HomeMy WebLinkAboutmeasurearpt-13-14MEASURE A
Essential Health Care Services Tax Ordinance
OVERSIGHT COMMITTEE
8TH REPORT TO THE ALAMEDA COUNTY
BOARD OF SUPERVISORS AND THE PUBLIC
Review of Expenditures July 1, 2013 – June 30, 2014
Fiscal Year 2013/2014
MEASURE A
Essential Health Care Services Tax Ordinance
OVERSIGHT COMMITTEE
8TH REPORT
TO THE ALAMEDA COUNTY BOARD OF SUPERVISORS
AND THE PUBLIC
REVIEW OF EXPENDITURES IN
Fiscal Year (FY) 2013/2014
July 1, 2013 – June 30, 2014
CONTENTS
Measure A Oversight Committee Members ........................................................................................... 1
Executive Summary ..................................................................................................................................................... 3
How The Money Was Spent ............................................................................................................................... 12
Review of FY 12/13 Expenditures: 75% of Measure A Funds
Allocated to Alameda Health System ............................................................................................................... 13
Review of FY 12/13 Expenditures: 25% of Measure A Funds
Allocated by the Alameda County Board of Supervisors ....................................................................... 21
Group 1: Behavioral Health
Asian Health Services (Bantreay Srei) ....................................................................................................................... 23
Behavioral Health and Alcohol and Other Drug (AOD) Community ................................................................ 25
Center for Empowering Refugees and Immigrants ................................................................................................. 26
Center for Healthy Schools & Communities (School-Based Behavioral Health Initiative) ............................ 27
Chabot/Las Positas Community College .................................................................................................................. 31
Criminal Justice Screening and In-Custody Services ............................................................................................. 32
Detoxification/Sobering Center .................................................................................................................................. 35
G.O.A.L.S. for Women, Inc. ......................................................................................................................................... 36
La Familia Counseling Services ................................................................................................................................... 38
Mental Health Services for Juvenile Justice Center ................................................................................................. 39
National Alliance on Mental Illness (NAMI) Tri-Valley ........................................................................................ 40
Safe Alternatives to Violent Environments (SAVE) ................................................................................................ 42
Senior Support Program of Tri-Valley ....................................................................................................................... 43
Tri-Valley Haven for Women ....................................................................................................................................... 44
Youth Alive! ..................................................................................................................................................................... 45
Group 2: Hospital, Tertiary Care, Other
Administration/Infrastructure Support .................................................................................................................... 48
San Leandro Hospital .................................................................................................................................................... 49
St. Rose Hospital ............................................................................................................................................................ 51
UCSF Benioff Children’s Hospital Oakland .............................................................................................................. 53
Group 3: Primary Care
Alameda County Dental Health .................................................................................................................................. 57
Center for Elder’s Independence ................................................................................................................................. 59
Center for Healthy Schools and Communities(School Health Centers) ............................................................ 60
Fire Station Health Portals ........................................................................................................................................... 62
Fremont Aging and Family Services ........................................................................................................................... 63
Health Enrollment for Children .................................................................................................................................. 66
Health Insurance Eligibility and Enrollment ............................................................................................................ 67
Health Services for Day Laborers: Community Initiatives (Day Labor Center) ............................................... 68
Health Services for Day Laborers: Multicultural Institute .................................................................................... 70
Health Services for Day Laborers: Street Level Health Project ............................................................................ 72
Increase Hospice Utilization ........................................................................................................................................ 74
Group 3: Primary Care (Continued)
Indigent Health Stabilization ....................................................................................................................................... 76
Medical Costs for Juvenile Justice Center: Direct Service Planning and Administration ............................... 80
Medical Costs for Juvenile Justice Center: Mind Body Awareness ...................................................................... 82
Medical Costs for Juvenile Justice Center: Niroga Institute .................................................................................. 84
Medical Costs for Juvenile Justice Center: Victims of Crime ................................................................................ 85
Preventive Care Pathways ............................................................................................................................................. 86
Primary Care Community-Based Organizations .................................................................................................... 87
Tiburcio Vasquez Health Center, Inc ......................................................................................................................... 89
Group 4: Public Health
Alameda Boys & Girls Club, Inc. ................................................................................................................................ 92
Alameda County Asthma Start ................................................................................................................................... 94
Berkeley Food & Housing Project ............................................................................................................................... 95
Center for Early Intervention on Deafness ............................................................................................................... 96
City of San Leandro ....................................................................................................................................................... 97
Eden Youth and Family Center .................................................................................................................................... 98
Emergency Medical Services (EMS) Corp .............................................................................................................. 100
Environmental Health: Improve Field Sanitation Conditions/Nail Salons ...................................................... 101
HIV Education and Prevention Project of Alameda County (HEPPAC) .......................................................... 103
LIFE ElderCare ............................................................................................................................................................. 105
LifeLong Medical Care: Heart 2 Heart .................................................................................................................... 106
Public Health Prevention Initiative .......................................................................................................................... 108
School of Imagination ................................................................................................................................................. 120
Senior Injury Prevention Program ........................................................................................................................... 122
Service Opportunties for Seniors (Meals on Wheels) .......................................................................................... 124
Spectrum Community Services, Inc. ....................................................................................................................... 125
SSI Housing Trust ........................................................................................................................................................ 127
Teleosis Institute ........................................................................................................................................................... 128
Viola Blythe Community Services ............................................................................................................................ 129
Youth and Family Opportunity Initiatives .............................................................................................................. 130
Appendices
Appendix A: Measure A Revenue Received ........................................................................................................ 138
APPENDIX B: FY 13/14 Budget Information ..................................................................................................... 139
Appendix c: FY 13/14 Measure A Fund Distribution by Provider or Program ................................. 141
Appendix d: Maps: Geographic Distribution of
Providers Funded by Measure A in FY 13/14 .................................................................................................... 146
MEASURE A
OVERSIGHT COMMITTEE MEMBERS
COMMITTEE MEMBER REPRESENTING/NOMINATED BY
John Becker City Managers’ Association
Olga Borjon Supervisor Richard Valle (District 2)
Arthur Chen, M.D. Alameda-Contra Costa Medical Association
Louis Chicoine Supervisor Scott Haggerty (District 1)
Bradley Cleveland Supervisor Nate Miley (District 4)
Fran David City Managers’ Association
Adam Davis Hospital Council of Northern California
Kuwaza Imara Central Labor Council of Alameda County
Gwendolyn McClain Alameda County Public Health Commission
Sally Morgan League of Women Voters
Al Murray City of Berkeley
George Phillips Supervisor Wilma Chan (District 3)
Rachel Richman Central Labor Council of Alameda County
Ursula Rolfe, M.D. League of Women Voters
(vacant) Alameda County Mental Health Board
(vacant) Supervisor Keith Carson (District 5)
(seat in abeyance) Alameda County Taxpayers Association, Inc.
ALAMEDA COUNTY HEALTH CARE SERVICES AGENCY STAFF
Rebecca Gebhart, Interim Agency Director
James Nguyen, Administrative Services Officer
Connie Soriano, Administrative Specialist II
FY 2013/14 Measure AExecutive Summary
ABOUT THE MEASURE A OVERSIGHT COMMITTEEOne of the provisions of Measure A required the
establishment of a Citizen Oversight Committee. The
Committee’s role is to annually review Measure A
expenditures for each fiscal year and report to the Alameda County
Board of Supervisors (Board) on whether such expenditures conform
to the purposes set forth in the Measure.
The Measure states: “The citizen oversight committee shall annually
review the expenditure of the essential health care services tax fund
for the prior year and shall report to the board of supervisors on the
conformity of such expenditures.”
The Oversight Committee spent several months reviewing allocation
reports, convening and deliberating concerns, communicating concerns
to providers, highlighting provider accomplishments, and reviewing and
editing the Measure A report. As part of this process, the Committee used
the report forms returned by most Measure A fund recipients, along with
information from several provider presentations, to review all funding
allocations.
OVERALL CONCLUSION
The Oversight Committee found that Alameda
Health System (AHS) and other recipients of the
sales tax revenue spent the funds in compliance
with the strictures of Measure A. The Oversight
Committee did have concerns for a small
number of allocations. These concerns are noted
in this Executive Summary and in the individual
report summaries for the relevant providers.
History of the Measure
Measure A, the Essential
Health Care Services Initiative,
was passed by 71% of Alameda County
voters in March 2004. In June 2014,
76% of voters passed Measure AA,
which extended the initiative through
2034. Both measures authorize the
County of Alameda to raise its sales tax
by one-half cent to provide additional
financial support for emergency
medical, hospital inpatient,
outpatient, public health, mental
health, and substance abuse
services to indigent, low income,
and uninsured adults, children,
families, seniors, and other
residents of Alameda County.
A AA
3
Measure A generated $126,761,410 in FY 13/14.
Highlights
Even in light of recent and ongoing federal health care reform, according
to American Community Survey data for 2014, an estimated 182,223
people, or 11.8% of County residents, are uninsured. Thus, Measure A
revenues continue to play a critical role in helping indigent, uninsured,
and low income residents of Alameda County—who depend on the
County’s health care safety net—maintain access to essential health
services.
With regard to Measure A recipient reporting, the Committee recognizes
an ongoing trend of improvement in the quality and level of detail in the
reporting compared to prior years. This is due in part to the ongoing
effort of the Committee and the Health Care Services Agency (HCSA)
to improve the accountability of Measure A recipients by implementing
a Results-Based Accountability framework to help providers report
measurable performance data that describes the effort, quality, and impact
of their programs and services.
DISTRIBUTION OF MEASURE A FUNDS
25%
75%
Of the $126,761,410 that Measure A generated in FY 13/14,
AHS received 75% and the remainder of the funds were
distributed by the Board to many health care providers to
provide essential health care services.
14%40%
15%14%
17%
Behavioral Services
Acute
Ambulatory Services
ER/Urgent/TraumaLong-Term Care
Public Health
Behavioral Health
Primary Care
24%18%
33%
24%
Hospital, Tertiary Care, Other
the Board of Supervisors
Measure A Funding Approved by
Allocati on of Measure A Funds toAlameda Health System
Total generated: $31.7 million
Total allocated: $33.6 million*
Total $95.1 million*Note: Board allocations are made in advance of a given fiscal year. Therefore,
the amount generated by Measure A for that year does not equal the amount
allocated by the Board.
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Highlights (continued)
Large Numbers Served
Measure A enabled a large number of providers to continue existing
programs and maintain the service levels offered by these programs.
For example, AHS saw more than 100,000 patients in its emergency
departments systemwide and conducted more than 320,000 outpatient
visits, while the Public Health Prevention Initiative served more than
100,000 Measure A clients.
Similarly, the community-based primary care health centers affiliated with
the Alameda Health Consortium provided comprehensive care for more
than 39,000 Measure A clients, who made a total of 111,686 visits.
Increased Access to Care
Measure A funds increased access to health care services both through
new/expanded facilities and through the provision of a greater number
and variety of services. At AHS alone, orthopedic visits to Highland
Hospital increased 81% over the baseline year FY 10/11, while cardiology
visits increased 47%.
Highland also expanded lactation services to seven days per week,
established a new Sunday high risk newborn clinic, opened a Same Day
Clinic (SDC) for patients with serious but non-life-threatening conditions,
and doubled enrollment in the Complex Care Program from 214 to 427
patients.
Among the Wellness Centers, Newark Wellness expanded specialty
care services to include psychiatry, mammography, early oral preventive
pediatric care services, and prenatal centering program; Hayward
Wellness relocated to Southland Mall to accommodate 36 new exam
rooms covering over 23,000 square feet; and Eastmont Wellness expanded
specialty care services to 16 exam rooms and 6,600 square feet.
Improved Outcomes
Most providers presented clear, quantified information that showed
increases in the number of clients served, increases in desired outcomes,
or decreases in harmful behavior as a result of Measure A-funded services.
For example, children participating in the Alameda County Dental
Health WIC “Dental Days” had 42% fewer restorative dental treatment
needs compared to children who did not benefit from the program, while
San Leandro Hospital showed significant reductions in patients leaving
without being seen (-77%), emergency department (ED) arrival-to-
discharge times (-32%), operating room (OR) turnover times (-75%), and
ED arrival-to-provider times (-61%).
Children participating
in the Alameda County
Dental Health WIC
“Dental Days” had
42% fewer restorative
dental treatment needs
compared to children
who did not benefit from
the program.
42%
Ambulatory Services
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$21.7
million
Client surveys revealed more qualitative outcomes also. At Safe
Alternatives to Violent Environments (SAVE), 88% of clients surveyed
reported that they felt safer and more equipped to make their own
decisions. Research data for the Mind Body Awareness program revealed
significant decreases (19.6%) in perceived stress, increases (23.7%) in
healthy self-regulation, and increases in self-esteem (14.1%) from pre- to
post-testing among youth participants in the Alameda County Juvenile
Justice Center.
Service Stabilization
Compared to the preceding year, FY 13/14 saw a decline of only 2% in
both the number of clients served and number of services delivered by the
Behavioral Health and Alcohol and Other Drug (AOD) Community. Given
County General Fund reductions of 10% and a cost of living increase of
2.4% for that period, Measure A support was very effective in stabilizing
services.
Hospitalization Reduction
As a result of immediate crisis intervention offered by Mental Health
Services at the Juvenile Justice Center, only two clients were hospitalized
in FY 13/14. In addition, thanks in part to Measure A funding, Preventive
Care Pathways clients experienced a reduction in emergency room visits
to AHS and outside emergency rooms.
Geographic Reach
Measure A funds increased access to health care services both
geographically and through the provision of a greater number and
variety of services. For example, Eden Youth and Family Center serves a
community of high need in South Hayward, and has developed a long-
term strategic plan to help area youth and families. The program works
collaboratively with its network of partnerships, which increases the
effectiveness of all the organizations.
Matching Funds
The recipients of the 25% of Measure A funds allocated by the Board
received a total of $33.6 million in allocations. This same group of
providers obtained $21.7 million in matching funds from public and
private sources. These matching funds represent a $.63 match for every $1
in Measure A funds.
AHS alone obtained $104 million in matching funds on its $95.2 million
Measure A allocation, thus obtaining better than a 1:1 return.
Measure AAllocation MatchingFunds
$34.8
million
The recipients of the
25% of Measure A funds
allocated by the Board
obtained $21,746,090
in matching funds
from public and private
sources.
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Flexible Response
Measure A gives the County flexibility to address unmet needs and
unanticipated costs. Specifically, the $150,000 each member of the Board
receives as a discretionary allocation gives the supervisors the flexibility to
respond to unanticipated needs in their districts. Over the period of this
report, there were 16 contracts for services for youth, children, seniors,
and the general population from the allocations. During this period, the
Committee noted an increased focus on healthy living, wellness, and
prevention initiatives.
Award-Winning Service
AHS programs and staff received numerous awards and accolades.
As just some examples: Fairmont Hospital received a 4-Star quality
rating from the Center for Medicare & Medicaid Services (CMS), while
Alameda Hospital received a Gold Plus Award from the American Heart
Association and American Stroke Association for excellence in the
treatment of heart disease, heart failure, and stroke.
Highland Hospital’s Cardiac Catheterization Laboratory Technicians
earned elite designation as a Registered Cardiovascular Invasive Specialist
(RCIS) from Cardiovascular Credentialing International (CCI).
John George Psychiatric Hospital (JGPH) Director of Nursing, Judy Linn,
was honored with the Annual Leadership Award from the American
Psychiatric Nurses Association, while the Occupational Therapy
Department at JGPH was honored with the Outstanding Collaboration
& Support Award from the Alameda County Network of Mental Health
Clients.
Concerns
In developing this report, the Oversight Committee identified several
concerns regarding the state of health care funding both during the years
of Measure A implementation (2004-2013) and in the foreseeable future.
While Measure A tax revenues have gradually increased each year since
their lowest levels in 2010, economic indicators reveal that the annual rate
of change from the prior year started to decrease in 2012. In addition, per
capita sales tax has declined and continues to trend downward, which will
impact the revenues raised by the measure.
Furthermore, many families living in disadvantaged communities have
not benefited from the improved job and housing markets during the
economic recovery over the past few years and continue to need access to
the essential health care services that Measure A provides.
The Board discretionary
allocations enabled the
supervisors to respond
to unanticipated needs
in their districts and
focus on healthy living,
wellness, and prevention
initiatives..
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At the same time, the Committee is paying close attention to the
recent and ongoing state and federal health care reform initiatives,
which have resulted in the expansion of health coverage to more than
200,000 previously uninsured County residents after 2014. While this
accomplishment represented a boost to health access for many children,
adults, and families, more than 33,000 individuals in Alameda County
continue to remain uninsured. Moreover, funding cuts from the previous
five years, Medi-Cal rate reductions, and potential state and federal
funding cuts have deteriorated the County’s safety net, decreased the
ability of health providers to offer services to the Medi-Cal and uninsured
populations, and challenged health care expansion efforts.
Realizing the full promise of these reforms presents a significant challenge
as the health care delivery system remains fragmented, eligibility systems
are cumbersome and difficult to negotiate, and access to care continues
to be compromised by low rates and a shortage of providers—particularly
in primary and preventative care. Measure A will continue to serve as an
essential revenue stream in developing creative and innovative ways to
improve access to care, lower the cost of care, and improve the patient
experience. This in turn helps promote equity in health care service
delivery by addressing the root causes of poor health outcomes.
Outside the area of health care funding, the Committee recognizes that
the composition of the Committee has improved in reflecting the diverse
make-up of the population served by Measure A. The Committee notes
that this should be an area of ongoing focus as Committee member
selections are made moving forward.
Regarding Measure A funding, the Committee raises the following
concerns.
NOTE: The Committee believes it is important to present any concerns it
noticed while reviewing Measure A recipient reports. At the same time, the
Committee wants to make clear that raising a concern does not necessarily
mean that a problem exists with a recipient’s use of Measure A funds.
For example, the concern may arise because of incomplete or inaccurate
reporting, not because of any inappropriate use of funds.
General Funding Concerns
The Committee recommends that HCSA create a process for Measure A
recipients to verify that they are using Measure A funds to provide their
described programs to the populations listed in the measure. This process
can include HCSA staff providing training to Measure A recipients on
how to effectively collect demographic data to report on the diverse
populations of indigent, uninsured, and low income clients they serve
by race, ethnicity, geography, and language. The Committee further
advocates that HCSA be sufficiently staffed to successfully implement
such a process.
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Reporting and Review Concerns
• As part of its role in providing fiscal oversight, the Committee
recognizes a need for providers and HCSA to work together to evaluate
the long-term impact of Measure A investments in Alameda County.
• The Oversight Committee believes that the interpretation of the statute
must be revised to expand the role of the Committee and appropriately
allocate Measure A funds for administrative staff to oversee the
contracts and ensure the effective use of public funds to all grantees.
• The Committee expresses an ongoing concern that the County
Counsel’s interpretation of the Measure A ordinance limits the
Committee’s ability to review program efficacy and cost-effectiveness.
In addition, the Committee does not have the capacity to review
HCSA’s process of controls and review of how the money is spent—via
audit or other method. The Committee recommends that the Board
authorize HCSA to include evaluations of Measure A programs as part
of its initiative to improve oversight and outcomes in all its programs.
This includes identifying an additional resource to ensure that Measure
A contracts are included in the initiative.
• Although reporting continues to improve, the Committee expresses
the ongoing concern that its review is impacted by the varying level of
detail provided in fund recipient reports, as well as varying levels of
responsiveness to specific questions posed by the Committee to specific
recipients. This makes it difficult for the Committee to determine
whether funding is being spent on the Measure A target population. For
example:
- Multiple provider reports listed objectives that are not measurable
and/or stated positive outcomes without quantifying the statements.
For example, Behavioral Health Care Services at Juvenile Justice
Center makes assertions of “increased coping skills” and “a great
benefit” from court-ordered evaluations without quantifying these
statements. The Mind Body Awareness Project was unable to collect
data during this period due to organizational transitions, which made
it difficult for the Committee to determine program effectiveness.
- For some reports, it is unclear whether the target population
falls within one of the categories listed in the Measure A statute:
“indigent, low income, and uninsured adults, children, families,
seniors, and other residents of Alameda County.” For example, the
information presented by providers such as Service Opportunities
for Seniors and the Teleosis Institute does not track whether the
population served falls within the requirements of Measure A.
- In other reports, the provider’s description of the services offered
raises questions as to their relevance to the wording of the Measure
A statute. For example, while the Committee recognizes the value of
the California Product Stewardship Council drug disposal program,
it is unclear whether these activities and their target populations fall
within the wording of Measure A.
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In light of some of these reporting concerns, the Committee recommends
that trainings reinforce proper and accurate completion of demographic
information and adherence to Measure A services. Additionally, the
Committee recommends that HCSA continue to work with recipients
to improve the use of results-based performance measures and ensure
that the population and services supported with Measure A comply with
the ordinance. The Committee recommends that the recipient reporting
form include a question about service delivery in multiple languages, as
language barriers can potentially impede access to services for members
of the Measure A target population.
Alameda Health System
In describing its program accomplishments, AHS often does not provide
measurable objectives, making it difficult to get a sense of progress from
the prior year. The Committee notes that this feedback has been offered
for several years to AHS/Alameda County Medical Center.
UCSF Benioff Children’s Hospital Oakland
The Committee notes that UCSF Benioff Children’s Hospital Oakland
does not list measurable objectives, a concern that has been raised
in the last several years. ED encounters can vary due to the severity
of flu seasons and other unexpected health trends. Therefore, it is
understandable that total ED encounters may change from year to year.
However, measurable objectives should still be set and performance
measured. This also applies to the Center for Child Protection (CCP) and
school clinics.
Also, two-thirds of the hospital’s $2.5 million allocation helps offset
undercompensated costs of ED visits from patients with Medi-Cal.
However, the hospital administration states that it is “not reasonable nor
possible to tie the Measure A funding to a specific number of patient
encounters.” The Committee asserts that this can and should be done to
ensure accountability for use of public tax dollars.
San Leandro Hospital
The provider report states that the hospital folded Measure A funding into
their general operating budget: “As described in previous presentations
and reports, we don’t specifically allocate these funds to individual
programs; rather, all of our operations are combined and we endeavor to
track the profitability for each of our programs.” The Committee asks the
provider to show an awareness of the purpose of this public money and to
address its requirements in the specific manner defined in the measure.
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Indigent Health Stabilization
Healthy Communities
The provider report indicates that logistical and other problems interfered
with completion of tasks funded by Measure A. There is no indication of
when these tasks will be completed.
West Oakland Health Council
No report was submitted. Therefore, there is no evidence of any
compliance. The Oversight Committee cannot assume that the funds
were used in compliance with Measure A. Until this situation is resolved,
the Oversight Committee recommends that this organization should not
receive any further Measure A funding.
Primary Care Community-Based Organizations
Healthy Communities
In addition to the eight clinics that are members of the Alameda Health
Consortium, a ninth provider, Healthy Communities (not a member of
the consortium) received an allocation of $163,114. No information was
provided regarding the use of Measure A funds by Healthy Communities,
and no additional report was submitted.
City of San Leandro
From the information provided, it is not clear whether the City of San
Leandro prioritized and/or ended up serving underserved populations.
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Alameda County
Board of Supervisors
DISTRIBUTION OF MEASURE A FUNDS
HOW THE MONEY WAS SPENT
Alameda Health System
Board of Trustees
25%
75%
Measure A tax revenue is used to provide
emergency medical, hospital inpatient,
outpatient, public health, mental health,
and substance abuse services to indigent,
low income, and uninsured adults,
children and families, seniors, and other
residents of Alameda County.
Each year, the Alameda Health System
(AHS) receives 75% of Measure A funds,
which is allocated by their Board of
Trustees to provide primary and specialty
care, preventative, and mental health
services to patients served at AHS’s
multiple facilities, including Highland
Hospital, John George Psychiatric
Hospital, Fairmont Hospital, San Leandro Hospital,
and Alameda Hospital.
The remaining 25% of the Measure A funds received is allocated by the Alameda County Board of Supervisors (Board) to
provide critical medical services offered by community-based health care providers, emergency care, public health, mental
health, and substance abuse services to address the many health needs of communities throughout the County.
In FY 13/14, Measure A generated $126,761,410 (not including interest earned). The funds were allocated as follows:
Alameda Health System (75%): $95,071,058
Alameda County (non-AHS) (25%): $31,690,352
TOTAL: $126,761,410
In FY 12/13, the Alameda County approved budget totaled $2,622,397,815. The HCSA approved budget totaled
$664,880,978, or 25.4% of the total County budget. Measure A revenues not specifically designated for AHS accounted for
4.6% of the HCSA budget.
The following sections in the report provide more detail on how AHS and the Board spent Measure A funds in FY 13/14,
which includes revenue generated in the reporting year as well as unspent funds earned in previous years.
2013-2014 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
12
BACKGROUND
Alameda Health System (AHS) is a patient- and family-centered system
of care that promotes wellness, eliminates disparities, and optimizes the
health of its diverse communities.
AHS program objectives are guided by a three-year strategic plan, which
is built on the following pillars:
• Growth/Access to Care goals relate to providing care to all County
residents by expanding access to services. Key goals in FY 13/14
included the following:
- Acquisition of San Leandro Hospital and affiliation with Alameda
Hospital
- Relocation of Hayward Wellness to Southland Mall
- Expanding specialty care at Eastmont, Newark, and Hayward
Wellness clinics
- Increasing Cardiology, Dermatology, Optometry, and Orthopedic
service lines
- Expanding Complex Care Program for high risk, high cost, complex
care patients
- Increasing medical home assignments for emergency department
(ED) and specialty clinic patients
- Increasing utilization rate of 24-hour nurse advice line
- Reducing overall EDs length-of-stay
• Quality Enhancement goals in FY 13/14 further aligned AHS
with patient safety initiatives, such as benchmarks set by the Joint
Commission, Center for Medicare and Medicaid Services (CMS)
and U.S. Centers for Disease Control (CDC). Key goals in FY 13/14
included the following:
- Continued focus on panel management, including increasing
preventive health screenings at outpatient facilities
- Incorporation of Alameda Health Partners, a physician organization
developed to streamlining clinical priorities and coordinating and
supporting physicians in delivering high quality, efficient, value-
Allocation: $95,071,058 | Expended/Encumbered: $95,071,058
Individuals served by Measure A: 434,778 (Total individuals served: 457,661)
Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors
Services provided: Emergency Medical, Hospital Inpatient, Hospital Outpatient, Public Health, Mental Health, Substance Abuse
Service area: Countywide, Outside of Alameda County
FY 13/14: 75% OF MEASURE A FUNDS ALLOCATED TOAlameda Health System
alamedahealthsystem.org
Matching Funds
AHS leveraged its Measure A allocation
to obtain $104 million in matching
funds through a number of different
IGTs provided by Alameda County,
including the following:
• Medicaid Waiver: $30 million
• Seniors and Persons with
Disabilities: $21 million
• Rate Range: $20 million
• DSRIP: $33 million
Measure AAllocation MatchingFunds
$95,071,058 $104,000,000
2013-2014 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
13
based care to patients and communities
- Continued focus on harm reduction, including reducing sepsis
infection and pressure ulcers at inpatient facilities
- Establishing a new care coordination infrastructure,
multidisciplinary teams, and processes to improve patient flow,
documentation, and avoidable readmissions
• Service Enhancement goals move toward greater patient loyalty, a
culture of customer service, and an enhanced patient experience. Key
goals in FY 13/14 included the following:
- Completing the first phase of MyAlamedaHealth.org, an online
patient portal designed to allow patients 24-hour secure access to
medical information and the ability to communicate with doctors
- Conducting patient experience surveys in cooperation with the U.S.
Agency for Healthcare Research and Quality (AHRQ) and Consumer
Assessment of Healthcare Providers and Systems (CAHPS)
- Sharing data, best practices, and findings with the Safety Net
Institute (SNI) to foster shared learning and benchmarking across
California’s public hospitals
- Improving patient transition from inpatient services to long term
care, rehabilitation, or the home
- Improving “fast track” door to discharge process for lower acuity
patients at John George Psychiatric Hospital (JGPH) and Highland
Hospital, for better patient flow and utilization of provider resources
• Fiscal Stewardship goals represent a commitment to financial stability,
operational efficiency, and debt reduction. Under the Affordable Care
Act, AHS seeks to offset declining federal funds with new patient
revenues from expanded Medi-Cal, the Health Insurance Exchange,
and new contracts with commercial payers. Key goals in FY 13/14
included the following:
- Expanding Kaizen rapid improvement events (Kaizen is a
management practice inspired by Japanese lean manufacturing,
which optimizes business processes by eliminating wasted efforts)
- Improving charge capture, billing, and revenue cycle management
processes across the organization
- Implementing an ongoing cost management initiative aimed at
Measure A Helps
COPD patient Mr. T. was discharged
to a residential drug treatment facility
because of his abuse of alcohol. With
staff support, he stopped drinking
and has maintained his sobriety for
nine months. He regularly attends the
COPD group clinic, where he learned
more about his disease and how to care
for himself. Eventually, he asked for
nicotine patches and subsequently quit
smoking. Now his health is stabilized,
he lives independently in transitional
housing, and he continues to encourage
other patients in the COPD group
clinic to cut back on or stop drinking
alcohol, using drugs, and smoking.
ALLOCATION OF ALAMEDA HEALTH SYSTEM
MEASURE A FUNDS IN FY 13/14
Ambulatory Services
ER/Urgent/Trauma
Long-Term CareAcute
Behavioral Services
40%
15%
14%
14%
27%
2013-2014 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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reducing unnecessary costs and improving efficiency by decreasing
usage of overtime labor and improving core staff scheduling,
redesigning the supply chain, improving purchased service contract
pricing, and implementing flex scheduling
- Developing a managed care contracting department to expand
access to commercially insured patients so patients who want to stay
with AHS can do so without service interruption
- Improving end-to-end revenue cycle functioning
• Workforce Development goals promote a culture of customer service,
innovation, and achievement by attracting, developing, and retaining
competent and compassionate staff. Key goals in FY 13/14 included the
following:
- Establishing Alameda Health Partners (AHP), a physician
organization dedicated to coordinating and supporting physicians
and streamlining clinical priorities
- Increasing staff training in population health management
- Evaluating and providing training in communication skills
competencies and customer service for permanent inpatient nurses
and staff members
- Hiring additional physician and support staff to meet patient
demand and expand service offerings
- Working to increase employee engagement and commitment to
organizational goals and patient experience
• Community/Image Enhancement goals address the need for
community stakeholders and constituents to understand AHS’s
contributions to the well-being of the entire County. Key goals in FY
13/14 included the following:
- Finalizing brand strategy, logos, informational materials, and
websites for San Leandro Hospital and AHS Wellness Centers
- Increasing awareness of AHS as Covered California certified sites
- Launching phase two of the AHS advertising campaign to improve
AHS brand awareness, challenge the stigma of public health systems,
and increase knowledge of the services provided by AHS
- Promoting AHS physicians as thought leaders with national
expertise and AHS as a teaching organization with coveted residency
programs
- Establishing a school-based clinic in San Leandro to support
children and families with high quality primary, specialty, and acute
care
- Creating relationships with non-health care stakeholders such as
local senior centers to provide health education, resources, and
support to the community
MEASURE A FUNDING SUMMARY
Measure A is a supplemental revenue source for AHS, reducing the gap
between reimbursement for services from a variety of sources and the
actual cost of providing those services to underinsured and uninsured
persons. AHS used Measure A funds to fill in budget gaps related to
Highlights
At JGPH, patient satisfaction improved
from the 72nd percentile in FY 12/13
to the 81st percentile in FY 13/14.
Fairmont Hospital received a 4-Star
quality rating from the Center for
Medicare & Medicaid Services (CMS).
Alameda Hospital received a Gold
Plus Award from the American Heart
Association and American Stroke
Association for excellence in the
treatment of heart disease, heart
failure, and stroke.
Alameda Hospital’s inpatient wound
and skin care program received the
Sharon Baronoski Founder’s Award, a
national award recognizing excellence
in the prevention and reduction of
pressure wounds with significant
improvement in patient outcomes.
2013-2014 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
15
providing primary care and specialty care, and preventative and mental
health services, to indigent, low income and uninsured children, families,
and seniors in Alameda County.
For FY 13/14, AHS made the following percentage allocations per service
line:
• 27% Behavioral Services
• 25% Ambulatory Services
• 18% Fairmont and Therapies
• 17% ED/Urgent Care/Trauma Services
• 13% Highland Acute Care and Ancillary Services
Measure A supports all of AHS’s services, with the exception of that
fraction of AHS’s business for which it receives full reimbursement for the
cost of services provided.
Measure A helped AHS achieve the following measurable objectives in FY
13/14:
AHS Client Results: Overview
• 321,128 outpatient visits
• 133,176 total inpatient days
• 101,670 visits to AHS medical EDs
• 16,483 system discharges
• 13,268 visits to JGPH ED
• 6,830 inpatient and outpatient surgeries performed
• 2,077 patients served by Trauma Center
• 1,131 babies delivered
• Interpreter services offered in 26 languages
Highland Hospital
• Increased Orthopedic visits 81% since FY 10/11, for a total of 15,502
• Increased Cardiology visits 47% over FY 10/11 baseline, for a total of
4,831
• Reduced backlog of Cardiology patients waiting for a first appointment
by 80% over two years, from 401 to 81 patients as of October 2013
Highlights
Many staff and programs received
local, regional, and national
recognition during the FY 13/14:
• JGPH Director of Nursing, Judy
Linn, was honored with the Annual
Leadership Award from American
Psychiatric Nurses Association
• JGPH Administrator, Guy Qvistgaard,
was appointed to the Board of
National Alliance of Mental Illness
• The Occupational Therapy
Department at JGPH was honored
with the Outstanding Collaboration
& Support Award from Alameda
County Network of Mental Health
Clients
• Alameda Hospital was featured in
the U.S. News and World Report,
“2015 Best Hospitals” edition
• Highland Hospital’s Cardiac
Catheterization Laboratory
Technicians earned elite designation
as Registered Cardiovascular
Invasive Specialist (RCIS) from
Cardiovascular Credentialing
International (CCI).
