HomeMy WebLinkAboutmeasurea-rpt-07-08-webREVIEW OF EXPENDITURES IN
Fiscal Year (FY) 2007/2008
July 1, 2007 – June 30, 2008
MEASURE A
Essential Health Care Services
Tax Ordinance
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OVERSIGHT COMMITTEE
3RD REPORT
TO THE ALAMEDA COUNTY
BOARD OF SUPERVISORS
AND THE PUBLIC
MEASURE A
Essential Health Care Services Tax Ordinance
OVERSIGHT COMMITTEE
3RD REPORT
TO THE ALAMEDA COUNTY BOARD OF SUPERVISORS
AND THE PUBLIC
REVIEW OF EXPENDITURES IN
Fiscal Year (FY) 2007/2008
July 1, 2007 – June 30, 2008
10/09
TABLE OF CONTENTS
MEASURE A OVERSIGHT COMMITTEE MEMBERS ................................................................................................ 1
EXECUTIVE SUMMARY ...................................................................................................................................3
SECTION 1: FUNDING ALLOCATION AND REVIEW PROCESS ................................................................................. 7
SECTION 2: HOW THE MONEY WAS SPENT .................................................................................................... 9
REVIEW OF FY 07/08 EXPENDITURES: 75% OF MEASURE A FUNDS
ALLOCATED TO THE ALAMEDA COUNTY MEDICAL CENTER ............................................................................................... 10
REVIEW OF FY 07/08 EXPENDITURES: 25% MEASURE A FUNDS
ALLOCATED BY THE ALAMEDA COUNTY BOARD OF SUPERVISORS ....................................................................................... 12
GROUP 1: PUBLIC HEALTH .....................................................................................................................................13
Alameda County Public Health Department: Prevention Initiative .................................................................... 13
Emergency Room and On-Call Physician Compensation .................................................................................. 14
GROUP 2: BEHAVIORAL HEALTH .............................................................................................................................. 16
Alameda County Behavioral Health Care Services Community-Based Organization Providers ......................... 16
Alameda County Behavioral Health Care Services Detox/Sobering Station ....................................................... 17
Mental Health Costs for Juvenile Justice Center ................................................................................................ 18
Mental Health Costs for Glen Dyer Jai in Oakland ............................................................................................ 19
Criminal Justice Screening/In-Custody Services at Santa Rita Jail ..................................................................... 19
GROUP 3: MEDICAL CARE, CAPITAL,AND ADMINISTRATIVE SERVICES .............................................................................. 20
Primary Care Community-Based Organizations ................................................................................................ 20
Non-County Hospitals ...................................................................................................................................... 22
School-Based Health Centers ............................................................................................................................ 23
Medical Costs for Juvenile Justice Center .......................................................................................................... 25
Capital Investment in the County’s Health Care Safety Net .............................................................................. 26
Other Capital ..................................................................................................................................................... 29
Administration/Infrastructure Support ............................................................................................................. 29
Healthy Communities, Inc. (doing business as Healthy Oakland) .................................................................... 30
Direct Medical and Support Services (Oakland) ............................................................................................... 30
GROUP 4: BOARD OF SUPERVISORS DISCRETIONARY ALLOCATIONS ................................................................................. 32
APPENDICES.................................................................................................................................................37
APPENDIX A: MEASURE A REVENUE RECEIVED IN EACH FISCAL YEAR .............................................................................. 39
APPENDIX B: FY 07/08 MEASURE A FUND DISTRIBUTION BY PROVIDER OR PROGRAM.................................................... 43
APPENDIX C: GEOGRAPHIC DISTRIBUTION OF PROVIDERS RECEIVING MEASURE A FUNDS
County,Private, and Nonprofit Hospitals and Alameda County Public Health Program ......................... Map 1
Capital Investment in the County’s Health Care Safety Net ..................................................................... Map 2
Emergency Rooms Where ER and On-Call Physicians Provided Service ................................................. Map 3
Alameda County Behavioral Health Care Services Alcohol and Drug Providers....................................... Map 4
Alameda County Behavioral Health Care Services Mental Health CBO Providers.................................... Map 5
Adolescent School-Based Health Centers................................................................................................. Map 6
Primary Care Community Based Organization (CBO) Clinics................................................................. Map 7
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MEASURE A OVERSIGHT COMMITTEE MEMBERS
COMMITTEE MEMBER REPRESENTING/NOMINATED BY
Ken Ballard, Pharm D.League of Women Voters
John Becker City Manager’s Association
Louis Chicoine Supervisorial District 1
Bradley Cleveland Central Labor Council of Alameda County
Kay Eisenhower Supervisorial District 4
Jay Garfinkle,M.D.Alameda-Contra Costa Medical Association
Arthur Geen Alameda County Taxpayers Association
Neil Marks Hospital Council of Northern California
Sumi Paranjape*Supervisorial District 5
Larry Platt, M.D.Alameda County Public Health Commission
Beth Pollard City Manager’s Association
Don Sheppard Supervisorial District 2
Ronald Tauber Alameda County Mental Health Board
Sal Tedesco League of Women Voters
Mee Ling Tung Supervisorial District 3
*Did not participate in the production of this report
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T HIS IS THE THIRD report of the Measure A Oversight Committee. It reviews the expenditure of
Measure A sales tax revenue for fiscal year 2007/2008 (FY 07/08).The Committee’s major
conclusion, highlights, and concerns are summarized below and discussed in greater detail
in the body of the report.
This report is based on a number of sources:
• self-reported information provided by recipients of Measure A funds
• presentations by the Alameda County Medical Center (ACMC), Alameda County Behavioral Health
Care Services (BHCS),the Alameda County Board of Supervisors (BOS), the Detoxification
Center/Sobering Station, and the Alameda Health Consortium
• the County Health Care Services Agency (HCSA), which monitors the contracts with recipients of
Measure A funds—including negotiating scope of work and payment schedule, developing actual
contracts,preparing Board letters for approval, authorizing payments, and tracking expenditures.
Measure A, the Essential Health Care Services Initiative, was passed by 71% of Alameda County voters in
March 2004. It authorized the County of Alameda to raise its sales tax by one-half cent in order 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.These services faced sharply increasing costs with
inadequate resources to meet the needs of County residents. Measure A funds substantially eased the
countywide crisis in health care; however, the current economic downturn threatens some of the gains
achieved.
The initiative generated $115,852,743 in FY 07/08. ACMC received 75% of these funds, and the BOS
distributed the remainder of the funds to other health care providers, including:
• initiatives funded by the Alameda County Public Health Department and BHCS
• emergency room physicians
• primary care clinics
• Children’s and St. Rose Hospitals
• school-based health centers.
In addition to helping ACMC stabilize its budget and expand its health care services, Measure A has helped
enable serious long-term planning to meet future health care needs for County residents. For example, the
Public Health Department has used Measure A funds to examine and address health inequities within the
client population and to develop a strategic plan.These initiatives will continue to bear fruit over time.
EXECUTIVE SUMMARY
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MAJOR CONCLUSION
The Oversight Committee found that ACMC and the other recipients of sales tax revenue spent the funds in
compliance with the strictures of Measure A. In addition, the Committee found that in FY 07/08 Measure
A enabled expansions in services and facilities, equipment purchases, and more, which reflects the original
primary goal of the Measure. In prior years, Measure A funding recipients used the money primarily to fill
service gaps.
HIGHLIGHTS
Measure A revenues are critical to maintain access to medical services by indigent, uninsured, and low
income residents of Alameda County, who depend on the County’s health care safety net. According to state
data, 18% of County residents, about 233,000 people, are uninsured, and another 20% are eligible for
public health insurance programs, including Medi-Cal and Healthy Families, that target low income
individuals and families.
In addition to continuing existing programs, during the year under review, the sales tax revenue allowed a
number of health care providers to expand services and plan for future growth:
• Measure A funds increased access to health care services for organizations ranging from ACMC to
school-based health centers.
• The Capital Investment fund served geographically diverse areas offering a large range of services.
• Several recipients, such as St. Rose Hospital, used Measure A funds as leverage to draw down matching
funds, both federal and foundation grants.The Capital Investment fund required any recipient of a
capital grant over $50,000 to obtain matching funds.
• The opening of the long-planned Detox/Sobering Station during this fiscal year represents a key capital
achievement.
• Many organizations and departments, including the Public Health Department and the school-based
health centers, used Measure A funds to increase health outreach and education efforts, with a focus on
prevention.
• FY 07/08 saw a growing collaboration among the County, ACMC, the Public Health Department, and
community-based clinics.Measure A helped fund some of these collaborative efforts.
•Measure A gives the County flexibility to address unmet needs and unanticipated costs. Specifically, the
$1 million BOS allocation gives the Supervisors the flexibility to respond to unanticipated needs in
their districts.
CONCERNS
In developing this report, the Oversight Committee has identified several concerns regarding the state of
health care funding during the years of Measure A implementation (2004-2008), including a decrease in
the rate of growth in sales tax revenue, health care funding cuts, and an increase in the number of
uninsured Alameda County residents. Sales tax receipts are growing at a slower rate each year or even
decreasing, meaning that Measure A funding increases grow more slowly also.The Oversight Committee is
concerned that continuing cuts in state and federal support for health care, combined with slower growth
in Measure A sales tax revenue, will result in an increase in the health disparities across different
communities that the Measure addresses.
County health care funding has undergone specific losses as well, such as the elimination of $1 million in
emergency medical services funding from the state. At the same time, unemployment has been on the rise
from FY 07/08 into FY 08/09 and FY 09/10, potentially increasing the number of indigent, uninsured,
and low income Alameda County residents who might seek Measure A-funded services.
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Recent and proposed federal regulations and funding cuts will add to the County’s health care burden.
Measure A revenues help fill this gap, but as federal and state cuts continue, it will be harder for County
medical services to meet the increased needs of low income, uninsured, and indigent patients.
Outside of the area of health care funding, the Committee has an ongoing concern that the composition of
the Committee does not reflect the diverse make-up of the population served by Measure A.
The Committee raised concerns regarding Measure A funding specifically, including the following:
General Concern Regarding Allocations
Because the Measure A allocations were based on public hearings in 2004, the Committee is concerned
that the BOS might renew these allocations for another three years without considering the best use of
these limited resources, given the changes that have occurred over the past six years, and the promise of
health reform on the horizon.
Reporting and Review Concerns
• The Committee expresses 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 Committee has not reviewed HCSA’s process of controls and review of how the money is spent—
via audit or other method.The Committee has not reviewed any of the documentation HCSA has
received to monitor their control of how the Measure A money has been spent. In response to this, the
Committee is trying to address its process to do a better job soliciting the information it needs.
• The Committee’s review was impacted by the varying level of detail provided in the 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 money is being spent on the Measure
A target population. As one example, many fund recipients provide services to seniors—however, the
Committee is aware that many seniors do not qualify as low income, uninsured, or indigent.
ACMC
• Some committee members are concerned that the County requires ACMC to make significant loan and
interest payments to the County, which come out of Measure A revenue. ACMC incurred much of this
debt before Measure A passed in 2004. Other members believe that this creates a political more than a
legal problem that might affect broader community support for the continuation of Measure A in the
future.At the same time, some Committee members recognize the importance of debt repayment to
the County budget.
• The Committee requested data from ACMC similar to that provided last year, which enabled the
Committee to examine Measure A results by specific sites. ACMC has not yet provided these data.
Bay Area Consortium for Quality Health Care (BACQHC)
The Oversight Committee is concerned that BACQHC was out of compliance with its contract with HCSA,
which specifies that BACQHC must provide at least 95% of contracted visits.
Alameda County BHCS Community-Based Organization (CBO) Providers
BHCS has implemented a cumbersome process and rules that have made it difficult for CBOs to access all
Measure A funds. BHCS has attempted to streamline the process, but this hasn’t resulted in all the money
being disbursed.The Committee’s concern is that service providers that have been allocated funds haven’t
received all of them because of these rules.
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Capital Investment Fund
• Some Committee members are concerned that there appears to be no requirement that recipients of
capital funds provide services to indigent, underinsured, or low income patients for any specified
period.
• In addition, the Committee is not aware of any requirements concerning the ultimate purpose of
capital projects that relied on Measure A funds. For example, if a building changes hands, the
Committee does not know if there is any requirement that the new building owner continue to
provide services to the Measure A target population.
• The Oversight Committee is also concerned that there is no continuing Capital Investment fund, and
recommends that the BOS identify Measure A funds that can be used to meet the capital needs of
nonprofit health care services providers in Alameda County.
ValleyCare
The Oversight Committee is concerned that Measure A funds paid 50% of the construction costs for an
expansion that serves such a low proportion of Measure A’s targeted population. Of course, over time the
percentages should equalize, given no additional allocations of Measure A funds. However,ValleyCare
signaled in its report to the Committee that they may be applying for Measure A funds for additional
expansion in the future.
