 seniors (target: 360)
• Through the Mercy Brown Bag program, distribute 553 grocery bags of
nutritional food to 650 eligible seniors (target: 576)
• Provide 16 health education classes attended by 530 seniors (target: 12
classes)
• Conduct 37 Pull Up a Chair exercise classes in which 550 seniors were
enrolled (target: 36 classes)
• Hold 424 fall prevention classes attended by 554 seniors (target: 208
classes)
• Conduct 1,938 other health and wellness classes
Allocation: $53,581 | Expended/Encumbered: $53,581
Individuals served by Measure A: 4,963 (Total individuals served: 60,295)
Populations served: Seniors
Services provided: Public Health
Service area: San Leandro, San Lorenzo
City of San Leandro
sanleandro.org
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Highlights
100% of clients rated the service as
good or excellent.
BACkGROUND
Drivers for Survivors provides free transportation service and supportive
companionship, from suspicious findings through treatments, for
ambulatory cancer patients that live in Fremont, Newark, and Union City.
MEASURE A FUNDING SUMMARY
Drivers for Survivors used its Measure A allocation to provide an average
of 253 rides per month and recruit 66 new clients.
Allocation: $10,000 | Expended/Encumbered: $10,000
Individuals served by Measure A: 8 (Total individuals served: 197)
Populations served: Low Income Adults, Seniors
Services provided: Emergency Medical, Hospital Outpatient
Service area: Fremont, Newark, Union City
Drivers for Survivors, Inc.
Driversforsurvivors.org
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BACkGROUND
The East Oakland Community Project (EOCP) empowers homeless
individuals and families in Alameda County to regain a life of self-
reliance. EOCP provides dignified emergency housing and compassionate
comprehensive support services that prepare homeless people to
successfully transition to permanent affordable housing, increased
financial stability, and well-being.
MEASURE A FUNDING SUMMARY
EOCP used its Measure A allocation to achieve the following:
• Create six office spaces through the design, purchase, and installation of
furnishings to provide office space in which case managers and housing
specialists meet with clients to provide case management services
• Provide case management and wraparound services to more than 150
homeless individuals and families
• Serve 558 persons in the shelter, of whom 28% obtained permanent
housing
Allocation: $30,000 | Expended/Encumbered: $30,000
Individuals served by Measure A: 558 (Total individuals served: 558)
Populations served: Indigent, Low Income, Uninsured Adults, Families
Services provided: Mental Health
Service area: Oakland
East Oakland Community Project
eocp.net
Measure A Helps
Mr. Hall, 83, came to EOCP from
Highland Hospital. He had been living
in Sacramento but became ill and lost
his housing when he was transferred
from a Sacramento hospital to Alta
Bates and finally to Highland. EOCP
helped Mr. Hall improve his health
and find housing in a group living
arrangement. He was not paying
his rent and seemed to be unable
to manage his SSI benefits. EOCP
provided him with money management
and representative payee services. Mr.
Hall is now looking for a better living
situation while he remains housed
because his major bills are paid on
time. EOCP is also connecting him
with other community-based senior
services.
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BACkGROUND
Eden Youth and Family Center (EYFC) provides and supports a
comprehensive array of services and advocacy for children, youth, and
families of the City of Hayward and the unincorporated Eden area of
Alameda County, enhancing the economic, social, educational, and
healthy well-being of the community.
The EYFC youth team serves over 400 culturally and ethnically rich
and diverse students and families per year. Services are designed to
address and circumvent negative experiences students encounter, such as
school system inequalities, unemployment, high levels of violence, and
incarceration. Many students are or have been involved in the foster care
system or juvenile justice system, or are pregnant or parenting.
The EYFC team provides youth with tutoring, academic skills, GED
preparation, college readiness, career coaching, and completion of
college and scholarship applications. EYFC also offers an after-school and
summer program to help transition-age youth improve their education
and employment goals and skills, become more autonomous and less
reliant on government programs and aid, and improve self-sufficiency and
physical and mental well-being. EYFC also partners with other agencies to
reduce substance abuse among youth and adults.
MEASURE A FUNDING SUMMARY
EYFC used its Measure A allocation to achieve the following:
• Provide 50 life skills training sessions to 400 youth and young adults.
The trainings covered health, wellness, drug prevention, and nutrition
information.
• Coordinate youth advisory councils on tobacco and alcohol use to
provide leadership development, training, and awareness campaigns.
Youth advisory council members participated in 50 weekly council
meetings to focus on creating an implementation plan around healthy
lifestyle choices for youth and young adults.
Allocation: $75,000 | Expended/Encumbered: $75,000
Individuals served by Measure A: 100 (Total individuals served: 100)
Populations served: Low Income, Uninsured Adults, Children, Families
Services provided: Public Health, Mental Health, Substance Abuse
Service area: Ashland, Castro Valley, Cherryland, Fremont, Hayward, Newark, Oakland, San Leandro, San Lorenzo, Union City
Eden Youth and Family Center
eyfconline.org
Measure A Helps
Renee, a 19-year-old former foster
care youth, was homeless and came
to EYFC after being robbed. EYFC
provided intensive case management
and connected her with mental health
services, medical support, housing,
and food. EYFC also connected her to
the South Hayward Parish to obtain
healthy food, a shower, and other
resources. EYFC’s case manager helped
Renee obtain temporary housing and
complete the forms needed to apply for
permanent housing. The case manager
also helped Renee secure an internship
at the EYFC Computer Clubhouse.
Renee maintains regular work
attendance, is no longer homeless, is
stable on her medication, and is able to
perform daily life skills with minimal
stress.
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• Plan and coordinate community presentations on marijuana and
the teenage brain. The presentations reached 687 members of the
community (652 youth and 35 adults) over four days.
• Provide Alcohol, Tobacco, and Other Drugs (ATOD) awareness
workshops to 85 Summer and After-School Youth Employment
Program participants. Fifteen youth participated in an interactive
speakers series presented by those who had struggled with sobriety.
Forty program participants and clients were referred to local adolescent
education, prevention, and treatment programs.
• Provide case management to 102 at-risk youth and young adults
with wraparound case management support, and link these youth to
valuable community resources to support their individual needs.
• Refer over 150 youth and families to onsite service providers for health
screenings, pediatric health care, behavioral health needs, and early
childhood education and child care.
EYFC used its
Measure A allocation
to provide case
management to 102
at-risk youth and
young adults with
wraparound case
management support.
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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. This program is designed to interrupt a pattern of behavior
that leads to violence and an unhealthy lifestyle. By guiding them through
a transformative mentoring process, and linking them with an entry level
career opportunity, the program improves the overall quality of each
individual’s physical and mental health.
MEASURE A FUNDING SUMMARY
The EMS Corps used its Measure A allocation to achieve the following:
• Receive 230 applications for the EMS Corps (target: 200)
• Operate 2 cohorts (target: 2)
• Interview 80 potential candidates (target: 80)
• Select 50 participants for the program
• Train 37 EMTs (target: 35)
• Employ 80% of graduates (target: 50%)
• Conduct 15 volunteer community service events (target: 10)
Allocation: $604,942 | Expended/Encumbered: $604,242
Individuals served by Measure A: 50 (Total individuals served: 50)
Populations served: Indigent, Low Income Adults, Children, Families
Services provided: Emergency Medical, Public Health, Mental Health, Substance Abuse
Service area: Countywide, Outside of Alameda County, Homeless or transient
Emergency Medical Services (EMS) Corps
acphd.org/ems-corps.aspx
Matching Funds
EMS Corps leveraged its Measure
A allocation to obtain $6,000 in
matching funds from a community
grant.
Measure AAllocation MatchingFunds
$604,942
$6,000
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BACkGROUND
The Alameda County Emergency Medical Services (EMS) Health Coach
program works to improve the community’s health by pairing members
with culturally sensitive health coaches trained on disease management.
Health Coaches provide linkages to primary care physicians, nutritional
services, mental health services, medication adherence support,
pharmacies, and community-based resources. They help in the facilitation
of medical appointments, insurance-related concerns, and accessing
social/legal services.
MEASURE A FUNDING SUMMARY
The EMS Health Coach program used its Measure A allocation to achieve
the following:
• Educate 1,580 community members on hypertension and diabetes
(target: 1,000)
• Coach 138 members over six months on compliance with medication,
decreasing emergency department visits, establishing a health home,
and increasing patient knowledge of disease (target: 100)
• Connect those members to a primary care physician and enroll them in
a health insurance plan
• Provide 1,500 patients with materials and resources on healthy eating
from nutritional services
Allocation: $236,000 | Expended/Encumbered: $236,000
Individuals served by Measure A: 1,500 (Total individuals served: 1,500)
Populations served: Low Income Uninsured Adults, Seniors
Services provided: Hospital Outpatient, Public Health, Mental Health, Substance Abuse
Service area: Ashland, Cherryland, Fremont, Hayward, Oakland, San Leandro, San Lorenzo
Emergency Medical Services (EMS) Health Coach Program
acgov.org/ems
Matching Funds
The Health Coach program leveraged
its Measure A allocation to obtain
$100,000 in matching funds.
Measure A
Allocation
Matching
Funds
$236,000
$100,000
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BACkGROUND
Alameda County Emergency Medical Services (EMS) provides quality
emergency medical services and prevention programs to improve health
and safety for residents in Alameda County. The Senior Injury Prevention
Program (SIPP), an EMS program, works to prevent unintentional injuries
or accidents among older adults and to raise awareness of the need for
injury prevention programs for older adults.
SIPP includes the following components:
• Home visits. Using health care professionals and paraprofessionals,
participants are visited in the home. Typically, these individuals
are frail. Home visits provide an opportunity to evaluate the home
environment and provide referrals, review of and education on
medication management, falls risk reduction, physical activities,
nutrition education, home safety, etc.
• Medication tools. In addition to providing education on medication
management and disposal, disposal events are held in the community.
Additionally, medication management devices such as medi-sets are
distributed to participants.
• Physical activity and nutrition. Participants are provided information
on and encouraged to participate in appropriate physical activity
programs/routines and nutrition classes.
• Evidence-based programs (EBPs). EBPs are based upon rigorous study
of the effects or outcomes of specific interventions or models. They
include HomeMeds, a computerized system that analyzes participants’
medications and identifies interactions; Flinders Chronic Disease Self-
Management Program, which assists in identifying self-management
skills necessary to successfully manage chronic diseases.; and Matter of
Balance, a falls prevention program.