ALLOCATION OF ALAMEDA HEALTH SYSTEM
MEASURE A FUNDS IN FY 13/14
Ambulatory Services
ER/Urgent/Trauma
Long-Term CareAcute
Behavioral Services
40%
15%
14%
14%
27%
2013-2014 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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• Increased Optometry visits 94% over the FY 10/11 baseline, for a total
of 5,617
• Increased Dermatology visits 167% over the FY 10/11 baseline, for a
total of 2,902
• Increased preventive screenings for breast cancer by 12% since FY
12/13 through a mammogram improvement project
• Developed “pod-care” entry to prenatal care—a “one-stop-shop” model
that centralizes prenatal care to provide easier access to services and
ensure no aspect of care is overlooked
- Expanded lactation services to seven days per week, including
evening shifts
- Established new Sunday high risk newborn clinic to see infants post-
discharge on Sundays when primary care clinics are closed
- Incorporated early pregnancy detection dating ultrasounds during
new OB physical exams using new GE ultrasound machines
• Answered a total of 3,686 Nurse Advice Line calls, an average of 369
calls per month, with a 66% increase during the last quarter of the year
• Piloted the Art of Caring Program, customer service training for over
90 nurses and nurse leaders, including feedback, coaching, and skills
application to improve patient experience
• Through the ED Navigator program, connected over 310 high risk
patients to a medical home and received the Kaiser Permanente Clinical
Systems Development Award for “Improving the Patient Experience/
Improving the Health of Populations”
• Increased compliance with sepsis bundle to 69%, a 68% improvement
over prior year
Highlights
Many staff and programs received
local, regional, and national
recognition during the FY 13/14:
• Highland Hospital earned
Echocardiography Accreditation
(ICAEL) from the Inter-societal
Accreditation Commission.
• Highland Hospital Earned
Prestigious Level II Trauma Center
Verification from the American
College of Surgeons.
• The Medical Director of the Hope
Center served as advisor to a
statewide collaborative for complex
care management, presenting
at Institute for Healthcare
Improvement conference.
• Hope Center received the 2013
Quality Leaders Award—Honorable
Mention from the California
Association of Public Hospitals.
REVENUE EARNED EACH FISCAL YEAR (FY 04/05 THROUGH FY 13/14)
FY 04/05
FY 05/06
FY 06/07
FY 07/08
FY 08/09
FY 09/10
FY 10/11
FY 11/12
FY 12/13
FY 13/14
1009080
Millions of dollars
706050403020100
$71,756,087
$82,401,622
$85,377,759
$86,889,558
$75,929,787
$70,587,890
$79,135,112
$84,405,378
$90,786,904
$95,191,659
2013-2014 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
17
Measure A Helps
Mr. G., 50, had heart failure. He
was managing stress with substance
abuse and cigarette smoking, and
had not seen a doctor in years. The
Care Transitions Program provided
smoking cessation counseling, nicotine
patches, assistance finding a doctor,
health education, and help applying for
entitlements. He received motivational
counseling to help make lifestyle
changes. At discharge, Mr. G had quit
smoking and was committed to his
health. He wrote to his social worker:
“Your help has seemed so relentless
and dedicated that you remind me of
a locomotive steaming down the track
and shoving every negative obstacle
out of the way.”
• Reinstated 19 licensed beds, added nine licensed beds, hired 10
inpatient nurses, and opened new 10-bed observation unit for low
acuity patients to keep beds for higher acuity admissions
• Improved patient flow by reducing ED median length-of-stay by 56%
for low acuity patients and 21% for high acuity patients over FY 10/11
baseline
Same Day Clinic and Highland Care Pavilion
• Opened 4,340-square foot Same Day Clinic (SDC), designed for
patients with serious but non-life threatening conditions, and cared for
11,669 patient visits
• Expanded SDC service hours to include Saturdays and opened Urgent
Dermatology Clinic to relieve stress on the ED
• Opened new 14-station Infusion Center in Highland Care Pavilion
COMPLEX CARE PROGRAM
The Complex Care Program involves close collaboration among the
Hope Center, which coordinates care for high cost, high risk patients
suffering multiple chronic conditions; the Pain Clinic; the Healthy Hearts
Clinic; and the Care Transitions Program to manage patient care, reduce
readmissions, and improve outcomes.
• Doubled enrollment in Complex Care Program from 214 to 427
patients
• Implemented the Hospital Admissions Risk Multiplier Screen
(HARMS-8), an evidenced-based tool to identify critical patient
intervention areas at intake
• Assigned a medical home to 78.5% of all patients falling into the high
risk criteria, compared to 73% the previous year
• Reduced 30-day readmissions for high risk patients who received full
complement of services by 44% over baseline, 90-day readmissions by
56%, and over-90-day readmissions by 24%
• Reduced 30-day readmissions at the COPD clinic by 21%
• Provided follow-up care from care managers at the AHS-sponsored
respite home to 27 patients
• Established training program for volunteer health coaches at the
Healthy Hearts Clinic
• Conducted 439 admission consults with medication reconciliation;
68 discharge clinic consults (correcting 10 patient safety problems);
1,031 post-discharge interventions, including 391 home/shelter visits;
164 patient education interventions; 175 refill authorizations; and
resolution of 82 insurance issues from program pharmacists
Wellness Centers: Newark, Eastmont, Hayward, Highland
• Expanded specialty care services at Newark Wellness, including
psychiatry, mammography, early oral preventive pediatric care services,
and prenatal centering program
• Relocated Hayward Wellness to Southland Mall to accommodate 36
2013-2014 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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new exam rooms; over 23,000 square feet; and an expected 50,000
annual visits for specialties such as optometry, podiatry, nephrology,
cardiology, psychiatry, acupuncture, nutrition, and health education
classes
• Expanded specialty care services at Eastmont Wellness to
accommodate 16 exam rooms; 6,600 square feet; and up to 40,000
additional expected annual visits, and expand services to offer a multi-
use clinic, orthopedic cast room, podiatry, urology, endocrinology,
ophthalmology, optometry, and rheumatology specialties
• Increased adult medicine, women, and pediatric patient encounters at
Oakland-based clinics (Highland and Eastmont) by 13% over the FY
10/11 baseline, for a total of 133,914 encounters
• Expanded “Centering Pregnancy” program to three Wellness Centers
• Established a “Baby-Friendly” Community Clinic at Eastmont Wellness,
including new remote equipment that enables tele-lactation support
• Trained 85% of adult medicine staff, providers, and residents in
population health management, including preventive screening for
breast cancer, diabetes, and other diseases
• Enrolled 102 children and 77 families in AHS’s childhood obesity
prevention program, Bite to Balance
• Upgraded the Electronic Health Record (EHR) system at Hayward,
Newark, and Eastmont Wellness to a new version with features to
improve the efficiency and quality of care
John George Psychiatric Hospital
• Achieved an employee engagement response rate of 91%
• Maintained seclusion-restraint incidents for inpatient services below
the community standard of 5 or fewer per 1,000 patient days, with 4.0
incidents per 1,000 patient days
• Maintained seclusion-restraint incidents for emergency services at 5.3
incidents per 1,000 patient visits, one of the lowest rates in the United
States compared to approximately 145 incidents per 1,000 patient visits
shown at other psychiatric hospitals
• Implemented Alternative Interventions Champions, a multi-
disciplinary group of staff experts who developed a half-day education
program and competency, and delivered it to entire JGPH staff resulting
in a 40% decrease in 1:1’s (sitters)
• Sustained best practice at 18 minutes for the amount of time in which
an ambulance can complete the patient drop-off and return to the field
• Sustained an average length of stay within the industry best practice
benchmark of 7.5-8.5 days
Fairmont Hospital
• Provided acute inpatient rehabilitation services to 20 patients per day,
while the skilled nursing facility had an average daily census of 101
patients
• Began design of the Rehab Healing Garden
• Provided a robotics exoskeleton unit at the physical therapy gym to
Measure A Helps
Mr. B., 27, had AIDS, hepatitis B,
tuberculosis, and secondary syphilis.
The RN Care Manager told Mr. B’s
mother to bring him immediately to
the Highland Hospital ED. The RN
followed the man throughout his
hospitalization, introducing him to
HIV services and other needed clinics
such as the Chest Clinic. Mr. B has not
been re-hospitalized in an eight-month
period. He is now employed, adheres to
his medication regimen, and regularly
attends his medical appointments. The
RN Care Manager believes this success
story is the result of inpatient teaching,
navigating the patient through the
system for his multiple health care
needs, and engaging him in the
importance of self-care.
2013-2014 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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enable stroke patients and those with lower limb disabilities, including
paraplegia as a result of spinal cord injury (SCI), to perform self-
initiated standing, walking, and turning
• Made an additional seven beds available for the Neuro-Respiratory Unit
San Leandro Hospital
• Projected $6.3 million in additional net revenue as a result of increased
volume
• Achieved a 19% increase in average weekly operating room surgical
volume
• Improved the average daily ED census by 18%
• Reduced the number of patients left without being seen by 77%
• Reduced the patient arrival-to-discharge times in the ED by 32%
• Reduced operating room turnover times by 75%
• Reduced arrival-to-provider time in the ED by 61%
• Established “daily/weekly operating report” with key performance
indicators
• Collected and collated regional market data to provide a comprehensive
understanding of how San Leandro is serving the needs of the market
and what needs the hospital is not filling
• Established benchmarks to identify appropriate staffing levels to help
increase patient satisfaction during high volume hours
• Established performance reviews at the department and executive
levels
• Executed monthly/weekly compliance audits
Alameda Hospital
• Affiliated with AHS on May 1, 2014, adding 281 beds (acute, sub-acute,
skilled nursing), 200 physicians, and 100 volunteers serving a greater
community of 100,000 people
• Gradually increased Emergency Care Center volume and maintained
door-to-doctor times at 30 minutes, well below the national average
• Treated approximately 1,800 patients at the Kate Creedon Center for
Advanced Wound Care since its opening in July 2012, with a nearly 90%
complete healing rate for chronic wounds
CONCERNS
In describing its program accomplishments, AHS often does not provide
measurable objectives, making it difficult to get a sense of progress from
the prior year. The Committee notes that this feedback has been offered
for several years to AHS/Alameda County Medical Center.
San Leandro Hospital
achieved a 19%
increase in average
weekly operating
room surgical volume
and improved the
average daily ED
census by 18%.
2013-2014 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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FY 13/14: 25% OF MEASURE A FUNDS ALLOCATED BYThe Alameda County Board of Supervisors
In FY 13/14, the Board of Supervisors (Board) approved approximately $33.6 million in total Measure A allocations. The
Board allocations are listed by group in the following chart.
NOTE: Since most of the allocations are approved by the Board before and during each fiscal year based on sales tax revenue
projections, the total allocation amount may not equal the actual revenue received. For more details on Board allocations, see
Appendix B: FY 13/14 Budget Information and Appendix C: FY 13/14 Measure A Fund Distribution by Provider or Program.
This list may include allocations that were approved by the Board but not expended by the end of the fiscal year.
MEASURE A FUNDING APPROVED BY THE BOARD OF SUPERVISORS IN FY 13/14
TOTAL MATCHING FUNDS OBTAINED BY LEVERAGING MEASURE A ALLOCATIONS
23.8%
18.3%33.5%
24.4%
Group 4: Public Health
$7,503,837
Group 1: Behavioral Health
$8,314,763
Group 2: Hospital, Tertiary Care, Other
$6,400,000Group 3: Primary Care
$11,353,279
Measure A Allocation MatchingFunds
$33,571,879
$21,748,160
2013-2014 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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FUNDS ALLOCATED BY THE ALAMEDA COUNTY BOARD OF SUPERVISORS
GROUP 1: BEHAVIORAL HEALTH
Asian Health Services (Bantreay Srei) ..........................................................................................................23
Behavioral Health and Alcohol and Other Drug (AOD) Community ............................................................25
Center for Empowering Refugees and Immigrants......................................................................................26
Center for Healthy Schools & Communities (School-Based Behavioral Health Initiative) ...........................27
Chabot/Las Positas Community College ......................................................................................................31
Criminal Justice Screening and In-Custody Services ....................................................................................32
Detoxification/Sobering Center ...................................................................................................................35
G.O.A.L.S. for Women, Inc. ..........................................................................................................................36
La Familia Counseling Services ....................................................................................................................38
Mental Health Services for Juvenile Justice Center .....................................................................................39
National Alliance on Mental Illness (NAMI) Tri-Valley .................................................................................40
Safe Alternatives to Violent Environments (SAVE) ......................................................................................42
Senior Support Program of Tri-Valley ..........................................................................................................43
Tri-Valley Haven for Women ........................................................................................................................44
Youth Alive! .................................................................................................................................................45
2013-2014 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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BACKGROUND
Banteay Srei is a youth development, asset-building organization that
is nonjudgmental of young Southeast Asian women who are at risk of
or engaged in the underground sex trade. Banteay Srei seeks to provide
the resources that support women’s healthy development through self-
empowerment and self-determination.
Banteay Srei believes in providing young women at risk of or currently
impacted by sexual exploitation with holistic services. Banteay Srei’s youth
development/after-school programs provide young Southeast Asian and
Asian American women with the safe spaces that promote sex-positive
education, community-building activities, leadership development, and
peer and intergenerational support. The culturally relevant programs
foster cultural pride, a stronger support system, and self-determination.
Banteay Srei also serves as a gateway to health.
MEASURE A FUNDING SUMMARY
With the support of Measure A funds, Banteay Srei has achieved the
following during FY 13/14:
• Conducted 39 weekly peer health educational workshops for 28
Southeast Asian young women to promote leadership development,
establish peer support networks, and enhance family support.
• Led three community workshops to engage the larger community/
neighborhood in developing positive alternatives for young women and
young people at risk.
• Provided 43 leadership trainings for five Southeast Asian youth leaders.
The youth leaders conducted the 39 peer health workshops mentioned
above.
• Delivered 10 presentations/trainings on topics of CSEC health
screening, awareness of CSEC patterns or recruitment, and
recommendations of supporting at-risk or sexually exploited young
women. Banteay Srei has presented to over 400 local community
members and both local and national service providers and health
advocates.
Allocation: $25,000 | Expended/Encumbered: $25,000
Individuals served by Measure A: 33 (Total individuals served: 33)
Populations served: Low Income Children, Seniors
Services provided: Public Health, Mental Health
Service area: Oakland
Asian Health Services (Bantreay Srei)
www.asianhealthservices.org
Measure A Helps
A committed participant of Banteay
Srei became sexually exploited after
meeting a man she first encountered
on social media. She was able to get
herself out of the situation and back
home safely. She declined mental health
services from a therapist and instead
sought out Banteay Srei for peer and
intergenerational group support, where
she felt safe and gained knowledge of
women’s health and empowerment.
Through Banteay Srei, the young
woman accessed Asian Health Services
Youth Program’s Teen Clinic for
reproductive health. With the support
of Banteay Srei, the woman graduated
high school and started community
college.
2013-2014 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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• Supported 15 young Southeast Asian women to access academic
support, housing, mental/medical health, and career development
services.
These efforts helped lead to the following outcomes:
• All 33 young women served by the program reported that:
- They have built their self-confidence, learned more about caring for
their bodies, are proud of their culture, and believe they can make a
difference.
- Banteay Srei has provided them with tools to make healthy decisions,
build healthy relationships, and speak up more about issues that
impact them.
- They are aware of where to go to access medical and mental health
services.
• In addition, all 33 signed up for FPACT/Minor Consent.
• 13 young women accessed services with Asian Health Services’ Teen
Clinic and/or with mental health services partners.
• Four were re-enrolled in school or a GED program.
• Four have graduated high school and are college tracked.
• Six young women found jobs.
Highlights
All Banteay Srei participants reported
improvement in a wide variety of
areas related to self-esteem and self-
confidence.
Banteay Srei used Measure A funds to
support their annual Claws for a Cause
Fundraiser, which raised $3,600.
2013-2014 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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BACKGROUND
Alameda County Behavioral Health Care Services (BHCS) works to
maximize the recovery, resilience, and wellness of all eligible Alameda
County residents who are developing or experience serious mental health,
alcohol, or drug concerns.
Community-based organizations (CBOs) provide mental health and
substance use disorder services under contract with BHCS to meet the
diverse cultural and language needs of County resident populations.
MEASURE A FUNDING SUMMARY
The BHCS-contracted CBOs used Measure A funds to provide a broad
array of mental health and substance use disorder services, ranging from
outreach to intensive programs, in multiple geographic areas across the
county. Measure A funds have helped mitigate budget cuts and the lack
of cost-of-living adjustments (COLAs), which would have resulted in
program cuts. Measure A funds have also helped offset the impact of
reductions in funding, thereby contributing to system stability.
The use of Measure A funds to mitigate budget cuts allowed providers
to serve approximately the same number of County residents in alcohol
and other drug (AOD) programs, despite unavoidable cost increases for
insurance, utilities, and other non-service-related operational expenses.
These additional funds contributed to significant client-level outcomes,
such as service continuity, outreach effectiveness, and client engagement
in treatment objectives that would be put at risk by cutbacks in provider
service capacity.
Allocation: $738,480 | Expended/Encumbered: $738,480
Individuals served by Measure A: 7,500 (Total individuals served: 44,000)
Populations served: Indigent, Low Income, Uninsured Adults, Children, Seniors
Services provided: Mental Health, Substance Abuse
Service area: Countywide
Behavioral Health and Alcohol and Other Drug (AOD) Community
www.acbhcs.org
Highlights
Compared to the preceding year,
FY 13/14 saw a decline of only 2% in
both the number of clients served and
number of services delivered. Given
County General Fund reductions of 10%
and a cost of living increase of 2.4% for
that period, Measure A support was
very effective in stabilizing services.
Matching Funds
BHCS-contracted CBOs leveraged
their Measure A allocations to obtain
$19,706 in matching funds from Medi-
Cal and the Medi-Cal Administrative
Activities (MAA) program.
Measure A
Allocation
Matching
Funds
$738,480
$19,706
2013-2014 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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BACKGROUND
The Center for Empowering Refugees and Immigrants (CERI) is a
grassroots, nonprofit organization dedicated to providing culturally
competent mental health and other social services to refugee and
immigrant families with multiple layers of complex needs, exposure to
violence and trauma both in their current environment and in their native
countries, and weakening intergenerational relationships. CERI works to
improve the social, economic, and psychological health of refugees and
their families affected by war, torture, or other forms of extreme trauma.
MEASURE A FUNDING SUMMARY
With its Measure A funding, CERI offered four to six groups per week
to youth of various ages. The groups provided social and emotional
support and introduced the youth to a variety of activities to enhance self-
esteem and improve family and social relationships. CERI also provided
tutoring, case management, nonviolent communication mentoring, and
sponsorship of fun activities in the community.
Specifically, CERI used its Measure A allocation to achieve the following:
• Community-wide events with outreach to at least 50 individuals (target:
8 events; actual: 10 monthly potlucks plus a community event with over
100 attending)
• Support groups, including life skills classes, art, and other
nontraditional mental health prevention activities (target: 4 ongoing
groups serving 5–12 children and youth at each group; actual: 3
ongoing groups serving 5–10 participants at each group, plus 3 short-
term groups)
• Consultation and/or training for community-based organizations
(CBOs) (target: 2 trainings; actual 2 trainings)
• Early intervention for individuals and families including short-term,
low-intensity interventions (target: 40 hours to at least 4 individuals;
actual: no youth enrolled in the early intervention program; 8
individuals did receive 50 hours of one-on-one interventions)
Allocation: $76,500 | Expended/Encumbered: $76,500
Individuals served by Measure A: 24 (Total individuals served: 48)
Populations served: Low Income, Uninsured Children, Families
Service provided: Mental Health
Service area: Oakland, Union City
Center for Empowering Refugees and Immigrants
cerieastbay.org
Measure A Helps
A homeless young woman who
was involved in a violent domestic
relationship was shot last year. CERI
connected her to a program that helps
homeless adults in Oakland find
emergency and permanent housing. At
the time of this report, the woman is
connected to permanent housing, has
ended the violent domestic relationship,
and is working.
Matching Funds
CERI leveraged its Measure A
allocation to obtain $76,500 in
matching funds from the Mental
Health Services Act (MHSA).
Measure AAllocation MatchingFunds
$76,500 $76,500
2013-2014 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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BACKGROUND
The Center for Healthy Schools and Communities (CHSC) works to foster
the academic success, health, and well-being of Alameda County youth
by building universal access to high quality supports and opportunities
in schools and neighborhoods. The Center focuses its programs on five
specific result areas:
• Children are physically, socially, and emotionally healthy.
• Children succeed academically.
• Environments are safe, supportive, and stable.
• Families are supported and supportive.
• Systems are integrated and care is coordinated and equitable.
Co-coordinated by CHSC and the Alameda County Behavioral Health
Care Services (BHCS) Agency, the Alameda County School-Based
Behavioral Health Initiative strives to strengthen and expand school-based
behavioral health practice, finance, evaluation, and policy in Alameda
County. In partnership with school districts and service providers, the
Initiative works to deliver a continuum of school-based behavioral health
supports to students in schools throughout Alameda County.
CHSC and BHCS used their Measure A allocation to enhance two core
programs of the Alameda County School-Based Behavioral Health
Initiative: the Our Kids Our Families Program, and the School District
Consultation program.
• The Our Kids Our Families program, provided at 29 school sites in
the Hayward and Oakland Unified School Districts, is a school-based
behavioral health program that fosters social-emotional wellness
in an educational environment so that children and families feel
connected, safe, and supported in school. The Our Kids Our Families
program supports prevention efforts at the school sites, as well as early
intervention and treatment services for any student and their family
that needs it.
Allocation: $603,100 | Expended/Encumbered: $603,100
Individuals served by Measure A: 3,064 (Total individuals served: 3,064)
Populations served: Indigent, Low Income, Uninsured Adults, Children, Families
Services provided: Mental Health, Substance Abuse
Service area: Ashland, Cherryland, Dublin, Emeryville, Hayward, Livermore, Newark, Oakland, Pleasanton, San Leandro, San Lorenzo, Union
City, Homeless or transient
Center for Healthy Schools & Communities
(School-Based Behavioral Health Initiative)
achealthyschools.org
Measure A Helps
A 17-year-old student was referred for
services for being angry, yelling, and
hitting school property. The student
planned to join the military, which
would require him to return to and
graduate from his comprehensive
high school. The student and
consultant discussed the behavior
he would need to show to return to
the school. Together they determined
what triggered his anger and set
up a plan for either avoiding these
triggers or addressing his anger if he
is triggered. The student was able to
use the plan effectively and return to
the comprehensive high school. He is
expecting to graduate and then begin
his military career.
2013-2014 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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• The School District Consultation program places behavioral health
consultants (BHCs) in school districts to provide and enhance
preventive social-emotional supports and mental health services
for students and their families. The BHCs conducted the following
activities:
- Assessed the social-emotional service needs and infrastructure of a
school district or set of schools and developed a service plan
- Coordinated the work of all partner agencies who deliver behavioral
health services in schools and districts
- Provided and/or coordinated clinical case management, group, and
individual counseling to students
- Provided workshops, parenting groups, and mental health and other
appropriate consultation to parents/caregivers; linked parents/
caregivers with needed resources in the school and community;
supported school and school district efforts to engage and support
families in meaningful and positive ways
- Provided crisis assessment and intervention for students, supported
schools in effective crisis response, and supported school districts in
developing crisis response protocols
- Provided clinical supervision to interns and/or actively participated
in intern recruitment and placement
- Conducted planning to develop service referral and coordination
systems
- Provided behavioral health consultation to district/school staff to
strengthen connections between students and adults
- Conducted psycho-education for administrators, teachers, school
staff, parents, students, and community partners
- Participated in district- or school-wide efforts to create a positive
climate, prevent conflicts and violence, and enhance the community
setting for all members
- Developed or coordinated leadership and other opportunities for
children/youth that allow them to participate meaningfully in their
school
- Expanded partnerships with County, city, and/or community-based
organizations to fill service gaps
- Worked to become more integrated into the school district’s
operational systems
Highlights
Parent surveys reported a high
level of satisfaction. Parents saw
improvements in their children’s
ability to handle school and daily
life, resolve problems, and interact
positively with peers and adults.
Parents also reported having a support
network to assist them in dealing with
their child’s behavioral problems.
The majority of parents reported
that the parent/family engagement
events were useful and informative,
addressed their needs, and increased
their knowledge and parenting skills.
Middle school students who had
received behavioral health services
reported that those services were
extremely helpful in improving
their ability to handle daily life, get
along better with friends and family
members, and succeed in school.
A district-specific assessment of the
six CFE domains found that Hayward
students demonstrated significant
improvement in each of the six
domains of the CFE when comparing
intake to discharge, while Oakland
students demonstrated significant
improvement in five of the six
domains.
2013-2014 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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MEASURE A FUNDING SUMMARY
The School-Based Behavioral Health Initiative used its Measure A
allocation to achieve the following objectives through the District
Behavioral Health Consultation program.
Increase access to behavioral health supports for students and their
families in eight school districts in Alameda County
Measure A funding has been instrumental in helping expand to previously
underserved school districts in the County, specifically the following:
• Emery Unified
• Newark Unified
• New Haven Unified
• Dublin Unified
• Livermore Valley Joint Unified
• Pleasanton Unified
• San Leandro Unified
• Hayward Unified
Address the behavioral health support needs of students
As measured by the Community Functioning Evaluation (CFE)
administered to all students receiving early intervention and treatment
services under the School-Based Behavioral Health Initiative, services
delivered and/or coordinated by BHCs yielded positive results. At intake
and discharge, school-based providers and BHCs assess their clients on six
common problem areas:
• Academic functioning
• Social relationships
• Exposure to violence/challenging environments
• Emotional and behavioral functioning
• Health/basic needs
• Living arrangements and basic functioning
The Our Kids Our Families Intern Program supervised a total of nine
social work and MFT interns. The intern programs enabled Our Famlies
Our Kids to increase service capacity and service access for students and
their families.
Strengthen the use of evidence-based practices along a continuum of
behavioral health supports that includes prevention, early intervention,
and treatment
BHCs in all eight school districts are responsible for planning and/or
implementing evidence-based prevention programs that promote social/
emotional learning and development (SEL) learning in students and SEL
application in adults, including the following:
• Positive behavioral interventions and supports
Matching Funds
The School-Based Behavioral Health
Initiative leveraged its Measure A
allocation to obtain $4,581,118 in
matching funds from the following
sources:
• Early Periodic Screening, Diagnosis,
and Treatment (EPSDT) funding:
$503,100
• Tobacco Master Settlement Fund
(TMSF)/CHSC discretionary :
$1,513,112
• Medi-Cal Administrative Activity
(MAA): $850,000
• Mental Health Services Act
Prevention/Early Intervention
Program: $1,167,332
• City of Oakland, Oakland Unite:
$200,000
• School District funding: $347,574
Measure A
Allocation
Matching
Funds
$603,100
$4,581,118
2013-2014 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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• Restorative justice
• Mental health consultation with teachers, staff, parents, and students
In addition, BHCs worked to strengthen the quality of early intervention
and treatment programs in all school districts. BHCs in all districts either
directly provided crisis response services or coordinated crisis response.
Implement consistent criteria, procedures, and practices for behavioral
health assessments, referrals, and linkages in the schools
BHCs support the implementation of Coordination of Services
Teams (COST) in the schools. COST is an evidence-based model for
coordinating care at a school site. The multidisciplinary COST works
together to do the following:
• Use referrals and data-driven screenings to identify students who are
struggling
• Deliberate strengths and challenges
• Assess supports needed
• Help implement interventions
• Monitor progress and provide appropriate follow-up
• Identify the broader learning support resource needs of the school
• Make recommendations about resource allocation
In six of the eight school districts supported under this program,
considerable progress was made toward strengthening and expanding
COST in FY 13/14.
BHCs support the
implementation of
Coordination of
Services Teams
in the schools.
2013-2014 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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BACKGROUND
Chabot/Las Positas Community College works to strengthen student
learning, retention, and success. They accomplish this by supporting the
physical, emotional, and social well-being of students through accessible,
high quality health services and activities.
A licensed marriage and family therapist (MFT) and a marriage family
therapy intern are contracted to provide services through the Las Positas
College Student Health and Wellness Center.
MEASURE A FUNDING SUMMARY
Chabot/Las Positas Community College used its Measure A allocation to
achieve the following:
• Provide immediate interventions to eight students in emotional crisis
following the Las Positas College Mental Health Emergency guidelines
with the mental health crisis response team
• Provide 20–28 hours of marriage and family therapy per week to 61
clients, for a total of 457 visits
• Provide 42 mental health community referrals
• Provide psychiatric referrals as needed for medication evaluation,
treatment, and management
Allocation: $20,000 | Expended/Encumbered: $19,396
Individuals served by Measure A: 111 (Total individuals served: 11,899)
Populations served: Indigent, Low Income, Uninsured Adults
Services provided: Mental Health
Service area: Countywide
Chabot/Las Positas Community College
clpccd.org
Measure A Helps
K.L. is a 29-year-old Korean student
attending Las Positas College. She
came to the Health and Wellness
Center and told the nurse that she was
depressed and had suicidal thoughts.
Staff recommended K.L. be seen by a
psychiatrist to provide a medication
evaluation and possible medication.
She agreed to visit a free walk-in
psychiatric clinic where should could
be assessed by a psychiatrist and
prescribed medication the same day.
Staff also explained how she could seek
help herself in the future by going to
any hospital with an emergency room,
calling Alameda County’s 24-hour
crisis line by dialing 911, or coming to
the health center.
2013-2014 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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BACKGROUND
Alameda County Behavioral Health Care Services (BHCS) works to
maximize the recovery, resilience, and wellness of all eligible Alameda
County residents who are developing or experience serious mental health,
alcohol, or drug concerns.
A program of BHCS, Criminal Justice (CJ) Screening/In-Custody Services
provides a full range of mental health services to approximately 1,200
County jail inmates every month. An estimated 16% of inmates have
serious mental illnesses. Without jail mental health services, mentally ill
inmates would go untreated.
MEASURE A FUNDING SUMMARY
BHCS used its Measure A fund allocation to maintain staff at CJ
Screening/In-Custody Services who provided assessment of all inmates
and improved care by ensuring timely access to medications and reduced
potential medication abuse at Santa Rita Jail. To deliver mental health
services effectively, mental health staff were assigned to various areas
of the jail: intake (booking), inmate housing units, and the clinic. Staff
worked in the intake section of the jail seven days a week, two shifts
per day.
Specific services supported by Measure A include the following.
Mental Health Screening
• Initial (Intake). At the time of booking, all inmates are screened
for medical and psychiatric treatment needs. Within 14 days, staff
conducts an additional mental health appraisal. Inmates found to need
a further mental health evaluation are referred to CJMH. The screening
assessment includes an evaluation of the inmate’s current psychiatric
condition, psychiatric history, substance abuse (addictions) history
and current use, psychiatric medication history and current need for
medications, suicide history and current risk factors, and more.
• Post-booking. Criminal Justice Mental Health (CJMH clinicians triage
and screen all referred inmates for mental health service needs and
recommend appropriate treatment plans based on the assessment.
Allocation: $4,306,000 | Expended/Encumbered: $4,306,000
Individuals served by Measure A: approximately 2,971 (Total individuals served: 4,872)
Populations served: Indigent, Low Income, Uninsured Adults, Seniors
Services provided: Hospital Inpatient, Mental Health
Service area: Countywide
Criminal Justice Screening and In-Custody Services
Highlights
The jail’s suicide prevention program,
a collaborative effort between mental
health and other staffs, has resulted
in a significant decrease in inmate
suicides.
At the time
of booking,
all inmates are
screened for medical
and psychiatric
treatment needs.
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Crisis Intervention
• Onsite. CJMH clinicians respond to urgent calls regarding
seriously distressed inmates and provide crisis counseling, make
recommendations for interventions, initiate interim placements, and/or
make arrangements for psychiatric hospitalization.
• On-call. When there are no mental health staff onsite, a CJMH clinician
is on call and can be reached by pager to assist with urgent mental
health matters.
Management of Inmate Behavioral Problems
CJMH clinicians collaborate with and provide consultation to deputies
and staff to develop and implement plans for appropriate management of
inmate behavioral problems.
Suicide Prevention
CJMH participates with sheriff’s personnel and medical staff in training,
oversight, and procedures designed to prevent inmate suicides. At the
time of booking, all inmates are assessed for suicide risk. In addition,
CJMH conducts a suicide risk assessment on all inmates called to
their attention as a result of inmates expressing suicidal thoughts or
demonstrating self-injurious behaviors. CJMH staff work with inmates
who demonstrate a risk for suicide and address risk factors, develop
relapse prevention strategies, and discuss coping strategies.
Ongoing Treatment Services, Treatment Planning, Stabilization of
Mental Disorders, and Other Services
All inmates receiving mental health services are seen by CJMH clinicians,
who develop individualized treatment plans to help inmates achieve
mental stability, develop an awareness of their psychological and
behavioral problems, and acquire coping skills while incarcerated.
• Medication support services. When appropriate, CJMH psychiatrists
evaluate inmates and prescribe psychotropic medications to alleviate
symptoms and allow the inmates to achieve an optimal level of
functioning while incarcerated.
• Counseling services. Inmates referred for counseling services receive
an additional post-booking assessment and are provided ongoing
counseling sessions as determined by their treatment plan.
• Misdemeanant incompetents. With regard to misdemeanant
Incompetent to Stand Trial (PC 1370.01) inmates, CJMH staff
collaborate with the courts to provide treatment geared to restoring
competence and/or refer inmates to community programs that can
address competency.
• Court-ordered evaluations. CJMH clinicians conduct court-ordered
psychiatric evaluations (PC 4011.6s) to assess the need for acute
inpatient psychiatric care and provide reports back to the courts.
• Inpatient services. CJMH staff or deputies send inmates requiring acute
inpatient hospitalization to acute psychiatric inpatient hospitals. When
inmates are returned to the jail, they are held in the Outpatient Housing
Measure A Helps
Mr. M., a 51-year-old homeless
veteran, was arrested on misdemeanor
charges and found incompetent to
stand trial due to serious mental
illness. Mr. M. had not been
participating in community treatment
and had been kicked out of his board
and care home. He initially refused
all mental health services in the
jail, but with engagement efforts
made by jail mental health, Mr. M.
gradually agreed to take his psychiatric
medications. The psychiatrist was
able to adjust Mr. M’s medications
over time, and he became much more
stable. Mr. M. was transferred to
Villa Fairmont, where he is doing well
and will likely be discharged when he
completes the program.
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Unit (Infirmary) until CJMH clinicians can assess them, continue their
medications, and clear them for housing
• Inmates who refuse treatment. All treatment is voluntary. CJMH staff
monitor inmates with serious mental illnesses who refuse treatment
and make an ongoing attempt to engage these inmates in treatment.