The language of Measure A includes a commitment to geographic distribution of the funds raised, and the
allocation to ValleyCare helps to keep that commitment. But it is also important that Measure A funds be
restricted to providing services to the target population as laid out in the ballot language.
BOS Discretionary Allocations
The Committee acknowledges that the Supervisors responded to some of the concerns raised in last year’s
report, but notes the following ongoing and new concerns:
• No specified process exists to announce the availability of funding or to request a District allocation.
• As income from the sales tax decreases, the BOS fixed dollar amount of the allocation becomes a larger
percentage of the whole.
CITIZEN OVERSIGHT COMMITTEE
One of the provisions of Measure A required the establishment of a Citizen Oversight Committee.The role
of the Oversight Committee is to annually review Measure A expenditures for each fiscal year and report to
the BOS on the conformity of such expenditures to the purposes set forth in the Measure.
The Measure explicity states that the Committee’s charge does not include reviewing the efficiency of
programs funded by Measure A.
The full report of the Oversight Committee and all supporting documents are available online at
www.acgov.org/health/. For more information about Measure A expenditures or the Oversight
Committee,please contact Linda Truong at (510) 667-7994 or Linda.Truong@acgov.org.
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SECTION 1
FUNDING ALLOCATION AND REVIEW PROCESS
The language of Measure A allocates funds as follows:
• The Alameda County Medical Center (ACMC) receives a direct allocation of 75% of funds.
• The Alameda County Board of Supervisors (BOS) allocates the remaining 25%.
On December 14, 2004, after initial passage of the Measure, the BOS approved three-year funding
allocations of its 25% share of Measure A funds in eight general categories:
•The Alameda County Public Health Department Prevention Initiative
• Emergency Room and On-Call Physician Compensation
• Alameda County Behavioral Health Care Services (BHCS) Community-Based Organization (CBO)
Providers
•Alameda County Detoxification/Sober Station
• Community-Based Organization Primary Care Clinics
• Private and District Hospitals
•School-Based Health Centers
• Health Insurance Expansion and Board of Supervisors Discretionary Allocation.
When these three-year funding allocations expired in June 2007, the BOS agreed that maintaining most of
the existing allocations would best sustain a level of care to the County’s residents.The funding allocations
in the eight categories generally remained the same and, in December 2007, the BOS approved another
three-year allocation through June 2010.
As a tool for reviewing funding allocations, the Measure A Oversight Committee developed a reporting
form, containing questions on specific uses of funds received, for all Measure A fund recipients to
complete.The Committee also heard presentations on selected programs including, among others, ACMC,
BHCS, the BOS, the Detoxification Center/Sobering Station, and the Alameda Health Consortium.The
Committee used the report forms returned by most Measure A fund recipients, along with the
presentations where applicable, to review all funding allocations.The varying level of detail provided in the
reports, as well as varying levels of responsiveness to specific questions posed by the Committee to specific
recipients, made it difficult for the Committee to evaluate the reports consistently and thoroughly.The
following sections discuss the Committee’s findings in detail.
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SECTION 2
HOW THE MONEY WAS SPENT
THE ALAMEDA COUNTY MEDICAL CENTER (ACMC) receives 75% of Measure A funds through a specific
designation.The ACMC Board of Trustees allocates these funds within ACMC.The Alameda County
Board of Supervisors (BOS) allocates the remaining 25% of Measure A funds.The Alameda County
Health Care Services Agency (HCSA) manages these funds.
Measure A generated $115,852,743 (not including interest earned) in FY 07/08.The funds were allocated
as follows::
Funds Specifically Designated for ACMC (75%)$86,889,558
Funds Allocated by the BOS (25%)$28,963,185
TOTAL $115,852,743
In FY 07/08,the Alameda County budget totaled $2,262,889,978.The HCSA budget totaled
$523,121,455,or 23.12% of the total County budget. Measure A funds not specifically designated for
ACMC accounted for 5.5% of the HCSA budget.
The following sections provide more detail on the allocation and expenditure of Measure A funds.
Figure 1
DISTRIBUTION OF MEASURE A FUNDS
Alameda County Board of Supervisors
Alameda County Medical Center Board of Trustees
25%
75%
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REVIEW OF FY 07/08 EXPENDITURES:
75% OF MEASURE A FUNDS ALLOCATED TO
THE ALAMEDA COUNTY MEDICAL CENTER
FY 07/08 allocation:$86,889,558
Expended/encumbered:$86,889,558
The Alameda County Medical Center (ACMC) received a total of $86,889,558 in Measure A revenue in FY
07/08. Measure A revenue represented approximately 20% of ACMC’s total annual revenue of
approximately $459,757,387. By comparison, ACMC received a total of $85,777,759 in Measure A revenue
in FY 06/07.Thus, Measure A funding to ACMC increased 1% between the two fiscal years.
ACMC accounts for over half of all indigent,uncompensated, and charity care provided in Alameda County.
Medi-Cal and Medicare, ACMC’s most significant payors, cover slightly more than half its costs for the
provision of care. Measure A revenue helps to fill this “funding gap.” As last year’s Oversight Committee
report commented, ACMC continues to face the problem of sporadic, uneven state and federal
reimbursements at the same time that sales tax revenues are declining, thus reducing ACMC’s ability to cope
with escalating health care costs.
ACMC receives 75% of all Measure A revenue to support its network of three hospitals – Highland,
Fairmont,and John George Psychiatric Pavilion—and its three satellite clinics: Eastmont Wellness, Winton
Wellness,and Newark Health Center.
HIGHLIGHTS
With the support of Measure A funds in FY 07/08, ACMC increased all of the following over FY 06/07:
• Total patient days
• Average daily census
• Inpatient and outpatient surgeries performed
• Emergency room (ER) visits
•Outpatient visits at all sites, although these were not as high as in FY 05/06.
Figure 2
ALAMEDA COUNTY MEDICAL CENTER TOTAL ANNUAL REVENUE
Grants & Other 3%
County-Funded Programs 22%
Patient Services Revenue 31%
Supplementals 24%
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Specifically, Measure A funds helped ACMC address health
disparities across neighborhoods in the following ways:
• Establishment of a new program, the Healthy Hearts Clinic,
a skill-building service. Patients with heart failure receive
tools they need to prevent readmission to the hospital.
• Development of the Primary Care Health Coach Program
to provide productive self-management support to
patients with chronic health conditions.
• Clinic redesign in all of ACMC’s freestanding health
centers, which allows more patients to be served in each
clinic without reducing contact time with their physicians.
• Creation of an asthma lounge, to treat patients in distress
rapidly, through the Emergency Department (ED) Rapid
Evaluation Accelerated Care at Triage (REACT).This
award-winning program cuts waiting times in the ED.
REACT reduced average triage time from 128 minutes
to 24 minutes and reduced “left without treatment” from
21.9% to 8.4%.
• Reduction in the wait time for Adult Medicine physician
appointments to 25 days from baseline of 75 days.
CONCERNS
Some members of the Oversight Committee are concerned that the County requires ACMC to make
significant loan and interest payments to the County,which come out of Measure A revenue. Much of this
debt was incurred before Measure A passed in 2004. It is unlikely that voters foresaw this use of Measure A
funds, and some committee members question its legality. Other members believe that this creates a
political more than a legal problem, which might affect broader community support for the continuation
of Measure A in the future. At the same time, some Committee members recognize the importance of debt
repayment to the County budget.
The Committee requested data from ACMC similar to that provided last year, which enabled the Committee
to examine Measure A results by specific sites. ACMC has not yet provided these data.
ACMC HIGHLIGHTS FOR FY 07/08
n increased total patient days, daily
census, inpatient and outpatient
surgeries, and outpatient visits
over FY 06/07
n expanded service offerings
through the newy established
Healthy Hearts Clinic, Primary
Care Health Coach Program,
and asthma lounge
n redesigned all freestanding
health centers to improve the
patient experience
n reduced triage times and
appointment wait times in
targeted departments
Figure 3
ALLOCATION OF ACMC MEASURE A FUNDS, BY %
Capital 5%
Psychiatric 9%
Long-Term Care 3%
Graduate Medical Education 6%
O/P Clinics 7%
E/R Trauma 12%
Hospital-Based Services* 42%
Debt Service 16%
* Hospital-Based Services includes ICU, TCU, Medical/Surgical, Preoperative, Labor and Delivery, Nursery and NICU, Oncology, Skilled
Nursing, and Ancillaries (i.e., laboratory, radiology, therapies).
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REVIEW OF FY 07/08 EXPENDITURES:
25% OF MEASURE A FUNDS ALLOCATED BY
THE ALAMEDA COUNTY BOARD OF SUPERVISORS
In FY 07/08, the 25% of Measure A revenue allocated by the Board of Supervisors (BOS) totaled
approximately $32.8 million.The BOS allocated these funds as follows:
Carryover Budget Expended Carryover
FY 07/08 from Adjustments Total and/or to Savings
Department Allocation Previous FY* ** Allocation Encumbered Next FY* Total ***
Public Health (Total: 4,635,000)
Public Health Prevention Initiative 3,000,000 90,000 3,090,000 3,084,852 0 3,084,852 5,148
ER Physician Reimbursement 1,500,000 150,000 45,000 1,695,000 1,545,000 150,000 1,695,000 0
Behavioral Health (Total: 9,782,499)
CBO Providers 2,650,000 79,500 2,729,500 2,603,908 0 2,603,908 125,592
Detox/Sobering Station 2,000,000 2,695,000 60,000 4,755,000 2,249,035 2,505,965 4,755,000 0
Criminal Justice Screening/
In-Custody Services 3,597,572 107,927 3,705,499 3,705,499 0 3,705,499 0
MH Costs for Glen Dyer Jail 750,000 22,500 772,500 772,500 0 772,500 0
MH Costs for Juvenile Justice Center 500,000 15,000 515,000 515,000 0 515,000 0
Medical Care, Capital, & Administrative Services (Total: 17,327,249)
Primary Care CBOs 6,476,960 194,309 6,671,269 6,366,769 304,500 6,671,269 0
Non-County Hospitals*4,500,000 1,385,000 5,885,000 5,750,000 135,000 5,885,000 0
School Based Health Centers 1,000,000 210,000 30,000 1,240,000 1,139,212 100,788 1,240,000 0
Insurance Expansion 250,000 (250,000)0 0 0
Admin/Infrastructure Support 200,000 6,000 206,000 117,473 0 117,473 88,527
Medical Costs for JJC 250,000 7,500 257,500 130,619 126,881 257,500 0
Other Capital 0 1,100,000 0 1,100,000 1,000,000 100,000 1,100,000 0
Healthy Oakland 0 125,000 0 125,000 125,000 0 125,000 0
Capital Investment in the County’s
Health Care Safety Net 0 3,019,980 3,019,980 1,679,695 1,340,285 3,019,980 0
Direct Medical & Support Svc. (Oak.)0 257,500 257,500 257,500 0 257,500 0
BOS Discretionary Allocation****500,000 474,205 515,000 1,489,205 803,761 685,444 1,489,205 0
TOTAL FY 07/08 27,174,532 4,754,205 5,585,216 37,513,953 31,845,823 5,448,863 37,294,686 219,267
* Carryover amounts are approved by the BOS and must be used for the same purpose for which the BOS approved the original allocation.
** Budget adjustments are approved by the BOS. In FY 07/08 these adjustments included a 3% across the board COLA for all allocations, increased alloca-
tion of $1.25M for non-county hospitals, a redirection of the Insurance Expansion allocation to direct medical and support services (Oakland), a capital RFP,
and an increase to the BOS allocation of $515,000.
*** Savings are unexpended funds that will revert to the general Measure A account for reallocation.
**** The BOS as a whole allocates 25% of Measure A funds. Within this 25%, each Supervisor was allocated $203,000 for discretionary spending within
within his or her district: a total of $1,015,00
Public Health (PH)
PH Prevention Initiative, $3,090,000
Medical Care, Capital, & Administrative Services
Behavioral Health
Community-Based Org (CBO)
Providers, $2,729,500
Board of Supervisors, $1,015,000
Direct Medical & Support Services (Oakland), $257,500
Capital Investment in the County’s
Health Care Safety Net, $3,019,980
Medical Costs for Juvenile Justice Center (JJC), $257,500
Admin/Infrastructure Support, $206,000
School-Based Health Centers, $1,030,000
Non-County Hospitals, $5,885,000
County Primary Care CBOs, $6,671,269
ER Physician Reimbursement, $1,545,000
Detox/Sobering Station, $2,060,000
Criminal Justice Screening/
In-Custody Services, $3,705,499
MH Costs for Glen Dyer Jail, $772,500
MH Costs for Juvenile Justice Center, $515,000
Figure 4
FY 07/08 MEASURE A FUNDING ALLOCATED BY THE BOARD OF SUPERVISORS
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FUNDS ALLOCATED BY THE ALAMEDA COUNTY BOARD OF SUPERVISORS
GROUP 1: PUBLIC HEALTH
Alameda County Public Health Department: Prevention Initiative
Emergency Room and On-Call Physician Compensation
ALAMEDA COUNTY PUBLIC HEALTH DEPARTMENT:
PREVENTION INITIATIVE
FY 07/08 allocation:$3,090,000
Amount carried over from prior year allocations:0
Expended/encumbered in FY 07/08: $3,084,852
Amount carried over to FY 08/09:0
FY 07/08 savings transferred to reserve:$ 5,148
The Alameda County Public Health Department
Prevention Initiative operated in conformance with
Measure A provisions in FY 07/08.The dollars
allocated represent about 4% of the overall Alameda
County Public Health Department budget.