• Physician visits. Health care professionals and/or paraprofessionals
accompany participants to visits with their physicians and help them
prepare questions for their physician.
Allocation: $210,112 | Expended/Encumbered: $210,112
Individuals served by Measure A: 702 (Total individuals served: 702)
Populations served: Low Income Adults, Seniors
Services provided: Public Health, Mental Health
Service area: Countywide
Emergency Medical Services (EMS) Injury Prevention
acgov.org/ems
Measure A Helps
CITY OF FREMONT
In Afghanistan, Fawzia was hit with
shrapnel when a bomb exploded
nearby. This resulted in neurological
damage and post-traumatic stress.
After coming to the U.S., Fawzia was
unable to work and needed significant
help from her family. At the Healthy,
Happy Me Program (HHM), Fawzia
reported that she would easily get
dizzy and at times fall, and that she
knew she was crazy. Staff helped
Fawzia obtain a walker and developed
questions for her primary physician to
explore. Fawzia’s physician discovered
that she had a significant issue with
her heart. Fawzia began treatment and
the program will continue to work on
both her physical condition and her
post-traumatic stress.
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• Socialization. Regularly scheduled group activities such as health
education sessions, exercise classes, nutrition classes, etc. provide
participants an opportunity to socialize.
MEASURE A FUNDING SUMMARY
SIPP providers used their Measure A allocation to achieve the following:
• DayBreak Adult Day Centers: Medication Management
- Serve 39 unduplicated seniors (target: 40)
- Dispose of 35 expired medications (target: 20)
• City of Fremont Health Promotion
- Serve 163 unduplicated Afghan seniors (target: 125)
- Ensure 161 seniors receive regular care from a primary care
physician (target: 100)
- Complete 69 wellness screens (target: 60)
- Conduct 75 home safety evaluations (target: 40)
- Provide 161 socialization services (target: 100)
• City of Fremont Service Linkage
- Conduct 729 home visits to 122 clients (target: 350 visits to 85 clients)
- Refer 28 clients to case management/counseling services (target: 25)
- Provide assistance in eligibility and access to supportive services to
112 seniors (target: 100)
- Provide 80 health education services (target: 50)
• City of Fremont Happy, Healthy Me (Chronic Condition Management)
- Have 46 seniors complete the Partners in Health screening (target:
45)
- Perform a six-month PIH reassessment on 36 seniors (target: 45)
• City of Fremont Medication Assistance
- Provide medication review, education, and counseling to 91 seniors
(target: 50)
• City of Fremont Chronic Disease Self-Management/Health Education
& Support Group
- Provide 16 hours of Matter of Balance (MOB) fall prevention class
(target: 16)
- Have 10 Afghan seniors participate in MOB class (target: 10)
- Offer one six-week Diabetes class (target: 1)
- Have six clients attend Diabetes class (target: 12)
• Senior Support Services of the Tri-Valley
- Serve 38 unduplicated seniors (target: 38)
- Dispose of 20 expired medications (target: 20)
• St. Mary’s Center Medication Management
- Serve 64 unduplicated seniors (target: 47)
- Complete 64 medication compliance reports (target: 47)
- Dispose of 64 expired medications (target: 24)
• United Seniors Oakland Alameda County (USOAC) Medication
Education
- Serve 334 unduplicated seniors (target: 225)
- Host one medication disposal event (target: 1)
Highlights
In many areas, SIPP providers
exceeded their targets, sometimes
dramatically. For example, City of
Fremont Health Promotion exceeded
its target for home safety evaluations
by 88%, while City of Fremont Service
Linkages exceeded its target for home
visits by over 100%.
• Nine DayBreak Adult Centers
seniors receiving medication
management significantly improved
medication compliance.
• 30 seniors in the City of Fremont
Happy, Healthy me program showed
improved PIH scores after nine
months, and 13 showed improved
blood pressure, pulse rate, or blood
sugar scores.
• 50 seniors receiving City of Fremont
medication assistance showed
increased knowledge of their
medication, and 45 improved
deficits in medication compliance.
• 10 Afghan seniors in the City of
Fremont MOB class showed an
increase in knowledge of falls and
fall prevention.
• 47 seniors receiving medication
management from St. Mary’s Center
showed improved medication
compliance, while 135 seniors
at USOAC showed improved
understanding of medication
compliance and safety.
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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
emergency food assistance to an average of 100 children, adults, and
seniors weekly. The program served a total of 882 clients.
Allocation: $5,000 | Expended/Encumbered: $5,000
Individuals served by Measure A: 882 (Total individuals served: 4,170)
Populations served: Low Income Adults, Children, Families, Seniors
Services provided: Public Health
Service area: Oakland
Genesis Worship Center
genesiswc.com
Matching Funds
Genesis Worship Center leveraged its
Measure A allocation to obtain $4,000
in matching funds from the church
and community members.
Measure AAllocation MatchingFunds
$5,000 $4,000
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BACkGROUND
The HIV Education and Prevention Project of Alameda County (HEPPAC)
works to stop the spread of preventable diseases among increased-risk
communities. HEPPAC strives to reduce the impact of health-related
harm in the community by addressing health disparities and external
barriers and increasing access to basic needs services.
HEPPAC provides ancillary services throughout Oakland and Alameda
County including the Casa Segura daytime drop-in center to access basic
needs: shower, laundry, referrals, access to food, and Overdose Prevention
Education and Naloxone Distribution (OPEND) services. HEPPAC’s
mobile outreach provides HIV/HCV counseling, testing, linkage to
primary/specialty care, distribution of harm reduction supplies, access to
food, OPEND syringe exchange services, and referrals.
OPEND services occur at three offsite syringe exchange sites in West
to East Oakland, through street and community outreach, and by
appointment at the drop-in center. Thanks to HEPPAC’s OPEND
program, Alameda County now has an integrated overdose prevention
and free naloxone distribution program to reduce accidental overdose
deaths by opioids.
MEASURE A FUNDING SUMMARY
HEPPAC used its Measure A allocation to achieve the following:
• Design and develop the Alameda County OPEND program. HEPPAC
hired its OPEND Coordinator and completed the development of
policies and procedures, program instructional materials signage,
standing order, surveys, and a data collection methodology.
• Administer 258 one-on-one OPEND trainings to active opioid users
who access syringe exchange services for themselves and multiple
drug-using peers and/or active opioid users recently released from
incarceration at fixed syringe exchange locations in Oakland (target:
Allocation: $150,000 | Expended/Encumbered: $150,000
Individuals served by Measure A: 385 (Total individuals served: 1,955)
Populations served: Adults, Families, Seniors
Services provided: Emergency Medical, Public Health, Substance Abusee
Service area: Countywide, Homeless or transient
HIV Education and Prevention Project of Alameda County OPEND Program
casasegura.org
Measure A Helps
A training participant came to
HEPPAC to get Narcan for his
girlfriend, a 31-year-old woman, who
had overdosed the night before. He said
they had both used heroin and cocaine
and she had an extreme reaction to
the drugs, while he didn’t. She began
foaming at the mouth and was less and
less responsive over time. He said in
the dark and in a panic it was difficult
to draw the dose up, but after giving it,
his girlfriend came back within a few
minutes. He reported that she was the
thirty-first person he had saved.
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100). Trainings were conducted in HEPPAC’s three Oakland syringe
exchange locations, homeless encampments, street corners, and other
places the target population convenes. Training participants received
education on how to identify an opioid overdose, current state and
federal laws for assisting during a medical emergency, and how to
administer Narcan via nasal and/or auto-injection.
• Provide 25 OPEND trainings to 10 Alameda County community-based
providers who work with active and former opioid users. The training
provided education on the opioid epidemic in Alameda County, how to
recognize an opioid overdose, how to administer Narcan, and strategies
to engage opioid users on their overdose risk. Each agency began to
incorporate OPEND into their preexisting programs as standard.
• Provide a minimum of four presentations on current trends of opioid
use, OPEND activities and accomplishments, and challenges of the
OPEND project to key community stakeholders, including board
members, funders, collaborators, and those who support and/or access
services.
Highlights
• HEPPAC exceeded its target for one-
on-one OPEND trainings by 158%.
• 100% of OPEND training
participants self-reported an
increase in their ability to recognize,
administer, and reverse an
overdose.
• 100% of training participants
increased their opioid overdose
knowledge, found the training
useful, would recommend the
training to a peer, and were satisfied
with the training.
• 100% of community-based
organizations who received the
training reported an increase in
knowledge and stated they were
more comfortable identifying and
responding to an accidental opiate
overdose.
• 100% of organizations reported
that they found the training
informative, realistic, and easy to
administer, and that they would
recommend this training to other
services providers in Alameda
County.
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BACkGROUND
The HIV Education and Prevention Project of Alameda County (HEPPAC)
works to stop the spread of preventable diseases among increased-risk
communities. HEPPAC strives to reduce the impact of health-related
harm in the community by addressing health disparities and external
barriers and increasing access to basic needs services.
HEPPAC is responsible for the operation of Oakland’s harm reduction
services for active substance users. Specific harm reduction-based services
include syringe exchange, pickup of littered syringes in public locations,
HIV and HCV antibody screening services, individual-level risk-reduction
counseling/education, Narcan distribution, and distribution of harm
reduction supplies to homeless encampments. Herbal/acupuncture and
crisis counseling services are also offered during exchange service hours.
HEPPACs integrated service model includes HIV/HCV counseling,
testing, referral, and linkage (CTRL) health education and prevention in
non-clinical settings.
MEASURE A FUNDING SUMMARY
HEPPAC used its Measure A allocation to achieve the following:
• Increase access to sterile syringes for people who inject drugs (PWIDs),
at least 18 years of age residing in northern Alameda County, by
conducting syringe exchange services in areas where PWIDs reside
and/or frequent. A total of 2,453 contacts were made during mobile
services and fixed exchange hours. Of the 2,453 contacts, 84% self-
reported to have engaged in intravenous drug use within the past 10
days.
- Exchange at least 50,000 sterile syringes for used ones during two
two-hour outdoor syringe exchange sites and one two-hour indoor
site. Food, hygiene kits, and other harm reduction supplies were also
provided.
Allocation: $150,000 | Expended/Encumbered: $150,000
Individuals served by Measure A: 1,009 (Total individuals served: 3,015)
Populations served: Indigent, Low Income, Uninsured Adults, Seniors
Services provided: Emergency Medical, Public Health, Substance Abusee
Service area: Countywide, Homeless or transient
HIV Education and Prevention Project of Alameda County Syringe Program
casasegura.org
Measure A Helps
B, a 46-year-old Latina, is the only
female staying in a non-operative
mobile trailer shared with three men.