• Outreach and teamwork. CJMH clinicians and psychiatrists closely
monitor inmates in Special Housing Units—Ad Seg, Mental, Women’s.
Visits occur several times a week, including cell checks for inmates who
refuse to be seen or who are noncompliant with treatment.
• Substance abuse treatment. Inmates have access to programs that
specifically address addiction problems. CJMH clinicians also address
substance abuse as part of their ongoing interventions with inmates.
Mental Health On-Call/Emergency Services
Emergency mental health services are available 24 hours a day by onsite
staff or by mental health professionals who work on call. Access to 24-
hour acute psychiatric hospitalization is available. A CJMH psychiatrist is
on call to accommodate the continuity of psychotropic medications.
Discharge Planning/Continuity of Care
When CJMH staff have advance notice of an inmate’s date of release,
staff make a referral for follow-up outpatient treatment. CJMH staff work
closely with court mental health advocates the Court Advocacy Project
(CAP), the Forensic Assertive Community Treatment (FACT) team, the
Behavioral Health Court (BHC), and community service providers in
coordinating treatment plans and release plans for persons in custody
with serious mental illnesses.
Training
The CJMH Director, the Senior Clinician(s), and other mental health
professionals provide training to sheriff’s personnel and civilian staffs
in mental illnesses and suicide prevention. All new CJMH staff receive
40 hours of initial training. CJMH managers and psychiatrists provide
ongoing training to CJMH line staff in topics related to the practice of jail
psychiatric services.
Administration of Psychotropic Medications to Patients in a Psychiatric
Emergency
Psychiatrists can legally prescribe psychotropic medication for emergency
situations. The CJMH Lead Psychiatrist attends the monthly BHCS
Psychiatric Practices Committee and shares information learned with
other CJMH psychiatrists.
Inmates have access
within the jail to
programs that
specifically address
addiction problems.
CJMH staff work
with inmates who
demonstrate a risk for
suicide and address
risk factors, develop
relapse prevention
strategies, and discuss
coping strategies.
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BACKGROUND
The Detox/Sobering Center works to maximize the recovery, resilience,
and wellness of all eligible Alameda County residents who are developing
or experience serious mental health, alcohol, or drug concerns.
The Detox Center is a social model nonmedical detoxification center
specifically designed for individuals requiring 24-hour/7-day-a-week
monitoring. It offers van transport for individuals needing transportation
to and from medical, psychiatric, treatment, housing, or any other
ancillary service. These services allow clients to fulfill all admission
requirements for their next level of treatment.
The Sobering Center is designed to assist those needing immediate
sobering services from alcohol/drugs. It provides a brief visit of 23 hours
or less with continual monitoring for safe withdrawal, 24 hours per day,
seven days per week. Within the Sobering Center, the Health Center is
staffed with nurse coordinators who monitor withdrawal and assist with
medical triage/assessment to ensure safe and healthy withdrawal. The
center also provides TB tests and referrals to medical/psychiatric services
for all individuals as needed.
MEASURE A FUNDING SUMMARY
Measure A provides 100% of the funding to Cherry Hill Detoxification
Services Program/Horizon Services, Inc., the sole provider of the Detox/
Sobering Center.
With this funding, the Detox/Sobering Center achieved the following
measurable outcomes:
• Cherry Hill Sobering Center provided 4,679 units of service.
• The Detox Center provided 2,194 units of service.
• The Health Center provided 720 services to existing clients.
• Law enforcement leadership and officers attended bi-monthly trainings
in groups of 25-30 for training, education, and orientation around the
Detox/Sobering Center’s programs and services.
Allocation: $2,040,000 | Expended/Encumbered: $2,040,000
Individuals served by Measure A: 6,873 (Total individuals served: 6,873)
Populations served: Indigent, Low Income, Uninsured Adults, Seniors
Services provided: Substance Abuse
Service area: Countywide, Outside of Alameda County
Detoxification/Sobering Center
Measure A Helps
A 40-year-old male client has a 25-year
history of multiple substance abuse.
He also has a history of trauma, having
witnessed his uncle’s suicide at age
10. The client did not want to come to
Cherry Hill; however, he was forced by
his family. The client gradually became
less resistant to treatment, and agreed
to have a mental health assessment
regarding his childhood trauma. As the
days passed, the client became willing
to go to residential treatment for one
year. His father stated, “I don’t know
what magic you do here at Cherry Hill,
but this is the first time I’ve spoken to
my son in 10 years.”
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BACKGROUND
G.O.A.L.S. for Women works to ensure that no and very low income
women, children, and families (including men and boys) who identify
with the African American experience have access to free, culturally
competent, and responsive peer and clinical mental health counseling,
case management, and support services in their local neighborhoods, at
the right time and in the right dose/intensity/duration to reduce/eliminate
suffering, prevent conditions from worsening, and support wellness and
recovery.
Users of G.O.A.L.S. services are primarily disadvantaged and trauma-
surviving African American women (mostly single women, some pregnant
and parenting or of child-bearing age). Another moderate percentage
of participants are older adults and grandparents raising grand-
children. Services are provided both in the G.O.A.L.S. South Berkeley
neighborhood-based outpatient clinic and at various locations throughout
the County through targeted outreach at special events. Services are
specifically focused on reducing psychological distress, building stress
management and coping skills, reducing prolonged suffering/isolation,
and building social connections while reducing the stigma and mistrust of
seeking mental health-related care.
Many participants do not have a usual source of primary care (although
most have Medi-Cal) or have not previously experienced the benefits of
obtaining culturally appropriate mental health services and supports.
Some participants have serious physical health conditions and require
advocacy to access primary care or SSI.
MEASURE A FUNDING SUMMARY
Measure A funds enabled G.O.A.L.S. for Women to provide ethnically
appropriate mental health outpatient assessment, counseling , case
management, supportive peer group services (Kitchen Table Talks),
mental health and wellness education, referrals to other services including
insurance coverage, mentoring, coaching, and suicide prevention.
Allocation: $50,000 | Expended/Encumbered: $50,000
Individuals served by Measure A: 55 (Total individuals served: 147)
Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors
Services provided: Mental Health
Service area: Berkeley, Hayward, Oakland
G.O.A.L.S. for Women, Inc.
goalsforwomen.com
Highlights
Across service areas, 100% of
clients receiving services report
improvements in self-esteem,
reduction in stigma, and other
positive changes.
Matching Funds
G.O.A.L.S. for Women leveraged
its Measure A allocation to obtain
$91,250 in matching funds from a
private foundation.
Measure AAllocation MatchingFunds
$50,000
$91,250
2013-2014 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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The G.O.A.L.S. clinic is not authorized to bill Medi-Cal, so they would not
have been able to serve and support clients without Measure A funding.
G.O.A.L.S. for Women used its Measure A allocation to achieve the
following:
• Provide culturally appropriate mental health and Medi-Cal enrollment
outreach, education, and consultation and reduce risk for onset of
mental illnesses, prolonged suffering , and stigma and discrimination.
G.O.A.L.S. facilitated drop-in, telephone, and text message requests
for mental health support and offered appointments during the day,
evenings, and weekends (target: 35 unduplicated community members;
actual: 56).
• Provide culturally appropriate mental health screenings (target: 20
community members; actual: 28).
• Provide culturally appropriate mental health assessments and
engagement, which includes screening utilizing an African-American-
sensitive general anxiety checklist and cultural idiom of distress
common in African-American populations meeting medical necessity
for mental health intervention (target: 10 community members; actual:
11).
• Provide free individual and/or clinical group counseling (target: 8
community members; actual: 11).
• Provide referrals to other needed health, housing, or other social
services on an as-needed basis (actual: 8 referrals).
• Provide culturally appropriate drop-in Kitchen Table Talks, which are
peer/cultural support groups (target: 10 community members;
actual: 22).
Measure A Helps
In a letter to Alameda County
Supervisors and Health Care
Services Agency staff, a G.O.A.L.S.
client writes:
I have been a G.O.A.L.S. client for
2 ½ years. I had been searching for an
African-American support system that
would make me feel at ease with the
issues I was addressing. I have been
carrying a load of stress all alone for
so long, and this organization came
into my life at a very critical point.
I feel that G.O.A.L.S. for Women is
critical to the well-being of African
American women and our families.
Being a college student studying to
become a social worker and give back,
G.O.A.L.S. has been a foundation for
me to make that dream a reality.
2013-2014 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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BACKGROUND
La Familia Counseling Service is an inclusive, Latino community-based,
multicultural organization committed to strengthening the emotional
wellness of individuals and the preservation of families.
MEASURE A FUNDING SUMMARY
La Familia used its Measure A allocation to conduct mental health-
related workshops. The workshops were based on the National Alliance
on Mental Illness (NAMI) Mental Health Curriculum and Healthy
Relationships of California. Topics included working and communicating
with family members who have mental health issues.
Allocation: $12,000 | Expended/Encumbered: $12,000
Individuals served by Measure A: 3,174 (Total individuals served: 3,174)
Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors
Services provided: Public Health
Service area: Ashland, Cherryland, Hayward, San Leandro, San Lorenzo
La Familia Counseling Services
lafamiliacounseling.org
2013-2014 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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BACKGROUND
Alameda County Behavioral Health Care Services (BHCS) offers mental
health services to youth at the Alameda County Juvenile Hall in an effort
to maximize the recovery, resilience, and wellness of those who develop or
experience serious mental health, alcohol, or drug concerns. The services
provided consist of individual therapy, case management, court-ordered
evaluations, crisis intervention, and consultation to Juvenile Hall staff,
probation officers, and the Juvenile Court.
Youth who are detained in Juvenile Hall by nature of being in a locked
facility away from family and friends experience anxiety, agitation, and
depression in regards to their situation. This is in addition to any pre-
existing mental health conditions that the youth struggle with prior to
being admitted into Juvenile Hall. The goal of BHCS is to mitigate as much
as possible the negative emotional impact of detention.
MEASURE A FUNDING SUMMARY
BHCS used its Measure A allocation to provide mental health services
to youth detained in the Juvenile Hall facility. The funding helped BHCS
attain the following objectives:
• Mitigate the mental health issues of detained youth by offering crisis
intervention and ongoing mental health support while detained.
• Provide court-ordered mental health assessments. Guidance Clinic staff
completed approximately 246 mental health assessments in FY 13/14.
Measure A funding covered approximately 66 of those assessments.
• Offer immediate crisis intervention for suicidal youth to avoid self-
harm. The Guidance Clinic performed 238 crisis interventions to avoid
self-harm and/or hospitalization, of which Measure A funded 127.
Allocation: $360,000 | Expended/Encumbered: $360,000
Individuals served by Measure A: 136 (Total individuals served: 1,002)
Populations served: Low Income Children, Families
Services provided: Mental Health
Service area: Countywide
Mental Health Services for Juvenile Justice Center
Highlights
Thanks in part to Measure A funding,
the program achieved the following:
• The program resulted in increased
coping skills among the target
population for managing anxiety,
depression, and trauma symptoms
due to being detained.
• As a result of immediate crisis
intervention, only two clients were
hospitalized in FY 13/14.
Matching Funds
BHCS leveraged its Measure A
allocation to obtain $80,822 in
matching funds.
Measure AAllocation MatchingFunds
$360,000
$80,000
2013-2014 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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BACKGROUND
National Alliance on Mental Illness (NAMI) Tri-Valley, in collaboration
with other community agencies and organizations, is dedicated to
improving the quality of life for those whose lives are affected by mental
illness by providing support, resource information, education programs,
and advocacy.
NAMI Tri-Valley not only provides peer support groups and information
and referrals, but also offers advocacy for families and their loved ones,
educational public meetings, and workshops, including the following:
• Family-to-Family Education Program. Family-to-Family is an evidence-
based national program that teaches family/caregivers all aspects
around mental illness and recovery.
• NAMI Tri-Valley Family/Caregiver Support Groups. The Family/
Caregiver support groups are a safe place for tired, stressed-out
caregivers to gain knowledge and support from their peers. The groups
are facilitated by volunteer-experienced family members and mental
health professionals. By encouraging peers to network with, they can
provide each other continual support between support groups.
• NAMI Tri-Valley Parent Resource and Support Group. This monthly
group helps parents of children who are suspected of or are diagnosed
with an emotional or psychiatric disorder. The group provides
information, resources, and support for parents needing coping tools
and strategies in caring for their child or children.
• NAMI Tri-Valley General Meetings. NAMI’s general meetings are
open to the public and offer a venue to provide valuable information
and connections as guest speakers talk about their particular areas
of expertise. These meetings help many find resources and support,
regardless whether they are a consumer, a family member, or an
interested member of the public.
MEASURE A FUNDING SUMMARY
NAMI Tri-Valley used its Measure A allocation to support the following
programs:
Allocation: $3,683 | Expended/Encumbered: $2,915
Individuals served by Measure A: 453 (Total individuals served: 453)
Populations served: Indigent, Low Income, Uninsured Adults, Families, Seniors
Services provided: Mental Health
Service area: Castro Valley, Dublin, Hayward, Livermore, Pleasanton, San Leandro, San Lorenzo, Sunol, Outside of Alameda County
National Alliance on Mental Illness (NAMI) Tri-Valley
nami-trivalley.org
Measure A Helps
One mother whose young adult son
was diagnosed with schizophrenia
decided the best support that she could
give to her son was to learn all that
she could about his illness. She first
attended the Family/Caregiver support
groups on a regular basis, then took the
Family-to-Family Education course.
During this time, when her son’s
mental health deteriorated, she was
able to advocate for and maintain a
close relationship with her son because
of all she learned at NAMI. This
greatly helped in her son’s recovery,
from hospitalization to a group home
setting and on to an apartment, living
independently.
2013-2014 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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Highlights
Based on end-of-class surveys, 100%
of those who took the 12-week Family-
to-Family course learned considerable
to vast amounts of information that
have improved their lives and gave
them the ability to better support
their loved one with serious and
persistent mental illness.
• Family-to-Family Education Program. NAMI Tri-Valley provided two
12-week series of classes in FY 13/14 (target: one series). Overall, 30
attended and completed the classes.
• NAMI Tri-Valley Family/Caregiver Support Groups. NAMI Tri-Valley
offered twice-monthly peer support group for families and caregivers.
The groups provide a safe place to talk, network, learn new coping
skills, and gain resources in the community around their mentally ill
loved one. On average, 12–18 people attended each meeting, with a
total attendance of 245 in FY 13/14.
• NAMI Tri-Valley Parent Resource and Support Group. NAMI Tri-
Valley offered a once-monthly peer support group to support parents,
grandparents, and guardians of children suspected of or diagnosed with
a mood disorder. On average, six people attended the monthly meeting,
with a total attendance of 48 in FY 13/14.
• NAMI Tri-Valley General Meetings. NAMI Tri-Valley held a once-
monthly public meeting at which invited guest speakers talked about
mental health topics or issues. On average, 25–30 people attended each
meeting, with a total attendance of 130 in FY 13/14.
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BACKGROUND
Safe Alternatives to Violent Environments (SAVE) works to strengthen
every individual and family they serve with the knowledge and support
needed to end the cycle of abuse and build healthier lives.
All SAVE services are provided free of charge. At SAVE the only criteria
for participation in counseling services is that the client has experienced
or is experiencing domestic violence. The drop-in domestic violence
support groups held at SAVE’s community office are open to any woman
struggling with the effects of domestic violence in her life. Any woman
can come to group whenever she needs it. There is no registration process,
and there are no limitations on how often she can come.
Support groups provide a safe place for women to talk about their issues
with each other and the support of a trained facilitator. The information
and sense of community they receive from the group helps to reduce
isolation and see that the blame lies with the abuser.
Counseling staff are all trained in domestic violence and have expertise
in the effects of that particular kind of trauma. They also understand the
types of additional challenges clients who are low income or disabled
or struggling with substance abuse or mental health issues might face.
They work to ensure that they provide a trauma-informed, culturally
appropriate, safe environment in which no client will ever feel judged or
blamed for her choices.
MEASURE A FUNDING SUMMARY
Measure A funds are a key source of funds for SAVE counseling services.
SAVE used its Measure A funds to provide 40 domestic violence support
group sessions and 80 sessions of individual counseling for domestic
violence victims.
Allocation: $10,000 | Expended/Encumbered: $10,000
Individuals served by Measure A: 263 (Total individuals served: 3,241)
Populations served: Indigent, Low Income, Uninsured Adults, Seniors
Services provided: Mental Health
Service area: Alameda, Berkeley, Castro Valley, Dublin, Fremont, Hayward, Livermore, Newark, Oakland, Pleasanton, San Leandro, San
Lorenzo, Union City, Outside of Alameda County
Safe Alternatives to Violent Environments (SAVE)
save-dv.org
Measure A Helps
Lisa, 30, came to the SAVE shelter
with one of her children and no familial
support system. Shortly after her
arrival, Lisa had a seizure that landed
her in the hospital. Her daughter
was taken into CPS custody. After
being released from the hospital, Lisa
expressed suicidal thoughts. With the
support of a psychologist and case
management staff, Lisa began to look at
her issues and made the hard decision
to enter a residential treatment
program, where she is doing well.
Highlights
Of the counseling participants
surveyed, 88% of clients reported that
they felt safer and more equipped to
make their own decisions.
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BACKGROUND
Senior Support Program of Tri-Valley provides seniors services and
assistance to foster independence, promote safety and well-being,
preserve dignity, and improve quality of life.
The In-Home Counseling Program makes a difference in the lives of
Tri-Valley seniors by providing counseling services in seniors’ homes.
Staff members receive referrals from case managers, family members,
caregivers, and other concerned members of the community. Counseling
occurs on an individual basis. During sessions, counselors conduct
assessments, including psychosocial, physical, mental health status, and
personal history. Counselors also provide crisis intervention, resources,
and referrals, as needed.
By making this service free of charge, many older adults get the benefit of
much needed support with their most challenging end-of-life issues. In
many cases, the counselor is the only contact the client has.
MEASURE A FUNDING SUMMARY
Senior Support Program of Tri-Valley depends on Measure A funding to
support its In-Home Counseling program. The program received 24 new
referrals in the last quarter of FY 13/14 alone.
Measure A funding supported the following objectives:
• Provide In-Home Counseling services to at least 20 seniors with mental
health issues who are referred from community, staff, family, etc.
• Conduct progress evaluations of clients every six weeks until discharge
• Train and supervise interns to assist with counseling
• Evaluate and adjust the program throughout the year by giving
evaluation surveys to clients at the end of each client’s program
Allocation: $20,000 | Expended/Encumbered: $20,000
Individuals served by Measure A: 51 (Total individuals served: 51)
Populations served: Low Income, Uninsured Families, Seniors
Services provided: Mental Health
Service area: Dublin, Livermore, Pleasanton, Sunol
Senior Support Program of Tri-Valley
ssptv.org
Measure A Helps
Diana, 78, lives alone in a senior
housing complex. Due to consistent
paranoia, she has alienated her
family and people in her community.
When Diana was referred to In-
Home Counseling, she didn’t have
any friends in her complex and was
becoming more and more isolated. The
counselor helped Diana increase her
social skills by practicing assertive
communication. The counselor also
suggested ways to improve listening
skills and encouraged her to accept
differences of opinions. Within a few
months, Diana started attending more
functions at the senior housing facility.
She reported making two friends she
feels comfortable with and no longer
reports being left out of activities.
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BACKGROUND
Tri-Valley Haven for Women (TVH) creates homes safe from abuse and
contributes to a more peaceful society. TVH strives to build a world
without violence.
The majority of clients at Tri-Valley Haven have experienced domestic
violence, sexual abuse, molestation, or assault at some time in their lives.
TVH professional counseling staff provide intake and assessment and
ongoing counseling services.
Counseling involves validating client experiences, providing education on
domestic violence and sexual abuse, helping clients realize they are not
alone, and providing support in many clinical ways. Clients leave with
a desire to take care of themselves, many for the first time in their adult
lives, and with a positive feeling about their future.
All of these factors help clients live fuller lives and have a positive sense of
self and community rather than living in a state of shame and fear where
they feel alone, hopeless, and worthless.
MEASURE A FUNDING SUMMARY
Funding through Measure A provided increased availability of counseling
staff and increased access to counseling sessions.
TVH used its Measure A allocation to meet the following objectives:
• Provide professional counseling sessions to adult and children clients
(target: 200 sessions to 25 unduplicated clients; actual: 205 sessions to
37 clients)
• Based on staff assessment, have clients show improved mental health
(target: 60% of clients served; actual: 75%)
Allocation: $25,000 | Expended/Encumbered: $25,000
Individuals served by Measure A: 37 (Total individuals served: 128)
Populations served: Indigent, Low Income, Uninsured Adult, Children, Families, Seniors
Services provided: Mental Health
Service area: Castro Valley, Livermore, Pleasanton
Tri-Valley Haven for Women
trivalleyhaven.org
Measure A Helps
Rachel, 26, came to TVH to process
memories of childhood sexual abuse.
Rachel had self-harmed her whole life
and had been involved in a number of
abusive relationships. As treatment
progressed, Rachel became committed
to her healing and explored not only
the trauma itself but also the wider
dysfunction in her family of origin,
which included parental neglect.
Rachel has been able to navigate
conflicts with family members,
develop a healthy relationship with
a partner, and identify and pursue
her professional goals. Rachel has
also become an increasingly strong
advocate for survivors of childhood
sexual abuse and sexual assault.
2013-2014 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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BACKGROUND
Youth ALIVE! works to prevent violence and develop youth leadership.
The Youth ALIVE!/Khadafy Washington Project (KWP) provides first
responder crisis intervention, intensive support, emotional “first aid,”
and linkage to ongoing mental health services to the families of Oakland
homicide victims.
KWP offers families of homicide families a “ministry of presence.” This
takes the form of peer-based mental health first aid and a supportive staff
presence from KWP’s first response staff that delivers intense outreach for
an initial period of 4–6 weeks. Specific barriers that the program assists
with include the following:
• Navigation of funeral/burial process
• Support/advocacy with funeral homes
• Access to Victim of Crime (VoC) services, including financial support
for mental health services
• Relocation (due to violent incidence)
• Providing immediate/basic needs such as food in home, gift cards, and
transportation for appointments
For families that have received threats after a homicide, KWP addresses
their safety concerns and coordinates with Oakland Police Department
and community-based Street Outreach partners to monitor their loved
one’s services to deter more violence that would further complicate their
existing trauma. KWP also conducts wellness checks with families to
assess how their coping skills and resiliency are developing. For those that
have emerging needs or resurfacing symptoms, KWP advocates to have
these families linked back into mental health services to promote their
healing.
MEASURE A FUNDING SUMMARY
Youth Alive!/KWP used its Measure A allocation to achieve the following
measurable objectives in FY 13/14:
• Provide first responder crisis intervention services to an estimated 15–
Allocation: $25,000 | Expended/Encumbered: $25,000
Individuals served by Measure A: 47 families, 118 individuals (Total individuals served: 87 families, 234 individuals)
Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors
Services provided: Mental Health
Service area: Oakland
Youth Alive!
youthalive.org
Measure A Helps
An 18-year-old Latino man was shot
and killed in front of his home. Youth
ALIVE!/KWP staff contacted the
family within 24 hours, and found
that their landlord had sent them an
eviction notice due to delinquent rent.
KWP negotiated to allow the family
to stay in the home until the end of
the month. KWP then helped link the
famly to mental health services through
CCEB, enroll the younger siblings
in school, secure employment for the
oldest son, and arrange assistance with
U-Visa application and grief support.
The victim’s mother shared that she
and her children were “feeling a sense
of hope” for the first time.
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20 Spanish-speaking victim groups (families and friends of homicide
victims) associated with Oakland homicides.
• Respond to and serve 87 families impacted by homicides in Oakland.
There were 15 homicides (17%) of Latino victims and, of these, 15
victim groups were Latino and/or Spanish-speaking families.
• Serve an additional 32 victim groups (African-American families),
bringing the total to 47 victim groups given intensive support services
though these funds.
• Accompany and support each impacted family through their VoC
appointment, guide them through the funeral and burial arrangements,
and provide a “ministry of presence.”
• In addition to the VoC services offered ($5,000 for burial costs
and funding for mental health visits), secure additional financial
contributions for half of the families served through the Crisis
Response Support Network (CRSN) emergency fund.
• Give all families information about therapeutic services and basic grief/
trauma symptoms, and refer five families for immediate therapeutic
intervention through Catholic Charities of the East Bay (CCEB).
Youth Alive!/KWP
used its Measure A
allocation to provide
first responder crisis
intervention services
to an estimated
15–20 Spanish-
speaking victim
groups associated with
Oakland homicides.
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FUNDS ALLOCATED BY THE ALAMEDA COUNTY BOARD OF SUPERVISORS
GROUP 2: HOSPITAL, TERTIARY CARE, OTHER
Administration/Infrastructure Support .......................................................................................................48
San Leandro Hospital ...................................................................................................................................49
St. Rose Hospital ..........................................................................................................................................51
UCSF Benioff Children’s Hospital Oakland ...................................................................................................53
2013-2014 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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BACKGROUND
The Alameda County Health Care Services Agency (HCSA) works to
provide fully integrated health care services through a comprehensive
network of public and private partnerships that ensures optimal health and
well-being and respects the diversity of all residents.
The HCSA Administration/Indigent Health department serves to provides
the following:
• Integrated health care services to the residents of Alameda County within
the context of managed care and a private/public partnership structure
• Direct oversight, administrative, and fiscal support for the County’s
medically Indigent Services Plan and its provider network and all cross-
departmental and cross-jurisdictional services, with an emphasis on
children’s services
• General oversight, administrative, and fiscal support for the Public
Health, Environmental Health, and Behavioral Health Care Services
Departments
• Leadership for implementation of Countywide or agency-wide health
care initiatives
• Leadership and assistance to private and publicly operated health care
delivery systems, including implementation of programs that expand
accessibility of needed medical services in the most appropriate and cost-
effective settings, development of insurance alternatives for previously
uninsured County residents, and implementation of programs that
expand accessibility of needed medical services targeting children
MEASURE A FUNDING SUMMARY
The HCSA Administration/Indigent Health department used its Measure
A allocation to provide administrative support for the management
of Measure A including, but not limited to, contract development and
monitoring, management of special projects, budget oversight and
preparation of the annual reports, and staffing of the Measure A Oversight
Committee.
HCSA provided contract and administrative support for 60 Measure A
allocations in FY 13/14. There were two RBA 101 trainings in April 2014,
with a total of 14 organizations and 39 participants attending one of the
trainings.
Allocation: $400,000 | Expended/Encumbered: $249,979
Recipient does not provide direct services
Administration/Infrastructure Support
acgov.org/health
The HCSA
Administration/
Indigent Health
department used
its Measure A
allocation to provide
administrative
support for the
management of
Measure A.
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BACKGROUND
San Leandro Hospital is a 93-bed community-based hospital that was
acquired by Alameda Health System (AHS) in 2013. It provides inpatient
and outpatient services including medical, surgical, and intensive care,
as well as 24-hour emergency services in its 13-bed, Level II Emergency
Department (ED). The hospital serves central Alameda County, a
community of 265,000 people.
Program objectives have been aligned with the AHS three-year strategic
plan. Within the plan, specific objectives for San Leandro Hospital include
the following:
• Standardize and install management control systems across ED and
operating room (OR)
• Design and install metrics management tools
• Develop a recurring operating report to highlight performance
• Improve rounding intervals to focus on standard work times
• Optimize patient visits by reducing length-of-stay and arrival-to-
provider times
• Implement a governance model to create a continuous improvement
culture
• Provide adequate resources for the ED and OR based on census
demand
• Create better delegation and clarity of roles and responsibilities among
staff
• Standardize the referral management and review process
• Increase performance of practices allowing for better capacity
utilization and increased patient throughput
• Improve productivity as a result of data-driven management practices
to reduce operational costs
MEASURE A FUNDING SUMMARY
Measure A is a supplemental revenue source that supports all San
Leandro Hospital services with the exception of a small share of services
for which AHS receives full reimbursement. Measure A funds are
Allocation: $1,000,000 | Expended/Encumbered: $1,000,000
Individuals served by Measure A: 4,935 (Total individuals served: 22,033)
Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors
Services provided: Emergency Medical, Hospital Inpatient, Hospital Outpatient, Public Health, Mental Health
Service area: Ashland, Cherryland, San Leandro, San Lorenzo
San Leandro Hospital
sanleandroahs.org
Measure A funds
are critical to San
Leandro Hospital’s
ability to reduce
the gap between
reimbursement
for services from a
variety of sources
and the actual
cost of providing
those services to
underinsured and
uninsured persons.
2013-2014 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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critical to San Leandro Hospital’s ability to reduce the gap between
reimbursement for services from a variety of sources and the actual cost of
providing those services to underinsured and uninsured persons.
With the help of Measure A funding, San Leandro Hospital was able to
provide the following services in FY 13/14:
• 7,615 total inpatient days
• 19,897 visits to to the medical ED
• 1,686 discharges
• 901 inpatient and outpatient surgeries performed
Measure A funding also helped San Leandro Hospital achieve the
following:
• Projected $6.3 million in additional net revenue due to increased
patient volume
• 19% increase in average weekly OR surgical volume
• 18% improvement in average daily ED census
• 77% reduction in patients leaving without being seen
• 32% reduction in patient arrival-to-discharge times in the ED
• 75% reduction in OR turnover times
• 61% reduction in arrival-to-provider time in the ED
• Establishment of “daily/weekly operating report” containing key
performance indicators for enhancing patient satisfaction
• Development of capacity plan to identify minimum/maximum
constraints based on forecasted volume for the ED, OR, and floor
• Collection of regional market data to provide a comprehensive
understanding of how San Leandro is and is not serving the needs of
the market
• Establishment of benchmarks to identify appropriate staffing levels
• Establishment of performance reviews at the department and executive
levels
• Holding of weekly meetings the surgical services, ED, and strategic
planning management action teams
• Execution of monthly/weekly compliance audits
CONCERNS
The provider report states that the hospital folded Measure A funding into
their general operating budget: “As described in previous presentations
and reports, we don’t specifically allocate these funds to individual
programs; rather, all of our operations are combined and we endeavor to
track the profitability for each of our programs.” The Committee asks the
provider to show an awareness of the purpose of this public money and to
address its requirements in the specific manner defined in the measure.
Highlights
San Leandro Hospital improved
patient care metrics in a number
of key areas, including significant
reductions in patients leaving without
being seen (-77%), ED arrival-to-
discharge times (-32%), OR turnover
times (-75%), and ED arrival-to-
provider times (-61%).
Measure A funding
helped San Leandro
Hospital achieve
a projected $6.3
million in additional
net revenue due to
increased patient
volume.
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BACKGROUND
St. Rose Hospital (SRH) is a safety-net, independent hospital that provides
critical access to emergency medical, hospital inpatient, and outpatient
services for indigent, low income, underinsured populations in Central
and Southern Alameda County. These services include the following:
• Critical access. SRH serves as a critical access point for Alameda
County and is the only Medi-Cal-contracted facility between Oakland
and Fremont. Additionally, SRH serves as a safety-net hospital and
provides health care access to many low income residents that do not
have adequate transportation to the Alameda County Medical Center.
• Hospitalists programs. The Hospitalists assume care of indigent
and uninsured patients who are admitted to SRH. This alleviates the
financial impact of the private physicians who request compensation
for lack of reimbursement.
• Women’s services. SRH operates the Women’s Center to meet the
growing demand for OB/GYN services in the community, because
many OB practitioners do not accept Medi-Cal rates. The program
provides immediate and emergency care for pregnant women who
present to the emergency room (ER), often with no history of prenatal
care.
• Cardiac care. SRH is the only Medi-Cal-contracted facility to provide
elective cardiac and percutaneous coronary intervention (PCI) services
in central Alameda County. There has been a 3% increase in procedures
for Medi-Cal beneficiaries in fiscal year 2014 over 2013. SRH routinely
accepts hospital transfers for emergency and elective cardiac care from
non-Medi-Cal providers.
MEASURE A FUNDING SUMMARY
SRH used its Measure A allocation to help achieve the following
objectives:
• Provide emergency care for uninsured patients. The SRH ER
experienced 35,163 visits in FY 13/14, including 73%, or 25,549 visits,
from uninsured and underinsured patients.
• Provide financial support to hospital-based physician groups to take
Allocation: $2,000,000 | Expended/Encumbered: $2,000,000
Individuals served by Measure A: 11,156 (Total individuals served: 40,805)
Populations served: Indigent, Low Income Adults, Children, Families, Seniors
Services provided: Emergency Medical, Hospital Inpatient, Hospital Outpatient, Public Health, Mental Health, Substance Abuse
Service area: Countywide
St. Rose Hospital
strosehospital.org
Measure A Helps
A 42-year-old female with abdominal
pain sought treatment at the SRH ER.
A CT scan revealed acute appendicitis.
The patient underwent a successful
emergency laparoscopic appendectomy.
This patient was uninsured. After
receiving her bill from the hospital, she
was devastated, worried that she and
her husband might lose their home.
She asked the hospital if there was a
program that could help them with the
bill. SRH made the decision to waive
the hospital bill due to the family’s
circumstances. Measure A made it
possible for the hospital to help with
the family’s bill and their financial
hardship.
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ER calls and provide services to uninsured patients. SRH inpatient
volumes, including nursery service utilization, included 45.5% Medi-
Cal patients and 6.2% uninsured patients.
• Provide referral services for follow-up/after care for uninsured patients.
• Assist in supporting SRH inpatient services to uninsured and
underinsured patients. Hospital-based physicians provided over 12,093
patient encounters for uninsured patients for the year.
• Employ a financial counselor to assist in identifying uninsured
patients who may qualify for other funding sources such as Medi-Cal
or HealthPAC. In FY 13/14 the ER financial counselor assisted 1,809
uninsured patients, an increase of 7.2% over the preceding year.
Matching Funds
SRH leveraged its Measure A allocation
to obtain $1,000,000 in matching
funds from the intergovernmental
transfer program through the private
hospital supplemental payment
program. This represents a $1 match
for every $2 in Measure A funds.
Measure AAllocation MatchingFunds
$2,000,000
$1,000,000
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BACKGROUND
UCSF Benioff Children’s Hospital Oakland (CHO) works to protect
and advance the health and well-being of children through clinical care,
teaching, and research.