The Alameda County Public Health Department
Prevention Initiative operates in the context of an
overall vision of comprehensive health and a
developing strategic plan aimed at reducing health
disparities among various geographic and other
communities within the Measure A target population.
Measure A funds under the Public Health Department
Prevention Initiative supported three main priorities,
listed here with the funding for each:
Priority FY 07/08 Expended
Chronic Disease and Injury Prevention $848,310
Health Inequities and Community Capacity-Building $1,240,306
Obesity Prevention and School Health $996,236
Examples of projects funded under each of the priorities are as follows.
CHRONIC DISEASE AND INJURY PREVENTION
• The Asthma Start Program provided case management to more than 250 low income children
diagnosed with asthma.This helped significantly lower the rate of Emergency Room (ER) visits, from
66% to 25%, and hospitalizations, from 53% to 23%.
“Eliminating health disparities requires
long-term commitment to medical
treatment as well as interventions that
address BOTH internal neighborhood
context (low rates of social cohesion,
neighborhood disorganization, and
lack of leadership) as well as external
context (discriminatory political,
economic, and social policies).”
— from the Alameda County Public
Health Department Report
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•The Diabetes Program provided clients with diabetes self-management classes in English, Spanish,
Chinese, Punjabi, Hindi, and Farsi.The program helped significantly reduce ER and hospitalization
rates for these clients. It is the only program offering in-home case management for persons with
diabetes.
HEALTH INEQUITIES AND COMMUNITY CAPACITY BUILDING
• Public Health Department nurses conducted 115 immunizations by partnering with the Oakland
Unified School District to sponsor the James Madison Middle School Back to School IZ Clinic.
•Healthy Passages implemented the Adolescent Reproductive Health and Social Marketing Initiative.
•Community Assessment Planning and Evaluation (CAPE)used Measure A funds to work with
Sobrante Park and West Oakland residents to improve community environments, offer after-school
activities, support mentoring, teach emergency preparedness, and provide training to youth.
OBESITY PREVENTION AND SCHOOL HEALTH
• The City of Berkeley developed a referral system for families, teachers, and school staff to refer a child
and/or family to the Berkeley School Nurses Project,averaging 20 consultations a month.
•Nutrition Services conducted the Soda-Free Summer social marketing campaign,developed Healthy
Living Councils, performed community mini-granting,and supported school wellness policy
development and implementation through active participation in Oakland’s Coordinated School
Health Council and Food Policy Council.
• Nursing formed Grannies for Sobrante,a community group to support healthy eating and physical
activity.
The Public Health Department used the following review criteria when determining which projects to fund:
• Consistency with Measure A requirements
• Capacity for leveraging funds
• Focus on addressing disparities in health status among different groups.
The department used Measure A funds to leverage an additional $81,896 in FY 07/08, as well as
significant in-kind contributions and volunteer services.
EMERGENCY ROOM AND ON-CALL PHYSICIAN COMPENSATION
FY 07/08 allocation:$1,545,000
Amount carried over from prior year allocations:$150,000
Expended/encumbered in FY 07/08: $1,545,000
Amount carried over to FY 08/09:$150,000
FY 07/08 savings transferred to reserve:0
Measure A funds paid for the cost of emergency care for almost 21,000 indigent and uninsured patients
treated at emergency rooms throughout Alameda County.The law requires hospital emergency rooms to
treat all patients needing urgent care, but doctors receive only partial payment—if any—for emergency
services rendered to these patients.
15
Measure A helps to fill a funding gap created by state and federal policy. Funding for emergency care
provided by physicians decreased significantly in 1983, when the California legislature transferred financial
responsibility for providing care to indigent adults from the state to counties. Payments to private
physicians for emergency care of these patients disappeared rapidly. In addition, the state fails to fully
reimburse physicians who treat patients with Medi-Cal, the public insurance program available to some
low income families.
In FY 07/08, the Alameda County Public Health Department reimbursed emergency room (ER) and on-
call physicians a total of $2,951,694 using funds generated from SB 12/612 (Maddy) legislation, the
Proposition 99 Emergency Medical Services Appropriation, and Measure A. Measure A funds accounted for
approximately 52% of those reimbursements—a total of $1,545,000.
Payments were made to 19 medical groups and 23 individual physicians, and the total number of claims
paid was 20,735.
16
FUNDS ALLOCATED BY THE ALAMEDA COUNTY BOARD OF SUPERVISORS
GROUP 2: BEHAVIORAL HEALTH
Alameda County Behavioral Health Care Services Community-Based Organization Providers
Alameda County Behavioral Health Care Services Detox/Sobering Station
Mental Health Costs for Juvenile Justice Center
Mental Health Costs for Glen Dyer Jail in Oakland
Criminal Justice Screening/In-Custody Services at Santa Rita Jail
ALAMEDA COUNTY BEHAVIORAL HEALTH CARE SERVICES COMMUNITY-
BASED ORGANIZATION PROVIDERS
FY 07/08 allocation:$2,729,500
Amount carried over from prior year allocations:0
Expended/encumbered in FY 07/08:$2,603,908
Amount carried over to FY 08/09:0
FY 07/08 savings transferred to reserve:$ 125,592
In FY 07/08,community-based organizations (CBOs) received $2,729,500 in Measure A Funds.These
funds helped enable the CBOs to maintain the same level of service even as the cost of providing these
services escalates annually.This is known as “Maintenance of Effort”(MOE).
Because the County’s cost of living adjustments for Behavioral Health Care Services (BHCS) do not keep
pace with increases in business and facility costs, employee salaries do not keep up with inflation. Loss of
Measure A funding would result in a decrease in the number of services provided and the number of
clients seen.
BHCS manages the contracts with CBO providers. For FY 07/08, BHCS objectives included:
• provide appropriate behavioral health care services
• minimize hospitalizations
• reduce the incidence of drug abuse problems
•provide individualization of treatment to product better outcomes.
BHCS used these objectives as criteria to allocate funding to over 80 nonprofit and for-profiit CBO service
providers throughout Alameda County.
Challenges in the BHCS allocation process resulted in the inability of some CBOs to access all of the
Measure A funds.The BHCS agreement with the providers includes the “last dollar” standard, which states
that providers must spend all other revenue before using Measure A revenue. BHCS has since implemented
a mitigating policy that allows CBOs to expand the categories they may use for Measure A reimbursement
to include costs outside of service delivery—for example, capital improvement and non-Medi-Cal
allowable costs.
17
HIGHLIGHTS
Measure A funding helped CBO providers restore 60,000 units of service to 2,000 clients.The funding also
helped CBOs offset a 7% increase in costs from FY 06/07 to FY 07/08.
CONCERNS
BHCS has implemented a cumbersome process and rules that have made it difficult for CBOs to access all
Measure A funds.There is an attempt to streamline this process, but it hasn’t resulted in all the money
being disbursed.The Committee’s concern is that service providers that have been allocated funds haven’t
received all of them because of these rules.
ALAMEDA COUNTY BEHAVIORAL HEALTH CARE SERVICES
DETOX/SOBERING STATION
FY 07/08 allocation:$2,060,000
Amount carried over from prior year allocations:$2,695,000
Expended/encumbered in FY 07/08:$2,249,035
Amount carried over to FY 08/09:$2,505,965
FY 07/08 savings transferred to reserve:0
In January 2008,Alameda County completed construction of a new Detox/Sobering Station at the County’s
Fairmont Hospital Campus on the San Leandro/Castro Valley border.The Measure A Oversight Committee
reviewed the history of planning and constructing the Detox/Sobering station in its FY 05/06-FY 06/07
report. Further information on the project development is contained in the “Building Acceptance and
Recovery” brochure prepared by Alameda County.
The impetus for the project includes the following:
• An increasing countywide population of low income and indigent residents
• A high incidence of alcohol and drug/substance overuse among this population, often resulting in
debilitating health effects
•Frequently co-occurring mental disorders
• The increase in cost over the years of treating this population.
In February 2008, the Alameda County Health Care Services Agency (HCSA) began offering services at the
new Detox/Sobering Station through the Behavioral Health Care Services (BHCS).The facilities and services
provided there are:
• Cherry Hill, a 24/7, 32-bed monitored residential detoxification center for persons withdrawing from
the effects of overuse, with average stays of three to five days.The facility offers comprehensive
intervention services including 12-step and similar support groups, accommodations for non-English
speakers, HIV and Hepatitis C testing and education, assessment, post-detoxification planning,
placement, referral, and transportation to treatment interviews.
•Safe House, a 24/7, 50-person capacity sobering center where adults may stay an average of four to six
hours to “sleep it off.” A hospital, law enforcement, or other approved source must directly refer
residents to the center. Discharge services may include referrals to alcohol and drug treatment
providers and mental health services.
18
• The Transport Van Program, which includes several vans, staffed with an EMT and an Outreach Worker,
who transport individuals throughout the County to and from the Safe House.
The Detox/Sobering Station receives 100% of its funding from Measure A. During the first four months of
operations, utilization steadily increased at both facilities, with the Detox Center being at capacity within
two months. Over this four-month period, the center received referrals from 10 hospitals and six law
enforcement agencies.
HIGHLIGHTS
• The opening of this long-awaited center, which faced difficulty in finding an acceptable location to the
community, fills a noticeable void in the greater system of care.
• Measure A was completely responsible for bringing the center to fruition.
• The center has the potential to be a cost-effective alternative to traditional services of institutional
care, ambulance and police transports, hospital admittance or care, and booking/incarceration into
County jails.
MENTAL HEALTH COSTS FOR JUVENILE JUSTICE CENTER
FY 07/08 allocation:$515,000
Amount carried over from prior year allocations:0
Expended/encumbered in FY 07/08:$515,000
Amount carried over to FY 08/09:0
FY 07/08 savings transferred to reserve:0
During the design process for the new Juvenile Justice Center (JJC), planners identified a shortfall.The
Board of Supervisors (BOS) approved the use of Measure A funds in the amount of $500,000 to cover this
shortfall. Measure A funds prevented staff cuts that would have decreased the quality of care currently
received at JJC.This prevented a loss of approximately 15%, or 3,800 hours, of services provided.
HIGHLIGHTS
Planners used Measure A funding in the redesign of services at the new JJC Guidance Center for increased
staffing, to place treatment staff in each housing unit.
MENTAL HEALTH COSTS FOR GLEN DYER JAIL IN OAKLAND
FY 07/08 allocation:$772,000
Amount carried over from prior year allocations:0
Expended/encumbered in FY 07/08:$772,000
Amount carried over to FY 08/09:0
FY 07/08 savings transferred to reserve:0
In FY 07/08,Behavioral Health Care Services (BHCS) received $750,000 in Measure A funds to cover
additional costs that arose from the closure of the Oakland City jail,which caused expanded use of the
19
County’s Glen Dyer jail. BHCS used the Measure A funds to hire additional staff to serve the increased
number of inmates with mental health needs.The funds also enabled improved care for adults and youth in
the justice system by providing timely access to medications and reducing potential medication abuse in
the jail setting. Mental health care services in the criminal justice settings increased by approximately 12%,
or approximately 1,200 hours of direct services.
CRIMINAL JUSTICE SCREENING/IN-CUSTODY SERVICES
AT SANTA RITA JAIL
FY 07/08 allocation:$3,705,499
Amount carried over from prior year allocations:0
Expended/encumbered in FY 07/08:$3,705,499
Amount carried over to FY 08/09:0
FY 07/08 savings transferred to reserve:0
During the FY 07/08, the Health Care Services Agency (HCSA) received $3,705,499 in Measure A funds as
part of a budget deficit reduction plan. Rather than spreading the Measure A funds throughout the HCSA
budget,the Board of Supervisors (BOS) allocated these funds to the Criminal Justice Screening Program. In
turn, HCSA disbursed general funds dollars that previously were in the Criminal Justice Screening budget
throughout the HSCA budget. Allocating the Measure A funding to one program allowed the agency to
simplify the accounting of the Measure A funds. HCSA used the funds to improve care for adults in the
justice system, by providing timely access to medications and reducing potential medication abuse at Santa
Rita. In FY 07/08, the program provided 9,887 services to 3,806 clients.