She approached HEPPAC’s female
outreach worker for an HIV/HCV
screening, crisis counseling, overdose
prevention, housing referrals, and
supplies including feminine hygiene
products. At the screening, B tested
reactive for Hepatitis C. She was
given safer injection information and
practiced her condom negotiation
skills by conducting role plays with
staff. B stated she learned a lot from
HEPPAC outreach staff and within
one week was attending the Thursday
syringe exchange consistently. She was
referred to Alameda Health System
and is receiving medication to cure her
Hepatitis C.
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- Distribute 327,600 syringes and collect 307,944 used syringes during
fixed and mobile exchange service hours. A total of 113 IDUs were
new to HEPPAC’s exchange services. This is an increase of 9% when
compared to this time last year.
- Conduct 23 hours of mobile exchange services per week in northern
Alameda County, primarily within the city of Oakland.
- Collect 89,580 used syringes from PWIDs and exchange them for
sterile syringes during non-fixed exchange site service hours.
• Provide PWIDs with increased access to primary medical and holistic
health services. HEPPAC provides acupuncture services at two of the
three syringe exchanges. A partnership with the Roots Community
Clinic has continued to provide primary medical care services during
syringe exchange hours.
- 60% of new clients (113) accessing the syringe exchange for the
first time were referred through previous contact with an outreach
worker during HEPPAC’s street outreach program.
- Provide medical care to 89 PWIDs during syringe exchange services.
Of the 89 unduplicated clients, 81 were treated for soft tissue
infections.
- Provide 89 PWIDs with safer injection education.
- Inform and refer at least 104 PWIDs to health care enrollment
services.
• Ensure that 154 PWIDs reached through unstructured workshops and
one-to-one encounters were able to identify at least one risk-reduction
practice. A total of 125 (81%) who accessed an unstructured group also
accessed HIV/HCV rapid antibody testing, were made aware of their
current HIV/HCV status, and were offered linkage services.
- 100% of clients attending were able to identify at least one risk-
reduction practice.
- 81% of clients that participated in an unstructured workshop
accessed HIV and HCV screening services within one month.
154 PWIDs reached
through unstructured
workshops and one-
to-one encounters
were able to identify
at least one risk-
reduction practice.
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Measure A Helps
NG, 85, has heart disease,
hypertension, CHF/angina, arthritis,
leg and back problems, and “emotional
problems.” During her initial fall
prevention assessment, her apartment
was cluttered and smelled of urine. NG
had over 20 bottles of medication, some
expired, and said that most of the time
she forgot to take them. In subsequent
visits, the HomeLIFE worker disposed
of and rearranged NG’s medications,
taught her chair exercises, went with
her for walks, and signed NG up for
Meals on Wheels. The program also got
her a free transfer bench so she could
use her shower.
BACkGROUND
LIFE ElderCare empowers seniors to live with independence and
interdependence by nourishing mind, body, and spirit.
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 through the
HomeLIFE fall prevention program. The program achieved the following:
• 143 eligible seniors received comprehensive fall prevention
assessments, education, and supports (target: 60).
• 572 interventions in the areas of exercise, medication management,
environmental assessment, and general well-being were recommended
to HomeLIFE seniors.
• 100% of very frail HomeLIFE seniors received an additional fall risk
assessment by the program Occupational Therapist (target: 100%).
• 53% of clients improved their score on one or both of the fall risk
assessments: the 4-Step Balance test or the 30-Second Chair test
(target: 50%).
Allocation: $32,698 | Expended/Encumbered: $32,698
Individuals served by Measure A: 60 (Total individuals served: 202)
Populations served: Seniors
Services provided: Public Health
Service area: Ashland, Castro Valley, Cherryland, Fremont, Hayward, Newark, San Leandro, San Lorenzo, Union City
LIFE ElderCare
lifeeldercare.org
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BACkGROUND
LifeLong Medical Care provides high quality health and social services
to underserved people of all ages; creates models of care for the elderly,
people with disabilities, and families; and advocates for continuous
improvements in the health of its communities.
The Emeryville Center for Community Living brings schools, a library,
and recreation and health services together in a single campus, providing
an opportunity for collaboration and revitalization in Emeryville.
MEASURE A FUNDING SUMMARY
LifeLong Medical Care used its Measure A allocation to purchase
equipment to equip the new LifeLong Emeryville Health Center, located
within the Emeryville Center for Community Life.
Allocation: $98,000 | Expended/Encumbered: $98,000
Individuals served by Measure A: N/A (Total individuals served: N/A) Note: Funds were used for equipment purchase, not direct services
Populations served: Low Income, Uninsured Adults, Children
Services provided: Public Health
Service area: Emeryville
LifeLong Medical Care Emery School Health Center
lifelongmedical.org
Matching Funds
LifeLong leveraged its Measure A
allocation to obtain $180,000 in
matching funds from the HEDCO
foundation and the U.S. Health
Resources Services & Administration
Oral Health Expansion.
Measure AAllocation MatchingFunds
$98,000
$180,000
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BACkGROUND
LifeLong Medical Care provides high quality health and social services
to underserved people of all ages; creates models of care for the elderly,
people with disabilities, and families; and advocates for continuous
improvements in the health of its communities.
The LifeLong Heart 2 Heart (H2H) program works to achieve the
following:
• Foster advocacy efforts to address community priorities
• Support community efforts to build strong networks among neighbors
• Engage residents in activities to promote healthier behaviors
• Increase the social and environmental supports for healthier behavior
MEASURE A FUNDING SUMMARY
The LifeLong H2H program used its Measure A allocation to achieve the
following:
• Train and certify 20 residents as Neighborhood Health Advocates
(NHAs) using curriculum adapted from other successful health
promoters programs, of which 100% graduated (target: 15 residents,
70% graduates). Topics included leadership, team development and
effectiveness, how to navigate through the health care system, and
health-specific issues.
• Engage with community members through 130 public events and/or
small presentations (target: 50). Activities provided health education
and linkages to community resources.
• Implement mini-grant programs and award five mini-grants to
programs such as community gardens that encourage healthy
behaviors, helping to create a positive change in the South Berkeley
community by improving the health and well-being of residents (target:
3–4).
• Provide information on health-related topics and services to 865
residents through 33 mobile health van events stationed within the
neighborhood and at other events (target: 200 residents at 10 events).
Allocation: $100,000 | Expended/Encumbered: $100,000
Individuals served by Measure A: 1,604 (Total individuals served: 1,604)
Populations served: Low Income, Uninsured Adults, Seniors
Services provided: Public Health
Service area: Berkeley
LifeLong Medical Care Heart2Heart
lifelongmedical.org
Highlights
In several areas, LifeLong H2H greatly
exceeded its targets. For example, it
provided 130 public events compared
to a target of 50, reached 865
residents through mobile outreach
compared to a target of 200, and
provided 1,696 visits to the HTN clinic
compared to a target of 500.
• 97% of NHA graduates reported
an increase in confidence as a
leader and connecting community
members to resources.
• 92% of community event attendees
reported an increased ability
to connect with community
resources.
• 90% of HTN event attendees
reported an increase in confidence
in managing their health.
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• Provide heart health information to 136 residents through 10 Health
Hubs events in local barbershops (target: 75 residents at 10 events).
• Contact 216 residents through 2 door-to-door outreach events to
promote healthy behaviors (target: 100 residents at 2 events).
• Organize 95 drop-in Hypertension (HTN) clinics to provide 1,696 visits
to residents for blood pressure screenings and health education to
increase their knowledge and awareness of cardiovascular health and
support healthy behaviors (target: 80 clinics providing 500 visits). 248
residents benefited from free blood pressure screenings and received
important information about cardiovascular health.
Matching Funds
LifeLong H2H leveraged its Measure
A allocation to obtain $72,349 in
matching funds from the Community
Development Block Grant awarded by
the City of Berkeley.
Measure AAllocation MatchingFunds
$100,000
$72,349
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BACkGROUND
Love Never Fails is dedicated to the restoration, education, and protection
of those involved or at risk of becoming involved in domestic sex
trafficking. The program provides trauma-informed safe housing, medical
case management, and mental health and substance abuse services.
MEASURE A FUNDING SUMMARY
Love Never Fails used its Measure A allocation to serve 22 clients. This
resulted in 53 completed medical visits and 229 mental health/substance
abuse meetings.
Allocation: $10,000 | Expended/Encumbered: $10,000
Individuals served by Measure A: 22 (Total individuals served: 22)
Populations served: Low Income, Uninsured Adults, Children, Seniors
Services provided: Public Health, Mental Health, Substance Abuse
Service area: Hayward
Love Never Fails
loveneverfailsus.com
Measure A Helps
A client who came to Love Never Fails
was homeless, was formerly addicted
to drugs, did not have custody of her
child, had multiple health problems,
and was traumatized from the
experience of being exploited. After 18
months in the safe housing program,
the client was able to gain full custody
of her daughter back, get her own
apartment, reinstate her driver’s
license, get a car, study for and pass
the real estate license exam, get a job at
a real estate company, and maintain a
healthy, sober lifestyle.
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BACkGROUND
Mandela MarketPlace, Inc. works in partnership with local residents,
family farmers, and community-based businesses to improve health,
create wealth, and build assets through cooperative food enterprises in
low income communities. The Ashland Cherryland Food Policy Council
(ACFPC) is a project of Mandela MarketPlace, Inc. The resident-led
ACFPC advises local government on policy to establish an equitable
and secure food system for residents of the low income, unincorporated
Alameda County communities of Ashland and Cherryland.
MEASURE A FUNDING SUMMARY
Mandela MarketPlace used its Measure A allocation to achieve the
following:
• Conduct community outreach with 559 Ashland and Cherryland
residents to increase participation in the ACFPC, the Eden Area
Livability Initiative, and other local community initiatives to increase
sustained community engagement in local self-governance initiatives
related to urban agriculture and environmental and food-centered
economic development policy (target: 300).
• Present data from the ACFPC’s Vacant Land Survey at 10
community meetings, and conduct education and outreach regarding
implementation of an Assembly bill related to urban agriculture
incentive zones, to 311 residents (target: 300).
• Construct one community garden in a low income housing complex in
Ashland to increase healthy food access for an underserved population.