At CHO, Measure A funding supported three programs/activities:
• The pediatric Emergency Department (ED), specifically to provide
adequate staffing for the large volume of children seen at the ED
• The Center for Child Protection (CCP)
• School-based clinics
Emergency Department
CHO provides highly specialized pediatric emergency services for the
children of Alameda County, 24 hours a day, seven days a week. CHO’s
ED sees a broad array of pediatric disease and injury from the basic to the
most complex. CHO is the leading provider for Alameda County children
in need of acute care. Children with Medi-Cal rely nearly exclusively on
CHO for emergency services since the public hospitals in the area do not
provide specialized pediatric care and do not have any beds for children in
the event a child needs to stay overnight. In the 2013-2014 year, to CHO’s
ED was the highest volume ED in the San Francisco Bay Area.
CHO’s ED is one of two designated Level 1 Pediatric Trauma Centers
in Northern California and the only one in the Bay Area. Children’s
Trauma Center has 24-hour in-house staff including pediatric specialists
in emergency medicine, trauma surgery, anesthesiology, neurosurgery,
orthopedics, diagnostic imaging, and critical care.
For many children, the ED also functions as the gateway to a regular
medical home, specialty care, or other community programs sponsored by
CHO or other organizations.
Approximately 70% of patients seen in the CHO ED receive Medi-Cal.
This number is higher than almost any other hospital—child or adult—in
Allocation: $3,000,000 | Expended/Encumbered: $3,000,000
Individuals served by Measure A: 31,365 (Total individuals served: 39,592)
Populations served: Indigent, Low Income, Uninsured Children
Services provided: Emergency Medical, Hospital Outpatient, Public Health, Mental Health
Service area: Countywide
UCSF Benioff Children’s Hospital Oakland
childrenshospitaloakland.org
Measure A Helps
Nadia, 9, was brought to the CHO
ED from her school, where she had
been attacked by a mentally ill person
wielding a claw hammer. Medical
and CCP staff completed a forensic
evaluation and psychosocial crisis
assessment, as well as a medical
evaluation and treatment. The CCP
clinical social worker provided crisis
support to parents. When Nadia was
discharged from the hospital, CCP
arranged for outpatient psychotherapy
and followed up with her in the
outpatient clinic. When Nadia
was returning to school, CCP staff
conducted advocacy for an interdistrict
transfer, and Nadia’s mother was able
to transition both Nadia and three
younger children to a new school.
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53
California. Without the CHO ED, children would need to travel further
and/or receive care that is not specialized to children. With little doubt,
more children would die without the CHO ED.
Center for Child Protection
CHO and Alameda County recognize that they share a responsibility
to provide immediate and comprehensive care for this population of
children, yet there are many challenges to maintaining this responsibility.
CCP serves more than 1,000 clients per year. CCP is a comprehensive
child abuse program within CHO. CCP is the only provider in Alameda
County that has the capacity to offer many of its services.
Because many CCP services are funded by external sources such as
Measure A, there is no charge for eligible clients. This feature is very
important because if CCP needed to charge insurance for these services,
there would be a record of services provided, and many families would not
step forward to divulge such sensitive information.
CCP maintains staffing 24 hours per day to respond to acute forensic
examinations for children under 14 years old when the alleged sexual
abuse occurred within 72 hours. Non-acute forensic examinations for
children under age 18 and second opinion medical consults are performed
in the CCP outpatient clinic through appointment only.
Clinical case management is provided to children and adolescents who
present to the ED and/or child abuse management clinic following
diagnosis or disclosure of abuse. Comprehensive evidenced-based mental
health services are provided to children, adolescents, and their families
who have been exposed to childhood trauma, including child abuse and/
or witness to violence. For most of these families, there are no alternatives
in Alameda County for many of the services provided by CCP.
School-Based Clinics
CHO runs two school-based health centers: one at Castlemont High
School and one at McClymonds High School. The school health centers
provide a safe and convenient place for students to receive integrated,
comprehensive medical and mental health services. The Youth Uprising/
Castlemont Health Clinic sees students from Castlemont High School
as well as members of the community ages 11–24. The Chappell Hayes
Health Clinic sees students from McClymonds High School as well as
members of the community ages 11–21.
The Castlemont site is now the highest-volume school-connected mental
health site in Alameda County. The sites’ School-Based Mental Health
Program has become a national model for the integration of medical
and mental health care, and it has been cited for success at addressing
underlying social stressors related to mental health. The program has
Matching Funds
CHO leveraged its Measure A
allocation to obtain $1,000,000
in matching funds through an
Intergovernmental Transfer (IGT)
using supplemental funds from the
California Department of Health Care
Services.
Measure AAllocation MatchingFunds
$3,000,000
$1,000,000
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developed a training and consultation program for school professionals
and mental health providers who work with schools, and it has contracts
to conduct trainings throughout Alameda County and California.
MEASURE A FUNDING SUMMARY
CHO used its Measure A allocation to achieve the following:
Emergency Department
• In FY 13/14, there were a total of 44,508 unique patients to the ED.
• 665 of these visits were trauma cases where the child faced an
immediate life-threatening situation.
• The total average time children spend at the ED has shrunk to 3.1
hours. This figure compares with 4.1 hours for CHO’s peer group
according to studies conducted by McKesson.
• Measure A funding has also helped the ED to upgrade its space to be
more kid-friendly and to purchase state-of-the-art equipment, such as
new monitors and imaging equipment.
• The average time for providing sickle cell patients with proper pain
medication has gone from 90 minutes to 30 minutes, which is among
the top in the nation.
• Over 400 children seen in the ED were referred to and seen at CHO’s
asthma clinic for follow-up care and asthma education.
Center for Child Protection
• In FY 13/14, the CCP served more than 1,000 children.
• The CCP conducted 104 forensic evidentiary examinations, 55 outpatient
medical consultations, and 57 inpatient medical consultations, and
provided clinical and psychotherapy services to 556 children.
School-Based Clinics
• In FY 13/14, the two clinics run by CHO had a total of 2,458 encounters
and saw 823 children/adolescents.
CONCERNS
The Committee notes that CHO does not list measurable objectives,
which has been raised in the last several years. ED encounters can vary
due to the severity of flu seasons and other unexpected health trends.
Therefore, it is understandable that total ED encounters may change
from year to year. However, measurable objectives should still be set and
performance measured. This also applies to the CCP and school clinics.
Also, two-thirds of the hospital’s $2.5 million allocation helps offset
undercompensated costs of ED visits from patients with Medi-Cal.
However, the hospital administration states that it is “not reasonable nor
possible to tie the Measure A funding to a specific number of patient
encounters.” The Committee asserts that this can and should be done to
ensure accountability for use of public tax dollars.
The average time for
providing sickle cell
patients with proper
pain medication has
gone from 90 minutes
to 30 minutes, which
is among the top in
the nation.
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FUNDS ALLOCATED BY THE ALAMEDA COUNTY BOARD OF SUPERVISORS
GROUP 3: PRIMARY CARE
Alameda County Dental Health ...................................................................................................................57
Center for Elder’s Independence ................................................................................................................59
Center for Healthy Schools and Communities (School Health Centers) ......................................................60
Fire Station Health Portals ...........................................................................................................................62
Fremont Aging and Family Services .............................................................................................................63
Health Enrollment for Children ...................................................................................................................66
Health Insurance Eligibility and Enrollment ................................................................................................67
Health Services for Day Laborers: Community Initiatives (Day Labor Center).............................................68
Health Services for Day Laborers: Multicultural Institute ............................................................................70
Health Services for Day Laborers: Street Level Health Project ....................................................................72
Increase Hospice Utilization ........................................................................................................................74
Indigent Health Stabilization .......................................................................................................................76
Medical Costs for Juvenile Justice Center: Direct Service Planning and Administration .............................80
Medical Costs for Juvenile Justice Center: Mind Body Awareness ..............................................................82
Medical Costs for Juvenile Justice Center: Niroga Institute .........................................................................84
Medical Costs for Juvenile Justice Center: Victims of Crime .......................................................................85
Preventive Care Pathways ...........................................................................................................................86
Primary Care Community-Based Organizations...........................................................................................87
Tiburcio Vasquez Health Center, Inc. ...........................................................................................................89
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BACKGROUND
The Alameda County Public Health Department works in partnership
with the community to ensure the optimal health and well-being of all
people through a dynamic and responsive process that respects the
diversity of the community and works to provide for present and future
generations.
A program of the Public Health Department, the WIC Oral Health
Collaborative program provides an accessible early entry point for oral
health assessment and preventive dental services for high risk families
and children ages 0–5 years at WIC, as well as continuity and referral for
regular follow-up dental care in the community. The services provided
at WIC include dental history interviews to identify risk factors and oral
home care practices, brushing the child’s teeth and applying fluoride,
assessing the child’s mouth, and setting goals for home care behaviors.
For children who need follow-up care beyond the services provided at
the WIC site, the outreach/case manager collaborates with the family to
assess insurance coverage, obtain a dental appointment with a provider,
and assist with making the initial dental appointment. For families lacking
insurance coverage, the case manager arranges insurance assistance
through the Healthy Smiles Dental Treatment program.
MEASURE A FUNDING SUMMARY
Measure A funding helped the WIC Oral Health Collaborative program
achieve the following measurable results:
• Enroll at least 400 infants and toddlers into the Healthy Kids Healthy
Teeth (HKHT) program of preventive dental services and access to
early dental care
• Provide 914 children with oral assessments and fluoride varnish
applications
• Provide 1,371 parents and caregivers dietary and dental health
education, anticipatory guidance, and assistance in accessing dental
care
Allocation: $151,213 | Expended/Encumbered: $151,213
Individuals served by Measure A: 2,285 (Total individuals served: 4,833)
Populations served: Indigent, Low Income, Uninsured Adults, Children, Families
Services provided: Outpatient, Public Health
Service area: Alameda, Castro Valley, Fremont, Hayward, Newark, Oakland, San Leandro, San Lorenzo, Union City
Alameda County Dental Health
www.acphd.org/dental-administration.aspx
Matching Funds
The WIC Oral Health Program
leveraged its Measure A allocation
to obtain an addition $205,594 in
matching federal funds from the
Maternal, Paternal, Child & Adolescent
Health Program (MCPAH) and Child
Health and Disability Prevention
(CHDP).
Measure AAllocation MatchingFunds
$151,213
$205,594
2013-2014 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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• Ensure that 78% of children/families receive care through Medi-Cal
• Increase the parent/caregiver’s oral health knowledge and preventive
oral health behaviors through the provision of at least six English and
Spanish dental health education sessions per month
• Ensure that a minimum of 150 families and children be assisted in
getting access to dental providers who are willing and able to provide
early care and become a dental home
• Ensure that at least 75% of children enrolled in HKHT visit a dentist
at least once during the year to begin accessing supplemental fluoride
varnish and additional oral health family education services
• Expand operation of WIC “Dental Days” to a fourth site (Fremont) in
addition to Hayward, Eastmont, and Telegraph
Highlights
An analysis of health outcomes for
children participating in the WIC
“Dental Days” shows that they
have 42% fewer restorative dental
treatment needs compared to children
who did not benefit from the program.
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BACKGROUND
The Center for Elders’ Independence (CEI) provides high quality,
affordable, integrated health care services to the elderly, which promote
autonomy, quality of life, and the ability of individuals to live in their
communities.
CEI also supports and educates family caregivers of frail senior
participants so they can help keep seniors healthy and safe.
MEASURE A FUNDING SUMMARY
CEI used its Measure A allocation to increase access to medical services
for seniors by efficiently assessing and enrolling seniors into the PACE
plan. PACE is considered the gold standard of care for frail older adults
with multiple, chronic, and complex health care needs—a truly integrated,
comprehensive, coordinated, interdisciplinary team-based approach.
Specifically, CEI hired and trained an assessment nurse (RN) who worked
with Alameda Alliance to develop a risk assessment tool and referral
process.
This effort resulted in the following:
• The RN assessed 123 seniors.
• 13 non-PACE eligible referrals were made.
• 70 applications were submitted to the CA Department of Health Care
Services (DHCS).
• 66 applicants were certified eligible by DHCS and enrolled in PACE.
• CEI completed care plans for all new enrollees within 60 days of
enrollment.
With this funding, CEI has also been able to streamline assessment
procedures to be more efficient going forward, and be better prepared for
increased referrals when the CCI/Cal MediConnect launches.
Allocation: $51,000 | Expended/Encumbered: $51,000
Individuals served by Measure A: 123 (Total individuals served: 699)
Populations served: Indigent, Low Income Adults, Seniors
Services provided: Public Health
Service area: Alameda, Albany, Ashland, Berkeley, Castro Valley, Cherryland, Emeryville, Hayward, Oakland, San Leandro, San Lorenzo
Center for Elder’s Independence
cei.elders.org
Measure A Helps
Mr. G. began to develop multiple
health problems that forced him to
retire and seek medical help. CEI
assessed and enrolled Mr. G., who
feels he has found the ideal health care
situation for his medical needs, with
a team of professionals and aides who
work together to help him with every
other aspect of his life. And he’s met a
community of friends with whom he
can socialize and share his memories
at the PACE center. In addition,
Measure A-funded presentations like
the one Mr. G. attended let seniors,
caregivers, and other community
service providers/physicians know
about PACE and lead to many CEI
enrollments.
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BACKGROUND
The Center for Healthy Schools and Communities works to foster the
academic success, health, and well-being of Alameda County youth by
building universal access to high quality supports and opportunities in
schools and neighborhoods.
A key component of the Center for Healthy Schools and Communities,
the school health centers (SHCs) play a vital role in creating universal
access to health services by providing a continuum of age-appropriate and
integrated health and wellness services for youth in a safe, youth-friendly
environment at or near schools.
The SHCs provide services in the following areas:
• Comprehensive school health services in a safe, accessible environment
on or near the school campus during convenient hours
• Referrals to necessary health and wellness services
• First aid, medical, and health education services
• Behavioral health services
• Dental health services
• Nonclinical services such as youth development and school climate
services
SHC services are accessible. SHCs are open during school hours and
often after school as well. SHC services are available at no cost to clients,
regardless of their insurance status, thus filling a gap for students who are
uninsured or underinsured. Of those clients with data recorded, 28% did
not have a primary care medical home, and 33% did not have a regular
dental provider.
The SHCs offered a variety of outreach activities over the school year,
such as parent workshops, speakers, and other after-school events for the
community.
Allocation: $1,887,000 | Expended/Encumbered: $1,887,000
Individuals served by Measure A: 13,017 (Total individuals served: 13,017 )
Populations served: Indigent, Low Income, Uninsured Adults, Children, Families
Services provided: Public Health, Mental Health, Substance Abus
Service area: Countywide
Center for Healthy Schools and Communities (School Health Centers)
achealthyschools.org/school-health-centers.html
Measure A Helps
A 13-year-old patient was overweight
and had high cholesterol, specifically
high triglycerides. He was motivated
through appointments with the SHC
Nurse Practitioner and the RD at
Preventative Medicine to make many
lifestyle changes. These included
increasing his exercise at school during
recess, after school, and on weekends
with his family. He stopped buying
chips and saved that money for other
things, drank more water, ate more
slowly, and talked more to family
during meals instead of automatically
getting seconds. His cholesterol is now
normal, with a significant decrease in
the triglycerides from 200 to 75.
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MEASURE A FUNDING SUMMARY
Measure A funds supported 15 of the 25 SHCs. The SHCs achieved the
following measurable outcomes in the target service areas:
• Alameda County SHCs continue to expand, now providing programs at
one elementary school, seven middle schools, 14 high schools, and one
community college.
• SHCs have improved academic outcomes. Without an SHC onsite,
many students might have been sent home, rather than having their
health issues addressed onsite and being sent back to class.
• Clients return for multiple visits to the SHCs, demonstrating the value
of integrated and youth-friendly services.
• Physical health services were provided during 43% of all SHC visits.
Individual and group behavioral health services were provided during
28% of all visits to 2,655 clients.
• Sexual/reproductive health services were provided during 32% of all
visits. According to clinic data, 46% of female clients reported that they
“always” used contraception at baseline, compared to 55% at follow-up.
• At the six SHC sites providing dental services in FY 13/14, 21% of
all visits (766 clients) had a dental service provided. These services
included screening exams and cleanings, case management, and
restorative treatment.
Measure A funds also allowed the SHCs to offer nonbillable services
such as youth development. SHC provided leadership development and
mentoring through peer health education programs and youth advisory
boards, as well as a variety of programming including sports, tutoring,
dance, arts, media, and gardening during lunch or after school.
This year, Measure A funds were also used to support a specific equity-
focused SHC project: the Latino Men and Boys (LMB) program. This
program provides youth development for males of color in five Oakland
schools with SHCs. The program collaborates with school administrators,
counselors, and the SHC to identify Latino youth that are at risk of
dropping out and provides them with intensive mentoring, academic
tutoring, and health-related supplemental programs that improve
educational outcomes and physical and emotional wellness. In 2014, LMB
program participants had over 250 visits at SHCs.
Matching Funds
The SHCs leveraged their Measure
A allocation to obtain $9,917,459
in matching funds from local, state,
federal, and private sources.
Measure AAllocation MatchingFunds
$1,887,000
$9,917,459
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BACKGROUND
Alameda County Health Care Services Agency (HCSA) works to provide
fully integrated health care services through a comprehensive network of
public and private partnerships that ensure optimal health and well-being
and respect the diversity of all residents.
The objective of the Firehouse Clinic is to provide a new access point
for comprehensive primary and preventative care to communities in
critical need of health care services. In addition, the Firehouse Clinic will
provide insurance enrollment assistance, connection to a medical home,
and emergency department and hospital discharge follow-up. The clinic
model in South Hayward, the first site, will reduce wait times for patients
seen at community clinics by guaranteeing primary care appointments
within 72 hours and providing extended hours. During the first two years
of operation, over 5,000 new patients are projected to be seen at the
Hayward site, the majority of whom will consist of low income, uninsured,
and indigent residents. The intention is to provide services to populations
that historically may have been excluded from mainstream health care.
The Firehouse Clinic will accept public insurance, such as Medi-Cal,
Medi-Care, and County-sponsored insurance coverage; some forms of
private insurance; or a flat-fee payment for particular services. Ability to
pay is not a factor in receipt of care.
MEASURE A FUNDING SUMMARY
Rollout of the first clinic site in Hayward is anticipated in spring 2015.
Thus, no clients have been served at the clinic at this time.
Measure A funding for this initiative has been approved by the Alameda
County Board of Supervisors for rollover until buildout of the Firehouse
Clinic is complete and clinical operations can begin. During FY 14/15 and
FY 15/16, Measure A funding will be expended towards this effort: $1.2
million in capital funding to the City of Hayward for construction of the
building and $970,000 for the provision of clinical services.
Allocation: $750,000 | Expended/Encumbered: $268,099
Individuals served by Measure A: Portal scheduled to open in spring 2015; no clients have been served up to this time
Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors (anticipated)
Services provided: Emergency Medical, Hospital Inpatient, Hospital Outpatient, Mental Health, Public Health (anticipated)
Service area: Hayward (anticipated)
Fire Station Health Portals
The clinic model
in South Hayward,
the first site, will
reduce wait times
for patients seen at
community clinics by
guaranteeing primary
care appointments
within 72 hours
and providing
extended hours.
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BACKGROUND
The City of Fremont’s Human Services Department (HSD) supports a
vibrant community through services that empower individuals, strengthen
families, encourage self-sufficiency, enhance neighborhoods, and foster a
high quality of life for all residents.
Aging and Family Services (AFS), a Division of the HSD, provides both
a Multi-Service Senior Center and a Senior Support Services team of
caring professionals from diverse backgrounds —social work, nursing,
gerontology, psychology, and public health—who serve seniors and their
families with dignity and respect.
The AFS Health Promoter Program improves both the physical and
mental health of older adults by increasing access to health services,
supporting healthy behavior changes, monitoring medications, and
providing health education classes. The program offers these services
at home and at community congregate sites to older adults in Southern
Alameda County, with a focus on low income, Afghan refugee women
over the age of 50 years.
Within the Health Promoter Program, Afghan Health Promoters develop
relationships with Afghan seniors, provide emotional support, offer health
education, and coordinate referrals for health and social services.
The Health Promoter Program is made up of four program areas:
• Happy, Healthy Me (HHM). HHM is a chronic condition self-
management program that helps elders identify healthy goals through
problem-solving and goal-setting. The program assesses 12 areas
related to successful self-management behavior and utilizes problem-
solving techniques, motivational interviewing, and goal-setting
techniques to help the elder establish obtainable goals.
• Medication assistance and counseling. Elders are able to consult with
AFS’s public health nurse at the weekly Healthy Aging Program. The
nurse and nursing students review the elder’s medications, check to
make sure each person understands one’s medications, provide teach-
Allocation: $51,000 | Expended/Encumbered: $51,000
Individuals served by Measure A: 123 (Total individuals served: 173)
Populations served: Indigent, Low Income, Uninsured Seniors
Services provided: Public Health, Mental Health
Service area: Fremont, Hayward, Newark, Union City
Fremont Aging and Family Services
www.fremont.gov/217/Aging-Family-Services
Measure A Helps
Mr. M., a 69-year-old man from
Afghanistan, was living in Hayward
but lost his housing. A friend in
Fremont offered his storage unit as
a place to live and referred Mr. M to
the Afghan Health Promoters. When
Mr. M. first met with his Health
Promoter, he had no income or medical
coverage, had high blood pressure
and arthritis, and was depressed. The
Health Promoter applied for Medi-Cal,
food stamps, and general assistance,
all of which Mr. M. is now receiving.
The Health Promoter is also assisting
Mr. M. as he applies for housing and
CAPI funds to help afford the housing,
as well as helping Mr. M. with his
citizenship.
2013-2014 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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back methods, and if necessary call the person’s doctor to request more
information on questionable medications or side effects.
• Linkages. The Linkages program provides information, referral, and
assistance to Afghan elderly, linking them to a variety of community
programs; social services; housing; and other federal, state, and local
entitlement programs. The Health Promoters provide translation,
transportation, completing forms, and other services as necessary to
improve the health and well-being of each person being served.
• Health education groups. In addition to the Healthy Aging Program’s
weekly presentations on health issues such as nutrition, heart disease,
and exercise, the Health Promoter Program also offers extended,
evidenced-based groups. Past groups have included a Diabetes group
and the Stanford Chronic Disease Self-Management program.
MEASURE A FUNDING SUMMARY
Measure A funding helped the Health Promoter Project meet its overall
program objective to improve both the physical and mental health of
older adults through increasing access to health services, supporting
healthy behavior changes, monitoring medications, and providing health
education classes.
Measure A helped the Health Promoter Project achieve the following
measurable objectives.
Service Linkage
• Provide health promotion services to Afghan clients (target: 100; actual:
173)
• Offer care from a primary care physician (target: 90; actual: 159
obtaining a primary care physician and/or a health plan)
• Provide health education and socialization from Health Promoters
(target: 100; actual: 135)
• Offer home visits (target: 85 clients; actual: 118)
• Conduct home safety evaluations (target: 40; actual: 35)
• Refer clients to City of Fremont case management and/or counseling
services (target: 25; actual: 62)
• Provide eligibility assistance and support to access supportive services
to clients (target: 100; actual: 103)
• Help clients access other community services (target: 50; actual: 71)
Wellness Plan
Ensure the following:
• Clients complete the Wellness Screen (target: 80; actual: 69)
• Clients develop a Wellness Action Plan (target: 40; actual: 39)
• Clients participate in their Action Plan (target: 30; actual: 32 of the 39
who completed the plan)
• Clients show improvement after six months (target: 30; actual: 17 of the
17 who completed the plan)
Measure A funding
helped the Health
Promoter Project
meet its overall
program objective
to improve both the
physical and mental
health of older adults
through increasing
access to health
services, supporting
healthy behavior
changes, monitoring
medications, and
providing health
education classes.
2013-2014 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
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Medication Management
• Provide medication review, education, and counseling (target: 50;
actual: 69)
• Utilize “teach back” methodology to show an increased knowledge of
medication among clients (target: 50; actual: 69)
• Improve medication compliance within six months for clients identified
as having deficits in medication compliance (target: 30; actual: 48)
Chronic Disease Self-Management
• Offer one 15-hour CDSMP class for Afghan participants (target: 18
participants; actual: class not held)
• Achieve participants showing an increase in their ability to manage
chronic conditions (target: 12; actual: NA, as class was not held)
• Offer one six-week diabetes class for participants (target: 20
participants; actual: 12)
Matching Funds
The Health Promoters program
leveraged its Measure A allocation
to obtain $70,059 in matching funds
from the Fremont General Funds.
Measure A
Allocation
Matching
Funds
$51,000
$70,059
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BACKGROUND
The Alameda County Health Care Services Agency Health Insurance
Enrollment Assistance department provides underinsured and uninsured
Alameda County residents information, referrals, and application
assistance for the following health care and benefit programs: Medi-Cal,
CalFresh, Cash Aid, Healthy Families, and Kaiser Child Health Plan.
In 2013, the Health Insurance Enrollment Assistance department began
a partnership with the Oakland Unified School District. The goal was to
offer health insurance assistance in a familiar setting to families served by
the district, who otherwise would not follow through with applying for or
renewing their county benefits. The school district gave the department
space to come in weekly to support families.
MEASURE A FUNDING SUMMARY
Thanks in part to Measure A funding, the program provided benefit
program application assistance to 2,167 Alameda County residents.
Allocation: $300,000 | Expended/Encumbered: $300,000
Individuals served by Measure A: 520 (Total individuals served: 2,167)
Populations served: Indigent, Low Incomes, Uninsured Adults, Children, Families
Services provided: Emergency Medical, Hospital Inpatient, Hospital Outpatient, Public Health, Mental Health, Substance Abuse
Service area: Countywide
Health Enrollment for Children
achealthcare.org/about/project-updates/childrens-health-insurance-enrollm
Matching Funds
The Health Insurance Enrollment
Assistance department leveraged
its Measure A allocation of obtain
$150,000 in matching funds from
Medi-Cal Administrative Activities
(MAA).
Measure AAllocation MatchingFunds
$300,000
$150,000
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BACKGROUND
The Alameda County Health Care Services Agency (HCSA) works to
provide fully integrated health care services through a comprehensive
network of public and private partnerships that ensures optimal health
and well-being and respects the diversity of all residents.
A specific program of HCSA focused on maximizing client access to
health services funded by Medi-Cal, through the elimination of system
errors created during the Healthy Families Transition and implementation
of the Affordable Care Act.
The MEDS error elimination services increase access to care for low
income Medi-Cal clients. When the MEDS system blocks a MEDS case,
clients seeking nonemergency care are often denied access to care or
service providers are not reimbursed for the care they provide.
Staff corrected errors that were generated by the MEDS system and
updated information that to ensure correct benefits were applied to the
case. These efforts give clients access to affordable, high quality health care
provided in the County.
MEASURE A FUNDING SUMMARY
In 2013, a total of 277,510 clients received Medi-Cal Benefits in Alameda
County. Data discrepancies cause eligible clients to have an inactive status
appear on their record, causing interruptions of care. Measure A funding
allowed a team of eligibility workers to dedicate themselves to resolving
these types of data/system conflicts, resulting in Medi-Cal records that are
active and ensuring continued access to medical care. In FY 12/13, a total
of 20,368 discrepant records were corrected by this team.
Allocation: $200,000 | Expended/Encumbered: $200,000
Individuals served by Measure A: 20,368 (Total individuals served: 277,510)
Populations served: Low Income Adults, Children, Families, Seniors
Services provided: Emergency Medical, Hospital Inpatient, Hospital Outpatient, Public Health, Mental Health, Substance Abuse
Service area: Countywide
Health Insurance Eligibility and Enrollment
Measure A Helps
The Ramos-Dominguez family
household includes five members with
distinct statuses and eligibility. Mrs.
Ramos is from El Salvador and has
legal presence in the United States as
a T-VISA holder. Mrs. Ramos has two
children from a previous marriage,
who are undocumented. Mrs. Ramos
is now married to Mr. Dominguez,
who is also from El Salvador and also
undocumented. Together they have
a child born in the United States.
With the help a Health Insurance
Technician, the family was able to
map out everyone’s eligibility. On the
end, everyone was covered, through
a combination of Covered California,
Kaiser Child Health Program, the
County’s HealthPAC program, and
Medi-Cal.
Measure A Helps
Individuals discontinued from SSI/
SSP due to the annual COLA
are placed in Craig v. Bonta aid
codes 1E aged, 2E blind, and 6E
disabled. These individuals remain
as “Exception Eligibles” until an
SSA eligibility worker completes
an eligibility determination. One
example: Ms. Smith, a 33-year-old
Berkeley resident, suffers from multiple
health issues including lupus. She
has frequent medical appointments
and pharmaceutical needs. Ms. Smith
contacted the MEDS EE team in
desperate need of assistance. Her
eligibility status showed as inactive,
and she was unsuccessful in getting
assistance from Social Security. The
team member resolved the issue, and
Ms. Smith was granted access to her
doctor and medications.
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BACKGROUND
The Health Service for Day Laborers Community Initiatives/Day Labor
Center (DLC) program works to enable low income, unemployed, and
underemployed individuals, including at-risk youth, re-entry clients,
and migrant workers, reach self-sufficiency through employment and
community integration programs.
Through the services of partners St. Rose Hospital in Hayward, Davis
Street Health Clinic in San Leandro, California State East Bay’s Initiative
for Community Wellness in Hayward, and Samuel Merritt University in
Oakland, the DLC Healthcare Portal Project provides primary health care
services to hundreds of under- and unemployed, mostly migrant workers
in Southern Alameda County. The DLC continues to develop culturally
competent material for its clientele and to train Peer Health Educators to
provide outreach and information services to this population.
The DLC provides services in the following areas:
• Mental health. The DLC provides workshops and informational
meetings to help workers’ mental health needs and issues related to
domestic violence.
• Alcohol and drug. The DLC provides workers with literature about the
effects of alcohol and drug use and abuse.
• Hospital and inpatient services. The DLC portal services use hospital
services for extreme and/or emergency cases only, including lab and
other specialty services as needed.
• Public health prevention. The DLC offers Zumba classes for women
workers, develops and monitors individual health plans for weight and
diabetes management and prevention, and provides HIV prevention
education and screening.
• Outpatient services. In addition to ancillary services provided by the
Davis Street Clinic and/or St. Rose Hospital sites, the County provides
DLC workers with dental services three months out of the year.
• Youth and community services. The DLC provides services to the
Allocation: $120,131 | Expended/Encumbered: $120,131
Individuals served by Measure A: 350 (Total individuals served: 660)
Populations served: Indigent, Low Income, Uninsured Adults, Families, Seniors
Services provided: Emergency Medical, Hospital Inpatient, Hospital Outpatient, Public Health, Mental Health, Substance Abuse
Service area: Ashland, Cherryland, Fremont, Hayward, Oakland, San Leandro, San Lorenzo, Union City
Health Services for Day Laborers: Community Initiatives (Day Labor Center)
achealthcare.org/about/project-updates/childrens-health-insurance-enrollm
Measure A Helps
Pedro, 54, came to the DLC to get
checked for his stomach and arm
pains. Staff checked his height, weight,
temperature, and blood pressure, and
sent him to give a blood sample to
test his blood sugar levels. When he
returned to get the test results, staff
recommended more tests because of
suspected diabetes. After this second
test, DLC staff confirmed Pedro’s
diabetes. They counseled him about his
diet and medication, encouraged him
to attend nutrition classes, and set up
regular blood sugar checks. Pedro’s
condition has improved greatly, and
DLC staff and health partners continue
to monitor him regularly.
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indigent population and youth from the surrounding neighborhood,
including job skills training and community volunteer service
opportunities.
• Socialization. The DLC maintains a community garden and has an
18-team soccer league to address the workers’ ailments of depression,
isolation, and loneliness due to being separated from their families in
their home countries.
MEASURE A FUNDING SUMMARY
Measure A funds provide approximately half of the support needed to
sustain the DLC Healthcare Portal Project.
Measure A funding helped the DLC achieve the following measurable
objectives:
• Offer health-related navigation and referral services specific to the
health care needs of the 640 workers within the working-age day labor
population at the DLC
• Provide over 900 primary health care referrals for health care
screenings and/or episodic care visits
• Conduct 210 follow-up assessments with and offer recommendations
to clients referred into the health care system
• Communicate the information and issues obtained in client follow-up
assessments to allied community-based organizations, policy makers,
and governmental agencies to assist in improving health care services
for the day labor population
• Hold five semi-annual meetings with appropriate staff from both the
clinic and Center to review and evaluate the services provided
• Advocate for the day labor population and their health care needs—
including hours of operation, types of services needed, and/or cost
structures—with local clinics by participating in several County and
City of Hayward meetings
• Train and work with four Peer Health Educators to provide health
education and outreach services to the day labor population
• Conduct external outreach to the working-age day labor population and
maintain a partnership between local clinics and the Center to ensure
day labor workers become integrated as part of the local health care
system
• Provide community health, safety, and wellness presentations and/or
trainings to unemployed and/or underemployed day labor workers
Matching Funds
The DLC leveraged its Measure A
allocation to obtain $154,000 in
matching funds from foundation
sources.
Measure AAllocation MatchingFunds
$120,131
$154,000
Measure A
funds provide
approximately
half of the support
needed to sustain
the DLC Healthcare
Portal Project.
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BACKGROUND
The Multicultural Institute (MI) accompanies immigrants in their
transition from poverty and isolation to prosperity and participation.
MI focuses its efforts in the following areas:
• Referrals and individualized follow-up for health services. The
community MI serves encounters various issues when accessing
medical services. MI’s case management and referral system assists
individuals in overcoming language barriers. MI provides navigation
in the health system and is a place where individuals can obtain
information on services needed.
• Street conditions. MI staff brings its services to about 40–50 day
laborers seeking work in West Berkeley every day. The program works
with local officials and businesses to ensure that the area is safe, there
is access to trash receptacles and bathrooms, and no harassment of
workers occurs.
• Job-matching. MI provides no-fee job-matching services for day
laborers to receive jobs at a fair minimum wage.
• Skill-building. MI offers different vocational trainings such as skills
needed to operate a business, Spanish-language GED preparation
courses, and other topics.
• Fair working conditions. MI staff aid workers in redressing problems
(wage claims, unsafe conditions, occupational injuries) that result from
jobs not obtained through the Institute.
• Community-building and healthy pastimes. Sponsoring events like
soccer matches, street cleaning, and a weekly simple shared meal helps
break down isolation and leads to new ways of working together.