FUNDS ALLOCATED BY THE ALAMEDA COUNTY BOARD OF SUPERVISORS
GROUP 3: MEDICAL CARE, CAPITAL, and ADMINISTRATIVE SERVICES
Primary Care Community-Based Organizations
Non-County Hospitals
School-Based Health Centers
Medical Costs for Juvenile Justice Center
Capital Investment in the County’s Health Care Safety Net
Other Capital
Administration/Infrastructure Support
Healthy Communities, Inc. (dba Healthy Oakland)
Direct Medical and Support Services (Oakland)
PRIMARY CARE COMMUNITY-BASED ORGANIZATIONS
FY 07/08 allocation:$6,671,269
Amount carried over from prior year allocations:0
Expended/encumbered in FY 07/08:$6,366,769
Amount carried over to FY 08/09:$304,500
FY 07/08 savings transferred to reserve:0
ALAMEDA HEALTH CONSORTIUM CLINICS
The Alameda Health Consortium and its member clinics—eight nonprofit corporations operating 23
community clinics throughout Alameda County—provide primary and dental care, mental health, and
health education services to 150,000 County residents.
20
Figure 5
ALLOCATIONS PER INDIVIDUAL CBO/CLINIC, FY 07/08
Asian Health Services $934,198 (14%)
AXIS Community Health Center $535,773 (8%)
Bay Area Consortium for
Quality Health Care $324,002 (5%)
West Oakland Health Center $631,605 (10%)
Day Laborer Program – Clinics TBD $154,500 (2%)
Life Long Medical Care $907,595 (13%)
Native American Health Center $411,834 (6%)
Tri-Cities Health Center $787,960 (12%)
Tiburcio Vasquez Health Center
$665,814 (10%)
La Clinica de la Raza $1,317,989 (20%)
21
Since the passage of Measure A in 2004, total County funding for its clinics has grown almost 50%, from
about $12 million to $18 million in FY 08.This funding has allowed Asian Health Services, Axis
Community Health, La Clinica de la Raza, Life Long Medical Care, Native American Health Center,Tiburcio
Vasquez Health Center,Tri-City Health Center, and West Oakland Health Center to improve health outcomes
for low income patients by augmenting their services, investing in clinic expansion, and working with the
Alameda County Medical Center (ACMC) and the County Public Health Department to coordinate care to
those living with chronic diseases.
The consortium member clinics provided nearly 700,000 patient visits, and worked to enroll patients into
appropriate public insurance plans: Medi-Cal, Healthy Families, and Medicare. Ninety percent of
consortium patients are low income, 41% qualify for Medi-Cal, and another 42% are uninsured.
Even with the Measure A funding, the consortium clinics are unable to meet the needs of the growing
number of uninsured.To address their financial constraints, clinics are focusing on improved health
outcomes by expanding primary and preventive care in order to reduce expensive hospitalization, and by
coordinating care for patients with diabetes, asthma, and depression.
HIGHLIGHTS
County Collaboration Improves Care
The Alameda Health Consortium collaborates with ACMC and the County Public Health Department to
implement best practices in the management of three chronic diseases: diabetes, asthma, and depression.
Clinicians from consortium clinics, ACMC,and the Public Health Department meet monthly to coordinate
care, which has reduced unnecessary hospitalizations, lowered the cost of care, and exceeded national
benchmarks that measure quality outcomes.
Alameda County Excellence
Consortium clinics are participating in the second year of a three-year chronic disease management
program,funded with supplemental federal payments.The consortium has received $3 million in new
revenue through the Alameda County Excellence (ACE) program, which has allowed its member clinics to
install a new computer system to better monitor care, and to provide an additional 17,500 visits in 2008
to patients with asthma and diabetes.
Consortium Exceeds Expectations
Member clinics have exceeded the goals established in the consortium’s County contracts.The clinics
provided almost 82,000 clinic visits to medically indigent patients,11.5% more than required under its
County Medical Services Program contract.The clinics have provided 7,600 more clinic visits than specified
in the ACE contract, 75% over the target.
County investment in the community clinics has paid off. For every $1 the County provides to consortium
clinics,other revenue sources have provided $10 to the clinics.
Measure A Capital Grants
Axis Community Health in the Pleasanton-Livermore area received two capital grants, funded with Measure
A revenue. Axis used the supplemental Measure A grants to open a clinic site dedicated to mental health
services, and to help fund the expansion of its women’s health clinic.
22
BAY AREA CONSORTIUM FOR QUALITY HEALTH CARE (BACQHC)
The Bay Area Consortium for Quality Health Care (BACQHC) received $324,000 in Measure A funds to
expand the availability of services at the Berkeley Health Center for Women and Men. BACQHC agreed to
provide an additional 3,040 clinic visits with the Measure A funds. As in previous years, BACQHC failed to
meet its target, providing only an additional 2,690 visits, or 85% of the contracted visits.
CONCERNS
The Oversight Committee is concerned that BACQHC was out of compliance with its contract with the
Health Care Services Agency (HCSA), which specifies that BACQHC must provide at least 95% of
contracted visits.
NON-COUNTY HOSPITALS
FY 07/08 allocation:$5,885,000
Amount carried over from prior year allocations:0
Expended/encumbered in FY 07/08:$5,750,000
Amount carried over to FY 08/09:$135,000
FY 07/08 savings transferred to reserve:0
NOTES:
A one-time budget adjustment in FY 07/08 resulted in a higher total allocation for St. Rose relative to Children’s Hospital.
A third non-county hospital,ValleyCare, received Measure A funding for a capital project. See “Other Capital” for information.
ST. ROSE HOSPITAL
St. Rose Hospital is a 175-bed nonprofit hospital
serving a disproportionately large number of
Medi-Cal and uninsured recipients. In FY 07/08,
St. Rose saw 14,000 visits to its pediatric clinics
from Alameda County residents.
Key accomplishments using Measure A funds
include acquiring seismic retrofit plans approved
by the State and implementing a diagnostic
radiology picture archiving system. Measure A
funds continued to be applied almost exclusively
to “maintenance of effort”—maintaining service
levels even as costs escalate—and St. Rose was
able to leverage Measure A funds to obtain
matching federal monies.
Continuation of Measure A funds annually is critical to the operation of St. Rose Hospital.
Figure 6
ST. ROSE HOSPITAL USE OF MEASURE A FUNDING
TO OBTAIN FEDERAL MATCHING FUNDS
$4,000,000
$3,000,000
$2,000,000
$1,000,000
$0
Measure A Allocation Federal Match
$3,500,000
$1,750,000
23
CHILDREN’S HOSPITAL AND RESEARCH CENTER
Children’s Hospital and Research Center in
Oakland received $2,250,000 in Measure A
revenue in FY 07/08.The federal government
provided an additional $1,125,000 in matching
funds, thus increasing the impact of the tax
revenue. While Children’s Hospital serves as a
regional pediatric center, Alameda County
residents received 66.8% of the total outpatient
services and 51.2% of the hospital’s inpatient
care.
Children’s Hospital allocated the Measure A and
federal matching dollars among five outpatient
services.The hospital based this allocation on
subsidizing primary outpatient programs for
Alameda County residents with high Medi-Cal and California Children’s Services (CCS) usage.These
programs appear to be consistent with the intent of Measure A. Each of these programs operates at a loss.
The programs include:
• the hospital-based adolescent medicine and school-based health clinics
• the emergency department
• the Center for Child Protection
• the hematology/oncology program
• the audiology service.
As a result of the Measure A funding, the hospital continues to serve youth in its adolescent clinics with a
wide range of services for the treatment of asthma, obesity, mental health, reproductive health care, sports
examinations,acute and chronic medical care issues, and child abuse.The funding also allows the hospital
to continue to offer emergency services to a wide spectrum of patients as well as providing education,
screening, counseling, and advocacy services to battered caregivers and to children exposed to domestic
violence.The hospital continues to provide surgical implants to address hearing loss in children.
SCHOOL-BASED HEALTH CENTERS
FY 07/08 allocation:$1,030,000
Amount carried over from prior year allocations:$210,000
Expended/encumbered in FY 07/08:$1,139,212
Amount carried over to FY 08/09:$100,788
FY 07/08 savings transferred to reserve:0
Alameda County’s School Health Services continues to expand its programs as it implements the second
year of its three-year strategic plan.The plan seeks to expand its program of “comprehensive, holistic
adolescent health services” and ensure long-term sustainability by diversifying its funding base.
Measure A revenues provide nearly half of the programs’ annual funding, $1.1 million of the School Health
Services’ $2.9 million budget.The program spent 75% of the Measure A funds on medical, mental health,
Figure 7
CHILDREN’S HOSPITAL USE OF MEASURE A FUNDING
TO OBTAIN FEDERAL MATCHING FUNDS
$2,500,000
$2,000,000
$1,500,000
$1,000,000
$500,000
$ 0 Measure A Allocation Federal Match
$2,250,000
$1,125,000
24
health education, and family planning services at
its 12 school-based clinics.The remaining
revenue funded program evaluation and support,
as well as planning for new clinics in Fremont
and the Pleasanton-Livermore Tri-Valley area.
The program used Measure A revenue to help
secure $7 million in matching funds from
participating school districts; local, state, and
federal agencies; and foundations and nonprofit
agencies, along with health insurance payments.
HIGHLIGHTS
School Health Services Opens Its 12th Clinic
The program contracted with East Bay Asian
Youth Center (EBAYC) to open the Shop55
Wellness at Oakland High School, for a total of
12 school-based clinics. EBAYC received grants from the Oakland Unified School District and the Measure
A capital fund to renovate the clinic space and purchase needed equipment.
In FY 07/08, its first year of operation, Shop55 Wellness provided medical, mental health, health
education,and family planning services to 300 adolescents, or 16% of the student body.
New Computer System Links 12 Sites
School Health Services installed a new computer system to collect and analyze data from its 12 school-
based sites.The program connected eight of its 12 sites to the system during its first year of operation.The
transition to the new system resulted in incomplete clinic data for FY 07/08.
According to this incomplete data,the 12 sites provided 24,000 clinic visits—two-thirds of which were
for medical and health education and family planning, and one-third of which were for mental health
services.
Students and Non-Students Receive Needed Care
Youth UpRising opened its two Oakland sites—the Chappell Hayes Health Clinic at McClymonds and the
Castlemont Health Center—to adolescents not enrolled at the schools.This move allows the clinics to reach
youth who might not otherwise have access to needed medical and mental health services.
Youth Action Institute Launches
School Health Services established the Youth Action Institute in the spring of 2008, to engage youth in the
assessment and design of its health and wellness services.The Institute trained 30 student researchers who
interviewed over 1,500 fellow students on needs and effectiveness of services.The Institute released its
report in January 2009.
Tiburcio Vasquez Expands Services at San Lorenzo Schools
Tiburcio Vasquez expanded mental health services at its two San Lorenzo School sites, Edendale and
Bohannon,with a $35,000 Measure A grant.The school clinics used the funds to offer over 1,400 hours of
Figure 8
ALAMEDA COUNTY SCHOOL HEALTH SERVICES (SHS)
USE OF MEASURE A FUNDING TO OBTAIN
LEVERAGED FUNDS, FY 07/08
$7,000,000
$6,000,000
$5,000,000
$4,000,000
$3,000,000
$2,000,000
$1,000,000
$0
Measure A Allocation Leveraged Funds
$1,139,212
$7,000,000
25
therapy and counseling to students who were not eligible for Medi-Cal-funded services.The grant also
allowed Tiburcio Vasquez to draw down additional federal matching funds.
MEDICAL COSTS FOR JUVENILE JUSTICE CENTER
FY 07/08 allocation:$257,500
Amount carried over from prior year allocations:0
Expended/encumbered in FY 07/08:$130,619
Amount carried over to FY 08/09:$126,881
FY 07/08 savings transferred to reserve:0
The Board of Supervisors (BOS) allocated $772,500 in FY 07/08 to provide medical and mental health
services to youth residing at the Juvenile Justice Center (JJC).This included $257,500 under
Administration/Indigent Health to provide medical services and $515,000 under Alameda County
Behavioral Health Care Services (BHCS) to provide mental health services (discussed in “Mental Health
Costs for Juvenile Justice Center”).
Of the $257,500 allocation under Administration/Indigent Health, JJC used $80,619 for the provision of
billing services to the Victims of Crime (VOC) unit. JJC leveraged this $80,619 investment to generate an
additional $200,000 in funding.
The $257,500 included an allocation of $50,000 to the Mind Body Awareness (MBA) Project, Inc., a non-
profit organization dedicated to the health and well-being of incarcerated and at-risk youth. MBA works
with youth both during and after incarceration, preparing them for successful re-entry into their families
and communities. MBA conducted 191 classes serving 495 separate youths.The youths gave the program
the average overall rating of 8.3 out of 10.They found the class taught them to relax, calm down, and
control themselves, and that its benefits lasted beyond the class time.The youth learned meditation
techniques, which positively impacted their sleep.They were very interested in having more class time.