• Engage 10 apartment residents in growing fruits and vegetables in
the community garden, and engage 60 additional apartment residents
through three gardening workshops, three food justice movie nights,
and one healthy cooking class (target: 50).
• Conduct one training and/or conference on leadership or skill
development attended by six ACFPC members to build their leadership
capacity and technical skills to advocate for healthy food access.
• Schedule four quarterly meetings with the District 4 County Supervisor
to provide policy and constituent updates.
Allocation: $10,000 | Expended/Encumbered: $10,000
Individuals served by Measure A: 936 (Total individuals served: 936)
Populations served: Low Income Adults, Children, Families, Seniors
Services provided: Public Health
Service area: Ashland, Cherryland
Mandela MarketPlace
mandelamarketplace.org
Matching Funds
Mandela MarketPlace, Inc. leveraged
its Measure A allocation to obtain
$13,950 in matching funds from
the Alameda County Public Health
Department.
Measure A
Allocation
Matching
Funds
$10,000 $13,950
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BACkGROUND
The Alameda County “Getting the Most Out of Life” (GMOL) program is
designed to reduce suffering and improve quality of care for older adults
and the terminally ill through increased education about and utilization
of advance care planning, palliative, and hospice services in Alameda
County.
MEASURE A FUNDING SUMMARY
Measure A funding helped the GMOL program plan a public event for
160 residents of Alameda County to increase education and utilization of
advance care planning and hospice services (target: 150).
Services were provided by 30 volunteers and vendors including nonprofits,
social services agencies, and hospice providers.
The event resulted in five notarized Advance Health Care Directives being
completed.
Allocation: $1,500 | Expended/Encumbered: $1,500
Individuals served by Measure A: 190 (Total individuals served: 190)
Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors
Services provided: Emergency Medical, Hospital Outpatient, Public Health, Mental Health
Service area: Countywide, Homeless or transient
National Health Care Decisions Day
gettingthemostoutoflife.org
Highlights
86% of residents who completed a
survey indicated that they felt more
comfortable talking about health care
or end-of-life choices after attending
the event.
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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.
The programs and organizations receiving Initiative funding include the
following:
• Asthma Start (see the separate “Alameda County Asthma Start” entry
on page 82)
• Berkeley School-Linked Health Services Program
• CAL-PEP
• Child Health Disability Prevention Program
• City and County Neighborhood Initiative
• Community Assessment, Planning, and Evaluation Unit
• Diabetes
• East Oakland Boxing Association
• Healthy Retail Project
• HIV Education and Prevention Project of Alameda County
• Home Visiting and Family Support
• HOPE Collaborative—A Project of the Tides Center
• Immunization
• Lotus Bloom
• Mandela MarketPlace
• Niroga Institute
• Nutrition Services
Allocation: $3,230,000 | Expended/Encumbered: $3,230,000
Individuals served by Measure A: 129,388 (Total individuals served: 181,363)
Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors
Services provided: Emergency Medical, Hospital Outpatient, Public Health, Mental Health, Substance Abuse
Service area: Countywide, Homeless or transient
Public Health Prevention Initiative
Matching Funds
Public Health Prevention Initiative
providers leveraged their Measure
A allocations to obtain $703,591 in
matching funds from the following
sources:
• Medi-Cal Administrative Activities
• Targeted Case Management (TCM)
• Children’s Health and Disability
Prevention (CHDP)
• Maternal, Child, and Adolescent
Health (MCAH)
• OFCY funds
• In-kind contributions from volunteer
medical professionals
• Kaiser Permanente
• Kaiser Community Benefit Grant
Measure A
Allocation
Matching
Funds
$3,230,000
$703,591
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• Office of Dental Health (see the separate “Alameda County Dental
Health” entry on page 46)
• Project New Start
• Public Health Nursing
• Public Health Nursing Healthy Living Project
MEASURE A FUNDING SUMMARY
The Public Health Prevention Initiative programs used Measure A funding
to help achieve the following.
Berkeley School-Linked Health Services (SLHS) Program
• Provide support at the school level as well to as individual students and
families.
• Provide over 120 consultations to school administration, elementary
school staff, and families on topics including vision, food allergies,
medications, immunizations, nutrition and obesity, tobacco prevention,
health insurance, and more.
• Conduct 15 public health family visits at their homes.
• Provide resources and referrals for emotional/behavioral/mental health
issues and housing.
• Participate in five 504/IEP/SST meetings with school staff and families.
• Support stronger linkages among programs to build more productive
inter- and intra-agency collaborations, with a focus on those that
address educational attainment.
• Collaborate with Berkeley Unified School District (BUSD) and other
agencies to develop and implement a coordinated, multi-agency 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 area of physical health, to
school administration and elementary school staff and families.
• Hold monthly meetings of the Berkeley Healthy Schools Collaborative
(BHSC), attended by public health staff doing work in BUSD, BUSD
representatives, youth, children, and City of Berkeley (COB) Youth
Services/2020 Vision representatives as partners.
• Participate in community events including the Heart 2 Heart Block
Party and Juneteenth, and coordinate public health participation in the
K to College Event, Attendance Awareness Month in September, and
BUSD Special Education Community event.
• Participate in two planning meetings with BUSD and UCSF Benioff
Children’s Hospital regarding the integration of the Family Navigation
& Information Desk program and the Office of Family Engagement and
Equity (OFEE).
• Provide over 30 health consultations to family engagement coordinators
for students with chronic absenteeism.
• Attend eight School Attendance Review Team/School Attendance
Review Board (SART/SARB) meetings.
The Berkeley SLHS
program conducted
15 public health
family visits at their
homes.
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• Convene planning and school implementation meetings with BUSD
staff and the Prescott-Joseph Center for Community Excellence
regarding Breathmobile services in BUSD.
• Organize a Multigenerational Family Night at Malcolm X elementary.
• Support 11 elementary school-based oral screenings for second and
fifth graders. Over 1,200 students were screened, and over 300 students
received dental sealants.
• Conduct outreach to students/families in severe need and track those
referrals, especially those who did not have a dental home or dental
insurance, to ensure that they were able to access care.
• Conduct five health trainings at staff meetings on the topics of seizure
disorders, cystic fibrosis, immunizations, Epi-Pen administration, and
medication administration.
• Consult with BUSD administration on the BUSD Parent Manual and
BUSD health webpage updates.
CAL-PEP
• Provide HIV testing and education services to those at highest risk for
HIV infection and their sexual partners.
• Enroll individuals with HIV-positive status found in need of extra
support services into Choosing Life: Empowerment! Action! Results!
(CLEAR) case management for one-on-one support with behavior
change support.
• Conduct education workshops promoting healthy choices and sexual
wellness with HIV-positive individuals and their sexual partners.
• Conduct Targeted Prevention Activities (TPAs) to 67 contacts 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.
• Conduct five health communication/public information (HCPI) events
designed to increase knowledge of current HIV status, risk-reduction
skills, and partner communication among African American HIV-
positive individuals and their negative sexual partners.
• Inform 58 partners of HIV positives or people in their social network of
their HIV status.
Child Health Disability Prevention (CHDP) Program
• Conduct universal developmental screening at CHDP pediatric sites to
identify children at risk for developmental delay between birth and age
three.
• Provide onsite training at 21 CHDP provider offices to implement
developmental screening or add a screening interval in their practice.
• Screen 8,191 children using the Ages & Stages Questionnaires (ASQ)
and Modified Checklist for Autism in Toddlers (M-CHAT) in pediatric
sites/clinics.
Measure A Helps
CAl-PEP
CAL-PEP encountered an HIV-
positive male living in a homeless
encampment. He engaged in sex work
and was a heavy substance user. His
focus was supporting his drug use and
finding shelter at night. CAL-PEP
enrolled him into CLEAR for one-on-
one support and case management
(CM) services for management of
his HIV infection. He received an
STD screen and was found to be also
infected with syphilis. He was treated
that day and a future appointment was
made for him to come back for follow-
up treatments and lab work.
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• Refer 1,596 of these children who scored of concern to the Help Me
Grow (HMG) phone line for follow-up, including referral to entitlement
services at Regional Center of the East Bay (RCEB) or Alameda County
Behavioral Health; family navigation services to assist families in
reaching needed services; referrals to play groups or community-based
programs; and provision of child development guidance and resources.
• Help ensure that 1,363 children needing follow-up received services.
• Increase the number of low income Medi-Cal or uninsured children
screened at nine, 18, and 24 months of age.
• 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.
• Recruit and train new Alameda County pediatricians in early childhood
mental health and developmental screening.
City and County Neighborhood Initiative (CCNI)
• Develop a leadership training plan and select trainers and curriculum
to help expand the program beyond Sobrante Park and West Oakland.
• Partner with residents in select neighborhoods to increase their shared
social and political power to enact the change in their neighborhoods
that they’d like to see. Residents were provided technical assistance,
seed funding, and training.
• Develop resident leadership, community priority setting, and
community cohesion. Staff met weekly with leaders in each
neighborhood providing training, coaching, and technical support
to the infrastructure development of their Resident Action Councils
(RACs). Staff also participated in the design and implementation of
monthly RAC meetings in each neighborhood, as well as in various
community-designed projects. Additionally, staff worked with youth
residents in West Oakland to help build their leadership capacity and
to eventually integrate them to the larger work of that neighborhood’s
RAC.
• Engage 12 Sobrante Park resident leaders and six West Oakland leaders
in ongoing coaching and technical assistance sessions.
• Have Sobrante Park resident leaders organize 11 community
improvement projects and two town hall meetings to help develop
cohesion to address the main priorities in Sobrante Park. Across the 11
community projects, 1,108 people participated.
• In West Oakland, have 100% of residents that participated in the
coaching sessions use a new skill to organize three projects and
activities and hold town hall meetings to select priorities for the RAC
participants. 776 community members participated.
• In West Oakland, hold a Juneteenth celebration and resource fair
attended by 750 participants. 60 local vendors provided activities and
/or resources, and 75 resident participants received blood pressure,
diabetes, and glucose health screening. 100% of those with a positive
screening result received onsite education and referral to care.
In West Oakland,
a Juneteenth
celebration and
resource fair was
attended by 750
participants. 75
resident participants
received blood
pressure, diabetes,
and glucose health
screening.
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Community Assessment, Planning, and Evaluation (CAPE) Unit
• Complete approximately 190 data requests.
• Have 92% of survey respondents indicate that they were very satisfied
with their overall experience with CAPE.