Allocation: $85,000 | Expended/Encumbered: $85,000
Individuals served by Measure A: 1,023 (Total individuals served: 1,023)
Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors
Services provided: Hospital Outpatient, Public Health
Service area: Berkeley, Oakland
Health Services for Day Laborers: Multicultural Institute
mionline.org/
Measure A Helps
A day laborer came for dental help
who had two front teeth that were so
rotten, they were ready to fall out. The
program assisted him at the onsite
dental van. He thought that that was
all the care he would need, but he had
extractions done along with a deep
cleaning. His teeth were so decayed
that after the onsite appointments, he
was referred to the LifeLong Medical
dental clinic for further help. In the
end, he received a full set of dentures.
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MEASURE A FUNDING SUMMARY
Measure A funding helped MI’s Day Laborer program conduct regular
outreach to day laborers to inform/give support about clinic services and
other health/health education activities (target: 600 unduplicated day
laborers; actual: 923).
More specifically, Measure A funding helped MI offer the following in
Alameda County:
• Provide health care services onsite or close by (target: 2,800 encounters;
actual: 2,726)
• Offer case management and/or referral in conjunction with health
services (target: 300 encounters; actual: 508)
• Have clients participate in training or workshops on various topics
such as occupational health/safety, sexual health, oral health, substance
abuse, nutrition, diabetes and high blood pressure, and health care
resources and program enrollment (target: 250 clients; actual: 252)
• Have clients participate in health screenings, receiving referrals as
needed (target: 100 clients; actual: 100)
• Provide health care (including dental and mental health) treatment
and services via contracted services (target: 700 health care visits/
encounters; actual: 501)
• Provide weekly distribution of Alameda County Food Bank groceries
for qualifying low income households (target: 2,000 beneficiaries in 500
unduplicated households; actual: 1,306 beneficiaries in 413 households)
• Develop new partnerships within the County to streamline client
integration in new and existing health care services for which they are
eligible (actual: 3 partnerships)
• Aid individuals with health insurance coverage requirements and
enrollment (actual: 29 individuals)
• Partner with UC Berkeley’s School of Social Welfare on project to
implement survey to day laborers to gather quantitative data capturing
environmental stressors and individual health indicators, resulting in
an aggregate data report on depression, anxiety, alcohol use, and sexual
behavior (target: 70 day laborers surveyed; actual: 83)
Matching Funds
MI leveraged its Measure A allocation
to obtain two years of matching
funds from the City of Berkeley in the
amount of $71,394 each year.
Measure AAllocation MatchingFunds
$85,000
$142,788
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BACKGROUND
Street Level Health Project is an Oakland-based grassroots organization
dedicated to improving the health and well-being of underserved urban
immigrant communities in the Bay Area. The Street Level community
center is an entry point to the health care and social service system
for those most often overlooked and neglected, namely the uninsured,
underinsured, and recently arrived. Street Level develops trusting
relationships with isolated immigrants, offers them a place to build a
healthy and vibrant community, and empowers them to advocate for the
well-being of themselves and their families.
Street Level Health Project provides a safe space for people from 33
different countries that speak 34 different languages to receive vital
services, information, and referrals. On an average program day
participants see a doctor, access mental health services, get vaccinated,
receive free medication, eat a hot meal, receive a bag of free healthy food,
and enroll in health care coverage, all within the same day and space.
MEASURE A FUNDING SUMMARY
Measure A funds allowed Street Level to develop and implement a new
patient screening questionnaire, which involved research and planning,
testing out the questionnaire, gathering feedback from community
members and health workers, making revisions, and training volunteers.
The questionnaire has allowed Street Level to both improve the quality
of clinical care and make significantly more tailored referrals to mental
health services, recovery resources, gynecology/reproductive services, STI
testing, and health care coverage.
Measure A funds also allowed Street Level to deepen the integration of
health education into its clinic visits. During FY 13/14, the Street Level
nutritionist collaborated with a volunteer to develop nutrition health
education materials that volunteers can review with patients as part of the
clinic visit.
Allocation: $85,000 | Expended/Encumbered: $85,000
Individuals served by Measure A: 408 (Total individuals served: 1,700)
Populations served: Indigent, Low Income, Uninsured Adults, Families
Services provided: Public Health, Mental Health
Service area: Countywide
Health Services for Day Laborers: Street Level Health Project
streetlevelhealth.org
Measure A Helps
Odsaikhan, 40, came to Street Level
Health Project seeking health care.
He had chronic thyroid issues and
had lost 20 pounds in the last 11
months, with symptoms of sweating,
tremors, palpitations, hair loss,
appetite changes, and shoulder pain.
After Odsaikhan’s physical exam,
staff diagnosed him with Graves’
Disease and hepatitis. Staff referred
Odsaikhan to Highland Hospital
and connected him to free hepatitis B
testing and HealthPAC enrollment,
both offered onsite at Street Level.
Odsaikhan returned a month later
for follow-up care, feeling pleased at
his improved health since beginning
treatment. Street Level will now
support Odsaikhan in transitioning
his primary care to a community clinic
that meets his needs.
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Measure A funds also allowed Street Level to provide Mam (a Mayan
language) and Mongolian interpretation to patients and clients.
Interpretation was provided within the clinic and during street outreach
with day laborers.
Measure A funds helped Street Level to strengthen its health navigation
and referral program by hiring a staff member to directly support health
navigation volunteers and build the program’s infrastructure.
In addition, Measure A funding helped Street Level Health Project achieve
the following measurable objectives:
• Provide health care screening and episodic care annually to clients
across multiple languages (target: 930 unduplicated clients; actual: 817)
• Offer health-related navigation/referral services (target: 800 referrals;
actual: 1,438)
• Provide mental health prevention workshops/trainings (target: 10;
actual 11)
• Offer mental health consultations/referrals annually to low income
immigrant communities in Alameda County (target: 125; actual: 144)
• Provide nutritionist/herbalist consultations (target: 150; actual: 134)
• Offer occupational health, violence prevention, health education, and
community wellness presentations to low income immigrants (target:
30 workshops; actual: 31)
• Distribute free healthy fruit and produce food bags to low wage workers
and their families (target: 4,000 bags to 400 workers/families; actual:
6,944 bags to 701 workers/families)
• Connect individuals to resources of local grassroots community
organizations that provide legal, educational, and social services (target:
850 referrals; actual: 981)
• Provide presentations related to the Affordable Care Act to low
wage workers and other community-based organizations (target: 5
presentations; actual: 5)
• Collaborate with community-based organizations, health care agencies,
and/or governmental agencies to promote the health and wellness
of immigrants and refugees (target: collaboration with 12 outside
agencies; actual: 20 collaborative events)
• Participate in meetings regarding health reform and implementation
(target: 4 meetings; actual: 5)
• Leverage financial support from private foundations by submitting
grant applications for the Health Access Program (target: 4
applications; actual: 8)
• Collaborate with students enrolled in the health field and health
care-related schools to train future multilingual health care providers,
providing them with experience working with uninsured low income
communities (target: 20 students; actual: 59)
Matching Funds
Street Level Health Project leveraged
its Measure A allocation to obtain a
total of $90,000 in matching funds
from the following sources:
• California Endowment
• Frances K. and Charles D. Field
Foundation
• Latino Community Foundation
• San Francisco Foundation
• Thomas J. Long Foundation
Measure A
Allocation
Matching
Funds
$85,000 $90,000
Measure A funds
also allowed
Street Level to
deepen the
integration of
health education
into its clinic visits.
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BACKGROUND
Alameda County Health Care Services Agency (HCSA) Human Resources
works to ensure that the agency and its operating departments achieve
organizational goals through a dynamic, comprehensive, and high quality
human resource service delivery.
Hospice is an underutilized Medicare and Medi-Cal benefit of significant
value. The Alameda County “Getting the Most Out of Life” (GMOL)
program is designed to reduce suffering and improve quality of care for
residents of Alameda County through advance health care planning and
hospice utilization.
GMOL seeks to accomplish the following:
• Change attitudes about end-of-life planning and hospice
• Increase willingness to advocate for end-of-life and hospice planning
for/by Measure A beneficiaries
• Increase knowledge about advance health care planning and hospice
• Increase willingness to refer eligible patients to hospice services
• Increase knowledge of how to improve hospice services
• Increase knowledge of and completion rate of CA Advance Health
Directives and the Physician’s Order for Life Sustaining Treatment
(POLST)
• Determine what percentage of Alameda County deaths are hospice
deaths and what percentage of eligible patients receive the hospice
option
• Answer the question: Have we increased hospice utilization?
MEASURE A FUNDING SUMMARY
Measure A provides 100% of the funding for the GMOL program.
In the area of hospice utilization and data collection, GMOL and HCSA
staff used Measure A funding to design an In-Home Support Services
(IHSS) pilot. While it is well established that hospice utilization reduces
costs, the proposal is to integrate health care and social services into a
Allocation: $200,000 | Expended/Encumbered: $182,140
Individuals served by Measure A: 600 (Total individuals served: 1,000)
Populations served: Indigent, Low Income, Uninsured Adults, Families, Seniors
Services provided: Emergency Medical, Hospital Inpatient, Hospital Outpatient, Public Health, Mental Health
Service area: Countywide
Increase Hospice Utilization
gettingthemostoutoflife.org/about-variant-2
The Alameda
County “Getting the
Most Out of Life”
(GMOL) program is
designed to reduce
suffering and improve
quality of care for
residents of Alameda
County through
advance health care
planning and hospice
utilization.
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system of care for the terminally ill. The innovation is the potential to
begin with a robust data collection plan to demonstrate the potential for
increasing hospice utilization.
In the area of collaborative stakeholder engagement, Measure A funding
helped the GMOL program achieve the following objectives:
• A coalition of hospice provider organizations, donors, and volunteers
presented The Art of Aging/Cycles of Life at the Oakland Museum. This
free event was attended by 200 people, including a large number of low
income and ethnically diverse community members.
• GMOL and the Alameda County Hospice Providers Coalition launched
its Conversation Campaign, encouraging people to have a conversation
about advance health care wishes and planning before a medical crisis
occurs. Results from the Campaign include the following:
- 253 people trained in Alameda County from 11 ethnic groups.
- 119 documentation cards returned by participants who made a
commitment to have conversation with family or loved ones and
return the cards to GMOL.
• Sponsorship of the Death Café in Fremont (South County) and a
National Healthcare Decisions Day (NHDD) Expo and Program at the
Kaiser Center in Oakland. The Kaiser Center Expo called The Life of
Stories attracted 182 attendees, 45 volunteers, and 29 end-of-life care
vendors, and resulted in 11 advance directives completed.
Measure A
provides 100% of
the funding for the
GMOL program.
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BACKGROUND
The Measure A grant for indigent health stabilization was awarded to six
organizations:
• Preventive Care Pathways: $200,000
• Davis Street Family Resource Center: $200,000 (expended: $177,968)
• Healthy Communities: $200,000
• Integrated Medical Associates of Alameda County: $200,000
• Roots Community Health: $150,000
• West Oakland Health Council: $200,000
Preventive Care Pathways
Preventive Care Pathways serves the needs of all that seek pathways
towards overall wellness. It offers “Pathways to Wellness” to the general
population by providing medical services for at-risk and indigent patients,
production and presentation of educational videos and literature, and
health care services for individuals re-entering the community from the
prison system.
Patients are African-American and other minority patients who are
indigent and homeless. Many patients are re-entry patients who typically
cannot receive services. Patients receive wraparound services and food,
clothing, and shelter, as well as laboratory services and medications.
Davis Street Family Resource Center
Davis Street Family Resource Center (DSFRC) helps people with low
incomes in the Eden area and its surrounding communities, which
includes the cities and unincorporated areas of San Leandro, San Lorenzo,
Castro Valley, Hayward, and Union City, improve their quality of life
through short- and long-term assistance.
The full-service primary health care clinic provides critical medical
services, as well as dental care, substance abuse treatment, domestic
violence prevention, and mental health care. DSFRC serves low income,
Allocation: $1,150,000 | Expended/Encumbered: $1,150,000
Individuals served by Measure A: 4,284 (Total individuals served: 7,765) Total numbers for the four providers who submitted reports and
completed work in FY 13/14 as explained in “Background,” below.
Populations served: Indigent, Low Income Uninsured Adults, Children, Families, Seniors
Services provided: Emergency Medical, Public Health, Mental Health, Substance Abuse
Service area: Countywide
Indigent Health Stabilization
Measure A Helps
Preventive Care Pathways
An African male with diabetes,
hypertension, neuropathy, and pain
had lost his job and was not able to
seek care. He had lost 40 pounds due to
the neuropathy. Through HealthPac’s
transition to Medicaid (Alameda
Alliance), he was able to be seen at
the Preventive Care Pathways clinic
and initiate insulin and medication
for neuropathy and pain. He has
gained 25 pounds and has his diabetes
under control. His quality of life has
improved significantly as a result of his
chronic/acute disease management.
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undocumented, and uninsured clients between the ages of 0 and 80+
years.
Healthy Communities
Healthy Communities works to decrease violence and health inequities
in people of color in every community in which it offers services.
To accomplish this, Healthy Communities collaborates with other
community-conscious organizations, churches, businesses, and
individuals. Healthy Communities also engages community and political
leadership to foster lasting relationships and activities that build a stronger
and safer community.
Integrated Medical Associates of Alameda County
Integrated Medical Associates of Alameda County Inc. (IMAAC) provides
medical services to low income or no income, transient, homeless, and
working poor; unemployed individuals; uninsured adults; individuals
recently released from incarceration; immigrant populations; seniors; and
other residents of Alameda County in the medically underserved/Health
Professional Shortage Area (HPSA).
The IMAAC clinic provides ongoing continuity of care for patients. The
majority are African-American and other minority patients who are
indigent, unemployed, and homeless. Many of these patients are re-entry
patients who typically receive medical services from the emergency
department (ED) when they are sick. Patients receive quality medical care,
continuity care, referrals to specialists, and follow-up visits, as well as
laboratory and imaging referral services.
Roots Community Health
The Roots Community Health funding period was for 18 months, from
January 2014 to June 2015. However, the contract was executed in June
2014, so work accomplished will be reported for FY 14/15.
West Oakland Health Council
As of the publication of this report, West Oakland Health Council had not
submitted a provider report.
MEASURE A FUNDING SUMMARY
The indigent health stabilization providers used their Measure A
allocations to achieve the following:
Preventive Care Pathways
• Become a Covered California Certified Enrollment Entity (CEE). The
application was submitted in November 2014.
Matching Funds
Preventive Care Pathways leveraged
its Measure A allocation to obtain
$105,750 in matching funds from the
following sources:
• General Assistance funding
• Preventive Care Pathways providers
• Staff providers in-kind services
• Preventive Care Network
administration
• Equipment and supplies in-kind
services
• Pharmacy and lab donations
• Volunteer services
• Funding generated from uninsured
HealthPac patients transitioning
to Medi-Cal and other covered
services/programs
Measure AAllocation MatchingFunds
$200,000
$105,750
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• Have staff approved and trained as Covered California Enrollment
Counselors. Four staff members were identified, and applications were
submitted on their behalf in November 2014.
• Designate one staff person to participate in the Covered CA CEE
Alameda Partnership meetings. Designated staff has attended two
meetings so far.
• Strategize on how to best coordinate enrollment efforts as Alameda
County works toward building a “No Wrong Door” approach to
enrollment.
• Recruit 1 FTE of each: nurse practitioner, medical assistant, and
administrative assistant.
• Provide direct medical service visits to 175 low income County
residents on average per month.
• Provide a total of 1,750 patient office visits to HealthPac/transitioning
HealthPac patients, who received quality medical care and follow-up
care.
Davis Street Family Resource Center
• See a total of 515 patients in the new primary care center. All of these
patients were sliding-scale fee-payers and, thus, would not have had
access to quality medical care without the existence of the new clinic.
• Pay consultant fees necessary for the development of a federal
application for a new federally qualified health center.
• Purchase new clinical equipment including five examination tables,
clinician rolling stools, diagnostic equipment, and licenses to electronic
health records and a patient management and electronic billing system.
Healthy Communities
• Provide health care coverage and public health services application
assistance and/or appropriate referrals for assistance for the re-entry
population in Alameda County.
• Increase access to culturally competent support services for West
Oakland Health Council (WOHC) re-entry patients through
participation in Healthy Communities Health Education, Violence
Prevention, and Community Outreach services.
• Make personal contact with Save a Life Wellness Center (SALWC)
patients and coordinate with the Alameda Health Enrollment with a
new medical home (target: 1,850 total, 1,300 new Medi-Cal/former
HealthPac, 150 HealthPac, 400 Medi-Cal; actual: 260 total, 238 former
HealthPac, three HealthPAC, 19 Medi-Cal).
• Enroll 33 former SALWC patients with a new primary care provider.
• Become a Covered CA Certified Entity (CEE). HCI became a CEE on
11/02/2013.
• Have staff approved and trained as Certified Enrollment Counselors
(CEC). Staff currently includes five CECs, with more going through the
certification process.
• Designate at least one staff person to participate in the Covered CA
CEE Alameda County Partnership meetings. One staff member has
been designated.
Measure A Helps
Davis Street Family Resource Center
The Chin family initially came to
DSFRC for the holiday bike give-away
and food basket. During the give-away,
Davis Street staff did a preliminary
screening of family needs. Staff learned
that the family had one disabled
parent, and the other was severely
underemployed. This family was
experiencing severe food shortages, two
of the children required dental care,
and the father needed medical care and
management of a chronic condition
that was not being monitored. Staff
developed a relationship with this
family and over the past year witnessed
improvement in their medical and
social condition. The father is now
fully employed, and the children have
qualified for medical insurance.
Preventive Care
Pathways provided
direct medical
service visits to 175
low income County
residents on average
per month.
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• Complete development of a mechanism to track benefits program
application submission to ensure application approval.
• Conduct five planning meetings with WOHC staff to design referral
system enhancements.
• Contract with consultants to provide assistance in the transformation
of Healthy Communities. This included the creation of a transformation
plan, an initial viability and feasibility assessment report, a nondisclosure
agreement, process mapping, a press release, and other documents and
instruments.
• Improve the forms used to process clients during intake and initial
assessment to help streamline the process and allow for better tracking
of outcomes resulting from assistance to clients.
Integrated Medical Associates of Alameda County
• Become a Covered California Certified Enrollment Entity (CEE)—
completed .
• Have staff approved and trained as Covered California Enrollment
Counselors. One staff members was identified, and an application was
submitted on his behalf in November 2014.
• Designate one staff person to participate in the Covered CA CEE
Alameda Partnership meetings. Designated staff has attended two
meetings so far.
• Strategize on how to best coordinate enrollment efforts as Alameda County
works toward building a “No Wrong Door” approach to enrollment.
• Provide application assistance and/or appropriate referrals to patients
that are eligible for CalFresh and CalWorks.
• Provide a total of 1,500 direct medical service visits and assistance to
low income Alameda County residents. Patients received referrals to
laboratories, NorCal imaging, and specialists for preventive services.
• Increase access to health care and public health services for low income
residents of Alameda County by providing health insurance and public
health services application assistance and/or appropriate referrals for
assistance.
• Offer diabetic education for pre-diabetic and diabetic patients.
CONCERNS
Healthy Communities
The provider report indicates that logistical and other problems interfered
with completion of tasks funded by Measure A. There is no indication of
when these tasks will be completed.
West Oakland Health Council
No report was submitted. Therefore, there is no evidence of any compliance.
The Oversight Committee cannot assume that the funds were used in
compliance with Measure A. Until this situation is resolved, the Oversight
Committee recommends that this organization should not receive any
further Measure A funding.
Measure A helped
Healthy Communities
to provide health
care coverage
and public health
services application
assistance and/or
appropriate referrals
for assistance for the
re-entry population
in Alameda County.
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BACKGROUND
The Alameda County Health Care Services Agency (HCSA) works to
provide fully integrated health care services through a comprehensive
network of public and private partnerships that ensures optimal health
and well-being and respects the diversity of all residents.
HCSA oversees certain programs that provide services at the Alameda
County Juvenile Justice Center (JJC). Included in these programs are
services provided by the JJC Health Services Director. The JJC Health
Services Director is responsible for the following:
• Plan, organize, direct, and evaluate the operations of all health services
programs for minors in the Alameda County juvenile justice system
including the Guidance Clinic, Children’s Hospital contract, HCSA-
contracted services for youth in JJC and Camp Sweeney, and Behavioral
Health Care Services (BHCS)-contracted services for youth in the
community
• Serve as the primary liaison to the Juvenile Court and Probation
Department for juvenile health services operations, collaborations, and
re-entry planning
• Coordinate service systems to ensure compliance with legislative
mandates and minimum standards as well as state and federal rules and
regulations
• Increase collaboration with Probation to enable better access to BHCS
services to youth on probation
MEASURE A FUNDING SUMMARY
This Measure A allocation covered the cost of the JJC Health Services
Director.
The services provided by the JJC Health Services Director contributed to
improving the lives of the youth in JJC in the following manner:
• Develop a blended funding model that covers the costs of youth mental
health services with no Medi-Cal. This model increased services to 10
youth at any given time a year.
Allocation: $261,000 | Expended/Encumbered: $261,000
Individuals served by Measure A: 0 (Total individuals served: 0)
Populations served: Children
Services provided: Mental Health
Service area: Countywide
Medical Costs for Juvenile Justice Center: Direct Service Planning and Administration
Matching Funds
The JJC Health Services Director
leveraged its Measure A allocation
to obtain $46,350 in matching funds
from Maternal Child Health (MCH).
Measure AAllocation MatchingFunds
$261,000
$46,350
This Measure A
allocation covered
the cost of the
JJC Health
Services Director.
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• Develop a report on the needs of girls in probation to guide future
program development.
• Redesign mental health services to allow for increased staffing in units.
This enabled more than one unit to have two clinicians onsite.
• Develop a program model for expansion of $1,000,000 of Medi-Cal
billable services to be implemented in FY 14-15.
• Develop a database for tracking psychotropic medications for youth in
JJC and Camp Sweeney.
• Develop a process to train probation and BHCS staff working in JJC and
Camp Sweeney on trauma-informed care.
Measure A
helped the JJC to
redesign mental
health services to
allow for increased
staffing in units.
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BACKGROUND
Founded in 2000 by a group of formerly incarcerated youth, Mind
Body Awareness (MBA) delivers mindfulness-based mental health
programming to at-risk, gang-involved, and incarcerated youth in three
Bay Area counties. MBA’s mission is to help youth transform harmful
behavior and live meaningful lives through the practices of mindfulness
meditation and emotional awareness. MBA also engages in customized
curriculum development and training for service providers working
with at-risk youth regionally and nationally. The heart of MBA’s work is
to provide the most at-risk youth in the most difficult environments—
probation detention facilities, youth detention camps, and at-risk
schools—with concrete tools to reduce stress, impulsivity, and violent
behavior and increase self-esteem, self-regulation, and overall well-being.
MEASURE A FUNDING SUMMARY
Measure A funding helped MBA achieve the following measurable
objectives:
• Provide mindfulness-based classes at the ACJJC. MBA used Measure A
funds to deliver mindfulness-based stress reduction programs in several
units (1, 2, 3, and 4) of the Alameda County Juvenile Justice Center
(ACJJC) as well as Camp Sweeney. Classes took place once per week,
for 1.5 hours.
• Offer at least one team-taught (co-facilitated by more than one
instructor) class, with a goal of eventually team-teaching all classes.
Approximately 55% of classes were team-taught in FY 13/14.
• Provide a minimum of one instructor per class. MBA met this objective
for 100% of classes taught. Classes that weren’t taught were results of
the units being on lockdown, instructor illness, or instructor scheduling
issues.
• Collaborate with probation, the medical unit at ACJJC, and Alameda
County Behavioral Health Care Services (BHCS) to make sure these
agencies are reinforcing services outside of classes. The prior and
Allocation: $56,100 | Expended/Encumbered: $56,100
Individuals served by Measure A: 160 (Total individuals served: 277)
Populations served: Indigent, Low Income, Uninsured Children
Services provided: Public Health, Mental Health, Substance Abuse
Service area: Countywide
Medical Costs for Juvenile Justice Center: Mind Body Awareness
mbaproject.org
Highlights
Research data analyzed in the past
year revealed a significant decrease
(19.6%) in perceived stress, a
significant increase (23.7%) in healthy
self-regulation, and a significant
increase in self-esteem (14.1%) from
pre- to post-testing.
Matching Funds
MBA leveraged its Measure A
allocation to obtain over $160,000 in
matching funds.
Measure AAllocation MatchingFunds
$56,100
$160,000
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current MBA Executive Directors met at various times with guidance
clinic (BHCS) and probation leadership to collaborate about reinforcing
services.
• Complete an evaluation of services. This evaluation included measuring
stress and self-regulation quantitatively, and interviewing both ACJJC
line staff and youth about the impact of the MBA program. MBA
collected data and published some academic journal articles on the
efficacy of its work in FY 13/14. The best-quality data was collected
from Camp Sweeney.
Measure A Helps
During the time Jerome, an MBA
participant, was working through
the program, another youth in the
unit was egging him on and verbally
abusing him. While Jerome wanted
to curse at or physically assault the
youth, he knew that choice would
lead to a new charge. Instead, in
his own words: “I just remembered
mindfulness and meditation. I took
about three or four breaths, and I made
a solid decision to walk back to my
room and not get in trouble.”
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BACKGROUND
Niroga Institute fosters health and well-being by bringing Transformative
Life Skills (TLS) or dynamic mindfulness to at-risk and underserved
individuals, families, and communities. TLS develops self-transforming
life skills through mindful movement, breathing techniques, and
meditation.
MEASURE A FUNDING SUMMARY
Niroga Institute used its Measure A allocation to provide the following at
the Alameda County Juvenile Justice Center (JJC):
• 13 TLS classes per week serving an average of eight youth each
• Three all-day immersions/retreats serving an average of eight youth
each
• Three intersessions with 10 classes per week, serving an average of 12
youth each
• One staff class per week serving an average of five staff each
Allocation: $40,000 | Expended/Encumbered: $40,000
Individuals served by Measure A: 132 (Total individuals served: 315)
Populations served: Indigent, Low Income, Uninsured Children, Adults (ages 16–24)
Services provided: Mental Health
Service area: Countywide
Medical Costs for Juvenile Justice Center: Niroga Institute
niroga.org
Highlights
In evaluation surveys, the vast majority
of participants expressed positive
outcomes such as an increase in
self-control, decrease in stress, and
healthy habits from Niroga Institute
activities: over 80% from weekly youth
TLS sessions, 100% from daylong
immersions, and 100% from staff
classes.
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BACKGROUND
The Victim/Witness Assistance Division of the Alameda County District
Attorney’s Office supports and empowers crime victims and their families
by promoting their rights within the criminal justice system and providing
services to aid in their recovery from the emotional, psychological, social,
and economic impact of crime as they reclaim their sense of safety, well-
being, and dignity.
The Victim Compensation Program offers the following:
• Crisis support referrals and follow-up to outside agencies
• Optimum compensation assistance through the investigation and
utilization of other applicable financial resources and recovery
• Support in navigating the client’s immediate access to critical needs
services: medical, mental health, pharmaceutical, etc.
• Swift processing of emergency claims to alleviate client financial
suffering and hardship
• Increased expansion of covered financial services and benefits, and
evaluation of their effectiveness in addressing the client’s needs
MEASURE A FUNDING SUMMARY
The Victim Compensation Program used its Measure A allocation to hire
staff, which enabled the program to expedite the processing of claims
submitted by the Guidance Clinic originating in the Alameda County
Family Justice Center, Camp Sweeney, school-based health centers in
Alameda County, and/or Crisis Service Response Teams.
Allocation: $90,000 | Expended/Encumbered: $90,000
Individuals served by Measure A: 35 (Total individuals served: 3,125)
Populations served: Indigent, Low Income, Uninsured Adult, Children, Families, Seniors
Services provided: Emergency Medical, Hospital Inpatient, Hospital Outpatient, Mental Health
Service area: Countywide
Medical Costs for Juvenile Justice Center: Victims of Crime
alcoda.org/victim_witness/california_victim_compensation_program
Highlights
Measure A funding helped enable
clients who would normally have
been ignored because of lack of
information of available resources, or
limited resources to pay for treatment
services, to receive necessary services
on an ongoing basis at no cost to the
client or to Alameda County.
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BACKGROUND
Preventive Care Pathways offers “Pathways to Wellness” to the general
population by providing medical services for at-risk and indigent patients
as well as individuals re-entering the community from the prison system.
Preventive Care Pathways also produces and presents educational videos
and literature.
Preventive Care Pathways primarily serves African-American and other
minority patients who are indigent and homeless. The clients receive
wraparound services as well as food, clothing, and shelter.
MEASURE A FUNDING SUMMARY
Preventive Care Pathways used its Measure A allocation to provide direct
medical and support services, including medical exams and pharmacy
and laboratory services, to 645 indigent patients enrolled in the Health
Program of Alameda County (HealthPAC).
Allocation: $204,000 | Expended/Encumbered: $204,000
Individuals served by Measure A: 2,098 (Total individuals served: 3,050)
Populations served: Indigent, Low Income, Uninsured Adults, Seniors
Services provided: Emergency Medical, Mental Health
Service area: Alameda, Albany, Berkeley, Castro Valley, Emeryville, Hayward, Oakland, Piedmont, Pleasanton, San Leandro, San Lorenzo
Preventive Care Pathways
healthcare.gov/coverage/preventive-care-benefits
Highlights
Thanks in part to Measure A funding,
Preventive Care Pathways clients
experienced a reduction in emergency
room visits to Alameda Health System
and outside emergency rooms, as well
as improvement in clinical findings
related to diabetes, hypertension, and
congestive heart failure.
Matching Funds
Preventive Care Pathways leveraged
its Measure A allocation to obtain
$131,596 in matching funds and in-
kind contributions.
Measure AAllocation MatchingFunds
$204,000
$131,596
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BACKGROUND
The Alameda Health Consortium is a regional association of eight
community-based primary care health centers that work together
and support the involvement of their communities in achieving
comprehensive, accessible health care and improved outcomes for
everyone in Alameda County.
The Alameda Health Consortium is guided by the following principles:
• All people have the right to accessible and affordable high quality health
care that prevents illness, promotes wellness, and is sensitive to the
unique needs of particular communities and cultures.
• The barriers that prevent people from seeking care must be eliminated.
• Individuals and families must be empowered to participate in their own
health care.
• Low income and underserved people play an important role in the
formation of health policy at the local, state, and national level.
• Building consensus and coalitions around important health issues leads
to innovative solutions.
• Providing quality health care improves the well-being of our
communities.
• Racial and ethnic health disparities must be eliminated in order to have
healthy communities.
The Consortium’s outpatient services are provided at community health
center locations throughout Alameda County and are not hospital-based.
Over 20 different languages are spoken across the health centers.
The Alameda Health Consortium’s eight member health centers are the
following:
• Asian Health Services
• Axis Community Health
• La Clinica
• LifeLong Medical Care
• Native American Health Center
• Tiburcio Vasquez Health Center
• Tri-City Health Center
• West Oakland Health Council
Allocation: $5,611,835 | Expended/Encumbered: $5,611,835
Individuals served by Measure A: 38,918 (Total individuals served: 175,000)
Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors
Services provided: Outpatient, Mental Health
Service area: Countywide
Primary Care Community-Based Organizations
Highlights
Alameda Health consortium Centers
exceeded the “Healthy People 2020”
goals for prenatal care, both in regards
of percentage of patients starting
prenatal care in the first trimester and
notably in reducing low birth weight
deliveries (4.4% vs goal of <7.9%).
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MEASURE A FUNDING SUMMARY
The eight Alameda Health Consortium member health centers used their
Measure A allocation to provide essential health services—primary care
medical, behavioral health, dental—to uninsured, low income (<200%
FPL) Alameda County residents.
Specifically, Measure A funding helped Consortium member community
health centers achieve the following measurable objectives:
• 39,000 Alameda County residents accessed quality services such
as primary care, dental care, and mental health services, as well a
prescription medicines at very low costs through HealthPAC.
• Patients made over 111,686 visits collectively to the health centers.
• For dental services alone, patients made over 7,000 visits that included
cleanings, examinations, and fluoride treatments.
• In terms of mental health, Measure A funds supported 7,000 mental
health visits.
• Over 185,000 laboratory tests were given to patients during visits.
• Measure A funds supported the transition of 20,000 HealthPAC
patients now eligible for Medi-Cal under the Affordable Care Act
CONCERNS
Healthy Communities
In addition to the eight clinics that are members of the Alameda Health
Consortium, a ninth provider, Healthy Communities (not a member of
the consortium) received an allocation of $163,114. No information was
provided regarding the use of Measure A funds by Healthy Communities,
and no additional report was submitted.
Actual Visits for Each Consortium Health Center
Total Patients
Primary Care,
Specialty Visits Dental Visits
Mental Health
Visits Total Visits
Asian Health Services 6,046 14,276 253 459 14,988
Axis Community Health 4,144 11,160 -2,040 13,200
La Clinica de la Raza 10,041 27,288 2,487 272 30,047
LifeLong Medical Care 4,978 12,995 295 2,505 15,795
Native American Health Center 1,131 2,317 807 122 3,246
Tiburcio Vasquez Health Center 5,399 12,261 1,641 905 14,807
Tri-City Health Center 5,509 13,142 1,259 438 14,839
West Oakland Health Council 1,670 4,157 475 132 4,764
Total 38,918 97,596 7,217 6,873 111,686
Measure A Helps
From an interview with the son of an
undocumented patient at Asian Health
Services:
“In Korea, there were only hospitals
and no community health clinics. In
the United States, with the health
insurance and its complicated
system, community health clinics
play a very important and absolutely
humanitarian role to treat the low
income population and immigrants.
To be honest, we have never been to
the hospital in a long time. So, the
problem is we don’t know what kind
of problems we have. My mom was
recently able to enroll in HealthPAC
at Asian Health Services clinic and
saw her doctor a few times already. I
know she is almost 60, so we need to
watch out for her health especially her
diet. Because our family has history of
diabetes, she shows some signs of pre-
diabetes. “
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BACKGROUND
Tiburcio Vasquez Health Center, Inc. (TVHC) is dedicated to promoting
the health and well-being of the community by providing accessible
high quality care. TVHC’s individual and organizational commitment
is to ensure this human right through quality service, advocacy, and
community empowerment.
Through its Logan and Tennyson school health centers, TVHC offers
health education, case management, and youth and parent leadership
development programs. Providing health education and youth leadership
development services helps to ensure that youth receive comprehensive
intervention and support. These programs include the following:
• Young Men’s & Women’s Programs. These programs work to foster
leadership and empowerment in young men and women, specifically
youth from disenfranchised communities. The programs explore
oppression through a social justice lens, community organizing, and
personal subjects.