Figure 9
DISTRIBUTION OF MEASURE A FUNDS ALLOCATED TO SCHOOL-BASED HEALTH CENTERS
(Providers are italicized and listed below the clinics in parentheses)
65%
20%
15%
Oakland High, Shop55 $66,950 (9%)
(East Bay Asian Youth Center)
McClymonds, Youth UpRising $133,900 (18%)
(Children’s Hospital)
Alameda, Encinal $133,900 (18%)
(Alameda Family Services)
Berkeley High $66,950 (9%)
(City of Berkeley)
Oakland Tech, Tiger, San Lorenzo $200,850 (28%)
(La Clinica de la Raza)
Miscellaneous Programmatic
and Administrative Costs.
Evaluation Contract
with UCSF
Tennyson, Logan $133,900 (18%)
(Tiburcio Vasquez)
26
JJC will carry over the remaining $126,88 and use it to reimburse Children’s Hospital and Research Center of
Oakland (CHRCO), the provider of medical services at JJC, for cost overruns incurred in FY 07/08 due to the
provision of increased lab panels and increased pharmacy costs. CHRCO’s clinical program at JJC has received
rave results from all collaborating agencies, most notably the Probation Department.
CAPITAL INVESTMENT IN THE COUNTY’S HEALTH CARE SAFETY NET
FY 07/08 allocation:$3,019,980
Amount carried over from prior year allocations:0
Expended/encumbered in FY 07/08:$1,679,695
Amount carried over to FY 08/09:$1,340,285
FY 07/08 savings transferred to reserve:0
The Alameda County Board of Supervisors (BOS) allocated $3 million of Measure A revenue for a Capital
Investment fund.The Supervisors directed the County Health Care Services Agency (HCSA) to develop and
release the “Request for Proposals”; review the capital investment proposals submitted by community-based,
nonprofit health care agencies; and submit recommendations for funding to the BOS for consideration.
During the Measure A Community Hearings, conducted in 2004 following the passage of the ballot initiative,
many nonprofit agencies urged the BOS to use a portion of the Measure A revenue for capital investments.
Health clinics find it difficult to expand their services and invest in needed medical equipment because
money is tight and there are few sources of funding for critical investments in facilities and equipment.
In response to the need for a Capital Investment fund, the BOS allocated $3 million in unspent Measure A
revenue to invest in new buildings and clinic expansion, computer equipment and medical equipment,
transportation vans, and facility renovations.
HCSA established the eligibility guidelines for the capital fund. Eligibility for funding was limited to non-
profit agencies providing:
AIDS/HIV services
Substance abuse programs
Mental health services
Primary care
Other health providers.
HCSA set two additional requirements:
• Organizations requesting $50,000 or more must secure matching fund.
• Recipients must adhere to the requirements of the County’s Small, Local, and Emerging Businesses
Program. (Go to www.agov.org to learn more about the program requirements).
HCSA received 67 proposals, requesting over $7.5 million, demonstrating the significant need for capital
investments in the County’s health care safety net.The review panel, convened by the agency, recommended
funding for 38 or these proposals.
A
P
O
MH
SA
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Award
Agency Amount Purpose Location
AIDS Project of the East Bay $125,000 elevator, renovation, MIS Oakland
Alameda Family Services $25,000 HVAC Oakland
Asian Health Services $135,000 equipment Oakland
Asian Pacific Psychological Services $41,000 MIS, renovation Oakland
Axis Community Health $135,000 clinic expansion Pleasanton
Axis Community Health $108,570 telephone system, practice management, Pleasanton
system, tenant improvements, furnishings
Berkeley Youth Alternatives $26,525 MIS, security gates Berkeley
Brighter Beginnings $44,392 case management database Oakland
C. U. R. A., Inc.$68,218 water and electrical systems renovation Fremont
Center for Elders’ Independence $90,375 dental equipment Oakland
Crisis Support Services $25,517 MIS Oakland
of Alameda County
Davis Street Family Resource Center $32,500 MIS San Leandro
Davis Street Family Resource Center $100,000 acquisition of property San Leandro
East Bay Community Recovery Project $149,750 acquisition of property Oakland
East Oakland Community Project $137,500 equipment and furniture Oakland
Emergency Shelter Program $55,000 renovation and expansion Hayward
Family Paths Inc.$45,384 roof Oakland
Fred Finch Youth Center $75,000 MIS, acquisition of property Oakland
Girls Inc.$52,000 MIS, equipment purchase, renovation San Leandro
Health & Human Resource $25,041 equipment Berkeley
Education Center
HIV Education and Prevention Project $80,000 expansion Oakland
of Alameda County
Horizon Services Inc.$60,000 renovation Hayward
Humanistic Alternatives to Addiction $50,000 renovation Oakland
Research & Treatment
La Clinica de la Raza Inc.$144,082 dental equipment Oakland
Lifelong Medical Center $135,000 expansion, renovation, IT Berkeley
Lincoln Child Center $80,000 appliances Oakland
Magnolia Women’s Recovery Program $100,000 acquisition of property Hayward
Native American Health Center $135,000 construction Oakland
Options Recovery Services $74,618 plumbing and electrical Berkeley
Shuman-Liles Clinic, Inc.$30,000 MIS Fremont/
Oakland
St. Mary’s Center $135,000 land acquisition Oakland
Continued on next page.
A
C
C
MH
MH
MH
MH
MH
O
O
O
O
O
SA
SA
A
C
C
C
MH
MH
MH
MH
MH
MH
O
O
SA
SA
SA
SA
28
Award
Agency Amount Purpose Location
The Solid Foundation $50,000 renovation, equipment Oakland
Through the Looking Glass $43,682 MIS Berkeley
Tiburcio Vasquez Health Center, Inc. $77,055 renovation Hayward/
Union City
Tiburcio Vasquez Health Center, Inc. $48,720 furniture and equipment Hayward/
Union City
Tri-City Health Center $75,000 renovation Fremont
West Oakland Health Council $100,000 MIS Oakland
Women on the Way Recovery Center $100,000 acquisition of property Hayward
TOTAL $3,014,929
Specific examples of the purposes listed above include the following:
•Acquisition: purchase of land or a facility
•Equipment purchase: generally, purchase of large pieces of equipment such as dental chairs, exam
tables,or X-ray machines
•Renovation: renovation of an existing facility or a portion of a facility, for example exam rooms, a
kitchen, or a roof
•MIS: purchase and installation of various Management Information Systems equipment, such as
computers, servers, consultant time, or new billing systems.
HIGHLIGHTS
The Measure A Capital Investment fund helped 38 nonprofit agencies modernize their equipment and
computer technology,expand and renovate facilities, repair broken elevators, and fix leaky plumbing.This
investment is critical to improve clinic operations and ensure quality patient care.
CONCERNS
The Committee is concerned that there appears to be no requirement that recipients of capital funds
provide services to indigent, underinsured, or low income patients for a specified period. In addition, the
Committee is not aware of any requirements concerning the ultimate purpose of capital projects that relied
on Measure A funds. For example, if a building changes hands, the Committee does not know if there is
any requirement that the new building owner continue to provide services to the Measure A target
population.
The Oversight Committee is also concerned that there is no continuing Capital Investment fund, and
recommends that the BOS identify Measure A funds that can be used to meet the capital needs of nonprofit
health care services providers in Alameda County.
C
C
C
C
O
SA
SA
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OTHER CAPITAL
VALLEYCARE MEDICAL CENTER
FY 07/08 allocation:0
Amount carried over from prior year allocations:$1,100,000
Expended/encumbered in FY 07/08: $1,000,000
Amount carried over to FY 08/09:$100,000
FY 07/08 savings transferred to reserve:0
NOTE: ValleyCare did not receive a Measure A allocation in FY 07/08. ValleyCare spent a prior year’s allocation in FY 07/08.
ValleyCare Medical Center received its first Measure A allocation for capital expansion of its Emergency
Department (ED). With this expansion ValleyCare added seven single-exam rooms and one Sexual Assault
Response Team exam room.This was the first expansion of the ED since it opened in 1991.ValleyCare
provides emergency department services to any patient who presents to the ED, without regard to ability to
pay.
Measure A funds accounted for approximately 50% of the construction.The Oversight Committee
requested additional information from ValleyCare regarding the percentage of its ED patients who are part
of the Measure A targeted population, which includes indigent, low income, and uninsured residents of
Alameda County.ValleyCare replied that in FY 07 the Measure A target population was 19% of total visits;
in FY 08 it was 21% of total visits.
CONCERNS
The Oversight Committee is concerned that Measure A funds paid 50% of the construction costs for an
expansion that serves such a low proportion of Measure A’s targeted population. Of course, over time the
percentages should equalize,given no additional allocations of Measure A funds. However,ValleyCare
signaled in its report to the Committee that they may be applying for Measure A funds for additional
expansion in the future.
The language of Measure A includes a commitment to geographic distribution of the funds raised, and the
allocation to ValleyCare helps to keep that commitment. But it is also important that Measure A funds be
restricted to providing services to the target population as laid out in the ballot language.
ADMINISTRATION/INFRASTRUCTURE SUPPORT
FY 07/08 allocation:$206,000
Amount carried over from prior year allocations:0
Expended/encumbered in FY 07/08:$117,473
Amount carried over to FY 08/09:0
FY 07/08 savings transferred to reserve:$88,527
This allocation provides administrative support for the management of Measure A, including, but not
limited to, contract development and monitoring, management of capital request for proposal (RFP)
projects,budget oversight, and staffing of the Oversight Committee.
30
Measure A funds in FY 07/08 included an allocation of $206,000 for this purpose, of which $117,473
was expended for the following: Measure A Financial Manager salary and benefits, postage and/or other
mail delivery services for Measure A correspondence, facility rental fee for the Capital RFP applicants’
conference, expenses related to Measure A Oversight Committee meetings, and the Oversight Committee
Report Consultant fee.The remaining unspent $88,527 reverted back to the general Measure A account for
redistribution at a later date.
HEALTHY COMMUNITIES, INC. (DOING BUSINESS AS HEALTHY OAKLAND)
FY 07/08 allocation:0
Amount carried over from prior year allocations:$125,000
Expended/encumbered in FY 07/08:$125,000
Amount carried over to FY 08/09:0
FY 07/08 savings transferred to reserve:0
In FY 06/07,the Board of Supervisors (BOS) redirected $250,000 originally allocated for expansion of a
state-administered insurance program that failed to materialize. Of these redirected funds, the BOS
allocated $125,000 each to Healthy Oakland and to the Bay Area Consortium for Quality Health Care
(BACQHC).The BOS negotiated a contract with Healthy Oakland in FY 06/07, but not with BACQHC.
Therefore, in FY 07/08 the BOS allocated the remaining unspent $125,000 to Healthy Oakland.
HIGHLIGHTS
This funding enhanced and supplemented the prior year allocation and was used for infrastructure
development and capacity building. As a result of this Measure A investment, Healthy Oakland
accomplished the following:
• Conducted a practice management and billing assessment
•Prepared audited financial statements for the first time
• Submitted a Community Clinic State Licensing application, which resulted in Healthy Communities
Inc. becoming a licensed clinic
• Submitted an application for State Alcohol and Other Drugs certification
• Developed the first Healthy Communities, Inc. Business Plan (2009-2011).
Additionally, Measure A funds helped leverage an additional $225,000 from a combination of sources
including the Public Health Department, Bechtel Foundation, and TIDES Foundation.
DIRECT MEDICAL AND SUPPORT SERVICES (OAKLAND)
FY 07/08 allocation:$257,500
Amount carried over from prior year allocations:0
Expended/encumbered in FY 07/08: $257,500
Amount carried over to FY 08/09:0
FY 07/08 savings transferred to reserve:0
On June 12,2007, the Board of Supervisors (BOS) directed $250,000 of Measure A funds originally
allocated for health insurance expansion to high-risk populations within Alameda County.The BOS
31
authorized the Health Care Services Agency (HCSA) to work with the Board’s Health Committee and Board
representatives to develop a process and recommend specific programs and providers.
On September 11, 2007, the BOS approved a Request for Qualification (RFQ) for direct medical and
support services to adult residents of Oakland who are disproportionately impacted by health disparities,
with an emphasis on serving County residents who:
• are re-entering the community from the correctional system
• experience co-occurring disorders
• have incomes that fall below 200% of the Federal Poverty Level.
On December 18, 2007, the BOS authorized HCSA to negotiate and execute standard agreements with
Healthy Communities, Inc. and Preventive Care Pathways in the amount of $128,750 each (this includes a
3% COLA that was awarded in FY 07/08), with 50% to be used for direct medical and support services
and 50% to be used to support start-up and/or one-time capital and development costs in FY 07/08.The
BOS approved this funding to continue through FY 09/10—however, from FY 08/09 forward the BOS
required the funds to be used for direct medical and support services exclusively. Of six proposals received
in the RFQ process, the BOS rated these two providers as the top two proposals and encouraged them to
collaborate on a single, integrated approach.