• Have 96% indicate that they were very satisfied or satisfied with the
length of time it took to get the data/services from CAPE.
Diabetes
• Provide 16 hours of self-management education to approximately 890
adults with type 2 diabetes and pre-diabetes.
• Produce a monthly newsletter sent to over 375 past participants to keep
them informed on diabetes news, provide diabetes-friendly recipes, and
present other interesting stories.
• Hold 19 classes attended by 139 people.
• Achieve the following:
- 97% of clients in the diabetes self-management program
implemented positive nutrition lifestyle changes.
- 82% of clients lost weight.
- 90% of clients decreased their blood pressure.
- 98% of clients became more physically active.
- 89% of clients were at 7% or lower on the blood glucose
measurement (A1c) or lower than their original A1c measurement.
East Oakland Boxing Association (EOBA)
• Provide holistic wellness programming for at-risk youth through
health and wellness programs including nutrition education, cooking,
gardening, and physical education.
• Hold produce distributions once a week, distributing healthy food to 50
EOBA families.
• Offer cooking classes two days per week and sports nutrition classes
once per month for 285 East Oakland youth.
• Facilitate two health and nutrition presentations for at least 50 EOBA
youth and parents.
• 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.
• Have 21 high school gym participants participate in the community
service program, with 75% completing the program. The participants
completed a total of 572 community service hours.
• Have 15 youth interns participate in the youth leadership program, with
97% of clients in
the diabetes self-
management
program
implemented
positive nutrition
lifestyle changes.
2015-2016 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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93% of youth interns retained at the end of the year.
Healthy Retail Project
• Develop an intervention model including store selection, recruitment,
and enrollment; store and store owner assessment; technical assistance
to store owners on healthy retail; community engagement; product
guidelines (alcohol, tobacco, and healthy foods); sales tracking and
inventory management systems; store owner and staff training; healthy
foods procurement; and marketing.
• Develop and refine the Healthy Retail demonstration project by
working with six small corner stores.
• Work with each store to increase healthy food options, reorganize the
store to highlight healthier products, and reduce the availability of
and advertising for unhealthy products such as tobacco and alcohol
products.
• Continue contracting with two local community-based organizations to
further develop the program.
• Collect store and customer survey data for evaluation and analysis.
HIV Education and Prevention Project of Alameda County (HEPPAC)
• Have 171 people who inject drugs (PWIDs) increase knowledge of their
STI and/or HIV and/or HCV status.
• Provide 200 PWIDs with increased access to primary medical care and
holistic health services.
• Have 300 PWIDs increase their knowledge of and/or adopt/identify at
least one HIV/HCV risk-reduction strategy.
• Reach 150 PWIDs and link them to HEPPAC abscess/wound care and
clinic services. At least 40 PWIDs were unduplicated.
• Provide abscess/wound care services for soft tissue damage due to
injection drug use to 126 PWID patients.
• Provide abscess/wound care follow-up services to 84 PWIDs.
• Reinstall and maintain the syringe drop box by collecting on a weekly
basis any used and dirty syringes placed in the box. 7,433 used syringes
were collected from the box.
• Conduct outreach to 322 PWIDs accessing the drop box location to
make them aware of the drop box and provide them with information
on how to properly dispose of used syringes and reduce the risk of HIV
and Hepatitis C (HCV).
• Provide 104 PWIDs who congregate near the drop box location
information on how to properly dispose of used syringes and how
to reduce the transmission of HIV, HCV, and other blood-borne
pathogens.
• Encourage 306 PWIDs receiving abscess/wound care services to
participate in at least one of the following: HIV or HCV testing and
counseling services, with 100% participating in at least one service.
• 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 provided
200 PWIDs with
increased access to
primary medical care
and holistic health
services and 126
PWIDs with
abscess/wound care
services for soft
tissue damage due to
injection drug use.
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• Exchange 62,590 sterile syringes for used ones during two, two-hour
outdoor syringe exchange sites and one two-hour indoor site. Food,
hygiene kits, and other harm-reduction supplies were also provided.
• Conduct at least 25 weekly hours of syringe exchange services.
• Have PWIDs return 148,325 used syringes for sterile syringes during
non-fixed exchange site service hours.
• Provide care for 190 PWIDs from HEPPAC’s street medicine team at
HEPPAC’s fixed exchange locations and during non-exchange hours.
• Provide 322 PWIDs with safer injection education, including methods
to assist in vein rotation to decrease the number of skin infections and
abscesses, with 75% of wound care visitors successfully identifying at
least one safer injection technique.
• Have 306 syringe exchange and clinic visitors participate in at least one
unstructured workshop. Topics included information on HIV myths
and misconceptions. HIV/STI, Hepatitis B and C risk factors and
reduction, referrals to Casa Segura, and other social services.
• Have 100% of the unstructured workshop participants identify at least
one risk-reduction practice.
• Offer 100% of the unstructured workshop participants HIV and HCV
counseling and testing services.
• Reach 161 IDUs during targeted outreach/exchange and inform them
of HEPPACs integrated services model. 126 were unduplicated clients.
• Inform and refer 190 PWIDs to health care enrollment services.
Home Visiting and Family Support
• Increase the percentage of in-home, in-person interpretation through
pairing of interpreters with home visitors who visit pregnant women
and families with young children on a weekly or semi-monthly basis.
• Offer interpreter services in 16 languages.
• Provide 20,123 face-to-face visits to 1,343 families, of whom 347 spoke
a language other than English. 630 of these visits used an interpreter.
HOPE Collaborative: A Project of Tides Center
• Develop a healthy retail intervention model and implement it at three
stores.
• Provide 150 hours of technical assistance per store.
• Engage a total of 110 residents through surveys and 1,075 through
events, workdays, and taste-testing activities.
• Increase the inventory of healthy foods and healthy food sales, and
decrease alcohol and tobacco advertising, in all three stores.
• Decrease flavored tobacco products and alcohol products that target
youth in two of the three stores.
Immunization
• Work with over 200 health care organizations and immunization
providers to ensure data integrity in the California Immunization
Registry (CAIR), and help track immunization records for Alameda
County children and adults.
Measure A Helps
HOPE COLLABORATIVE/HEALTHY
RETAIL
HOPE Collaborative has been
partnering with One Stop Liquor’s
owners to improve the store and
increase its provision of fresh and
prepared healthy foods. HOPE
collaborated with the owners to
promote fresh fruit and cereal in the
front of the store. The owner recently
repaired his refrigerated deli case
and now provides fresh eggs, dairy
products, and deli meats instead of
filling the case with alcohol and junk
food. He plans to add a dedicated
produce rack and an upright freezer
to sell frozen fruit, vegetables, and
healthy meals. He is repainting the
store’s exterior to minimize “liquor”
and emphasize “market” or “groceries”
in the store’s signage.
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• Facilitate sending out 3,918 multilingual post cards and placing almost
2,973 phone calls on behalf of doctor offices to remind their patients
who were behind on immunizations that it was time to come in and be
brought up-to-date.
• Conduct data analysis from the CAIR system to determine
participation and success of school-based flu vaccine campaigns.
• Add 104,512 immunization records to CAIR. Recruit new non-health
care providers (e.g., schools, child care centers) to join the registry.
• Increase the completion rates for the HPV vaccine series from 57% to
64%, resulting in a completion rate at four health care sites that is much
higher than the state and national average.
• Provide training and technical assistance on registry use for medical
and non-medical office staff.
• Assist with reminder notices for immunizations due or recall notices
for overdue clients.
• Troubleshoot potential issues between data exchanges with medical
providers’ electronic health record systems.
• Maintain data quality and produce reports for providers.
• 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.
Lotus Bloom
• Build parent/resident leadership in two neighborhoods, Castlemont
and Uptown/West Oakland, to expand health, nutrition, and wellness.
• Host 10 monthly Parent Leader Meetings attended by a total of 59
parents/caregivers, and generate five new ideas and activities for
wellness activities at each.
• Implement two wellness activities at program sites.
• Recruit 20 parents at each site to attend the monthly meetings.
• Have 15 participants attend each of the wellness activities, for 90
participants total.
• Train a minimum of three parent leaders on applying for grants,
budgeting, program development, evaluation, and reporting.
• Administer eight Saturday Playtimes serving 416 children and 221
parents.
• Support five partner organizations to adopt a healthy food policy.
Mandela MarketPlace
• Develop an intervention model including store selection, recruitment,
and enrollment; store and store owner assessment; technical assistance
to store owners on healthy retail; community engagement; product
guidelines (alcohol, tobacco, and healthy foods); sales tracking and
inventory management systems; store owner and staff training; healthy
foods procurement; and marketing.
• Develop and refine the Healthy Retail demonstration project by
working with three stores.
Measure A Helps
MANDELA MARkETPLACE/HEALTHY
RETAIL
Mike and his family have owned Wah
Fay Market for over 30 years. The store
is busy and well-run, and the owner
and staff had a vision for offering more
healthy items. The program began by
delivering 15 varieties of fruits and
vegetables to the store bi-weekly. It
also developed and installed a series of
marketing materials, including price
tags, floor decals, a sandwich board,
and a façade banner, removing existing
alcohol and tobacco ads. The program
introduced Fresh Creds, which offers
EBT customer 50% off fresh, canned,
dried, and frozen fruits and vegetables.
Sales in those categories have increased
since the start of Fresh Creds.
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• Work with each store to increase healthy food options and reduce the
availability of and advertising for unhealthy products such as tobacco
and alcohol products.
Niroga Institute
• Provide scholarships to Niroga-trained yoga teachers to participate in
weekend module sessions for a period of one year.
• Provide 16 sessions of healing yoga therapy/meditation/stress reduction
classes, diabetes prevention and management support groups, and
hypertension prevention and management classes to the Alameda
County Public Health Department (ACPHD) – Chronic Disease
Program’s diabetes prevention and management classes.
• Provide yoga therapy/meditation/stress reduction sessions and
resources to the San Leandro Senior Center’s Diabetes and Wellness
Day participants.
• Provide healing yoga therapy/stress reduction/meditation sessions
to the Ethnic Health Institute (EHI) – Health Ministry Program’s
hypertension and prevention management clients.
• Recruit and train up to 12 young adults for a year-long certificated
Transformative Life Skills (TLS) Training Program.
• Place graduates in the community with greatest need in primary
prevention.
• Monitor the utilization of the 100-hour volunteering commitment of
each Integral Health Fellowship (IHF) graduate.