• After School Youth Empowerment Programs. The Hip-Hop Elements
program is a forum for any Logan student interested in creative
expression through hip-hop. The program focuses on several areas
of hip-hop, including the art of being a Disc Jockey (DJ), Graffiti Art,
Break Dancing, Master of Ceremony (MC)/Spoken Word, Poetry, etc.
• Youth Advisory Program/Peer Navigator Program. The Youth Advisory
Board (YAB) provides a platform for youth to give input into health
center policy and function. YAB members accomplish this by providing
feedback to health center staff and serve as an important evaluation
tool for the center’s services. YAB also serves as a means for youth to
actively promote health to the high school campus. They accomplish
this by developing school-wide “health tips” that air on the school
PSA system, hosting workshops, organizing an annual health fair,
and participating in community activities that promote leadership,
community involvement, and civic participation.
• CAFÉ Parent Engagement Program. At CAFÉ (Club de Aprendizaje
Para Una Familia Estable), parents learn about domestic violence and
immigration reform policies such as Deferred Action for Childhood
Allocation: $60,000 | Expended/Encumbered: $60,000
Individuals served by Measure A: 2,350 (Total individuals served: 5,500)
Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors
Services provided: Public Health, Mental Health, Substance Abuse
Service area: Ashland, Cherryland, Hayward, Union City
Tiburcio Vasquez Health Center, Inc.
tvhc.org
Matching Funds
TVHC leveraged its Measure A
allocation to obtain an addition
$20,000 in matching funds from the
Latino Community Foundation.
Measure AAllocation MatchingFunds
$60,000
$20,000
Providing health
education and
youth leadership
development services
helps to ensure
that youth receive
comprehensive
intervention and
support.
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Arrivals (DACA). The program strongly fosters leadership development
among participants.
• Health Education/Family Planning. The school-based health centers
provide one-on-one health education visits to youth. Students receive
individual counseling regarding family planning education, pregnancy
prevention options, and STI/HIV education. Additionally, wraparound
care is provided by case management to ensure all students are
provided support and care to meet their health needs.
MEASURE A FUNDING SUMMARY
Measure A funding helps make it possible for TVHC to continue to
provide school-based youth outreach, health education, case management
services, and parent engagement to high school students and their parents
through the Tennyson and Logan health centers.
Measure A funding helped TVHC achieve the following measurable
objectives:
• The Health Educator(s) and Youth Leaders coordinated a multi-racial
young women and young men’s empowerment program that met
weekly, reaching a total of 30 youth.
• The health centers served and provided outreach to over 5,000 students
to educate and promote the health center services.
• The centers conducted 868 individual case management sessions
covering sexual health education and pregnancy options counseling and
linking students to the medical services provided at the clinic.
• CAFÉ, the Spanish-speaking parent empowerment group, attracted
approximately 90 parents to weekly workshops. Since August 2013, a
total of 34 workshops have been organized, on topics including natural
health nutrition, how to navigate the education system, immigration
laws, health care reform, college readiness, and more. CAFÉ also
graduated 90 parents.
• Teams of Health Educators and Peer Health Educators provided
presentations about the health center and a range of health topics to
roughly 1,000 students.
• Health Educators conducted 1:1 health education counseling sessions
with a total of 200 students.
• 50 students received training to become Peer Educators. Students were
introduced to a variety of topics to share with their peers.
• Students have used the outreach and health promotion strategies
learned in their weekly workshops to promote pregnancy prevention
on their respective campuses. Their presentations have led to over 300
students registering as new patients at Tiburcio Vasquez Health Center.
• The Hip-Hop Elements program hosted a hip-hop freestyle dance event
that attracted over 200 youth and community members.
• TVHC helped train and develop 15 YAB members.
• For the annual health fair, 20+ community organizations and local
agencies participated. The event reached over 200 students.
Measure A Helps
A Latina client came into the health
center having suicidal thoughts.
During her meeting with the Health
Educator, it became clear that the
client’s anxiety was high and that she
was having thoughts of self-harm. The
health center contacted her parents and
informed them of what was occurring,
reassuring them that the client was
safe, and then the client was taken to a
psychiatric hospital for evaluation. A
week later, the client returned and has
been checking in regularly ever since.
She is receiving outpatient therapy,
continues to be involved in the Young
Women’s Empowerment group, and is
planning to participate in the Summer
Health Justice Leadership Academy.
The health centers
served and provided
outreach to over 5,000
students to educate
and promote the
health center services.
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FUNDS ALLOCATED BY THE ALAMEDA COUNTY BOARD OF SUPERVISORS
GROUP 4: PUBLIC HEALTH
Alameda Boys & Girls Club, Inc. ..................................................................................................................92
Alameda County Asthma Start ....................................................................................................................94
Berkeley Food & Housing Project ................................................................................................................95
Center for Early Intervention on Deafness ..................................................................................................96
City of San Leandro......................................................................................................................................97
Eden Youth and Family Center.....................................................................................................................98
Emergency Medical Services (EMS) Corp ..................................................................................................100
Environmental Health: Improve Field Sanitation Conditions/Nail Salons .................................................101
HIV Education and Prevention Project of Alameda County (HEPPAC) .......................................................103
LIFE ElderCare ............................................................................................................................................105
LifeLong Medical Care: Heart 2 Heart .......................................................................................................106
Public Health Prevention Initiative ............................................................................................................108
School of Imagination ................................................................................................................................120
Senior Injury Prevention Program .............................................................................................................122
Service Opportunties for Seniors (Meals on Wheels) ................................................................................124
Spectrum Community Services, Inc. ..........................................................................................................125
SSI Housing Trust .......................................................................................................................................127
Teleosis Institute ........................................................................................................................................128
Viola Blythe Community Services ..............................................................................................................129
Youth and Family Opportunity Initiatives ..................................................................................................130
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BACKGROUND
Founded in 1949, the Alameda Boys & Girls Club provides high impact,
affordable youth development programs and services for over 65,000
youth, ages 6–18. The Club strives to inspire and enable all youth,
especially those who need it the most, to realize their full potential as
productive, responsible, and caring citizens. The Club offers a variety
of life-enhancing and life-changing programs in the areas of health
and fitness, education and technology, performing and visual arts, and
leadership and life skills.
Seventy-eight percent of youth attending the Alameda Boys & Girls Club
come from families that live at or below the poverty line.
MEASURE A FUNDING SUMMARY
Alameda Boys & Girls Club used its Measure A allocation to serve youth
in these programs:
• Health Clinic services. Club youth serviced by the Health Clinic
received beneficial vision, dental, and respiratory screenings and
treatment to improve their physical well-being. This improved health
decreased their school absences.
- 424 youth participated.
- Four informational events/workshops were held.
- 278 youth were screened, representing 70% of overall club youth.
• Mental health services. Services offered included individual and family
counseling, as well as small group Life Skills workshops. Participants
demonstrated a decrease in confrontational incidents and improvement
in pursuit of healthy lifestyles, such as not smoking and avoiding drugs
and alcohol.
- 1,462 youth participated.
- 94 workshops were held.
- 324 clients participated in daily programming, with 91.5% showing
improvement.
• Get Cooking nutrition and healthy cooking program. Students
participating in health, nutrition, and fitness programs reported an
Allocation: $102,000 | Expended/Encumbered: $102,000
Individuals served by Measure A: 2,000 (Total individuals served: 5,175)
Populations served: Low Income, Uninsured Children
Services provided: Public Health, Mental Health, Substance Abuse
Service area: Alameda, Oakland
Alameda Boys & Girls Club, Inc.
alamedabgc.org
Measure A Helps
One of five children, club member
Lavell was raised by his single mother,
who died from an illness when he
was 13. He and his siblings moved in
with their aunt, who also died from
an illness. At the Boys & Girls Club,
Lavell assisted in Get Growing and
Get Cooking. He became interested
in transforming vegetables, fruits,
and herbs into delicious, nutritional
food. While Lavell was working as a
Program Assistant at the Club he was
also taking college courses, drumming
with the Drum Corps, and teaching
poetry workshops to Club teens. Lavell
won the 2014 Youth of the Year award
and received the $2,000 Sally Rudloff
Scholarship.
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increase in stamina, better weight management, and higher energy
levels. They influenced their parents and families to be more healthy
and fit as well.
- 413 youth participated.
- Two informational events/workshops were held.
- 93% of youth showed improvement.
• Get Growing sustainable garden.
- 306 youth participated.
- Two informational events/workshops were held.
- 90% of youth showed improvement.
• Physical recreation.
- 1,923 youth participated in gym fitness or outdoor recreational
activities.
- Five informational events/workshops were held.
- 100% of youth showed improvement.
Participants
demonstrated a
decrease in
confrontational
incidents and
improvement in
pursuit of healthy
lifestyles, such as not
smoking and avoiding
drugs and alcohol.
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BACKGROUND
A program of the Alameda County Public Health Department, Asthma
Start provides in-home case management to families of children and
adolescents with asthma. The program provides asthma education related
to disease, symptoms, medication, and its use. The program develops
a care plan for the family, inspects their home for asthma triggers, and
teaches the family how to remediate them; advocates with landlords;
and partners with Code Enforcement as needed to take care of identified
issues around healthy homes. Families are given supplies to assist in
managing their child’s asthma such as pillow and mattress encasings,
non-bleach-based mold cleaner, vacuums, etc. Families are linked to any
needed services such as food, housing, medical home, and insurance.
Seventy-four percent of the children/adolescents seen last year were
covered by a Medi-Cal program and from low income families. Asthma
Start is the only program in the County doing in-home asthma case
management. Physicians do not see their patient’s home, so medication
can be given but control may not be obtained.
MEASURE A FUNDING SUMMARY
Asthma Start used its Measure A allocation to achieve the following:
• Increase caregiver knowledge of asthma (target: 90% of caregivers
passing an asthma post test with a score of 90% or better; actual: 99%)
• Help children maintain or reduce asthma symptoms to the lowest level
(target: 95% of children; actual: 98%)
• Help caregivers reduce at least one identified asthma trigger (target:
95% of caregivers; actual: 100%)
• Reduce instances of children requiring hospitalization or emergency
department visits post-case management (target: 20% or less of
children; actual: 12% needing hospitalization, 16% needing emergency
department visits)
• Increase caregiver confidence in managing their child’s asthma (target:
95% of caregivers reporting increased confidence; actual: 100%)
• Ensure children have a medical home and insurance before discharge
(target: 100% of children; actual: 100%)
Allocation: $100,000 | Expended/Encumbered: $100,000
Individuals served by Measure A: 46 (Total individuals served: 367)
Populations served: Children
Services provided: Public Health
Service area: Countywide, Homeless or transient, Outside of Alameda County
Alameda County Asthma Start
acphd.org/asthma.aspx
Matching Funds
The Asthma Start program leveraged
its Measure A allocation to obtain
$1,035 in matching funds from
Targeted Case Management (TCM)
and Medi-Cal Administrative Activities
(MAA).
Measure AAllocation MatchingFunds
$100,000
$1,035
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BACKGROUND
Berkeley Food & Housing Project provides emergency food and shelter,
transitional housing, permanent housing, and housing placement with
support services to homeless individuals and families.
Berkeley Food & Housing Project’s North County Women’s Center
serves homeless or formerly homeless women and children, many of
whom are domestic violence survivors. About 80% of the women served
are from disadvantaged populations, minorities, and of extremely low
socioeconomic status.
MEASURE A FUNDING SUMMARY
Berkeley Food & Housing Project used its Measure A allocation to
increase access to medical, mental health, and public health services to
women and children. To meet this objective, Berkeley Food & Housing
Project offered the following:
• Health screenings and workshops. All of the clients were presented
with the opportunity to attend two health fairs, weekly onsite clinics,
and women’s health workshops.
• Cooking and nutritional instruction. Eight clients in the transitional
housing program graduated from a six-week cooking instruction course
designed to help them gain vital life skills that would allow them to
be self-sufficient once they moved into their permanent housing. The
cooking course also helped the women prepare affordable meals while
maintaining a healthy and nutritious balance of ingredients.
• Exercise and recreational activities. Zumba exercise dance was introduced.
• The program served 275 women and children at its North County
Women’s Center in FY 13/14.
Berkeley Food & Housing Project also provided clients linkages, referrals,
and access to health care and behavioral health care services through
the U.C. Berkeley Suitcase clinic, LifeLong Medical clinic, and Berkeley
Mental Health to 75% of the clients served. This has positively reduced one
of greatest barriers this population faces: access to health care services.
Allocation: $25,000 | Expended/Encumbered: $25,000
Individuals served by Measure A: 6 (Total individuals served: 275)
Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors
Services provided: Public Health, Mental Health, Substance Abuse
Service area: Berkeley
Berkeley Food & Housing Project
bfhp.org
Matching Funds
Berkeley Food & Housing Project
leveraged its Measure A allocation to
obtain $5,875 in matching funds from
Medi-Cal Administrative Activities
(MAA).
Measure AAllocation MatchingFunds
$25,000
$5,875
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BACKGROUND
The Center for Early Intervention on Deafness (CEID) works to maximize
the communication potential of young children (0–5 years old) who are
deaf, are hard of hearing, or have severe speech and language delays
by providing exemplary early start educational services. CEID strives
to create a diverse, inclusive, and educationally rich environment to
empower students and their families with the academic and social tools
needed to reach their full potential.
As one of the few audiology providers in the area that accepts Medi-Cal
patients, CEID provides a critical service to an underserved population.
Its waiting times are significantly shorter than other clinics, and it
provides services in the language of the patient (two staff members are
bilingual Spanish/English). Patients receive the service as well as the
follow-up information necessary to continue to monitor their or their
child’s hearing health care needs.
CEID provides audiological services, including hearing evaluations and
dispensing of hearing devices, to Alameda County children, many from
low income, ethnically diverse families. Without the availability of CEID’s
audiological services, many of these children would be undiagnosed
and would not have proper hearing devices. In addition, CEID provides
regular trainings to pediatric residents from Alameda County hospitals in
the early identification of hearing loss and the resources available to them
and their patients.
MEASURE A FUNDING SUMMARY
Measure A funding helped CEID provide the following services:
• Newborn hearing screenings (target: 120 patients; actual: 155)
• Audiological evaluations (target: 250 patients; actual: 269)
• Hearing aids and molds (target: 275 patients; actual: 225)
• Hearing screenings/Head Start (target: 100 patients; actual: 108)
• Training for pediatric residents (target: 70 residents; actual: 74)
Allocation: $51,000 | Expended/Encumbered: $51,000
Individuals served by Measure A: 790 (Total individuals served: 1,210)
Populations served: Indigent, Low Income Adults, Children, Families, Seniors
Services provided: Public Health
Service area: Alameda, Albany, Berkeley, Castro Valley, Dublin, Emeryville, Fremont, Hayward, Livermore, Newark, Oakland, Pleasanton, San
Leandro, San Lorenzo, Union City
Center for Early Intervention on Deafness
ceid.org
Matching Funds
CEID leveraged its Measure A
allocation to obtain $25,500 in
matching funds from Medi-Cal
Administrative Activities (MAA).
Measure A
Allocation
Matching
Funds
$51,000
$25,500
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BACKGROUND
The San Leandro Recreation and Human Services Department strongly
emphasizes the importance of health and wellness. The department strives
to educate the public about how they can achieve improved health and
wellness and continually provides or partners in programs that support
health and wellness in the community.
The department has developed program guidelines and expectations
regarding healthy eating and physical activity.
MEASURE A FUNDING SUMMARY
The part-time staff provided by Measure A allows Recreation and Human
Services to maintain quality senior services, grow programs, and continue
to offer critical health and wellness services to San Leandro seniors.
Measure A funding supports a comprehensive health and wellness
framework by allowing the City of San Leandro to offer the following
critical programs to seniors. The City of San Leandro set an attendance
objective of 50% of Senior Community Center members participating in
programs and services formulated to promote health and wellness.
Specific target and actual numbers are as follows:
• Blood pressure/weight checks (target: 360, actual: 579)
• Mercy Brown Bag program—Grocery bag of nutritional food monthly
to eligible seniors (target: 576; actual: 593)
• Health education classes (target: 6 classes; actual: 12)
• Pull Up a Chair exercise class (target: 720 participants; actual: 891)
• Fall prevention class (target: 3,600 participants; actual: 6,675)
• Referral to additional health and wellness programs and services
(target: 30% of participants; actual: 40%)
CONCERNS
From the information provided, it is not clear whether the City of San
Leandro prioritized and/or ended up serving underserved populations.
Allocation: $51,000 | Expended/Encumbered: $51,000
Individuals served by Measure A: 70,008 (Total individuals served: 189,141)
Populations served: Seniors
Services provided: Public Health
Service area: San Leandro, San Lorenzo
City of San Leandro
sanleandro.org
Measure A Helps
Melody, in her 70s, lives by herself and
has no family in the area. She is faced
with many health challenges, among
them chronic obstructive pulmonary
disease and leukemia. Her Social
Security check is her sole income, and
often she doesn’t have enough funds
to meet her basic needs. Through City
of San Leandro programs, each month
Melody receives a free blood pressure
check, and twice monthly she picks up
a nutritious bag of groceries from the
Mercy Brown Bag program. When her
health permits, she volunteers at the
Senior Community Center, where she
also attends multiple drop-in social
programs, a handicrafts class, and
many community education programs.
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BACKGROUND
Eden Youth and Family Center (EYFC) provides and supports a
comprehensive array of public health, mental health, outpatient, substance
abuse, and other services and advocacy for children, youth, and families
in South Hayward and throughout Alameda County. The vision is to
create a multiservice agency that serves as a hub to draw critical services
to enhance the economic, social, educational, and health needs of
community members.
EYFC staff use early intervention strategies for youth that are at risk
of lapsing into self-destructive behaviors, such as gang membership,
violence, alcohol and drug problems, personal and family crisis, and
physical and mental health issues. EYFC teaches them the importance of
nutrition, peer support groups, leadership skills, adult/peer mentoring,
organizational skills, critical thinking, community involvement, education,
training, life skills, career preparation, and employment and job retention.
EYFC partners and links with public and private community organizations
to ensure public and mental health resources are available for children,
youth, and families to improve the delivery of services. EYFC is currently
in contact with several school districts, youth organizations, and
employers on a regular basis.
EYFC partnerships include the following:
• The Children’s Hospital & Research Center Oakland Center for Child
Protection offers a full range of medical and mental health services
to children and adolescents impacted by abuse and/or exposure to
violence.
• The California Offender Program Services is a diversion program that
offers classes to address offenders who are minors.
• The Community Alliance for Special Education provides individual
technical assistance, consultations, representation, and training
through their network of educational and legal specialists.
• The Hayward Community School provides educational opportunities
for 40-50 referred students, ages 12–17, whose behavior prevents their
Allocation: $160,000 | Expended/Encumbered: $160,000
Individuals served by Measure A: 440 (Total individuals served: 42,000)
Populations served: Indigent, Low Income, Uninsured Adults, Children, Families
Services provided: Public Health, Mental Health, Substance Abuse
Service area: Ashland, Castro Valley, Cherryland, Fremont, Hayward, San Leandro, San Lorenzo, Union City, Homeless or transient
Eden Youth and Family Center
eyfconline.org
Measure A Helps
A female youth at EYFC has addictions
to marijuana, tobacco, and alcohol.
She remains wary and sensitive about
discussing these topics. Two high
schools have expelled her, and she has
been arrested multiple times. EYFC
staff had a difficult time getting this
youth involved in multimedia projects,
but slowly she began to open up. She
has begun to learn graphic design and
has spent time in the music studio. She
has improved her language and opens
up about her personal conflicts. She
now completes multimedia projects
and is starting to think about a career.
Dependent on getting a work permit,
she will receive an internship in
EYFC’s sister program.
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Highlights
The program serves a community of
high need in South Hayward, and has
developed a long-term strategic plan
to help area youth and families.
The program works collaboratively
with its network of partnerships,
which increases the effectiveness of
all the organizations.
success in a regular school setting.
• The Silva Pediatric Medical Clinic is a pediatric primary health care
clinic serving the residents of Hayward and surrounding communities.
• The La Familia Counseling Service family advocate provides families
with insurance information and application assistance for Medi-Cal
through additional partner clinics.
• The Tiburcio Vasquez Health Center mental health worker provides
Hayward Community School students with mental health assessments,
treatment and rehabilitation services, and consultation with staff at
mental health agencies, and conducts clinical supervision of the mental
health staff and its administrative services.
MEASURE A FUNDING SUMMARY
EYFC used its Measure A allocation to support implementation of a youth
program expansion plan and a financial sustainability plan.
Specifically, EYFC created a system (through its own programs and
collaborative partners) that blends academic education, occupational
training, career/life skills training, work-based learning, and
multidimensional wraparound public and mental health support services
to create a rich, holistic, client-centric learning environment.
Through these program enhancements, Measure A funding helped EYFC
achieve the following objectives:
• Provide youth paid career and employability competency workshops
to improve behavioral health in terms of intrinsic motivation, locus of
control, and self-esteem (target: 100 youth; actual: 245)
• Provide youth with paid work experience opportunities that match
their interest and aptitudes to improve connections to peers, adults,
and community members (target: 100 youth; actual: 198)
• Provide youth with educational support services related to academic
tutoring, GED preparation and testing, career coaching, financial aid
advice, and scholarship opportunities to improve behavioral health in
terms of attendance and engagement in classroom (target: 75 youth;
actual: 540)
• Provide youth access to high end video, graphic, web design, music
production, and film production tools (target: 75 youth; actual: 337)
• Provide youth with gang tattoo removal treatments to make positive
behavioral changes by removing symbols of past behaviors associated
with gang and drug activities (target: 75 youth; actual: 195)
• Through EYFC service provider La Familia Counseling Service, provide
families with insurance information and application assistance for
Healthy Families and/or Medi-Cal through additional partner clinics
(target: 50 families; actual: 50)
• Through La Familia Counseling Service, match families and youth with
community resources (target: 50 families; actual: 50)
Matching Funds
EYFC leveraged its Measure A
allocation to obtain $142,422 in
matching funds from the following
grant contracts:
• Alameda County Probation
Department Evening Reporting
Center: $33,280
• Alameda County Social Services
Summer and Afterschool Youth
Employment Program: $45,500
• Kaiser Permanente (New Start
Tattoo Removal Program): $9,600
• EYFC Administration: $54,042
Measure AAllocation MatchingFunds
$160,000 $142,422
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BACKGROUND
The Emergency Medical Services (EMS) Corps works to increase the
number of underrepresented Emergency Medical Technicians through
youth development, mentoring, and job training.
The EMS Corps recruits young men of color from low income/
underserved communities. Some EMS Corps participants are from the
Camp Sweeney First Responder Program, a 10-week curriculum-based
program offered in partnership with the Alameda County Probation
Department. The EMS Corps also accepts referrals from the Alameda
County Pipeline Partnership and various community-based organizations.
EMS Corps program recipients perform community service and receive a
monthly stipend. The EMS Corps graduates enter the EMS workforce as
EMTs, Health Coaches, and Health Technicians. Some graduates enroll in
college and take advantage of the EMS Corps Fire Academy. EMS Corps
students are reaching a younger generation of boys and young men of
color by volunteering their time at middle and high schools, teaching life-
saving skills to other students.
MEASURE A FUNDING SUMMARY
The EMS Corps used its Measure A allocation to support the following:
• Two annual five-month-long cohorts of approximately 80 youth
attending an EMT training course, consisting of 136 hours of
instruction and 24 hours of supervised clinical experience
• Mental health services for 40 EMS Corps youth including weekly
Healing Circles and 90 hours of individual psychotherapy sessions, self-
care reform, and health and wellness
• Mentorship, case management, life coaching, and academic tutoring
Program results include the following:
• 35 EMS Corps youth are certified EMTs.
• 30 are employed.
• 20 youth participated in the Camp Sweeney First Responder program.
Allocation: $602,800 | Expended/Encumbered: $598,544
Individuals served by Measure A: 80 (Total individuals served: 80)
Populations served: Indigent, Low Income, Uninsured Adults, Children
Services provided: Emergency Medical, Public Health, Mental Health
Service area: Countywide
Emergency Medical Services (EMS) Corp
acphd.org/ems-corps.aspx
Measure A Helps
EMS Corps graduate Dexter Harris
was once incarcerated at Camp
Sweeney. He attended and graduated
from the First Responder program
at the Camp. Once he was released,
he enrolled and graduated from the
EMS Corps. Currently, he works for
Paramedics Plus as an Emergency
Medical Technician. Dexter also
graduated from the BAY EMT Fire
Fighter academy through a partnership
with Merritt College. Dexter wanted
to give back to the young men at
Camp Sweeney, so he became a
Lead Instructor, teaching the First
Responder program to Camp Sweeney
youth. Dexter was featured in the PBS
News hour story on the EMS Corps
as well The Robert Wood Johnson
Foundation “Promise Story” on the
program.
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BACKGROUND
Alameda County Environmental Health Services (EHS) promotes
the health, safety, and well-being of the public through promotion of
environmental quality. EHS uses enforcement authority, education,
and cooperation to promote awareness of environmental protection,
environmental justice, and pollution prevention. EHS carries out this
mission in partnership with a wide variety of other government, nonprofit,
and for-profit organizations.
The Alameda County Environmental Health Department (ACEH) created
a Healthy Nail Salon Recognition (HNSR) program and technician
certification with the California Healthy Nail Salon Collaborative. The
HNSR program achieves its goals through the following activities:
• Identifying highest risk nail salon products and practices and assisting
salon owners and workers in selecting preferable products, practices,
and protective equipment to improve worker, client, and community
safety
• Identifying or creating reliable information sources for salon workers/
owners
• Offering a rebate to cover all or most of the cost of purchasing and
installing appropriate air purification equipment
• Providing recognition (certificate and use of logo) to salons to promote
themselves as Healthy Nail Salons
• Providing online and branding tools for customers/clients to find and
patronize Healthy Nail Salons
• Providing training and training certificates to empower workers with
better information and a way to demonstrate to prospective employers
that they know Healthy Nail Salon criteria
Allocation: $0 | Expended/Encumbered: $12,319 (This provider received its allocaton in FY 12/13 but expended it in FY 13/14.)
Individuals served by Measure A: 383 (Total individuals served: 383)
Populations served: Low Income Adults
Services provided: Public Health
Service area: Alameda, Albany, Berkeley, Fremont, Hayward, Oakland, San Leandro
Environmental Health: Improve Field Sanitation Conditions/Nail Salons
.acgov.org/aceh/healthynail/index.htm
Measure A Helps
Vicky’s Nails in Alameda is the largest
salon to become certified in Alameda
County so far. Owner Xuan Huynh
has actively sought to create a healthy
work space as well as a safer space
for clients. Because most workers eat
lunch at the salon, Mr. Huynh moved
all volatile chemicals to a location
at least 15 feet away from the break
area. With these storage practices,
installation of new air purification
equipment, and increased use of
gloves and other protective equipment,
Vicky’s Nails has become a healthier
place for workers and clients. Xuan
Huynh actively promotes his salon’s
Healthy Nail Salon status with signage
and information on his website.
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MEASURE A FUNDING SUMMARY
Measure A funding helped ACEH/HNSR program achieve the following
measurable outcomes:
• Notify over 330 Alameda County nail salons about the HNSR Program
by mail
• Through the CA Healthy Nail Salon Collaborative, notify an additional
35 Alameda County salons that are members of the Collaborative
• Provide workshop training to 21 salon owners and workers
• Receive applications from 17 salons for HNSR recognition
• Replace between 25% and 50% of nail polish products at eight salons
with safer formulations
• Install approved air purification units at seven salons
• Recognize eight salons as Healthy Nail Salons
Highlights
The program leveraged its Measure
A allocation by teaming with Asian
Health Services for an in-kind match
of donated staff hours valued at
$9,000 and by collaborating with
Supervisor Wilma Chan for recognition
of participating salons.
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BACKGROUND
The HIV Education and Prevention Project of Alameda County (HEPPAC)
works to stop the further spread of preventable diseases among increased-
risk populations in the communities it serves. HEPPAC strives to reduce
the impact of harm by addressing external barriers and increasing access
to basic needs services.
HEPPACs wound care services are available throughout the week at
exchanges, during outreach, during syringe exchange services hours, and
at HEPPAC’s Casa Segura location. Clients have reduced the mortality and
morbidity related to active substance use as a result of HEPPAC services.
MEASURE A FUNDING SUMMARY
Measure A has contributed to improving the overall health results of
HEPPAC’s client population by providing critical wound care and clinical
services to extremely low income, marginalized active injection drug users
and high risk youth and young adults engaging in unprotected sex with
multiple partners who generally do not access traditional hospital and
clinic settings.
HEPPAC used its Measure A allocation to achieve the following
measurable objectives:
• Administer care for soft tissue damage due to injection drug use, and
dispense prescriptions of antibiotics by a qualified medical professional
at the Casa Segura clinic and syringe exchange locations (target: 600
wound care visits, 50 unduplicated clients; actual: 305 visits, 100
unduplicated clients)
• Provide wound care follow-up services to intravenous drug users
(IDUs) at both the Casa Segura clinic and syringe exchange program
(target: 100 visits; actual: 46)
• Provide wound care and general health care referral services to various
local health care agencies, including Highland Hospital (target: referrals
Allocation: $31,000 | Expended/Encumbered: $31,000
Individuals served by Measure A: 592 (Total individuals served: 1,492)
Populations served: Indigent, Low Income, Uninsured Adults, Seniors
Services provided: Public Health, Substance Abuse
Service area: Countywide
HIV Education and Prevention Project of Alameda County (HEPPAC)
casasegura.org
Measure A Helps
Client O., 48, has utilized HEPPACs
Tuesday Fruitvale syringe exchange
site for the past five years. He has
completed at least nine substance use
treatment programs, almost lost his
left leg due to an untreated abscess,
and has lost communication with his
family. O. receives wound care services
and education on vein rotation during
his exchange visits. He has established
a small network of peers who also
utilize HEPPACs syringe exchange
services, and they congregate over food
each week during their exchange visits.
Through HEPPACs transportation
assistance service, O. is able to visit the
Casa Segura site, where he showers,
washes clothes, and volunteers his time
while staying off the streets.
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for 20 unduplicated clients; actual: 65)
• Provide patient and health education and trainings during wound
care visits with IDUs on topics such as safer injection and overdose
prevention (target: 100 visits/trainings; actual: 120)
• Provide STI screening and/or HIV/HCV rapid testing at the Casa
Segura clinic, and then provide treatment for those who test positive for
chlamydia and/or gonorrhea at HEPPACs Casa Segura Drop-in Center
(target: 100% of clients who test positive for HIV/HCV; actual: 100%)
• Refer IDUs and/or their sexual partners who test positive for HIV and/
or HCV to primary care services as needed (target: 100 referrals to 50
unduplicated clients; actual: 171 referrals to 52 unduplicated clients)
• Provide risk-reduction education and awareness to at-risk youth, young
adults, and IDUs and/or their injecting and sexual partners (target:
100% of youth who access STI testing services; actual: 100%)
• Install and maintain the syringe drop box by collecting on a weekly
basis any used and dirty syringes placed in the box; in addition, survey
the drop box location and collect any loose syringes in the immediate
area (target: collect 5,000 syringes; actual: 3,483)
• Conduct outreach to the IDUs accessing the drop box location to make
them aware of the drop box and provide them with information on how
to properly dispose of used syringes and reduce the risk of HIV and
HCV (target: 100 IDU clients; actual: 132)
Measure A
helped HEPPAC
to administer care for
soft tissue damage
due to injection drug
use, and dispense
prescriptions of
antibiotics by a
qualified medical
professional at the
Casa Segura clinic
and syringe exchange
locations.
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BACKGROUND
LIFE ElderCare empowers seniors to live with independence and
interdependence by nourishing mind, body, and spirit.
LIFE Elder Care programs include fall prevention, individualized exercise
programs, medication screening and education, and environmental
assessments and minor home modifications.
MEASURE A FUNDING SUMMARY
LIFE ElderCare used its Measure A funds to increase access to public
health services for seniors living in Fremont, Newark, and Union City
through fall prevention programs to reduce the number of falls among
seniors and risk of falling for at-risk seniors. The programs achieved the
following:
• 80% of seniors participating in the programs demonstrated fewer (or if
0, no more than 0) falls in the three months after they enrolled than in
the three months prior to enrollment.
• 76% of enrollees express reduced fear of falling post-program.
• 78% of enrollees had improved times on the Single Leg Stand test post-
program vs. pre-program
• 65% of enrollees had improved scores on the Berg & Tinetti Balance
Tests post-program vs. pre-program.
• 67% of enrollees had improved scores on the Timed Up & Go test post-
program vs. pre program.
Allocation: $10,000 | Expended/Encumbered: $10,000
Individuals served by Measure A: 38 (Total individuals served: 420)
Populations served: Low Income Seniors
Services provided: Public Health
Service area: Fremont, Hayward, Newark, Union City
LIFE ElderCare
lifeeldercare.org
80% of seniors
in the programs
demonstrated fewer
falls in the three
months after they
enrolled than in the
three months prior to
enrollment.
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BACKGROUND
LifeLong Medical Care provides high quality health and social services
to underserved people of all ages; creates models of care for the elderly,
people with disabilities, and families; and advocates for continuous
improvements in the health of its communities.
The LifeLong Heart 2 Heart (H2H) program works to achieve the
following:
• Foster advocacy efforts to address community priorities
• Support community efforts to build strong networks among neighbors
• Engage residents in activities to promote healthier behaviors
• Increase the social and environmental supports for healthier behavior
MEASURE A FUNDING SUMMARY
Measure A was the major funder for H2H services in FY 13/14.
The LifeLong H2H program used its Measure A allocation to achieve the
following measurable objectives in its four target areas.
Increase access to public health services to residents in South Berkeley
by working collaboratively with existing neighborhood groups (such
as neighborhood watch or charge-related groups) to address common
priorities.
• Provide health education to neighborhood groups, such as the health
ministry of a local faith congregation, to equip and familiarize their
members with information so that they can help others find health
and social services they need. Outreach included 12 Health Hubs, 10
Mobile Van events, two farmers market events, and 16 Health Advocate
workshops.