32
FUNDS ALLOCATED BY THE ALAMEDA COUNTY BOARD OF SUPERVISORS
GROUP 4: BOARD OF SUPERVISORS
DISCRETIONARY ALLOCATIONS
BOARD OF SUPERVISORS DISCRETIONARY ALLOCATIONS
FY 07/08 allocation:$1,015,000
Amount carried over from prior year allocations:$474,205
Expended/encumbered in FY 07/08:$803,761
Amount carried over to FY 08/09:$685,444
FY 07/08 savings transferred to reserve:0
On December 14,2004,the Board of
Supervisors (BOS) adopted a moyion to
receive a discretionary allocation of $100,000
per district for each fiscal year beginning in
FY 04/05, for “other” services.This allocation
authorized each member of the BOS to
recommend appropriations totaling up to
$100,000 in each fiscal year.The
recommended appropriations require BOS
approval.
On October 9, 2007, the BOS approved a 3%
cost of living adjustment (COLA) for all
programs receiving Measure A allocations and
adopted to increase the BOS discretionary
allocation from $100,000 to $200,000.
Therefore, effective FY 07/08, each member
of the BOS could recommend appropriations
totaling up to $215,000 in each fiscal year.
The discretionary BOS appropriations must
meet all of the administrative and policy
requirements of Measure A. Supervisors can
submit allocation requests at any time during
the fiscal year and can carry over any unspent
or unallocated funds designated for their
districts from one fiscal year to the next.The
full BOS approves all contracts recommended
by the individual Supervisors.
BOARD OF SUPERVISORS’ MEASURE A
DISTRICT ALLOCATIONS FUNDING
OBJECTIVES FOR FY 07/08.
Supervisor Scott Haggerty/District 1:Allocations
are directed specifically to District 1 and generally
to seniors and agencies that can leverage funds.
Supervisor Gail Steele/District 2:Allocations are
focused on children’s services and on supporting
direct service programs, rather than prevention.
Attention is given to the numbers of clients
served and unmet needs being addressed.
Supervisor Alice Lai-Bitker/District 3:Allocations
attempt to fill small gaps in addressing health
disparities, with attention given to language
issues.
Supervisor Nate Miley/District 4:Emphasis is
placed on public health and prevention, especially
in Ashland and Cherryland, and on senior issues.
Supervisor Keith Carson/District 5:Has generally
not allocated funds in the hope of funding a
larger and more significant project, but may forgo
this plan and fund smaller agencies in the future.
33
Sample allocations in FY 07/08 include the following:
Horizon Services:Alameda County Behavioral Health Care Services (BHCS) contracted in FY 07/08 with
Horizon Services to conduct client focus groups in order to prioritize best practice methods in Senior
Alcohol and Other Drug (AOD) prevention.The $10,000 contract with Horizon Services represents 0.16%
of the total annual BHCS budget.
The programs recruited 50 senior participants for six focus groups, which provided the input necessary to
develop of an assessment of the Senior AOD Prevention plan, identify and prioritize best practices in Senior
AOD prevention strategies, and produce and disseminate of the plan to senior-related events and
organizations.
Asian Community Mental Health Services:BHCS contracted in FY 07/08 with Asian Community Mental
Health Services to ensure that 15 to 20 uninsured children and youth in Alameda County received mental
health services.The $20,000 contract with Asian Community Mental Health Services represents 0.3% of the
agency’s total annual budget.
Without Measure A funds, the 20 uninsured youth or children would not have received 150 mental health
sessions, including 114 individual psychotherapy sessions, 14 group counseling sessions, and 22 family
therapy sessions.
Public Health:In the area of Public Health, the BOS made allocations both to organizations that received
other Measure A funds, and those that did not. Of this latter group, five organizations provide services to
seniors,one provides osteoporosis services, and four are community-building organizations.
School-Based Health Centers:See the section “School-Based/Linked Health Centers” for information on
BOS allocations and other Measure A funds received. For example, a three-year Measure A grant of $50,000
per year helped fund the planning and development of the new Shop55 Wellness at Oakland High School,
including a student survey on health care needs.
For FY 07/08 the BOS District Allocations were as follows:
LEGEND:
Dist = District District 3 = Supervisor Alice Lai-Bitker
District 1 = Supervisor Scott Haggerty District 4 = Supervisor Nate Miley
District 2 = Supervisor Gail Steele District 5 = Supervisor Keith Carson
Expended/
Dist Agency/Contractor Encumbered Description
1 Valley Care $50,000.00 Emergency room capital improvement
Tri-City Homeless Coaltion $31,200.00 Driver for mobile health van
LIFE ElderCare, Inc.$20,000.00 Senior fall prevention
Senior Support Program of Tri-Valley $35,000.00 Services promoting senior health
CAPS - City of Fremont $40,000.00 Services promoting senior health
TOTAL $176,200.00
Continued on next page.
34
Expended/
Dist Agency/Contractor Encumbered Description
2 St. Rose Hospital $50,000.00 Silva Clinic
Spectrum Community Services $20,000.00 Senior fall risk reduction
Tiburcio Vasquez Health Center $60,000.00 Health education at Tennyson and
Logan High
TOTAL $130,000.00
3 HEPPAC $20,000.00 IDU harm reduction and prevention
Spectrum Community Services $30,000.00 Senior fall risk reduction
Davis St. Community Center $15,000.00 Sustainability evaluation for delivery
of health services
Asian Community Mental Health Services $20,000.00 Youth counseling services for uninsured
Center for Early Intervention $10,000.00 Interpretation services for low income,
on Deafness uninsured, and limited-English-speaking
families
Foundation for Osteoporosis $10,500.00 Osteoporosis screening program
Research and Education (FORE)
Lisa Ann Nichols $1,500.00 Sustainability evaluation for delivery of
health services for Davis Street
Community Center
s2i consulting $50,000.00 Project management and consulting
services to develop an initiative to
reduce health disparities in San Lorenzo
TOTAL $156,999.70
4 Legal Assistance for Seniors $7,500.00 Health insurance and health law training
for seniors
Livable Communities Interns $7,697.94 Livability Initiative
Livable Communities Policy Consultant $16,502.80 Livability Initiative
Horizon Services - CommPre Program $10,000.00 Senior AOD Prevention Project
Prevention Institute $20,000.00 Healthy and Livable Communities Project
Spectrum $25,000.00 Senior fall risk reduction
U First Health Partners $44,638.00 Capital improvement
Livable Communities Policy Consultant $26,312.51 Livability Initiative
Livable Communities Intern $2,000.00 Livability Initiative
Livable Communities Intern $910.00 Livability Initiative
Life Elder Care $5,000.00 Senior fall prevention
TOTAL $165,561.25
35
Expended/
Dist Agency/Contractor Encumbered Description
5 Center for Early Intervention $150,000.00 Health services for children and adults
on Deafness with hearing impairments or severe
speech and/or language delays
Preventive Care Pathways $25,000.00 Mobile health van services
TOTAL $175,000.00
CONCERNS
The Committee acknowledges that the Supervisors responded to some of the concerns raised in last year’s
report, but notes the following ongoing and new concerns:
• No specified process exists to announce the availability of funding or to request a District allocation.
• As income from the sales tax decreases, the BOS fixed dollar amount of the allocation becomes a larger
percentage of the whole.
36
37
APPENDIX A:Measure A Revenue Received in Each Fiscal Year
APPENDIX B:FY 07/08 Measure A Fund Distribution by Provider or Program
APPENDIX C:Maps: Geographic Distribution of Providers Receiving Measure A
Funds in FY 07/08
Map 1: County, Private, and Nonprofit Hospitals and Alameda County Public
Health Programs That Received Measure A Funds in FY 07/08
Map 2: Alameda County Health Care Services Agency
FY 07/08 Measure A Capital Investment in the County’s Health Care
Safety Net
Map 3:Emergency Rooms Where ER and On-Call Physicians Provided
Service and Were Compensated With Measure A Funds in
FY 07/08
Map 4: Alameda County Behavioral Health Care Services Alcohol
and Drug Providers That Received Measure A Funds in
FY 07/08
Map 5: Alameda County Behavioral Health Care Services Mental Health CBO
Providers That Received Measure A Funds in FY 07/08
Map 6: Adolescent School-Based Health Centers That Received Measure A
Funding in FY 07/08
Map 7: Primary Care Community Based Organization (CBO) Clinics Receiving
Measure A Funding in FY 07/08
APPENDICES
38
39
APPENDIX A:
MEASURE A REVENUE RECEIVED IN EACH FISCAL YEAR
FISCAL YEAR 04/05
County
Date Month ACMC Cumulative Total
Received Earned ACMC County Total Total Total Cumulative
9/22/04 07/04 5,211,585 1,737,195 6,948,780 5,211,585 1,737,195 6,948,780
10/21/04 08/04 5,142,150 1,714,050 6,856,200 10,353,735 3,451,245 13,804,980
11/19/04 09/04 6,856,200 2,285,400 9,141,600 17,209,935 5,736,645 22,946,580
12/28/04 10/04 5,494,355 1,831,452 7,325,807 22,704,290 7,568,097 30,272,387
01/19/05 11/04 5,437,350 1,812,450 7,249,800 28,141,640 9,380,547 37,522,187
02/17/05 12/04 7,249,800 2,416,600 9,666,400 35,391,440 11,797,147 47,188,587
03/31/05 01/05 6,299,953 2,099,984 8,399,937 41,691,393 13,897,131 55,588,524
04/21/05 02/05 4,291,500 1,430,500 5,722,000 45,982,893 15,327,631 61,310,524
05/18/05 03/05 5,722,050 1,907,350 7,629,400 51,704,943 17,234,981 68,939,924
06/24/05 04/05 8,412,419 2,804,139 11,216,559 60,117,362 20,039,120 80,156,483
07/20/05 05/05 4,988,025 1,662,676 6,650,700 65,105,387 21,701,796 86,807,183
08/19/05 06/05 6,650,700 2,216,900 8,867,600 71,756,087 23,918,696 95,674,783
Interest earned 116,927 116,927
TOTAL 71,756,087 24,035,623 95,791,710
FISCAL YEAR 05/06
County
Date Month ACMC Cumulative Total
Received Earned ACMC County Total Total Total Cumulative
9/23/05 07/05 7,593,094 2,531,031 10,124,125 7,593,094 2,531,031 10,124,125
10/20/05 08/05 4,791,900 1,597,300 6,389,200 12,384,994 4,128,331 16,513,325
11/18/05 09/05 6,389,250 2,129,750 8,519,000 18,774,244 6,258,081 25,032,325
12/23/05 10/05 10,712,696 3,570,899 14,283,595 29,486,940 9,828,980 39,315,920
01/19/06 11/05 5,642,475 1,880,825 7,523,300 35,129,415 11,709,805 46,839,220
02/16/06 12/05 7,523,250 2,507,750 10,031,000 42,652,665 14,217,555 56,870,220
03/31/06 01/06 7,854,305 2,618,102 10,472,407 50,506,970 16,835,657 67,342,627
04/21/06 02/06 5,059,800 1,686,600 6,746,400 55,566,770 18,522,257 74,089,027
05/18/06 03/06 6,746,400 2,248,800 8,995,200 62,313,170 20,771,057 83,084,227
06/23/06 04/06 7,371,527 2,457,176 9,828,703 69,684,697 23,228,233 92,912,930
07/20/06 05/06 5,450,100 1,816,700 7,266,800 75,134,797 25,044,933 100,179,730
08/17/06 06/06 7,266,825 2,422,275 9,689,100 82,401,622 27,467,208 109,868,830
Interest earned 380,741 380,741
TOTAL 82,401,622 27,847,949 110,249,571
40
FISCAL YEAR 06/07
County
Date Month ACMC Cumulative Total
Received Earned ACMC County Total Total Total Cumulative
09/22/06 07/06 8,322,635 2,774,212 11,096,847 8,322,635 2,774,212 11,096,847
10/18/06 08/06 5,513,100 1,837,700 7,350,800 13,835,735 4,611,912 18,447,647
11/16/06 09/06 9,242,400 3,080,800 12,323,200 23,078,135 7,692,712 30,770,847
12/22/06 10/06 7,953,029 2,651,009 10,604,038 31,031,164 10,343,721 41,374,885
01/18/07 11/06 6,025,875 2,008,625 8,034,500 37,057,039 12,352,346 49,409,385
02/22/07 12/06 8,004,300 2,668,100 10,672,400 45,061,339 15,020,446 60,081,785