• Recruit four Niroga-trained yoga teachers to participate in weekend
module sessions for a period of one year.
• Collaborate with the ACPHD to conduct yoga therapy sessions to at
least 200 participants at the Diabetes and Wellness Day in October
2015.
• Develop and distribute short (5-minute) and long (15-minute) yoga
therapy protocols for hypertension prevention and management.
• Distribute yoga therapy protocols as follow-up support to at least 10
faith-based organizations in Alameda County.
Nutrition Services
• Staff an epidemiologist in the CAPE unit with a focus on data
collection, data analysis, and report development.
• Coordinate with East Oakland Boxing Association and Lotus Bloom on
their activities.
Project New Start
• Serve 75–90 youth.
• Rent lasers and purchase medical supplies, food, and beverages.
• Conduct 24 no-cost tattoo removal clinics providing over 1,500–2,000
treatments for very high risk youth, of whom 75% were underinsured or
uninsured and formerly adjudicated or gang/drug-involved.
• Provide support service linkage, care-coaching, and guidance for
personal and professional development.
Project New Start
conducted 24 no-cost
tattoo removal clinics
providing over 1,500–
2,000 treatments for
very high risk youth.
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• Help 92% of the youth who desired employment acquire and maintain
their employment goal by working.
• Help 67% of the youth who desired educational gains progress through
their educational goals and work toward certificates or degrees.
• Have 86% of Project New Start youth who received laser tattoo removal
treatments report an increase in the quality of life based on their
individual goals and overall wellness.
Public Health Nursing
• Provide 326 instances of social services to 495 low income residents of
Alameda County including housing assistance, access to public benefits,
establishing primary care homes, access to employment, child care, and
disability services.
• Help 49% of clients served gain access to services such as cash aid, food,
and primary care for the first time.
Public Health Nursing Healthy Living Program
• Conduct four training sessions consisting of nine weeks in length for a
total of 43 classes.
• Enroll 34 students who set health-related goals and attended classes.
• Provide students with a healthy snack once a week and a workbook to
guide their learning.
• Obtain 100% retention and graduation rates.
Measure A Helps
PUBLIC HEALTH NURSING
An unemployed single mother of four
children under the age of 10, who
was receiving Cal Fresh and cash aid,
was suddenly denied benefits. After
several attempts to reach her eligibility
worker, she contacted the Public
Health Nursing outreach worker. The
worker placed a call to a supervisor
explaining that the mother was unable
to provide food and other necessities
for her children. The program manager
contacted the eligibility worker and
determined that a miscalculation of
the mother’s income had led to an
erroneous denial of benefits. Immediate
steps were taken to reinstate the
mother’s benefits, which she received
the following day.
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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 1,649 new seniors in FY 15/16, compared to a
target of 1,050 new seniors.
Measure A funding helped SIPP achieve the following:
• Fall risk screening, assessment, and education. A health care
professional or paraprofessional used a validated screening tool to
Allocation: $103,000 | Expended/Encumbered: $103,000
Individuals served by Measure A: 1,649 (Total individuals served: 1,649)
Populations served: Indigent, Low Income, Uninsured Adults, Seniors
Services provided: Public Health
Service area: Countywide
Senior Injury Prevention Program
acphd.org/ipp/sipp.aspx
Highlights
In all areas, the SIPP providers
exceeded their targets, in some cases
dramatically. For example, the target
for minor home modifications was 58,
while the actual number was 90—an
increase of over 55%.
2015-2016 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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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: 840).
• 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: 90).
• 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: 75).
• 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 and
other health measures for managing their medication properly (target
for all providers: 196; actual: 246).
The program made
90 residential
modifications that
were necessary
where risk for falls
and other risk factors
could be reduced or
minimized by minor
home adaptations.
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BACkGROUND
Service Opportunity for Seniors (SOS) Meals on Wheels assists
homebound seniors who are in need of supplemental balanced nutrition
and a wellness check through a daily home-delivered meal service to
prevent early institutionalization and to allow clients to remain safely at
home for as long as they can.
Meals on Wheels targets low income seniors who are age 60 and older,
homebound, alone, recently discharged from the hospital, or with a
physical or mental impairment.
MEASURE A FUNDING SUMMARY
Meals on Wheels used its Measure A allocation to deliver 6,349 meals and
provide wellness checks to 60 unduplicated seniors in Castro Valley.
Allocation: $16,000 | Expended/Encumbered: $16,000
Individuals served by Measure A: 60 (Total individuals served: 1,783)
Populations served: Indigent, Low Income, Uninsured Seniors
Services provided: Hospital Outpatient, Public Health
Service area: Castro Valley
Service Opportunities for Seniors (Meals on Wheels)
sosmow.org
Highlights
• 91% of seniors rated their delivered
meals as good, very good, or
excellent.
• 98% said that the service they
received from their meal delivery
driver was excellent.
• 88% said that receiving a daily meal
and wellness check improved their
health and overall living situation.
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BACkGROUND
Social and Environmental Entrepreneurs (SEE) works to empower,
encourage, and catalyze projects to collaborate and facilitate progressive
change in areas of social and environmental justice.
MEASURE A FUNDING SUMMARY
SEE used its Measure A allocation to design, develop, and maintain, in
collaboration with multiple stakeholders, seven edible gardens in Oakland
and Emeryville. The project included development and implementation
of tailored Edible Garden Project curriculum that includes nutrition
programs for each site.
Allocation: $80,000 | Expended/Encumbered: $80,000
Individuals served by Measure A: 1,476 (Total individuals served: 2,467)
Populations served: Low Income Children
Services provided: Public Health
Service area: Emeryville, Oakland
Social and Environmental Entrepreneurs, Inc. (Acta Non Verba)
www.saveourplanet.org
SEE used its
Measure A allocation
to design, develop,
and maintain seven
edible gardens
in Oakland
and Emeryville.
2015-2016 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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BACkGROUND
Spectrum Community Services improves the health and safety of seniors
and low income residents in Alameda County by enhancing their quality
of life and helping them age at home with dignity.
Spectrum’s Fall Risk Reduction Program (FRRP) uses a multi-pronged
approach to address the physical, behavioral, and environmental
factors that contribute to falls. The physical aspect focuses on balance,
strength, and flexibility. The behavior aspect educates participants about
medication management, primary care physician visits, vision and hearing
checks, and healthier eating habits. The environmental aspect educates
participants about ways to make the home safer or tips outside of the
home to prevent from falling and going to hospitals.
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:
• Provide 715 fall prevention class sessions to 568 seniors through one-
hour sessions each week at eight County locations (target: 400 seniors).
• Have 64% of seniors attend 40 or more classes with a focus on balance,
upper- and lower-body strength, and flexibility. By attending these
classes, seniors gained useful knowledge about daily living skills, eating
healthier, and making good choices to avoid falls.
• Conduct a one-on-one consultation with seniors who experience a
fall within 48 hours of notification to identify factors that caused the
incident and recommend home modifications and home exercises to
prevent future falls.
• Conduct seven fall prevention workshops for 368 senior participants
(target: four workshops).
• Evaluate participants on improvement in strength, mobility, and
balance, with the following results:
- Strength: 59% improved, 30% maintained
- Mobility: 45% improved, 39% maintained
- Balance: 54% improved, 34% maintained
Allocation: $107,289 | Expended/Encumbered: $107,289
Individuals served by Measure A: 568 (Total individuals served: 568)
Populations served: Indigent, Low Income, Uninsured Adults, Families, Seniors
Services provided: Public Health, Mental Health
Service area: Castro Valley, Fremont, Hayward, Newark, Oakland, San Leandro, San Lorenzo, Union City
Spectrum Community Services, Inc. Fall Prevention
spectrumcs.org
Measure A Helps
Anne, 74, has difficulty with tremors
and balance. Her doctors haven’t been
able to come up with a diagnosis. She
has been going to the fall prevention
program for three years and says, “I
don’t know what I would do without
this program.” Anne struggles some
days, while other she stays balanced
and says, “I did it.” When the
instructor first met Anne, her posture
was very poor and she did not have
the confidence to go out many places.
Anne has more confidence to go out in
public now as she is taking classes at
the local community college. Anne’s
quality of life has grown because of this
program.
2015-2016 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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BACkGROUND
Spectrum Community Services improves the health and safety of seniors
and low income residents in Alameda County by enhancing their quality
of life and helping them age at home with dignity.
The Spectrum Senior Nutrition Program offers weekly evening meals
that include whole grains, fruits, vegetables, and dairy, thus helping
to supplement clients’ nutrient intake. The program also provides
socialization to participants.
MEASURE A FUNDING SUMMARY
The Spectrum Senior Nutrition Program used its Measure A allocation to
serve 2,035 meals to 59 unduplicated clients. 100% of the meals provided
met the Title IIIC nutrition guidelines for servings of fruits and vegetables
at each meal.
Allocation: $12,004 | Expended/Encumbered: $12,004
Individuals served by Measure A: 59 (Total individuals served: 4,322)
Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors
Services provided: Public Health
Service area: Fremont, Hayward, Newark, Union City, Outside of Alameda County, Homeless or transient
Spectrum Community Services, Inc. Senior Nutrition Program
spectrumcs.org
Highlights
94% of clients surveyed would
recommend the meals program to
someone they know.
2015-2016 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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BACkGROUND
Timeless Group, Inc. focuses on rehabilitation, education, skills
development, and job placement for pre- and post-release prisoners,
including juveniles and low income families. Timelist Group aims to end
the cycle of violence, crime, poverty, and recidivism through community
services, resources, and educational programs.
MEASURE A FUNDING SUMMARY
Timelist Group planned to use its Measure A funding to provide
probation-based services to incarcerated juveniles, unemployed youth,
and adult parolees and probationers as well as low income households
residing in Union City, Fremont, Newark, and South Hayward. These
re-entry and reintegration services are limited to medical, mental health,
and/or substance abuse treatment referral services.
CONCERN
This provider did not supply any Measure A funding information for FY
15/16. Therefore, the Committee cannot evaluate whether funds were
spent in accordance with the strictures of Measure A.
Allocation: $5,000 | Expended/Encumbered: Unknown
Individuals served by Measure A: Unknown
Populations served: Low Income Adults, Children, Families
Services provided: Public Health, Mental Health, Substance Abuse
Service area: Fremont, Hayward, Newark, Union City
Timelist Group Inc.