• Distribute mini-grants to support stronger networks among neighbors,
foster leadership, and build capacity opportunities for healthy
behaviors. H2H awarded the following mini-grants:
- McGee Avenue Baptist Church. Partnering with the Youth Advocacy
Initiative, McGee conducted trainings on gardening and nutrition to
Allocation: $200,000 | Expended/Encumbered: $200,000 (2-year contract, $100,000 per year)
Individuals served by Measure A: 1,230 (Total individuals served: 1,230)
Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors
Services provided: Public Health
Service area: Berkeley
LifeLong Medical Care: Heart 2 Heart
lifelongmedical.org/services/heart-2-heart.html
Measure A Helps
Mr. Davis, a diabetic, lives in the H2H
neighborhood. During a barbershop
Health Hub event, a team member
noticed Mr. Davis was limping. The
team member found out that Mr.
Davis’s toe had turned black and
that he was in severe pain. The team
member made a doctor’s appointment
for Mr. Davis’s foot to be looked at the
next day. Later that month, Mr. Davis
explained his toe was badly infected
and needed to be amputated, and that
the same leg had multiple ulcers.
He thanked the team member for
encouraging him to see his doctor and
was very grateful to have seen H2H
that day.
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teach youth how to become leaders and advocates by exploring the
benefits of a healthy diet. Along with the youth trainings McGee also
engaged adults by hosting trainings on how to choose healthy foods.
- Lunch Love Community Documentary Project. This project held two
events focused on concerns regarding health, nutrition, and food
justice. Both events provided participants with a healthy meal, food
justice films which were shot locally, and a discussion panel.
- Farm Fresh Choice/ Ecology Center. Farm Fresh Choice provides
healthy, organic, locally grown produce to South Berkeley
residences. They used their grant to hire a youth outreach worker to
run their stand.
• Assist in the coordination of door-to-door neighborhood visits twice
a year, in coordination with the Alta Bates Summit Ethnic Health
Institute and Alameda County Health Pipeline Partnership, to promote
healthy behaviors. H2H held two door-to-door outreach events.
Increase access to public health services to residents in South Berkeley
by supporting individuals to make healthy choices
• Provide monthly information and referral services through the mobile
van. Each monthly mobile van has a theme to provide opportunities
and resources for the community.
• Train and support staff at local barbershop Health Hubs to provide
heart health information to costumers.
• Offer fresh produce at all H2H events.
Increase access to public health services to residences in South Berkeley
by engaging residents in activities to promote healthier behaviors
• Recruit seven neighborhood residents to attend Health Promoters
Program. Health Promoters are trained to conduct a health analysis
to prioritize health concerns and the root causes in their community;
disseminate information and education about LifeLong; provide health
education; and support the implementation of the Affordable Care Act.
• Train and certify seven Health Promoter residents on topic including
health leadership, team development and effectiveness, and health-
specific issues.
• Mentor and coordinate activates of Health Promoters to lead
community-building efforts, provide health promotion messages to
individuals and community groups, and link residents to health services
and health insurance as appropriate. Each certified Health Advocate
attended and/or performed outreach at least two events.
Increase access to public health services to residents in South Berkeley
by evaluating the effectiveness of the H2H project.
• Evaluate the effectiveness of the H2H project in achieving its
intermediate goals of creating a community in which prepared
providers and community partners work with informed patients with
hypertension. Focus groups have been completed and initial analysis
will be reviewed.
Matching Funds
LifeLong H2H leveraged its Measure
A allocation to obtain $65,000 in
matching funds from the City of
Berkeley.
Measure AAllocation MatchingFunds
$200,000
$65,000
Partnering with the
Youth Advocacy
Initiative, McGee
conducted trainings
on gardening and
nutrition to teach
youth how to become
leaders and advocates
by exploring the
benefits of a healthy
diet.
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BACKGROUND
The Alameda County Public Health Department works in partnership
with the community to ensure the optimal health and well-being of all
people through a dynamic and responsive process respecting the diversity
of the community and providing for present and future generations.
The Measure A Prevention Initiative aims to reduce health disparities via
three priority areas:
• Chronic Disease & Injury Prevention
• Health Inequities & Community Capacity-Building
• Obesity Prevention & School Health
The programs that make up these three priority areas are not designed
to operate as standalone efforts but rather are complementary to other
departmental programs and strategies.
These priority areas encompass the following programs.
Chronic Disease & Injury Prevention
• Asthma Start. Provides in-home case management to families of
children/adolescents with asthma, including asthma education and
a care plan for the family. For information on this program, see the
separate “Asthma Start” entry on page 94.
• Diabetes. Provides self-management education to adults with type 2
diabetes, including classes, a support group, and a monthly newsletter.
• Healthy Kids Healthy Teeth. Provides an accessible early entry point
for oral health assessment and preventive dental services for high
risk families and children ages 0–5 years at WIC as well as continuity
and referral for regular follow-up dental care in the community. For
information on this program, see the separate “Alameda County Dental
Health” entry on page 57.
• Project New Start. Provides services to build on youth assets and
positive development, focus on environmental change, promote
protective factors while preventing risk factors, and collaborate
consistently and holistically.
Allocation: $3,135,037 | Expended/Encumbered: $2,278,231
Individuals served by Measure A: 108,802 (Total individuals served: 148,751)
Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors
Services provided: Emergency Medical, Hospital Outpatient, Public Health, Mental Health
Service area: Countywide, Outside of Alameda County
Public Health Prevention Initiative
Measure A Helps
PROJECT NEW START
From program participant Tony:
“After high school, I had no direction.
I didn’t even know how to get into
college. Having nothing to do caused
me to do stupid things, such as
getting tattoos. After I got a tattoo
on my hand, I realized I made the
wrong decision. I enrolled in Project
New Start, which changed my life.
Project New Start has a very good
way of requiring us to seek help from
a mentor. My mentor Mike has helped
me succeed in school, work, and
socializing. Eventually I was able to
get the job that I’ve always wanted,
and I am working for EVA airways at
SFO.”
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• Dating Matters/Teen Violence. Exposes 11- to 14-year-olds to healthy
relationship competencies and promotes pro-social relationship norms
to support the development of healthy relationships and prevention of
adolescent dating abuse.
• Senior Services: Day Break Adult Day. Assists seniors in gaining
knowledge about the proper use of medications and reduces the
number of illnesses, hospitalizations, and emergency department visits
due to mismanaged medications.
• Senior Services: St. Mary’s. Assists older adults in getting knowledge
about the proper use of medications and reduces the number of
illnesses.
• Senior Services: City of Fremont Health Promoter Project. Provides
access to health resources and guidance to low income, frail, primarily
homebound, Afghan elders. For information on this program, see the
separate “Fremont Aging and Family Services” entry on page 63.
• Senior Services: Senior Injury Prevention. Maximizes independence of
older persons by removing individual and social barriers and providing
needed services. For information on this program, see the separate
“Senior Injury Prevention Program” entry on page 122.
• Senior Services: Senior Support of Tri Valley. Assists seniors in gaining
knowledge about the proper use of medications and reduces the
number of illnesses, hospitalizations, and emergency department visits
due to mismanaged medications.
• Senior Support Services: United Seniors of Oakland & Alameda
County. Assists seniors in gaining knowledge about the proper use of
medications and reduces the number of illnesses, hospitalizations, and
emergency department visits due to mismanaged medications.
Health Inequities & Community Capacity-Building
• School Health and Community Nursing: Berkeley School-Linked
Health Services (SLHS) Program. Collaborates with Berkeley Unified
School District (BUSD) and other agencies to develop and implement
a coordinated service delivery model that links students, families, and
school staff to needed resources, with a special focus on attendance and
truancy.
• School Health and Community Nursing: City and County
Neighborhood Initiative. Provides vital medical, health education, and
community-building services to West Oakland residents.
• School Health and Community Nursing: Healthy Living Program at
Madison Park Business and Art Academy. Offers middle school-aged
students the nine-lesson Madison Health Living curriculum, which
includes nutrition basis, web-based diet analysis, information about
energy and calories, label reading, exercise, fast food, breakfast, and
media influence.
• School Health and Community Nursing: Higher Ground Youth
Leadership Program. Develops leadership skills, provides academic
support, and supports health behavior adoption through educational
sessions and workshops, tutoring and mentoring, and family
engagement events.
Matching Funds
Many Public Health Prevention
Initiative providers leveraged their
Measure A allocations to obtain
matching funds:
• The Medication Safety project
used Measure A funds to leverage
foundation grants.
• Lotus Bloom leveraged funding from
two organizations through in-kind
services and assisted a parent in
applying for a Best Babies Zone
grant in the amount of $1,500 for
nutrition and cooking activities
within the playgroup program at
Castlemont.
• Niroga used Measure A fund to
supplement funds from other grant
funding sources.
• Project New Start used Measure A
funds to leverage funds from Medi-
Cal Administrative Activities (MAA)
and large in-kind contributions/
partnerships from volunteer
medical professionals whose service
provision amounts to well over
$200,000 per year.
• East Oakland Boxing Association
used Measure A funds as a match
for OFCY funds to support the
SmartMoves program, which
includes health and wellness
programs.
• Mandela Marketplace used
Measure A funds were to leverage
Kresge Foundation and California
Endowment grants.
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• Immunization. Recruits health care providers to join the California
Immunization Registry program (CAIR) in Alameda County and
provides training and technical assistance on registry use.
• HIV Prevention: HEPPAC. Increases awareness of harm reduction-
based health, specifically abscess wound care, OPEND, and vein
rotation practices, and provides access to services to increased-risk
populations.
• HIV Prevention: CALPEP. Provides services including HIV testing,
partner services, CLEAR case management, group education, and
referrals.
• Lotus Bloom. Administers a series of health-related nutrition programs
to serve families as well as the at-large community.
• Niroga. Empowers low income young adults with a training in yoga and
Transformative Life Skills (TLS) to bring into their communities
• Mandela Marketplace. Through the Food Policy Council, advises and
advocates for residents of Ashland/Cherryland on agricultural and food
policy issues.
• Family Planning: CALPEP. Provides street outreach in high risk
communities including homeless encampments, drug treatment
programs, prostitute strolls, drug houses, and schools and school-based
programs.
• Perinatal Services. Provides outreach and education to marginalized,
often linguistically and/or culturally isolated Pacific Islander women of
child-bearing age and their families.
• Child Services: Child Health Disability Prevention Program. Provides
children aged 0–5 years in Alameda County with developmental and
behavioral screening and support with service linkage.
• Child Services: Family Health Services Home Visiting. Provides
culturally competent care through interpreter services to pregnant
women and families with young children.
• City/County Neighborhood Initiative. Addresses an array of barriers,
including child and family cultural/linguistic barriers, the need for
increased services for vulnerable populations, and lack of knowledge of
available services.
• Health Pipeline Program. Utilizes best practices to increase the
participation of youth by streamlining their operations and leveraging
current and new partnerships with stakeholders in the health
workforce.
Obesity Prevention & School Health
• Nutrition Services. Conducts community interventions and
programming as well as social marketing/education on the health
effects of obesity.
• East Oakland Boxing Association. Provides holistic wellness
programming to youth through nutrition, gardening, and physical
fitness programs.
Lotus Bloom
administers
a series of health-
related nutrition
programs to serve
families as well as the
at-large community.
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MEASURE A FUNDING SUMMARY
The Public Health Prevention Initiative programs used Measure A funding
to help achieve the following objectives,
Chronic Disease & Injury Prevention
Diabetes
• Reduce A1c, a test that shows how well a person is controlling his or
her diabetes, in 84% of clients (target: 75%).
• Reduce blood pressure in 53% of clients (target: 50%).
• Reduce weight in 50% of clients (target: 75%).
• Increase physical activity among 67% of clients (target: 50%).
• Achieve 84% of clients starting to read food labels, count carbohydrates,
and practice portion control (target: 75%).
Project New Start
• Partner at least 75–90 formerly involved gang youth with sponsoring
agencies committed to supporting each youth’s lifestyle change.
• Conduct 24 no-cost tattoo removal clinics providing 1,500–2,000
treatments for very high risk youth, of whom 75% are underinsured or
uninsured and formerly adjudicated or gang/drug-involved.
• Provide support service linkage, self-care coaching, and guidance for
personal and professional development.
• Require youth to get involved in positive activities such as employment,
educational attainment, vocational training, mentoring, and
community service.
• Achieve 60% of youth consistently returning for tattoo removal
treatments, completing community service hours, maintaining
mentorship relationships, and either enrolling in school or a
GED program or completing a job training program and getting
employment.
Dating Matters/Teen Violence
• Deliver the Dating Matters curricula (six 50–minute sessions) to 456
sixth grade students at five Oakland middle schools.
• Deliver the Dating Matters curricula (seven 50–minute sessions) to 441
seventh grade students at five Oakland middle schools.
• Deliver the Safe Dates curricula (10 50–minute sessions) to 845 eighth
grade students at 10 Oakland middle schools.
Senior Services: Day Break Adult Day
• Achieve the following:
- 20% of program participants improving medication compliance
- 50% disposing of inactive medications
- 70% of staff forwarding updated medication inventories and
pharmacy reports to the participants primary care physicians
- 50% of physicians responding to medication safety reports forwarded
to them
Measure A Helps
SENIOR SERVICES: ST. MARY’S
Nancy, 87, suffers from arthritis,
hypertension, and heart disease, and
experiences bouts of depression and
fatigue. At St. Mary’s Center she
would sit by herself, eat her lunch
quickly, then leave. Through patience
and a little TLC, her Senior Advocate
helped coax Nancy out of her shell.
Though Nancy has limited mobility
and is often in pain, she has joined her
building’s exercise class, which makes
her feel very proud and increases her
energy. When she comes to the center
for hot lunch, she sits at the same
table with her new friends. Her Senior
Advocate continues to works with
her on nutrition and her medication
regimen.
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- 30% of physicians making a change in medication regimen or
requesting a follow-up appointment with their patient or the
caregiver
Senior Services: St. Mary’s
• Serve 73 clients in this program (target: 47).
• Have 40 clients submit medication interaction reports to their health
provider for review (target: 24).
• Conduct 1,041 phone calls to discuss medication compliance with the
73 clients served.
• Provide 373 face-to-face conversations with the 73 clients served.
• Achieve 69 clients participating in a “Be Well, Be Happy” nutritional
workshop.
• Provide medi-sets to 37 clients to keep their medication in one place.
Senior Services: Senior Support of Tri Valley
• Serve 42 clients in the Medication Safety program, educating them on
topics regarding medication disposal.
• Have nine clients dispose of medications through this program. All
other participants had no medications to dispose of or had already
disposed of medications via their pharmacy or take back days.
• Of the 42 clients served:
- 2% had their medications adjusted.
- 66% stated they had become more compliant with their medication
regime
- 100% reported that they felt better overall.
• Of the 33 interaction reports completed, there were a total of:
- 230 major drug interaction alerts
- 299 moderate drug interaction alerts
- 73 minor drug interaction alerts
- 14 major drug/food interaction alerts
- 60 moderate drug/food interaction alerts
- 13 minor drug/food interaction alerts
Senior Support Services: United Seniors of Oakland & Alameda
County
• Train 270 seniors on proper use of their medications determined by
pre- and post-test results gathered in 12 provider trainings (target: 300
seniors in 20 trainings).
• Increase the number of Spanish-speaking participants.
• Utilize pretrained senior volunteers who had complete the program
with the previous year’s Measure A funding.
• Achieve a 60% success rate showing knowledge of medication safety
based on result differences in correctly answered questions between the
scores of pre and post tests (target: 60%).
Health Inequities & Community Capacity-Building
School Health and Community Nursing: Berkeley School-Linked
St. Mary’s conducted
1,041 phone calls
and 373 face-to-face
conversations to
discuss medication
compliance with the
73 clients served.
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Health Services (SLHS) Program
• In partnership with the City of Berkeley’s Immunization Coordinator,
improve BUSD kindergarten vaccination rates by 10%.
• Hold monthly meetings of the “Berkeley Healthy Schools Collaborative”
on topics including housing, resources, family engagement providers,
mental health crisis services, and school mindfulness programs.
• Make presentations on “Chronic Absenteeism & Health: What Is Your
Role?”, attended by over 20 participants, and on “Early Prevention and
Treatment of Asthma: The Case for Preventing Chronic Absenteeism”,
attended by over 15 participants.
• Provide over 20 school-linked referrals/case consultations from the
SLHS public health nurse.
• Participate in 12 SARB and 5 SART elementary meetings.
• Establish biweekly meetings with the BUSD Office of Family
Engagement and Equity.
• Assist BUSD in planning and implementation of the Northern
California Breathmobile at two elementary schools and one preschool.
• Provide Breathmobile services to over 55 BUSD students.
• Provide oral health screenings to over 1,100 second and fifth graders in
11 elementary schools, and provide sealants to over 145 students.
• Provide over 130 health consultations covering topics such as
vision, food allergies/Epi-pen, medications, nutrition/obesity, health
Insurance/ACA, and more.
• Partner in 13 504s/IEPs/SST meetings with school staff and families.
• Conduct 10 public health nurse family visits.
• Conduct five health trainings at staff meetings on the topics of allergies/
Epi-pen, seizure disorders, and medication administration.
School Health and Community Nursing: City and County
Neighborhood Initiative
• Provide health screening in various venues with referrals to health care
providers and/or local clinics as well as Covered California.
• Connect clients with needed health care services.
• Succeed in getting clients to return to school to obtain their high school
diplomas.
School Health and Community Nursing: Healthy Living Program at
Madison Park Business and Art Academy
• Have 22 middle school-aged youth participate in the healthy living
program.
• Achieve 100% of students reporting making at least one improvement
in eating choices or physical activity
• Achieve 50% of students making at least one lasting eating choice and
working on more.
School Health and Community Nursing: Higher Ground Youth
Leadership Program
• Achieve the following:
Measure A Helps
LOTUS BLOOM
Aroni, 3, has been attending
playgroups for about one year with
grandpa Cesario. Aroni’s mom
works 40+ hours to provide for their
household. Aroni’s dad has been in and
out of Aroni’s life. He tends to have
tantrums during transitions. Aroni
also has had episodes of biting, hitting,
and throwing objects. Lotus Bloom
staff has provided his family with
resources for additional services as the
family waits for Medi-Cal services.
In the meantime, Aroni attends the
playgroups on a weekly basis, enjoys
the BBZ nutrition workshops by
parent leader Laura, and makes the
best of his experience. Grandpa also
participates in monthly workshops.
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- 77% of parents reporting they are more involved in their children’s
school life and activities
- 100% of students completing the program
- 50% reporting that student-led workshops were useful
- 50% completing at least two life goals
- 100% being promoted to the next grade
- 90% ranking their presentation skills as good or better
Immunization
• Provide education and support contributing to over 40 providers/
medical groups meeting the Stage 1 Meaningful Use attestation
requirement for the Medicare and Medicaid EHR Incentive Program.
• Send out over 4,000 recall postcards reminding patients they are due
for their immunizations.
• Promote the elimination of vaccine-preventable diseases by
implementing the California Immunization Registry program (CAIR) in
Alameda County to eliminate both missed opportunities to immunize
and unnecessary immunizations.
• Increase the number of providers who use CAIR in Alameda County to
120 organizations, and the number of Alameda County patient records
in CAIR to 49,430.
HIV Prevention: HEPPAC
• Provide abscess/wound care services for soft tissue damage due to
injection drug use to 388 people who inject drugs (PWID) patients (592
total visits from 235 unduplicated clients) at the Casa Segura Clinic
(target: 300 PWID patients).
• Provide abscess/wound care follow-up services to 313 PWIDs (301
unique clients) at HEPPACs SEP locations (target: 300 PWIDs).
• Provide abscess/wound care follow-up services to 92 unique clients
(124 visits) at the Casa Segura site (target: 156 clients).
• Refer 105 clients from HEPPACs SEPs to Casa Segura for a total of
402 visits (177 STI visits and/or 225 HIV visits/tests and/or 120 HCV
rapid testing visits) for STI and/or HIV and/or HCV rapid testing
and provide treatment for those testing positive for STIs (target: 156
clients).
• Refer 151 clients who tested positive for HCV and/or HIV to primary
care services.
• Conduct 61 Safer Injection workshops with 135 participants and 37
Overdose Prevention trainings with 65 participants at the Casa Segura
Drop-in Center (target: 300 participants).
HIV Prevention: CALPEP
• Conduct Targeted Prevention Activities (TPAs) at many venues
including testing sites, community events, HIV-positive venues,
homeless shelters, primary care sites, and other community-based
organizations.
• Provide all TPA contacts with risk-reduction materials and/or
HEPPAC provided
abscess/wound care
services for soft tissue
damage due to
injection drug use
to 388 people who
inject drugs (PWID)
patients.
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information, including condoms, lube, safer sex literature, and/or
needle hygiene kits.
• Refer 100% of the clients to at least one resource including primary care
services, housing assistance/shelter, CAL-PEP’s medical services, legal
assistance, food pantry, and partner services.
• Enroll eight clients in the CLEAR program.
• Have four HIV-positive individuals complete a minimum of eight
sessions with their case manager.
• Achieve 88% of clients improving and/or maintaining greater risk
behavior understanding by their discharge date.
Lotus Bloom
• Create a healthy cookbook that captures recipes from participants in
the playgroup program, and distribute the cookbook to 40 parents.
• Offer a seven-week PLAN training to 25 parent participants, with 100%
of participants reporting that they learned new skills on parents’ rights,
how to advocate for their own child, choosing and enrolling in school,
and speaking in public.
• Administer 16 sessions of dance and movement by an average of 35
parent/child dyads attended, a Yoga for Strength series attended by 12
people, and parent/child yoga sessions attended by 18 participants.
• Achieve 100% of the 65 participants of the dance and yoga series
reporting that they now include exercise activities at least one day per
week for at least 20 minutes.
• Achieve 100% of participants (210 people) in the playgroup program
participating in weekly physical movement at least twice per week.
• Create an organizational healthy food policy listing foods that are
welcomed in the centers and foods to refrain from, and have 100% of
participants honor the policy.
Niroga
• Provide classes in yoga and Transformative Life Skills (TLS) to over 15
youth agencies and organizations.
• Achieve the following after a daylong retreat at the Alameda County
Juvenile Justice Center:
- 83% of the youth reported learning techniques to manage stress and
difficult emotions.
- 83% reported learning healthy habits.
- 100% reported that they felt they had a sense of community and
understanding with their peers.
• Offer a total of 767 classes in the Public Health department and
underserved communities over the past year, serving 772 unduplicated
children and adults.
• Save the medical care system at least $1,512,000 for one year through
avoidance of emergency room visits.
• Accept and provide scholarships to 12–16 low income young people to
become certified yoga teachers, with 12 students graduating.
• Require graduates of the program to give back 100 hours of community
Measure A Helps
NIROGA
When Brishana was two years old,
her mom was murdered near their
home. Her father passed away when
she was nine. After she turned 18,
she experienced periods of depression,
paranoia, and anxiety attacks. She
was working a full-time job, living
and providing on her own. Through
Niroga’s Breathe Campaign, Brishana
for the first time visited the street
where her mother was murdered.
After continuing with Niroga’s yoga
program, Brishana is now, at age 21, a
Niroga Integral Health Fellow (IHF).
She says, “The biggest impact Niroga
has had on me is being a part of a
community and feeling like I’m home. I
think that’s what I’ve been wanting.”
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service providing TLS
• Provide TLS training for approximately 35 Alameda County Public
Health Department–WIC staff to incorporate strategies and techniques
with clients.
• In a feedback form surveying the effectiveness of the training, achieve
the following:
- 82% of students were satisfied/very satisfied with Niroga’s support in
helping them develop and maintain a consistent yoga practice.
- 100% were satisfied/very satisfied with Niroga’s support in helping
them incorporate the concepts of yoga philosophy into their life.
- 91% were satisfied to very satisfied with Niroga’s help in preparing
them to safely and effectively teach yoga to others.
Mandela Marketplace
• Hire a Food Policy Council Coordinator.
Perinatal Services
• Translate a one-page English language pregnancy resource guide into
Tongan and Samoan, two of the largest Pacific Islander subpopulations
in Alameda County.
• Tailor the materials in a culturally sensitive design and print them.
• Distribute the guides at the 2nd Annual Asian and Pacific Islander
Women’s Health Summit and in the community.
Child Services: Child Health Disability Prevention Program
• Screen 5,872 children using the Ages and Stages Questionnaire (ASQ)
and Modified Checklist for Autism in Toddlers (MCHAT) in Help Me
Grow pediatric sites and clinics.
• Refer 1,228 children who scored of concern to the Help Me Grow
phone line for follow-up, which could include referral to entitlement
services such as the Regional Center of the East Bay or Alameda County
Behavioral Health; referral for family navigation services; referrals to
play groups or community-based programs; and provision of child
development guidance and resources.
Child Services: Family Health Services Home Visiting
• Provide in-home, in-person interpretation in 149 languages by pairing
interpreters with home visitors who visit pregnant women and families
with young children on a weekly or semi-monthly basis.
• Assign interpreters to certain cases wherever possible to strengthen the
relationship between the interpreter and the client.
• Arrange for interpreters to accompany clients to health care provider
visits when possible.
City/County Neighborhood Initiative (CCNI): Sobrante Park
• Conduct monthly meetings of the Sobrante Park Resident Action
Council (RAC) and the Neighborhood Crime Prevention Council
(NCPC), attended by an average of 32 residents.
Niroga saved the
medical care system
at least $1,512,000
for one year through
avoidance of
emergency room
visits.
Family Health
Services Home
Visiting provided
in-home, in-person
interpretation in 149
languages by pairing
interpreters with
home visitors who
visit pregnant women
and families
with young children
on a weekly or semi-
monthly basis.
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• Hold annual events such as the Sobrante Park Time Banking Health
Fair, which served 500 residents this year with over 40 vendors offering
health education workshops, and the La Posada/Kwanzaa celebration,
involving 250 residents.
• Conduct three meetings of the Sobrante Park Leadership Council
(SPLC), which brings together leaders of 14 community institutions.
• Partner with Alameda County to provide a career and college-readiness
program for 31 Sobrante Park youth of different races and cultural
backgrounds.
• Link 31 families with culturally appropriate mental health services
to help them cope with a traumatic event that happened in the
neighborhood.
City/County Neighborhood Initiative (CCNI): West Oakland
• Conduct program and strategic planning for a new West Oakland
Youth Center.
• Through the West Oakland Mini-Grant Collaborative, distribute
$20,000 to 14 distinctive resident grant applicants.
• Through the West Oakland Young Adult Mini-Grant Collaborative,
distribute $5,000 to four grant applicants.
• Establish a summer enrichment program for 10 Hoover Elementary
School students and Spanish language classes for parents at Hoover
Elementary and McClymond’s High School.
• Host a series of community dinners to discuss community
responsibility, strengthen West Oakland, and reduce violence, with
approximately 80-100 youth attending these events.
• Offer a six-week series of summer family engagement activities called
Friday Night Live, attended by over 500 residents.
• Raise more than $12,000 for the Juneteenth celebration, attended by
over 1,000 participants.
• Conduct the West Oakland Job Fair, which attracted about 600 job-
seekers.
• Place 25 youth in paying jobs.
• Offer a construction job orientation for re-entry individuals, which was
attended by 30 residents.
Health Pipeline Program (HPP)
• Support the position of the Alameda County HPP (ACHPP)
coordinator, who is instrumental in administrating the ACHPP steering
committee and cross collaboration.
• Support 1,440 youth into Pipeline programs.
• Create a mini-grant program that awarded three organizations that
developed innovative strategies to engage young men of color (YMOC)
a total of $44,502.
• Enable 14 YMOC to participate in Mentoring in Medicine and Science’s
Clinical Exposure and Mentoring Summer Internship.
• Enable 34 YMOC to become involved in the ROPE initiative, including
attending a three-day retreat to improve levels of self-confidence and
Measure A Helps
CHILD HEALTH: FAMILY HEALTH
SERVICES HOME VISITING
A home visiting nurse worked with
a Hindi-speaking interpreter, case
managing a medically fragile baby
born to a recent immigrant mother
from India. When the nurse screened
the mom for postpartum depression,
the mom described how badly treated
she felt in the home, as her in-laws
threatened to send her back to India
without her baby if she didn’t comply
with their orders. With the interpreter
serving as both linguistic and cultural
broker, the nurse implemented a care
plan for the baby and helped the mom
to deal with her in-laws, helped her
understand her rights living in the US,
and provided her with tools to learn
basic English.
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self-understanding, making college trips, and receiving individual and
group tutoring.
• Provide summer internships for eight YMOC with supplemental
workshops on college/career preparation, professionalism
development, and exposure to YMOC college students as program
facilitators.
• Host 48 ACHPP high school and college students to participate in an
anatomy lab workshop and campus tour at Samuel Merritt University.
• Host eight 8 ACHPP high school and college students for an exclusive
tour at Santa Clara Kaiser Medical Center.
• Sponsor 70 student rafting trips where students were matched with
college and post-baccalaureate students for mentorship.
• Recruit 20 ACHPP youth to volunteer at the 2013 We Connect Health
Fair in Oakland.
Obesity Prevention & School Health
Nutrition Services
• Through a subcontract with the Oakland Food Policy Council (OFPC),
provide advocacy that led the Oakland Planning Department to develop
zoning and other regulations that would provide residents the ability to
grow food on their land.
• Support an epidemiologist in the CAPE unit for data collection,
analysis, and report development.
• Support the CHS Health Care Program Administrator working on
County collaborations and overseeing the Food 2 Families program,
as well as the Ashland Cherryland Food Policy Council and Mandela
Marketplace.
• Support the Soda Free Summer campaign including social media, video
contests, and collateral materials.
• Support of Safe Routes to School Program funded by CalTrans.
• Participate in food systems/food Policy Collaboratives including HOPE,
Oakland Food Policy Council, Berkeley Food Policy Council, and Place
Matters Land Use and Transportation workgroup.
• Monitor contracts of CBOs conducting nutrition and physical activity
promotion efforts under Measure A.
East Oakland Boxing Association (EOBA)
• Offer cooking classes two days per week and gardening classes three
days per week for 200 East Oakland youth focused on healthy eating.
• Host a six-week culturally based cooking and nutrition workshop each
quarter for at least 50 families.
• Create three YouTube videos through the EOBA Urban Fresh
Gardeners program.
• Have all youth participate in daily physical activity and maintain
awareness of the importance of being active to improve their health,
with 75% of EOBA youth reporting exercising four or more times per
week.
Health Pipeline
Program created a
mini-grant program
that awarded three
organizations that
developed innovative
strategies to engage
young men of color
a total of $44,502.
East Oakland Boxing
Association offered
cooking classes two
days per week and
gardening classes
three days per week
for 200 East Oakland
youth focused on
healthy eating.
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• Participate in four workshops at local schools or community
organizations.
• Provide lunch to over 130 youth every day for seven weeks through the
Oakland Summer Lunch Program.
• Provide over 900 hours of tutoring to children ages 5–20.
• Assist 10 youth on their journey from high school to beginning their
first year at college.
• Distribute 20,406 pounds of fresh produce and 8,851 pounds of food to
the low income Oakland community.
• Take youth on 15 field trips including hiking, camping, kayaking, and
visits to the aquarium and zoo.
Measure A Helps
SCHOOL HEALTH & COMMUNITY
NURSING: CITY AND COUNTY
NEIGHBORHOOD INITIATIVE
A woman who had a history of
hypertension and complained of
dizziness received a health screening
at a Health Fair. The client had not
seen a doctor in over two years and
stopped taking her high blood pressure
medication over a year ago. The
screener advised the women’s friend to
take her to the emergency room right
away. Three weeks later, the client
called the screener, stating that the
screener had saved her life. She said, “I
went to the emergency room like you
told me. They told me if I would have
waited any longer, I could have had a
stroke.”
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BACKGROUND
The School of Imagination brings out the extraordinary in every child by
providing groundbreaking, collaborative, and individualized educational,
therapeutic, and family support services in a nurturing and positive
environment through the highest quality inclusion program that supports
all children, encouraging them to become positive influences on society.
School of Imagination serves over 300 children each week. Its program
has contributed to improving the lives of the children it serves by
providing children with autism and developmental delays and disabilities
with the most effective, research-based therapeutic techniques.
Children on the autism spectrum often have skills that develop unevenly
due to the lack of development in some of the areas of their brain. Using
the cutting-edge Early Start Denver Model (ESDM)—a highly effective
treatment methodology for children with autism—clinicians and
educators can clearly define the level of development in a functional way is
extremely helpful in planning treatment that is most effective. Treatment
can occur within the classroom, in the therapy room, or at home, which
allows for much greater progress in a shorter period of time due to the
consistency and clarity of treatment protocols.
The ESDM also has a strong parent training component. This
methodology allows School of Imagination the opportunity to provide a
multidisciplinary approach (educators and clinicians) that is consistent
across disciplines and in the home. Children are making progress across
all areas of development (cognitive, language, motor skills, and self-care)
due to the implementation of this therapy protocol and methodology,
which improves their prognosis for catching up to their same-age peers
by the time that they are in kindergarten and no longer needing special
education services, which cost school districts millions of dollars each
year.
Allocation: $50,000 | Expended/Encumbered: $50,000
Individuals served by Measure A: 253 (Total individuals served: 325)
Populations served: Low Income, Uninsured Children
Services provided: Public Health
Service area: Alameda, Castro Valley, Fremont, Livermore, Pleasanton
School of Imagination
schoolofimagination.org
Measure A Helps
Letter from the parents of IDP
toddler Brandon:
When we came to speech therapy,
Brandon was demonstrating
significant receptive and expressive
language delay, testing in the lower
10th percentile. Brandon has been
universally described as exceptionally
strong willed (aka stubborn), and we
thought it was unlikely that he would
take to a speech therapy class. Ms.
Leslie took the time to learn Brandon’s
likes and dislikes and catered to his
pace and personality. In the past
six months, Brandon’s speech and
behavior have improved exponentially,
with another breakthrough session just
this past week. Ms. Leslie’s tremendous
dedication, patience, and love towards
Brandon has deeply impacted his life
and our family.
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MEASURE A FUNDING SUMMARY
Measure A funds provided training to School of Imagination’s clinical
and educational team on the ESDM treatment methodology for
children with autism. The teachers and clinicians who received this
training implemented protocols in the classrooms and therapy sessions,
specifically in the Infant Development Program (IDP) and individual
therapy sessions. Both the therapy and infant development programs
are provided to children ages 2–3 years old with developmental delays
and autism. The earlier that these children receive help, the greater their
chance is to develop age-appropriate skills.
This training immediately impacted over 250 children who attend School
of Imagination’s program by providing them with the most effective
treatment methodologies. This training allowed the treatment team to
impact the families in the community by continuing to disseminate the
ESDM to all children and families that need help. Parent training has
also commenced, which allows families to work directly with providers
using the ESDM model. The consistency between parents and providers
is greatly enhanced and has yielded even greater improvements in the
development of the children.