03/29/07 01/07 6,588,768 2,196,256 8,785,024 51,650,107 17,216,702 68,866,809
04/18/07 02/07 5,224,050 1,741,350 6,965,400 56,874,157 18,958,052 75,832,209
05/17/07 03/07 6,965,400 2,321,800 9,287,200 63,839,557 21,279,852 85,119,409
06/22/07 04/07 8,152,952 2,717,651 10,870,603 71,992,509 23,997,503 95,990,012
07/19/07 05/07 5,736,525 1,912,175 7,648,700 77,729,034 25,909,678 103,638,712
08/16/07 06/07 7,648,725 2,549,575 10,198,300 85,377,759 28,459,253 113,837,012
Interest earned 655,872 655,872
TOTAL 85,377,759 29,115,125 114,492,884
FISCAL YEAR 07/08
County
Date Month ACMC Cumulative Total
Received Earned ACMC County Total Total Total Cumulative
09/26/07 07/07 8,530,372 2,843,457 11,373,829 8,530,372 2,843,457 11,373,829
10/18/07 08/07 6,117,375 2,039,125 8,156,500 14,647,747 4,882,582 19,530,329
11/21/07 09/07 8,156,475 2,718,825 10,875,300 22,804,222 7,601,407 30,405,629
12/28/07 10/07 7,883,441 2,627,814 10,511,255 30,687,663 10,229,221 40,916,884
01/16/08 11/07 6,205,800 2,068,600 8,274,400 36,893,463 12,297,821 49,191,284
02/21/08 12/07 8,274,375 2,758,125 11,032,500 45,167,838 15,055,946 60,223,784
03/27/08 01/08 7,183,405 2,394,468 9,577,873 52,351,243 17,450,414 69,801,657
04/17/08 02/08 5,386,200 1,795,400 7,181,600 57,737,443 19,245,814 76,983,257
05/22/08 03/08 7,181,625 2,393,875 9,575,500 64,919,068 21,639,689 86,558,757
06/24/08 04/08 8,049,440 2,683,146 10,732,586 72,968,508 24,322,835 97,291,343
07/18/08 05/08 5,966,175 1,988,725 7,954,900 78,934,683 26,311,560 105,246,243
08/21/08 06/08 7,954,875 2,651,625 10,606,500 86,889,558 28,963,185 115,852,743
Interest earned 766,401 766,401
TOTAL 86,889,558 29,729,586 116,619,144
41
FISCAL YEAR 08/09
County
Date Month ACMC Cumulative Total
Received Earned ACMC County Total Total Total Cumulative
9/25/08 07/08 8,032,186 2,677,396 10,709,582 8,032,186 2,677,396 10,709,582
10/15/08 08/08 6,121,050 2,040,350 8,161,400 14,153,236 4,717,746 18,870,982
11/20/08 09/08 8,161,425 2,720,475 10,881,900 22,314,661 7,438,221 29,752,882
12/26/08 10/08 6,854,632 2,284,877 9,139,509 29,169,293 9,723,098 38,892,391
01/22/09 11/08 6,073,950 2,024,650 8,098,600 35,243,243 11,747,748 46,990,991
02/19/09 12/08 6,661,050 2,220,350 8,881,400 41,904,293 13,968,098 55,872,391
03/27/09 01/09 6,506,559 2,168,853 8,675,412 48,410,852 16,136,951 64,547,803
04/16/09 02/09 5,227,725 1,742,575 6,970,300 53,638,577 17,879,526 71,518,103
05/21/09 03/09 5,471,475 1,823,825 7,295,300 59,110,052 19,703,351 78,813,403
06/23/09 04/09 5,786,013 1,921,503 7,707,516 64,896,065 21,624,854 86,520,919
07/16/09 05/09 5,148,450 1,716,150 6,864,600 70,044,515 23,341,004 93,385,519
08/20/09 06/09 5,906,775 1,968,925 7,875,700 75,951,290 25,309,929 101,261,219
Interest earned 363,681 363,681
TOTAL 75,951,290 25,673,610 101,624,900
GRAND TOTAL 402,376,317 136,401,892 538,778,209
42
43
APPENDIX B:
FY 07/08 MEASURE A FUND DISTRIBUTION BY PROVIDER OR PROGRAM
Measure A Expended/
Allocation Encumbered
GROUP 1: PUBLIC HEALTH
Public Health Prevention Initiative
Chronic Disease and Injury Prevention
Project New Start $16,917 $16,541
Community-Designed Initiative $125,000 $125,000
Asthma $211,542 $211,818
Diabetes $262,028 $249,100
Healthy Kids, Healthy Teeth $147,212 $145,851
Emergency Medical Services (EMS)$100,000 $100,000
Health Inequities and Capacity Building
Community-Designed Initiative $50,000 $50,000
Office of Director/Community Assessment,
Planning, & Education (CAPE) $720,569 $719,210
Community Nursing $98,508 $89,133
Immunization Registry $197,263 $196,351
HIV Prevention $92,800 $92,574
Family Health Services (FHS)-Healthy Passage
System of Care $98,465 $93,038
Obesity Prevention and School Health
Nutrition Services $397,306 $423,909
Public Health Nursing $177,390 $179,393
Community-Designed Initiative $395,000 $392,934
TOTAL $3,090,000 $3,084,852
Measure A Number of
Allocation Claims Paid
ER and On-Call Physician Reimbursement
California Emergency Medical Group $444,403 5,060
Berkeley Emergency Medical Group $363,090 4,705
Oakcare Medical Group $334,979 5,714
Phoenix Emergency Physicians $101,323 1,402
Emergency Medical Association of Children $72,718 1,347
Pleasanton Emergency Medical Group $43,860 610
Bay Imaging Consultant Medical Group $34,515 1,403
Northern California Trauma Medical Group $26,622 106
R Scott Snyder MD Inc.$20,812 50
TOTAL FOR ABOVE 9 PROVIDERS $1,442,322 20,397
TOTAL FOR 32 PROVIDERS RECEIVING
UNDER $20,000 $102,678 338
GRAND TOTAL FOR ALL PROVIDERS $1,545,000 20,735
44
Measure A Expended/
Allocation Encumbered
GROUP 2: BEHAVIORAL HEALTH
Alameda County Behavioral Health Care Services Community-Based Organization Providers
Mental Health Providers
Alameda County Network of
Mental Health Clients (ACNMHC)$33,470 $33,470
Alameda Family Services $11,177 $11,177
Ann Martin $20,848 $20,848
Asian Community $64,516 $64,516
Bay Area Community Services (BACS)$108,070 $108,070
Berkeley Place $29,641 $29,641
Bonita House $72,200 $74,023
Building Opportunities for Self-Sufficiency (BOSS) $66,413 $66,413
Center for Independent Living $2,293 $2,293
Crisis Support Center $30,957 $30,957
East Bay AIDS Center (EBAC) $66,003 $66,003
East Bay Community Recovery Project (EBCRP) $16,618 $16,618
Family Paths $26,271 $26,271
La Cheim $31,566 $31,566
La Clinica $79,977 $79,977
La Familia $62,440 $62,440
Lincoln $24,601 $24,601
Mental Health Assoc $46,936 $46,936
Native American Master $3,020 $3,020
Regents of U.C. Center on Deafness $7,770 $7,770
Seneca Residential & Day Treatment $62,653 $62,653
Supplemental Rate Program (SRP)$44,904 $51,937
Subacute Treatment for Adolescent
Rehabilitation Services, Inc. (STARS)$15,160 $15,160
Telecare $1,069,515 $955,894
Traveler’s Aid $10,477 $10,477
West Oakland Health Council (WOHC) $73,315 $73,315
Alcohol & Drug Providers
Alameda Family Services $13,833 $13,833
Asian Community $4,040 $4,040
Asian Pacific $5,070 $5,070
Axis Community Health $24,820 $24,820
Berkeley Addiction Treatment Services $5,613 $5,613
Bay Area Addiction Research Treatment (BAART)
Behavioral Health Services $966 $966
BOSS $2,133 $2,133
Bi-Bett $38,787 $38,787
Community Drug Council $25,564 $24,791
Carnales Unidos Reformando Adictos (CURA)$21,832 $21,832
Davis Street $10,753 $10,428
East Bay Asian Youth Center $2,995 $2,995
EBCRP $35,401 $35,401
45
Measure A Expended/
Allocation Encumbered
GROUP 2: BEHAVIORAL HEALTH (CONTINUED)
Alameda County Behavioral Health Care Services Community-Based Organization Providers (Continued)
Alcohol & Drug Providers (Continued)
Filipinos for Affirmative Action $2,245 $2,245
Humanistic Alternatives To Addiction,
Research, and Treatment, Inc. (HAART)$3,085 $2,992
Health and Human Resource Education Center (HHREC) $5,010 $5,010
Horizon $109,329 $109,329
Latino Commission $60,132 $60,132
Magnolia $5,036 $5,036
Native American Health Center $3,848 $3,848
New Bridge $44,993 $44,993
Options $19,624 -
St. Mary’s $3,893 $3,893
Second Chance $72,090 $72,090
Senior Support $2,156 $2,156
Solid $56,067 $56,067
Sexual Minority Alliance of Alameda County (SMAAC)$2,536 $2,536
Thunder Road $12,278 $12,278
WOHC $44,848 $44,848
YMCA $9,436 $9,436
ZDK $276 $264
TOTAL $2,729,500 $2,603,908
Alameda County Behavioral Health Care Services
Detox/Sobering Station*$2,060,000 $2,249,035
Mental Health Costs for Juvenile Justice Center $515,000 $515,000
Mental Health Costs for Glen Dyer Jail in Oakland $772,000 $772,000
Criminal Justice Screening/In-Custody Services
at Santa Rita Jail $3,705,499 $3,705,499
GROUP 3: MEDICAL CARE, CAPITAL, AND ADMINISTRATIVE SERVICES
Primary Care Community-Based Organizations
Asian Health Services $934,198 $934,198
Bay Area Consortium for Quality Health Care $324,002 $108,000
Axis Community Health Center $535,773 $535,773
La Clinica de la Raza $1,317,989 $1,317,798
Life Long Medical Care $907,595 $907,595
Native American Health Center $411,834 $411,834
Tri-Cities Health Center $787,960 $787,960
Tiburcio Vasquez Health Center $665,814 $665,814
West Oakland Health Center $631,605 $631,605
Day Workers $154,500 $66,192
TOTAL $6,671,270 $6,366,769
46
Measure A Expended/
Allocation Encumbered
GROUP 3: MEDICAL CARE, CAPITAL, AND ADMINISTRATIVE SERVICES (CONTINUED)
Non-County Hospitals
Children’s Hospital Oakland *$3,567,500 $3,500,000
St. Rose Hospital *$2,317,500 $2,250,000
TOTAL $5,885,000 $5,750,000
School-Based Health Centers
Maintaining Existing Services
Base Funding for Existing SBHCs $669,500 $736,450
Core Evaluation $206,000 $206,000
Service Expansion
Capital Reserve $0 $42,262
Service System Coordination
Program Coordination $77,250 $77,250
Administrative Infrastructure and Support $77,250 $77,250
TOTAL $1,030,000 $1,139,212
Medical Costs for Juvenile Justice Center * $257,500 $126,881
Capital Investment in the County’s $3,019,980 $1,679,695
Health Care Safety Net *
Other Capital * $0 $1,000,000
Administration/Infrastructure Support $206,000 $117,473
Healthy Communities Inc. (dba Healthy Oakland) $125,000 $125,000
Direct Medical and Support Services (Oakland)$257,500 $257,500
GROUP 4: BOARD OF SUPERVISORS (BOS)
BOS Discretionary Allocations *$1,015,000 $803,761
*Unspent funds in these allocations are allowed to roll forward into subsequent years.
BERKELEY
ALAMEDA
SAN
LEANDRO
OAKLAND
HAYWARD
NEWARK
UNION
CITY
DUBLIN
PLEASANTON
LIVERMORECASTRO VALLEY
FREMONT
Children's Hospital
St. Rose Hospital
Highland Hospital
Eastmont Wellness Center
Fairmont Hospital
John George Psychiatric Pavilion
Winton Wellness Center
Newark Health Center
Calif Prevention and Eduction
Pipeline Project - Alta Bates Summit Medical Center
"I Want To, I Can" - Public Health Institute
Alameda County Public Health Department
Oakland's Alternative High School
Bay Area Black United Fund
Healthy Oakland
Sports 4 Kids
DOOF Vignettes - How Now Productions
Dental Health Foundation
Community Health Academy
"Get Fit" - La Clinica de la Raza
Senior Support of the Tri-Valley
100 Black Men of the Bay Area
Community Reformed Church
La Familia Counseling Service
Tiburcio Vasquez Health Center
October 15, 2009Prepared by: Alameda Co. Health Care Services Administration
County, Private, and Nonprofit Hospitals and
Alameda County Public Health Programs That
Received Measure A Funds in FY 07/08
Appendix C: Maps
hospitals.wor
Provider City
Highland Hospital Oakland
John George Psychiatric Pavilion San Leandro
Fairmont Hospital San Leandro
Eastmont Wellness Center Oakland
Winton Wellness Center Hayward
Newark Health Center Newark
Provider City
100 Black Men of the Bay Area Oakland
Alameda County Public Health Department Oakland
Bay Area Black United Fund Oakland
Calif Prevention and Eduction Oakland
City of Berkeley Berkeley
City of Fremont Fremont
Community Health Academy Oakland
Community Reformed Church Oakland
Dental Health Foundation Oakland
DOOF Vignettes - How Now Productions Berkeley
"Get Fit" - La Clinica de la Raza Oakland
Healthy Oakland Oakland
"I Want To, I Can" - Public Health Institute Oakland
La Familia Counseling Service Hayward
Oakland's Alternative High School Oakland
Pipeline Project - Alta Bates Summit Medical Center Oakland
Senior Support of the Tri-Valley Pleasanton
Sports 4 Kids Oakland
Students Run Oakland Oakland
Tiburcio Vasquez Health Center Union City
Provider City
St. Rose Hospital Hayward
Children's Hospital Oakland
Alameda County Medical Center Sites
Public Health Programs
Private Hospitals
S A N
L E A N D R O
O A K L A N D
A L A M E D A
B E R K E L E Y
C A S T R O V A L L E Y
H A Y W A R D
P L E A S A N T O N
D U B L I N
U N I O N C I T Y
F R E M O N T
N E W A R K
L I V E R M O R E
Girls Inc.