2015-2016 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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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 provide coordination of care, referrals, mental health
services, and other types of health supports to underserved youth and
families across the County.
The YFO organizations provide services focusing on mental health,
public health, alcohol and drugs, and youth and community. In addition,
YFO organizations provide a continuum of integrated and high quality
programs and services through effective care coordination. Care
coordination ensures that youth and families are connected to formal and
informal supports, providers, and community across their lives to support
achievement of positive health and life outcomes.
The organizations involved in the YFO initiative include the following:
• Alameda Family Services
• Alternatives in Action (AIA)
• Berkeley Youth Alternatives (BYA)
• East Bay Asian Youth Center (EBAYC)
• Fremont Family Resource Center
• La Familia Counseling Service
• Newark Unified School District
• REACH Ashland Youth Center
• Tri-Valley Health Initiative
• Union City Kid Zone
• Youth Radio
The YFO organizations offer family support and youth development
services as part of their holistic programming, and may serve as the safety
net for a young person or family who is just short of extreme crisis.
Allocation: $2,597,818 | Expended/Encumbered: $2,597,818
Individuals served by Measure A: 16,588 (Total individuals served: 16,588)
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.
Satisfaction rates for YFO programs
averaged 95% for youth and 97% for
families.
2015-2016 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
124
• Alameda Family Services provides an array of health and wellness
services to families, including information and referrals, health and
benefit enrollment assistance, case management, and workshops.
• AIA provides behavioral health services, youth development activities,
and gender-based empowerment groups with topics includeing healthy
living, violence prevention, restorative justice and conflict resolution
techniques, relationship-building, trauma recovery, anti-oppressive
education, and social justice.
• BYA provides culturally competent psycho-social, mental, and
emotional health services to low income and poverty-level children and
youth ages 6–18 and their families.
• EBAYC provides school-day and after-school holistic supports,
including individual case management, mental health, health education,
and youth development activities.
• Fremont Family Resource Center provides a wide array of health,
wellness, and basic needs supports to families, including counseling and
behavioral health services for individuals and groups.
• La Familia offers individual, family, and group mental health services,
crisis support, onsite Medi-Cal and Cal Fresh clinics, and family
support referrals to children, youth, and families.
• Newark Unified School District provides health and dental health
services, health education, and health enrollment and benefit referrals.
• REACH Ashland Youth Center offers a variety of programs for youth
that increase their healing, sense of connection, and belonging as well
as increasing their access to health care.
• The Tri-Valley Health Initiative supports Community Health and
Wellness Events in Pleasanton, Dublin, and Livermore to provide
physical, dental, and vision health screening and referrals, as well as
health care enrollment to youth and families.
• Union City Kids Zone offers behavioral health prevention groups
and workshops, acculturation groups for new immigrants, girls’
empowerment, mindfulness groups, and an array of youth development
activities.
• Youth Radio provides wraparound health and wellness support to
youth enrolled in their media arts education and internship placement
program, with services including assessment, behavioral health
services, healthy food, and individual advising.
MEASURE A FUNDING SUMMARY
Through the Measure A YFO initiative grant, 16,588 clients were served
during FY 15/16.
Client results were obtained across a variety of service areas, including:
• Youth-focused individual and group counseling, case management,
mental health, alcohol and drug assessment, and referrals
- 2,214 youth were seen in groups.
- 3,194 youth received individual services.
Matching Funds
The participating CBOs leveraged the
YFO initiative Measure A allocation to
obtain $2,740,580 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
$2,597,818 $2,740,580
2015-2016 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
125
• Family-focused individual and group counseling, case management,
mental health services, alcohol and drug assessment, and referrals
- 284 families were served in groups.
- 3,771 families received services one-on-one.
• Youth leadership development and enrichment activities on improving
personal growth, health and wellness, academic achievement, and
creating career opportunities
- 5,592 youth benefited from these services.
• Family engagement in schools focusing on health and wellness, work
readiness, and life skills
- 6,425 families benefited from these services.
• Referrals made for additional health and wellness services
- 3,324 youth and adults were referred to outside services.
• Community events focus on raising awareness of free and affordable
health care services
- 304 community events were held.
- 12,495 contacts were made at the events.
• Community health fairs providing children and families in Livermore,
Dublin, and Pleasanton with health information and service
- Three health fairs were held, attended by 600 residents.
- 47 organizations collaborated.
- 103 physicals, including sports physicals, were conducted.
- 35 immunizations were provided.
- 135 dental screenings, 138 vision screenings, and 83 hearing
screenings were provided.
The member CBOs used their YFO Initiative Measure A allocation to
achieve the following.
Alternatives in Action
• At the McClymonds Youth and Family Center, 89% of students reported
an increase in self-esteem.
Berkeley Youth Alternatives
• Youth demonstrated an overall increase in resilience, and better
understanding of themselves and others.
• Participants showed improvement in reductions in marijuana use,
improved attendance in school, and improved perspective on the
importance of finishing high school and going to college.
East Bay Asian Youth Center
• 94% of after-school program participants reported that the program
helped them to feel more confident about what they can do.
• 90% said the program helped them believe they can finish high school.
• 71% said that the program helped them learn how to be healthy.
Fremont Family Resource Center
• 74% of clients reported social-emotional stability at discharge, a 35%
positive change.
90% of East Bay
Asian Youth Center
after-school program
participants said the
program helped them
believe they can
finish high school.
2015-2016 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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Measure A Helps
FREMONT FAMILY RESOURCE CENTER
David, a third-grader, came to live
with his grandparents in Fremont due
to abuse and neglect from his biological
parent. David began to see a counselor
at school, who linked David and his
family to the Fremont Family Resource
Center for assistance with food and
health care benefits. The Center also
connected the family to the Shop with
a Cop program, which provided the
entire family with holiday gifts as well
as a positive interaction with Fremont
Police. Due to the coordinated support,
David was able to settle into his new
home, school, and community, and
feel safe.
• 72% of clients reported stability of family relationship at discharge, a
positive change of 18%.
• 75% of families served reported being in stable housing at discharge, a
positive change of 45%.
• 88% of families reported being stable related to food/clothing at
discharge, a 36% positive change.
• 72% of clients reported stability of employment at discharge, a positive
change of 30%.
• 66% of clients reported having stable finances at discharge, a 36%
positive change.
• Youth clients demonstrated improved school attendance and reduced
disciplinary incidents at school.
Newark Unified School District
• Administrators saw increased parent participation in their children’s
education, increased advocacy, and improved ability to seek health,
wellness, and basic needs resources.
• Children of families served showed increased social-emotional
intelligence and awareness.
REACH Ashland Youth Center
• The Fuente health clinic provided more than 1,000 clients with more
than 4,750 clinic visits.
• 86% of those surveyed said that the clinic helped them get help sooner
than they normally would.
• 85% said the clinic helped them get services they would not otherwise
get.
• Clients reported making better decisions regarding practicing safer sex
and/or using birth control (83%), exercising more (75%), and using less
tobacco, alcohol, and/or drugs (49%).
• Youth surveyed said that REACH AYC program/activity they engaged
in helped them feel happier (79%), feel more confident (79%), and deal
better when stressed (64%).
• 84% indicated that they had learned specific skills or increased their
knowledge in the program area.
• 85% reported that they learned skills that will help them in their future.
• 79% agreed that participating in REACH programming helped with
their future planning.
Union City Kids Zone
• The percentage of children served who met 75% of their social-
emotional indicators by the end of trimester 1 increased from 30% to
48%.
• The number of students who were on track to college- and career-
readiness increased by 26%, based on the number of students passing
Algebra by the end of ninth grade.
2015-2016 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
127
Youth Radio
• 95% of Youth Radio participants indicated that social-emotional
intelligence increased over the course of the session, including
communication and self-management.
• Over 80% agreed with the statement, “My leadership skills have
increased over the course of the session.”
• 95% of seniors graduated high school.
• 90% of students were admitted and expected to matriculate into college.
95% of Youth Radio
participants indicated
that social-emotional
intelligence increased
over the course of
the session.
2015-2016 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
128
BACkGROUND
Youth UpRising works to transform East Oakland into a healthy and
economically robust community by developing the leadership of youth
and young adults and improving the systems that impact them. Youth
UpRising’s primary focus is building a systems change and community
economic development platform that supports and strengthens personal
transformation work.
MEASURE A FUNDING SUMMARY
During FY 15/16, Youth UpRising used its Measure A allocation to
develop direct services that will be provided in FY 16/17. Targeted
services include mental health consultation, staff development, parent
wellness awareness groups, and behavioral interventions for students.
Allocation: $28,465 | Expended/Encumbered: $28,465
Individuals served by Measure A: N/A (Total individuals served: N/A)
Populations served: N/A
Services provided: N/A
Service area: N/A
Note: Provider did not provide direct services through its Measure A allocation in FY 15/16.
Youth UpRising
youthuprising.org
Youth UpRising
used its Measure A
allocation to develop
direct services that
will be provided in
FY 16/17.
2015-2016 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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2015-2016 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
130
APPENDICES
APPENDIx A: MEASURE A REVENUE RECEIVED
APPENDIx B: FY 15/16 BUDGET INFORMATION
APPENDIx C : FY 15/16 MEASURE A FUND DISTRIBUTION BY PROVIDER OR PROGRAM
APPENDIx D : MAPS: GEOGRAPHIC DISTRIBUTION OF PROVIDERS FUNDED BY MEASURE A IN FY 15/16
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
2015-2016 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
131
APPENDIX A
MEASURE A REVENUE RECEIVED
FY 04/05 through FY 15/16
totAl REvEnuE EARnEd (fY 04/05 tHRougH fY 15/16)
$1.56 BILLION
REvEnuE EARnEd EACH fISCAl YEAR (fY 04/05 tHRougH fY 15/16)
Alameda Health System Board of Trustees Alameda County Board of Supervisors
FY 04/05
FY 05/06
FY 06/07
FY 07/08
FY 08/09
FY 09/10
FY 10/11
FY 11/12
FY 12/13
FY 13/14
FY 14/15
FY 15/16
Alameda County Board of Supervisors$391 MILLION
Alameda Health System Board of Trustees$1,167 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%
$ 102,925,182 $34,308,394
$99,321,959 $33,107,320
2015-2016 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
132
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2015-2016 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
134
APPENDIx C:
FY 15/16 MEASURE A FUND DISTRIBUTION
BY PROVIDER OR PROGRAM
MEASURE A ALLOCATION FY 15/16
ExPENDED/ENCUMBERED FY 15/16
GROUP 1: BEHAVIORAL HEALTH
Alameda County Behavioral Health Care Services Community-Based organizations
Alameda County Mental Health Association 37,503 31,701
Alameda Family Services 4,696 1,830
Asian Community Mental Health Board 9,575 0
Axis Community Health, Inc. 7,187 2,929
Berkeley Addiction Treatment Services, Inc. 5,349 2,245
Bi-Bett Corporation 2,857 2,125
Bonita House, Inc. 57,234 6,941
Building Opportunities for Self-Sufficiency (BOSS) 31,665 27,831
Carnales Unidos Reformando Adictos, Inc. 23,356 23,356
Center for Independent Living 2,452 2,452
Community Health for Asian Americans 2,505 2,293
Crisis Support Services of Alameda County 33,119 33,119
East Bay Community Recovery Project 36,687 32,494
FamiliesFirst Inc. 30,719 30,719
Filipinos Advocates for Justice 15,359 15,359
Horizon Services, Inc. 13,713 10,628
Humanistic Alternatives to Addiction 2,479 1,198
Magnolia Women's Recovery Programs, Inc. 6,622 5,883
Native American Health Center, Inc. 27,807 20,993
New Bridge Foundation, Inc. 47,487 40,586
Second Chance, Inc. 51,578 51,368
Senior Support Program of the Tri Valley 32,836 32,836
Southern Alameda County Committee for Raza 108,132 105,082
St. Mary's Center 34,883 34,883
Thunder Road-Adolescent Treatment 10,182 842
West Oakland Health Council, Inc. 25,132 2,049
Unallocated 114,732 -
total Allocation 775,848 521,742
Center for Empowering Refugees and Immigrants (CERI) 80,371 80,371
Center for Healthy Schools and Communities (School-Based Behavioral Health Initiative)
Emery Unified School District 37,506 37,506
Hume Center 133,952 133,952
West Coast Childrens Clinic 51,900 51,900
Other Program Expenses 398,998 398,998
total Allocation 622,356 622,356
Cherry Hill Sobering and detoxification Center 2,143,224 1,996,448
2015-2016 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
135
MEASURE A ALLOCATION FY 15/16
ExPENDED/ENCUMBERED FY 15/16
gRouP 1: BEHAvIoRAl HEAltH (ContInuEd)
Criminal Justice Screening and In-Custody Services 4,306,000 4,306,000
La Familia Counseling Service 50,000 50,000
Mental Health Services for Juvenile Justice Center 360,000 360,000
Safe Alternatives to violent Environments (SAvE) 40,000 40,000
Senior Support Program of Tri-Valley 20,000 20,000
MEASURE A ALLOCATION FY 15/16
ExPENDED/ENCUMBERED FY 15/16
GROUP 2: HOSPITAL, TERTIARY CARE, OTHER
direct Service Planning and Administration 400,000 252,987
San leandro Hosptial 1,000,000 1,000,000
St. Rose Hospital 2,000,000 2,000,000
uCSf Benioff Children's Hospital oakland 2,000,000 2,000,000
MEASURE A ALLOCATION FY 15/16
ExPENDED/ENCUMBERED FY 15/16
GROUP 3: PRIMARY CARE
Alameda County Dental Health 157,580 157,580
Center for Elders' Independence 53,581 53,581
Center for Healthy Schools and Communities (School Health Centers)
Alameda Family Services 203,607 203,607
City of Berkeley 128,594 128,594
East Bay Agency for Children 4,964 4,964
East Bay Asian Youth Center 49,187 49,187
La Clinica de La Raza, Inc. 202,574 202,574
LifeLong Medical Center 61,000 61,000
Native American Health Center 113,500 113,500
Seneca Family of Agencies 40,000 40,000
Tiburcio Vasquez Health Center 219,681 219,681
UCSF Benioff Children's Hospital Oakland 98,374 98,374
University of California, San Francisco 135,269 135,269
Other Program Expenses 701,034 701,034
total Allocation 1,957,784 1,957,784
Community Initiatives 60,000 60,000
Connecting Kids to Coverage (CKC) Initiative 255,105 255,105
direct Medical and Support Services (oakland): Preventive Care Pathways 214,322 214,322
fire Station Health Portals 750,000 1,120,286
Fremont Aging and Family Services 53,581 53,581
Health Enrollment for Children 300,000 300,000
2015-2016 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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MEASURE A ALLOCATION FY 15/16
ExPENDED/ENCUMBERED FY 15/16
gRouP 3: PRIMARY CARE (ContInuEd )
Health Services for day laborers
Health Services for Day Laborers: Community Initiatives (Day Labor Center) 89,301 89,301
Health Services for Day Laborers: Multicultural Institute 89,301 89,301
Health Services for Day Laborers: Street Level Health Project 89,301 89,301
total Allocation 267,903 267,903
Hospice: getting the Most out of life Program 200,000 179,042
Medical Costs for Juvenile Justice Services
Medical Costs for Juvenile Justice Center: Direct Service Planning and Administration 261,000 261,000
Medical Costs for Juvenile Justice Center: Mind Body Awareness Project 58,939 58,939
Medical Costs for Juvenile Justice Center: Niroga Institute 83,224 83,224
Medical Costs for Juvenile Justice Center: Victims of Crime 102,800 90,000
total Allocation 505,963 493,163
Primary Care Community-Based organizations
Alameda Health Consortium
Asian Health Services 634,808 634,808
AXIS Community Health Center 663,694 663,694
La Clínica de La Raza 1,867,781 1,867,781
LifeLong Medical Center 721,610 721,610
Native American Health Center 279,930 279,930
Tiburcio Vasquez Health Center 904,478 904,478
Tri-City Health Center 615,035 615,035
West Oakland Health Council 183,158 183,158
total Allocation 5,870,494 5,870,494
tiburcio vasquez 60,000 60,000
Washington Hospital 33,000 33,000
MEASURE A
ALLOCATION
FY 15/16
ExPENDED/
ENCUMBERED
FY 15/16
GROUP 4: PUBLIC HEALTH
ACCMA Community Health foundation 37,840 37,840
Alameda Boys & girls Club, Inc. 107,161 107,161
Alameda County Asthma Start 100,000 100,000
Alameda County Breastfeeding Coalition Childcare taskforce 6,900 6,900
Center for Early Intervention on deafness 53,581 53,581
City of San Leandro Senior Services 53,581 53,581
Drivers for Survivors, Inc. 10,000 10,000
East Oakland Community Project 30,000 30,000
Eden Youth and Family Center 75,000 75,000
Emergency Medical Services Corps
Snowy River EMS Productions, Inc. 56,100 56,100
Other Program Expenses 548,842 548,842
total Allocation 604,942 604,242
2015-2016 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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MEASURE A ALLOCATION FY 15/16
ExPENDED/ENCUMBERED FY 15/16
gRouP 4: PuBlIC HEAltH (ContInuEd )
Emergency Medical Services Health Coach Program 236,000 236,000
Genesis Worship Center 5,000 5,000
HIv Education and Prevention Project of Alameda County (HEPPAC): oPEnd Project 150,000 150,000
HIv Education and Prevention Project of Alameda County (HEPPAC): Syringe Exchange Program 150,000 150,000
LIFE ElderCare 32,698 32,698
LifeLong Medical Care: Emery School Health Center 98,000 98,000
LifeLong Medical Care: Heart 2 Heart 100,000 100,000
Love Never Fails 10,000 10,000
Mandela MarketPlace, Inc. 10,000 10,000
national Health Care decisions day 1,500 1,500
Public Health Prevention Initiative
CAL-PEP Inc. 48,566 48,566
Center for Oral Health 67,262 134,524
City of Berkeley 180,835 180,835
East Oakland Boxing Association 52,530 52,530
Earth Island Institute 10,300 10,300
Emergency Medical Services Injury Prevention 210,112 210,112
Higher Ground Neighborhood Development 56,587 174,400
HIV Education and Prevention Project of Alameda County 194,150 44,150
Lotus Bloom 34,145 34,145
Lucile Packard Children's Hospital Stanford 41,613 41,613
Mandela MarketPlace 182,024 110,622
Niroga Institute, Inc. 56,771 36,771
Tides Center 140,000 68,598
Subtotal Program Expenses 1,264,595 1,147,166
Other Program Expenses 1,816,413 1,839,692
total Allocation 3,081,008 2,986,858
Senior Injury Prevention Program 103,000 103,000
Service Opportunity for Seniors (Meals on Wheels) 16,000 16,000
Social and Environmental Entrepreneurs, Inc. (Acta non verba) 155,600 155,600
Spectrum Community Servies, Inc.: fall Prevention Program 107,289 107,289
Spectrum Community Servies, Inc.: Senior Meals 12,004 12,004
Timelist Group, Inc. 5,000 5,000
Youth and family opportunity Initiatives
Alameda Family Services 107,161 107,161
Alternatives in Action (AIA) 278,211 278,211
Berkeley Youth Alternatives (BYA) 107,161 107,161
City of Fremont 163,863 163,863
Dublin Unified School District 17,860 17,860
East Bay Agency for Children for CKC 17,330 17,330
East Bay Asian Youth Center (EBAYC) 107,161 107,161
Fremont Unified School District 107,161 107,161
La Clinica de La Raza 112,519 112,519
2015-2016 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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MEASURE A ALLOCATION FY 15/16
ExPENDED/ENCUMBERED FY 15/16
gRouP 4: PuBlIC HEAltH (ContInuEd )
Youth and family opportunity Initiatives (Continued)
Livermore Unified School District 17,860 17,860
Newark Unified School District 111,201 111,201
New Haven Unified School District 107,161 107,161
Pleasanton Unified School District 17,860 17,860
Spanish Speaking Unity Council (LMB) 64,297 64,297
Southern Alameda County Committee for Raza 160,742 160,742
Youth Radio 107,161 107,161
Other Program Expenses 993,109 993,109
total Allocation 2,597,818 2,597,818
Youth UpRising 28,465 28,465
2015-2016 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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Map 3
alaMeda County beHaVioral HealtH Care serViCes
MENTAL HEALTH COMMUNITY-BASED ORGANIZATION PROVIDERS
Funded by Measure a in Fy 15/16
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Map 4
sCHool HealtH Centers Funded by Measure a in Fy 15/16
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Map 5
HEALTHPAC PROVIDER NETWORk
Funded by Measure a in Fy 15/16
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