Women on the Way Recovery Center
Native American Health Center
Brighter Beginnings
La Clinica de la Raza
Alameda Family Services
Davis Street Family Resource Center
Emergency Shelter Program, Inc.
Horizon Services, Inc.
Asian Health Services
Fred Finch Youth Center
HIV Education and Prevention Project of Alameda County (HEPPAC)
St. Mary's Center
Health & Human Resource Education Center
The Solid Foundation
Lincoln Child Center
Humanistic Alternatives to Addiction Research & Treatment
East Oakland Community Project
Schuman-Liles Clinic, Inc.AIDS Project of the East Bay
Family Paths Inc.
Center for Elders' Independence
East Bay Community Recovery Project
West Oakland Health Council
Asian Pacific Psychological Services
Berkeley Youth Alternatives
Options Recovery Services
Lifelong Medical Care
Through the Looking Glass
Axis Community Health
Magnolia Women's Recovery Program, Inc.
Tiburcio Vasquez Health Center
C.U.R.A. Inc.
Tri-City Health Center
Alameda County Health Care Services Agency
2007-2008 Measure A Capital Investment
In the County’s Health Care Safety Net
Prepared by: Alameda County Health Care Services Administration Capital RFP Fund Recipients.wor
Appendix C: Maps
October 15, 2009
Agency Award
AIDS Project of the East Bay 125,000
Alameda Family Services 25,000
Asian Health Services 135,000
Asian Pacific Psychological Services 41,000
Axis Community Health 243,570
Berkeley Youth Alternatives 26,525
Brighter Beginnings 44,392
Center for Elders' Independence 90,375
Crisis Support Services of Alameda County 25,517
C.U.R.A. Inc.68,218
Davis Street Family Resource Center 132,500
East Bay Community Recovery Project 149,750
East Oakland Community Project 137,500
Emergency Shelter Program, Inc.55,000
Family Paths Inc.45,384
Fred Finch Youth Center 75,000
Girls Inc.52,000
Health & Human Resource Education Center 25,041
HIV Education and Prevention Project of Alameda County (HEPPAC) 60,000
Horizon Services, Inc.60,000
Humanistic Alternatives to Addiction Research & Treatment 50,000
La Clinica de la Raza 144,082
Lifelong Medical Care 135,000
Lincoln Child Center 80,000
Magnolia Women's Recovery Program, Inc.100,000
Native American Health Center 135,000
Options Recovery Services 74,618
Schuman-Liles Clinic, Inc.30,000
St. Mary's Center 135,000
The Solid Foundation 50,000
Through the Looking Glass 43,682
Tiburcio Vasquez Health Center 125,775
Tri-City Health Center 75,000
West Oakland Health Council 100,000
OAKLAND
SAN
LEANDRO
ALAMEDA
DUBLINCASTRO VALLEY
UNION
CITY
PLEASANTON
HAYWARD
LIVERMORE
BERKELEY
NEWARK
FREMONT
Valley Care Hospital
Alameda Hospital
Washington Hospital
Eden Medical Center
San Leandro Hospital
St. Rose Hospital
Alameda County Medical Center
Summit Medical Center
Children's Hospital Oakland
Alta Bates Summit Medical Center
October 15, 2009Prepared by: Alameda Co. Health Care Services Administration
EMERGENCY ROOMS WHERE ER AND ON-CALL PHYSICIANS
PROVIDED SERVICE AND WERE COMPENSATED
WITH MEASURE A FUNDS IN FY 07/08
Appendix C: Maps
er.wor
SAN
LEANDRO
NEWARK
HAYWARD
OAKLANDALAMEDA
BERKELEY
LIVERMORE
PLEASANTON
DUBLINCASTRO VALLEY
UNION
CITY
FREMONT
October 15, 2009Prepared by: Alameda Co. Health Care Services Administration
Alameda County Behavioral Health Care Services
Alcohol and Drug Providers That
Received Measure A Funds in FY 07/08
Appendix C: Maps
bhcs.wor:2
Organization City
Alameda Family Services Alameda
Asian Community Mental Health Services Oakland
Asian Pacific Psychological Services Oakland
Axis Community Health, Inc.Pleasanton
B.A.A.R.T.Oakland
Berkeley Addiction Treatment Services, Inc. (B.A.T.S.) Berkeley
Bi-Bett Corporation Oakland
Building Opportunities for Self Sufficiency (B.O.S.S.) Berkeley
Carnales Unidos Reformando Adictos, Inc. (C.U.R.A.) Fremont
Community Drug Council Oakland
Davis Street Community Center San Leandro
East Bay Asian Youth Center Oakland
East Bay Community Recovery Project Oakland
Filipinos for Affirmative Action Union City
H.A.A.R.T. - Hayward Hayward
Health and Human Resource Education Center Berkeley
Horizon Services Oakland
Latino Commission Oakland
Magnolia Recovery Program, Inc.Newark
Native American Health Center Oakland
New Bridge Foundation Inc.Berkeley
Options Recovery Services Berkeley
S.M.A.C.C. of Alameda County Oakland
Second Chance Hayward
St. Mary's Recovery Center-Recovery 55 Oakland
The Solid Foundation Oakland
Thunder Road - Adolescent Treatment Centers, Inc. Oakland
Tri-Valley Community Foundation-Senior Support Program Pleasanton
West Oakland Health Council, Inc.Oakland
YMCA Of The East Bay-East Lake Oakland
ZDK, Inc.-The 14th St. Clinic Oakland
SAN
LEANDRO
NEWARK
HAYWARD
OAKLANDALAMEDA
BERKELEY
LIVERMORE
PLEASANTON
DUBLINCASTRO VALLEY
UNION
CITY
FREMONT
Alameda County Behavioral Health Care Services
Mental Health CBO Providers That
Received Measure A Funds in FY 07/08
Appendix C: Maps
October 15, 2009Prepared by: Alameda Co. Health Care Services Administration bhcs.wor:1
Adult Providers
Organization City
Alameda County Network of Mental Health Clients Oakland
Alameda Family Services Oakland
Asian Community Mental Health Services Oakland
BACS Oakland
BACS-Irvington Fremont
Berkeley Place-Casa DeLa Vida Oakland
Bonita House Berkeley
BOSS Oakland
Center for Independent Living Berkeley
Crisis Support Services Oakland
East Bay Community Recovery Project Oakland
La Clinica Oakland
Mental Health Association Oakland
Native American Health Center Oakland
Regents of the UC - Center on Deafness San Leandro
Supplement Rate Program San Leandro
Telecare Oakland
Travelers Aid Society Oakland
Organization City
Ann Martin Children's Center, Inc. Piedmont
East Bay Agency for Children Oakland
La Cheim Oakland
La Familia Hayward
Lincoln Child Center Oakland
Family Paths Oakland
Seneca Center San Leandro
STARS San Leandro
West Oakland Health Center Oakland
Child Providers
SAN
LEANDRO
HAYWARD
ALAMEDA
OAKLAND
CASTRO VALLEY
DUBLIN
PLEASANTON
UNION
CITY
BERKELEY
LIVERMORE
NEWARK
FREMONT
Youth Uprising Health Center
San Lorenzo High Health Center
Tennyson Health Center
Fremont High Tiger Clinic
Tri-High Health Services
Alameda Family Services SBHC
Roosevelt Health Center
McClymonds Health Center
Oakland TechniClinic
James Logan Health Center
Berkeley High Health Center
October 15, 2009Prepared by: Alameda Co. Health Care Services Administration
ADOLESCENT SCHOOL-BASED HEALTH CENTERS THAT
RECEIVED MEASURE A FUNDING IN FISCAL YEAR 07/08
Appendix C: Maps
adolescent_sbhc.wor
School Address City
Oakland TechniClinic 4351 Broadway Oakland
James Logan Health Center 1800 H St Union City
Berkeley High Health Center 2223 M. L. King Jr Dr Berkeley
Tri-High Health Services 2201 Encinal Ave Alameda
Fremont High Tiger Clinic 4610 Foothill Blvd Oakland
San Lorenzo High Health Center 50 E. Lewelling Blvd San Lorenzo
Roosevelt Health Center 1926 19th Ave Oakland
Tennyson Health Center 27035 Whitman St Hayward
McClymonds Health Center 2607 Myrtle St Oakland
Youth Uprising Health Center 2249 88th Ave Oakland
Alameda Family Services SBHC 210 Central Ave Alameda
PLEASANTON
DUBLINSAN
LEANDRO
HAYWARD
LIVERMORE
ALAMEDA
OAKLAND
BERKELEY
CASTRO VALLEY
NEWARK
UNION
CITY
FREMONT
Asian Adult Medical Services
Tri-City Health Center
Tri-City Health Center
Axis Community Health
Axis Community Health
Native American Health Center
Over 60 Health Center East
Clinica Alta Vista
La Clinica Dental/Children's
San Antonio Neighborhood
La Clinica de la Raza
La Clinica Dental
Asian Health Services
Albert J Thomas Medical Clinic
Asian Health Dental Clinic
Over 60 Health Center
LifeLong Medical Care DOC
West Oakland Health Center
LifeLong Dental Care Berkeley Women's Health Center
Berkeley Primary Care AccessWest Berkeley Family PracticeWilliam Byron Rumford Medical
Tiburcio Vasquez, Hayward
Tiburcio Vasquez Logan Health
Tiburcio Vasquez, Union City
October 15, 2009Prepared by: Alameda Co. Health Care Services Administration
West Oakland Health Council
Asian Health Services
La Clinica De La Raza
LifeLong Medical Care
Native American Health Center
Tiburcio Vasquez Health Center
Tri-City Health Center
Axis Community Health
Adult Medical Services
Asian Health Services
Dental Clinic
275 14th Street, Oakland
818 Webster St., Oakland
345 9th St., Oakland
La Clinica de la Raza
Clinica Alta Vista
La Clinica Dental
San Antonio Neighborhood
La Clinica Dental/Children's Hosp.
3451 E. 12th St., Oakland
1515 Fruitvale Ave., Oakland
3050 E. 16th St., Oakland
1030 E. 14th St., Oakland
757 E. 16th St., Oakland
Berkeley Primary Care
LifeLong Dental Care
Downtown Oakland Clinic
Over 60 Health Center East
Over 60 Health Center
W. Berkeley Family Practice
2001 Dwight Way, Berkeley
1860 Alcatraz Ave, Berkeley
616 16th St, Oakland
10700 MacArthur Blvd., Oakland
3260 Sacramento St., Berkeley
2031 Sixth St., Berkeley
Native American Health Ctr.3124 E. 14th St., Oakland
Tiburcio Vasquez Hayward
Tiburcio Vasquez Union City
22331 Mission Blvd., Hayward
33255 9th St., Union City
Tri-City Health Center
Tri-City Health Center
2299 Mowry Ave., Fremont
39500 Liberty St., Fremont
Axis Community Health
Axis Community Health
4361 Railroad Ave., Pleasanton
3311 Pacific Ave., Livermore
Albert J. Thomas Med. Clinic
West Oakland Health Center
William Byron Rumford Med. Ctr.
East Oakland Health Center
10615 International Bl., Oakland
700 Adeline St., Oakland
2960 Sacramento St., Berkeley
7450 International Bl., Oakland
PRIMARY CARE COMMUNITY-BASED
ORGANIZATION (CBO) CLINICS
RECEIVING MEASURE A FUNDING IN FISCAL YEAR 07/08
Bay Area Consortium for Quality Health Care
Berkeley Women's Health Ctr.2908 Ellsworth St., Berkeley
Community-Based Organizations
Appendix C: Maps
cmspnetwork.wor