All of School of Imagination’s 29 teachers and 13 therapists completed the
training and passed the assessment measures established by the UC Davis
MIND Institute.
Highlights
The results of the ESDM training have
been fantastic. Children are making
faster progress and parents know
what to do to best help their child due
to the new training methodology.
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BACKGROUND
The Alameda County Public Health Department works in partnership
with the community to ensure the optimal health and well-being of
all people through a dynamic and responsive process that respects
the diversity of the community and provides for present and future
generations.
The Public Health Department’s Senior Injury Prevention Program (SIPP)
has the following goals:
• Secure and maintain maximum independence and dignity in a home
environment of older and functionally impaired persons capable of self-
care with appropriate supportive services
• Remove individual and social barriers to economic and personal
independence for older persons
• Provide a range of services designed to meet the needs of all consumers
who need services, including those who are independent, semi-
dependent, and very dependent
The SIPP providers include the following:
• ADSNAC/DayBreak
• Rebuilding Together Oakland
• Senior Support Program of the Tri-Valley
• St. Mary’s Center
• Spectrum
• LIFE ElderCare
MEASURE A FUNDING SUMMARY
SIPP providers served 1,773 new clients in FY 13/14, compared to a target
of 820 new clients.
Measure A funding helped SIPP achieve the following objectives:
• Fall risk screening, assessment, and education. A health care
professional or paraprofessional used a validated screening tool to
screen and assess the fall risk of older adults. Appropriate education
Allocation: $100,000 | Expended/Encumbered: $100,000
Individuals served by Measure A: 2,788 (Total individuals served: 2,811)
Populations served: Low Income, Uninsured Seniors
Services provided: Public Health
Service area: Countywide
Senior Injury Prevention Program
acphd.org/ipp/sipp.aspx
Measure A Helps
A 70-year-old male had a stroke and
was experiencing extreme left-side
weakness, putting him at very high
risk of falls. Staff at LIFE ElderCare
designed a unique set of exercises for
him. The student nurse guided the
man extra slowly and performed the
exercises directly in front of him. After
four weeks, the client had learned the
routine and was able to stand for five
seconds on each leg. By the seventh
week, his single leg stand was at 15
seconds. By the end of the 10-week
program, he could walk to a nearby
park and back without feeling weak
afterwards.
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on fall-risk reduction, evidence-based physical activities, medication
management, and minor home modification referrals was made to meet
the client’s needs (target for all providers: 443; actual: 846).
• Minor home modifications. The program made residential
modifications that were necessary where risk for falls and other risk
factors could be reduced or minimized by minor home adaptations
(target for all providers: 57 assessments/modifications; actual: 59).
• Physical activity sessions. The program used individual and group
exercises using evidenced-based models to improve strength and
balance to reduce fall risk (target for all providers: 508; actual: 1,203).
• Individual/group medication management. The program educated
individual groups of older persons, in addition to their families, friends,
caregivers, and community individuals, on the safe disposal of and
other health measures for managing their medication properly (target
for all providers: 235; actual: 341).
SIPP providers served
1,773 new clients in
FY 13/14, compared
to a target of 820 new
clients.
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BACKGROUND
Meals on Wheels targets low income seniors who are age 60 and older,
homebound, alone, recently discharged from the hospital, or having
a physical or mental impairment. Ninety-five percent of Meals on
Wheels clients receive SSI or Medicare income, while the other 5% have
insufficient income to meet all their monthly expenses.
MEASURE A FUNDING SUMMARY
Meals on Wheels used its Measure A allocation to deliver 5,000 meals to
seniors in the unincorporated Castro Valley area.
Allocation: $16,000 | Expended/Encumbered: $16,000
Individuals served by Measure A: 348 (Total individuals served: 1,292)
Populations served: Indigent, Low Income Seniors
Services provided: Hospital Outpatient, Public Health
Service area: Castro Valley
Service Opportunties for Seniors (Meals on Wheels)
sosmow.org
Highlights
Every eligible senior received a hot
nutritious meal, and no waiting list
occurred in FY 13/14.
Measure A Helps
One day, when Meals on Wheels
recipient Eddie’s driver went to deliver
his meal, there was no answer at the
door. The driver tried to call Eddie
and also got no answer. The driver
immediately called his supervisor,
who ultimately contacted the police to
request a wellness check on Eddie. The
police reported that Eddie was being
transferred to the hospital due to a fall
that left him incapacitated. The Meals
on Wheels team might literally have
saved Eddie’s life.
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BACKGROUND
Spectrum Community Services assists low income, disadvantaged, and
elderly residents of Alameda County as they attempt to achieve and
maintain self-sufficiency and improve the quality of their lives. Spectrum
employs multiple strategies to implement this mission, offering individuals
and families programs that remedy crisis, maintain and improve health
and functionality, and develop skills and the capacity to help themselves.
Over four decades, Spectrum has developed programs that address
seniors’ most critical issues, including the Senior Nutrition Program and
the Fall Risk Reduction Program (FRRP).
In FY 13/14, Spectrum received two Measure A allocations: One for the FRRP,
and one for renovation of the kitchen used in the Senior Nutrition Program.
FRRP
Spectrum’s FRRP promotes wellness and delivers preventive services to
a population at high risk for falls and fall-related injuries. FRRP employs
strategies that educate about fall prevention; guide and refer for home
safety modifications that can prevent falls; and offer training to build
strength, stamina, mobility, balance, and fall prevention skills. Each program
component focuses on empowering seniors to implement solutions and to
become more confident of their control over their own lives.
Classes are provided at no cost to area seniors who are living on very low
fixed incomes. Spectrum targets its FRRP classes at senior housing and
recreation centers located in low income neighborhoods. The program
emphasizes social interaction, giving isolated seniors the opportunity to
develop new friendships and improve conditions like depression.
Senior Nutrition Program Kitchen Renovation
The renovated commercial kitchen at Josephine Lum Lodge is used 248
serving days each year to prepare and cook fresh, nutritious senior meals
Allocation: $90,000/$250,000 | Expended/Encumbered: $90,000/$250,000
Individuals served by Measure A: 500/* (Total individuals served: 500/2,935) Kitchen renovation was completed at the beginning of FY 14/15,
so Measure A clients served can be tracked from that point forward. Total clients served by the kitchen program is 2,935.
Populations served: Indigent, Low Income, Uninsured, Adults, Families, Seniors
Services provided: Public Health, Mental Health
Service area: Alameda, Ashland, Castro Valley, Cherryland, Fremont, Hayward, Newark, Oakland, San Leandro, San Lorenzo, Union City
Spectrum Community Services, Inc.
spectrumcs.org
Measure A Helps
FRRP
Anne H., 60, is a regular participant
of Spectrum’s Fall Prevention Exercise
Program. Having at one time weighed
350 lbs., Anne now weighs 200
lbs. Anne has been diagnosed with
Functional Movement Disorder.
When she joined the program, she was
having extreme difficulties walking,
even while using a walker, due to
severe leg weakness, tremors, and
poor trunk coordination. Anne has
made significant progress in mobility,
strength, and coordination. She has
stopped using the walker and is now
able to walk using a cane for balance.
Anne has regained much of her core
control and is able to perform daily
tasks with far more ease.
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in compliance with the Title III Older Americans Act. The meals are
distributed that day to 28 partner serving sites, plated, and served to the
seniors who eat together in a congregate style getting the benefits not only
of the nutritious food, but also the socialization to fight isolation.
MEASURE A FUNDING SUMMARY
FRRP
Measure A funding sustains Spectrum’s FRRP, enabling it to provide
services to seniors at no cost. The program used its Measure A allocation
to achieve the following objectives:
• Offer fall prevention education and regular exercise classes designed to
build strength, mobility, and balance to elders who are at risk for falls
• Reduce the incidence of falls among program participants
• Improve participating seniors’ strength, mobility, and ability to walk
with confidence
• Offer seniors and caregivers throughout the target area fall risk
prevention workshops at which participants can obtain practical
information about how to minimize fall risk
Services funded by Measure A included the following:
• Weekly fall prevention skill-building classes at seven sites in the target
area
• Evaluation and reassessment of class participants to measure individual
progress and identify changes needed to the program curriculum
• Quarterly workshops at five locations to provide practical training in
preventing falls
FRRP conducts senior fitness tests every six months to chart the impact
of the program and the progress in the participants. Recently conducted
tests show the following results:
• Muscular endurance: 40% improved, 47% maintained, 13% declined
• Flexibility: 49% improved, 41% maintained, 10% declined
• Mobility: 43% improved, 48% maintained, 9% declined
• Strength: 40% improved, 52% maintained, 8% declined
Senior Nutrition Program Kitchen Renovation
Spectrum received a one-time Measure A allocation to renovate its
commercial kitchen at Josephine Lum Lodge with increased capacity to
prepare senior meals. This renovation has allowed an increase in capacity
to serve senior meals in Alameda County, as noted by the following:
• In conjunction with the Alameda County Area Agency on Aging,
Spectrum increased its meal service area to include 11 partner sites
in Oakland and Alameda, as well as the ongoing areas of all Central
and South County. Spectrum is actively pursuing more partner sites to
make meals available to more seniors.
• Average daily meals served have increased from 300 to 400.
Measure A Helps
SENIOR NUTRITION PROGRAM
KITCHEN RENOVATION
Senior Meals participant Felicia
began her journey with Spectrum as a
volunteer over 20 years ago. No longer
able to volunteer herself, now she gets
served by others. With the assistance of
her walker, Felicia walks every day to
join her friends for a nutritious lunch.
Felicia has a difficult time sitting or
standing for a long period of time,
which makes it nearly impossible for
her to cook at home. With the help of
Spectrum, Felicia is able to get a fresh
meal and needed social interaction
each day, including a special birthday
celebration each year with a Spectrum
lunch.
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BACKGROUND
The Alameda County Health Services Agency (HCSA) helps poor,
disabled Alameda County residents receive disability income and
mitigates the negative impact of long processing times by stabilizing their
health and living situations while their applications are pending.
The HCSA SSI housing trust seeks to achieve the following:
• Connect clients to outpatient mental health and primary care
• Obtain health insurance benefits for clients
• Obtain disability income for clients
• Improve housing stability for clients
This increase in housing stability improves clients’ ability to access care,
enables them to work with disability advocates, and helps improve their
mental health.
MEASURE A FUNDING SUMMARY
Measure A funds were used to establish a revolving fund to increase
housing stability for clients. When clients are approved for disability
benefits, the fund is replenished from the client’s retroactive benefits.
Overall the program provided disability advocacy services, including
care coordination, to 2,135 individuals, of whom 1,006 were approved for
disability benefits and 779 still had claims pending at the end of the fiscal
year. These awards in disability income resulted in clients receiving over
$15 million in ongoing income since the date of their approvals.
Calendar year 2013 was pilot year to prove the concept. The project began
to transition to full scale in January of 2014. The leftover funds from FY
12/13 and FY 13/14 were rolled over to FY 14/15.
Allocation: $0 | Expended/Encumbered: $346,292 (This provider received its allocation in FY 12/13 but expended it in FY 13/14.)
Individuals served by Measure A: 300 (Total individuals served: 2,135)
Populations served: Indigent, Low Income, Uninsured Adults, Other residents: Disabled and Chronically Homeless
Services provided: Public Health, Mental Health
Service area: Countywide
SSI Housing Trust
Matching Funds
The SSI trust program leveraged
its Measure A allocation to obtain
$2,110,000 in matching funds from
public funding sources.
Measure AAllocation MatchingFunds
$947,611
$2,110,000
Highlights
Clients entering the program receive
a maximum of $336/month in
income. Through this fund, while
their disability application is pending,
client income nearly doubles to $654/
month. Upon approval for disability
benefits, client income nearly triples
to $865/month.
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BACKGROUND
The Teleosis Institute is developing develop a Safe Medication Disposal
Program with the goal of reducing unused medication from accumulating
in households and reducing risk or accidental poisoning for seniors,
youth, and children through education and take-back locations.
MEASURE A FUNDING SUMMARY
The Teleosis Institute used its Measure A funding to develop new take-
back sites, to coordinate the effort throughout the County, and to support
the development of the Safe Medication Disposal Ordinance.
Measure A funding helped the program achieve the following:
• Increase access to public health and/or substance abuse services to
seniors, adults, families, at-risk youths, and/or other residents by
assessing existing program results.
• Collect 12,564 lbs. of unused pharmaceuticals from four sites.
• Conduct educational outreach through a survey and follow-up calls.
• Prepare a final summary assessment that provides information about
program effectiveness, participation, and educational guidelines
for others to develop similar programs. The summary assessment
document contained the following recommendations:
- Establishing one agency to oversee a Countywide program would
minimize operational overlap and improve collection efficiency.
- Establishing sites in larger medical institutions such as hospitals
would provide the most efficient and effective results; pharmacy
take-back sites collection would also improve collection rates.
- Educational outreach for health executives and health professionals
in primary care and end-of-life care is essential for improved
program outcomes.
Allocation: $21,000 | Expended/Encumbered: $21,000
Individuals served by Measure A: 8,000 (Total individuals served: 8,000)
Populations served: Indigent, Low Income Adults, Children, Families, Seniors
Services provided: Hospital Outpatient, Public Health, Substance Abuse
Service area: Alameda, Albany, Berkeley, Oakland, San Leandro, Union City
Teleosis Institute
teleosis.org
The Teleosis Institute
used its Measure A
funding to develop
new take-back sites,
to coordinate the
effort throughout
the County, and
to support the
development of the
Safe Medication
Disposal Ordinance.
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BACKGROUND
The Viola Blythe Center is a nonprofit, nonsectarian corporation
organized to promote, support, and advocate for social and human
services to any person who is in immediate need. This mission is
accomplished by a variety of programs, including emergency food and
clothing distribution, referrals to other agencies, and special programs at
Thanksgiving and Christmas.
MEASURE A FUNDING SUMMARY
The Viola Blythe Center used its Measure A allocation to increase
access to public health for families through food and clothing programs.
Specifically, Measure A funding helped the Viola Blythe Center achieve
the following:
• 2,471 families with a total of 7,470 clients received more nutritional
food items such as fresh meat, milk, eggs, rice, and beans.
• 3,916 clients received clothing including warm coats and back-to-
school clothing for children.
Allocation: $10,000 | Expended/Encumbered: $10,000
Individuals served by Measure A: 7,470 (Total individuals served: 9,860)
Populations served: Indigent, Low Income, Uninsured Adults, Children, Families, Seniors
Services provided: Public Health
Service area: Fremont, Newark, Union City
Viola Blythe Community Services
violablythe.org
Measure A Helps
The Viola Blythe Center received an
emergency phone call on a Sunday
afternoon. A grandmother was crying
and in a panic mode because two of her
grandson’s children, ages six months
and two years, were left in her care
with nothing but the clothes on their
back. The grandson is incarcerated and
the mother has problems with drug
abuse. Within a few hours the Viola
Blythe Center was able to help her out
with food, baby food, formula, blankets,
diapers, car seats, new clothing, and
some other necessities. Measure A
funds helped this client out in a time of
immediate need.
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BACKGROUND
The Center for Healthy Schools & Communities works to foster the
academic success, health, and well-being of Alameda County youth by
building universal access to high quality supports and opportunities in
schools and neighborhoods.
The goal of the countywide Youth and Family Opportunity (YFO)
initiative is to strengthen the capacity of “anchor” community-based
organizations (CBOs) to provide a continuum of high quality, accessible
school-linked health and wellness supports to youth and families
experiencing poor health and educational outcomes.
The CBOs involved in the YFO initiative include the following:
• Alameda Family Services
• Alternatives in Action (AIA)
• Berkeley Youth Alternatives (BYA)
• City of Fremont: Human Services Agency
• East Bay Asian Youth Center (EBAYC)
• Eden Youth and Family Center
• Fremont Family Resource Center
• Fremont Unified School District
• La Familia
• New Haven Kid Zone
• Newark Unified School District
• REACH Ashland Youth Center
• Union City Kid Zone
• Youth Radio
Mental Health Services
The funded CBOs offer a broad array of mental health services, including
individual therapy, group therapy, case management, information and
referral, prevention, and early intervention. For example:
• Alameda Family Services provides an array of mental health services
to youth and families, including case management for youth, parenting
Allocation: $2,499,000 | Expended/Encumbered: $2,791,517
Individuals served by Measure A: 15,508 (Total individuals served: 15,508)
Populations served: Indigent, Low Income, Uninsured Adults, Children, Families
Services provided: Mental Health, Substance Abuse
Service area: Countywide
Youth and Family Opportunity Initiatives
achealthyschools.org/youth-development.html
Highlights
Measure A funding enabled the CBOs
participating in the YFO initiative to
achieve a wide variety of outcomes
for a large number of youth and their
families.
The funded CBOs
offer a broad array
of mental health
services, including
individual therapy,
group therapy,
case management,
information and
referral, prevention,
and early intervention.
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skills classes, teacher consultations, and more.
• AIA provides critical wraparound services and supports to address
students’ holistic needs. Services include empowerment groups on
topics such as violence prevention, restorative justice and conflict
resolution techniques, relationship building, trauma recovery, anti-
oppressive education, and social justice principles.
• BYA provides culturally competent psychosocial, mental, and
emotional health services to low income and poverty-level children
and youth ages 6–18. Participants are underinsured, undernourished,
and underdiagnosed, and live in families where there is a parent who is
either underemployed or unemployed.
• EBAYC provides case management, after-school learning, parent
engagement, intake sessions, individual advising, home visits, teacher/
administrator consultations, and more.
• Fremont Family Resource Center provides counseling and behavioral
health services for individuals and groups. It also offers one-on-one
case management support.
• New Haven Kid Zone provides resource and referrals, case
management, and individual therapy.
• Newark Unified School District uses both a school-wide anti-bullying
curriculum and individual counseling to create a safe and positive
environment for children to flourish academically and emotionally.
• Newark and Fremont Unified School Districts provide therapy using
trauma-informed cognitive behavioral therapy (CBT), art therapy, play
therapy, and motivational interviewing.
• Youth Radio offers intensive individual case management services to all
youth participants. Case managers work with youth to navigate a wide
range of challenges and opportunities, including health care system
navigation, family reunification, and school enrollment. Youth Radio
also provides group counseling.
Youth and Community Services
The CBOs offer enrichment programs to promote health and wellness
and improve the social, emotional, and physical health of youth and
their families. Many of the youth and community services include family
engagement. For example:
• BYA uses curriculum such as Alive & Free Violence Prevention
Curriculum, G.R.O.W. Workshops, and Youth Council and Mentoring.
BYA also hosted job fairs/job sessions with Oakland Unified School
District, Security Guard Training, OSHA 10 Training, Goodwill
Industries, and East Bay Innovations.
• Eden Youth and Family Center provides youth with paid career and
employability competency workshops to improve behavioral health in
terms of intrinsic motivation, locus of control, and self-esteem.
• Fremont Family Resource Center offers services in family financial
stability including an integrated program to support low income
individuals/families to build assets and become financially self-
Matching Funds
The participating CBOs leveraged the
YFO initiative Measure A allocation
to obtain an addition $1,657,900 in
matching funds from the following
sources:
• Medi-Cal Administrative Activities
• Targeted Case Management
• Early and Periodic Screening
Diagnosis and Treatment (EPSDT)
• Federal Funding (for example, 21st
Century Grants)
• Foundations (for example, Kaiser
Community Benefits)
• City of Berkeley and City of Oakland
funding
• Additional Alameda County funding:
Probation Department, Social
Services Administration, General
Fund
Measure A
Allocation
Matching
Funds
$2,489,000
$1,657,900
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sufficient.
• La Familia offers workshops and services that address needs such as
immigration, conversational English, and chronic disease education.
La Familia also addresses youth health and wellness needs through a
variety of services such as case management, youth support groups,
interactive workshops for youth, and summer camps. La Familia also
offered a diabetes series in partnership with the Alameda County
Diabetes Program.
• Newark Unified School District works to support family wellness
by hosting workshops directed at families most often underserved,
including Latino Literacy communication skills workshops, culturally
responsive parenting classes, and educational engagement workshops.
• REACH Ashland Youth Center offers a variety of programs for youth
directed at increasing a sense of connection and belonging as well as
widening their access to health access. Through its partners, REACH
Ashland Youth Center also offers career and employment workshops,
as well as recreation and fitness programming.
• Union City Kids Zone facilitates behavioral health prevention
groups and workshops including Psycho Education and Social Skills,
Acculturation Group for new immigrants, Girls Empowerment, and
Mindfulness. Union City Kids Zone also offered a variety of youth
development activities.
Wraparound Services
In addition to the formal services offered to youth and families described
above, CBOs also offer wraparound services and may serve as the safety
net for a family who is just short of extreme crisis. Wraparound services
are a way for staff to support young people to increase their self-esteem,
set goals, and have an accountability structure outside the formal
counseling setting. In addition to working directly with youth and parents,
staff advocate on their clients’ behalf with probation, schools, and other
public services to ensure the clients have completely accessed all the
services available to them.
• AIA wraparound services include home visits; coordinating meetings
with principals, teachers, and health service providers; meeting with
probation and families; attending school/legal/mental health/medical
consultations; and/or attending appointments.
• Alameda Family Services staff facilitate teacher consultation/IEPs,
and participate in Mental Health Service Teams for Transitional Aged
Youth.
• BYA provides home and office visits to check in with parents and
guardians. Staff regularly meet with school officials and Alameda
County Probation staff and participate in Individual Education Plan
(IEP) meetings on behalf of youth and parents. BYA offers a monthly
food program, in conjunction with the Alameda County Food Bank,
which provides a family of four with groceries that can last three weeks.
• EBAYC staff provides individual advising, home visits, teacher/
Measure A Helps
FREMONT FAMILY RESOURCE CENTER
Jorge, a fourth grader, was referred to
the Fremont Family Resource Center.
Jorge’s grades had dropped, and he
had been suspended from school after
shoving a classmate to the ground. The
Family Support Specialist discovered
that Jorge’s father was extremely
stressed due to financial concerns
and that his wife had recently passed
away. Staff linked Jorge’s father to
financial literacy education, as well as
help applying for health insurance and
CalFresh food benefits. Jorge received
counseling to build self-expression
and stress management skills. In a few
weeks Jorge reported being happier
at school, had improved his grades,
and was proud to report that he had
received no suspensions or detentions.
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administrator consultations, IEP meetings, school attendance review
team meetings, coordination of services team meetings, and more.
• Eden Family Youth Center partners on a number of collaboratives and
pilot programs to provide seamless wraparound services to youth.
• Fremont Family Resource Center provides support to families during
IEP meetings, School Attendance Review Board (SARB) meetings,
and teacher/principal consults. The program provides school-based
behavioral health services to students and case management services to
their families.
• La Familia offers monthly Medi-Cal enrollment and Cal-Fresh/SNAP
clinics for new/renewal community members.
• Newark Unified School District staff facilitate teacher/parent
consultations and meet regularly with parents and administrators.
• REACH Ashland Youth Center partners with schools and community
providers to provide recreation and fitness, arts and creativity, and
career and employment services; community-based behavioral health
and case management; and medical/dental services.
• Union City Kids Zone offers support for families with hardships by
connecting them with partnered service providers and referrals to
local resources. They also offer home visits, connections to therapists,
workshops to students and parents, translations for parents,
information on college readiness, college scholarship application
assistance, and teacher/student consultations.
• Youth Radio’s Direct Service staff provide comprehensive wraparound
services to young people, including healthy food service and academic
and career advising. Youth Radio staff also provide support at court
hearings, broker communication with probation officers and court
officers, write letters of support, and engage with teachers and guidance
counselors.
MEASURE A FUNDING SUMMARY
Through the Measure A YFO initiative grant, 15,508 clients were served
during FY 13/14.
Client results were obtained across a variety of service areas, including the
following:
• Youth-focused individual and group counseling, case management,
mental health, alcohol and drug assessment, and referrals
- 1,146 youth were seen in groups.
- 1,877 youth received individual services.
• Family-focused individual and group counseling, case management,
mental health services, alcohol and drug assessment, and referrals
- 3,384 families were served in groups.
- 1,102 families received services one-on-one.
• Youth leadership development and enrichment activities on improving
personal growth, health and wellness, academic achievement, and
creating career opportunities.
- 7,690 youth benefitted from these services.
In addition to
working directly with
youth and parents,
staff advocate on their
clients’ behalf with
probation, schools,
and other
public services to
ensure the clients
have completely
accessed all the
services available to
them.
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• Family engagement in schools focusing on health and wellness, work
readiness, and life skills
- 11,354 families benefitted from these services.
• Community events focus on raising awareness of free and affordable
health care services
- 314 community events .
- 8,451 contacts were made at the events.
The member CBOs used their YFO Initiative Measure A allocation to
achieve the following.
Alameda Family Services
• Alameda Family Services is improving integration of health supports
through implementation of an Effort to Outcome Database as part
of their YFO grant. Currently, four out of five programs at Alameda
Family Services use this database.
• The Family Support Center conducts a telephone survey twice a year
for clients currently enrolled in their program at the time of the survey.
In FY 13/14, 80% of survey participants reported that staff treat them
well, and 60% reported that services greatly improved their stability
and/or life skills.
• From previous feedback and research, Alameda Family Services learned
that their clients wanted the program to be open more hours with
more opportunities to contact case managers. AFS now has more case
managers directly engaged with the Family Support Center and are
therefore able to offer in-person services 3-4 days per week for at least
four hours per day. They also have more ongoing phone coverage by
case managers.
Alternatives in Action
• The behaviors/conditions that have improved include the following:
- Students have “graduated” from mental health (case management
and therapy) services.
- Students have completed probation, school attendance has
increased, grades have improved, and family engagement has
increased.
- Chronic absences dropped by more than 15%.
- Seniors have 100% FAFSA completion and 100% OUSD Cal Grant
Application completion.
• AIA also administered a student survey with the following results:
- 96% of students felt like they belonged in the program.
- 100% of students felt safe in this program.
- 97% said this program helps them to feel more confident about what
they can do.
- 99% said this program helps them believe they can finish high
school.
- 93% of students said that since coming to this program, they are
better at something that they used to think was hard.
Measure A Helps
YOUTH RADIO
Youth Radio met K. through its
MATCH program, which provides
media and tech education, wraparound
support services, and paid employment
to formerly incarcerated youth. K. left
the program and faced frequent bouts
of homelessness and other struggles.
This past year, K. came back to Youth
Radio needing help and an income.
Through Youth Radio’s Workforce
Development Pathway program,
K. received mental health support
services, college credit, a job at an
international hospitality company,
and a stable place to stay. He has since
obtained an opportunity through
a fellowship at Yosemite National
Park, where he is earning a wage and
work experience and participating in
many activities including hiking, cliff
jumping, and fishing.
2013-2014 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
134
- 94% said since coming to this program, they are better at setting
goals for themselves.
- 93% said this program helps them to feel like a part of their
community.
- 100% said this program helps them to make positive changes in their
schools or communities.
Berkeley Youth Alternatives
• Youth demonstrated an overall increase in resilience based on a pre-
and post-program 14-point resilience scale.
City of Fremont: Human Services Agency
Results from three of the primary service areas the City of Fremont/
Human Services Agency offers are summarized below.
Youth Counseling
• 13 out of 25 youth who responded to a client satisfaction survey
reported that their ability to talk about feelings had improved a lot and
they worry a lot less.
• The Family Development Matrix administered and the data aggregated
from this evaluation tool indicated 112 of the 145 clients achieved a
higher social-emotional health assessment score and increased stability
by the end of their participation in the program.
Parent Counseling
• 60% of parents surveyed indicated that counseling services were very
helpful.
• 30% indicated services were mostly helpful.
• 5 out of 11 parents stated that classroom behavior improved a lot.
• 4 out of 9 parents stated that school attendance for their children
improved a lot.
Financial Stability
• 92% of Volunteer Income Tax Assistance (VITA) customer respondents
reported that the quality of the tax preparation was excellent.
• 99% reported that they would recommend this free tax preparation
service to others.
East Bay Asian Youth Center
• Chronic absenteeism at Garfield Elementary School and Roosevelt
Middle School has been reduced by over 50% since the establishment of
an EBAYC/school-coordinated attendance promotion partnership.
Eden Youth and Family Center
• Through participation in monthly support groups and volunteer
commitments, participants have found peer support, exposure to
healthy life alternatives, increased self-esteem, positive outcomes in
career and social development, and safe separation from their past
lives.
112 of the 145 clients
achieved a
higher social-
emotional health
assessment score and
increased stability
by the end of their
participation in the
program.
2013-2014 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
135
• Eden began a new tattoo removal program in partnership with Kaiser
Permanente. The program utilized qualified volunteer doctors, nursing,
and medical staff in the tattoo removal process. Youth ages 13–25
must complete 50 hours of community service in lieu of payment for
treatment; be employed, enrolled in school, or enrolled in a job-training
program; and attend monthly group support sessions.
La Familia
• La Familia conducted a post survey with a sample group of 18 youth
who participated in their youth development workshops. The most
common theme in post-feedback was that youth felt “safe” coming
to the center onsite. They also reported they could trust staff and the
group.
Newark Unified School District
• Administrators report that student attendance has improved.
• Parents report feeling more confident when communicating needs to
school.
• Families report that their child is doing better in school and that family
communication has improved.
REACH Ashland Youth Center
Based on a youth survey administered in February 2014:
• 90-93% respondents stated that REACH AYC is fun, they would
recommend REACH AYC to a friend, they feel safe at REACH AYC,
and staff treat them with kindness and respect.
• 34% of respondents shared they talked with a staff person about a
personal challenge they were facing, and 89% said it was either helpful
or very helpful.
• 77% agreed that participating in REACH AYC helps improve their
grades.
• 74% agreed that participating in REACH AYC helps them work harder
in school.
Youth Radio
• According to Youth Radio’s evaluation, their programs and services
have helped 97% of participants graduate high school, and 88% percent
go to college. Education is a strong predictor of health and is associated
with practicing more health-promoting behaviors.
• Youth Radio’s workforce development program provided participants
with post-secondary education, intensive professional development,
and industry placement with employer partners across many sectors.
Upon admission to the fellowship program, participants concurrently
earned college credit as students in Berkeley Community College’s
Multimedia Arts Certificate program–a first college experience for
many participants. 100% of young people in the first cohort were placed
in externships with employer partners.
According to Youth
Radio’s evaluation,
their programs and
services have helped
97% of participants
graduate high school,
and 88% percent
go to college.
2013-2014 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
136
APPENDICES
APPENDIX A: MEASURE A REVENUE RECEIVED
APPENDIX B: FY 13/14 BUDGET INFORMATION
APPENDIX C: FY 13/14 MEASURE A FUND DISTRIBUTION BY PROVIDER OR PROGRAM
APPENDIX D: MAPS: GEOGRAPHIC DISTRIBUTION OF PROVIDERS FUNDED BY MEASURE A IN FY 13/14
Map 1 Alameda County Public Health Programs
Map 2 Alameda County Behavioral Health Care Services
Alcohol and Other Drug Providers
Map 3 Alameda County Behavioral Health Care Services
Mental Health Community-Based Organization Providers
Map 4 School Health Centers
Map 5 HealthPAC Provider Network
2013-2014 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
137
APPENDIX A
MEASURE A REVENUE RECEIVED
FY 04/05 through FY 13/14
TOTAL REVENUE EARNED (FY 04/05 THROUGH FY 13/14)
$1.28 BILLION
REVENUE EARNED EACH FISCAL YEAR (FY 04/05 THROUGH FY 13/14)
Alameda Health System Board of Trustees Alameda County Board of Supervisors
FY 04/05
FY 05/06
FY 06/07
FY 07/08
FY 08/09
FY 09/10
FY 10/11
FY 11/12
FY 12/13
FY 13/14
Alameda County Board of Supervisors$324 MILLION
Alameda Health System Board of Trustees$965 MILLION
1301201101009080
Millions of dollars
706050403020100
$71,756,087 $23,918,696
$82,401,622 $27,467,208
$85,377,759 $28,459,253
$86,889,558 $28,963,185
$75,929,787 $25,309,929
$70,587,890 $23,529,297
$79,135,112 $26,378,371
$84,405,378 $28,135,126
$90,786,904 $30,262,301
$95,071,058 $31,690,352
25%
75%
2013-2014 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
138
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140
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APPENDIX C:
FY 13/14 MEASURE A FUND DISTRIBUTION
BY PROVIDER OR PROGRAM
MEASURE A ALLOCATION FY 13/14
EXPENDED/ENCUMBERED FY 13/14
GROUP 1: BEHAVIORAL HEALTH
Asian Health Services (Banteay Srei)25,000 25,000
Alameda County Behavioral Health Care Services Community-Based Organizations
Mental Health Providers
Adolescent Treatment Centers, Inc. 8,760 8,760
Alameda County Mental Health Association 32,267 31,149
Alameda Family Services 2,020 2,018
Alameda Family Services 2,020 2,018
Asian Community Mental Health Board 8,238 0
Axis Community Health, Inc. 3,120 2,809
Axis Community Health, Inc. 2,193 1,455
Axis Community Health, Inc. 3,064 2,052
Berkeley Addiction Treatment Services, Inc. 4,601 3,840
Bi-Bett Corporation 1,648 955
Bonita House, Inc. 49,243 49,243
Building Opportunities for Self-Sufficiency (BOSS) 13,622 13,622
Carnales Unidos Reformando Adictos, Inc. 20,095 19,972
Center For Independent Living 2,110 2,110
Community Health for Asian-Americans 2,155 0
Crisis Support Services of Alameda County 28,495 28,495
East Bay Community Recovery Project 30,755 23,012
Filipino Advocates for Justice 2,067 2,047
Horizon Services, Inc. 18,027 17,953
Horizon Services, Inc. 11,799 0
Humanistic Alternatives To Addiction, Research, and Treatment, Inc. 2,133 1,656
Latino Commission on Alcohol and Drug Abuse of Alameda County 13,017 11,468
Latino Commission on Alcohol and Drug Abuse of Alameda County 5,723 5,723
Latino Commission on Alcohol and Drug Abuse of Alameda County 2,730 2,454
Latino Commission on Alcohol and Drug Abuse of Alameda County 2,453 2,213
Latino Commission on Alcohol and Drug Abuse of Alameda County 25,000 21,234
Magnolia Women'S Recovery Programs, Inc. 3,671 4,280
Native American Health Center, Inc. 4,603 1,721
New Bridge Foundation, Inc. 35,180 31,962
New Bridge Foundation, Inc. 5,678 5,664
Second Chance, Inc. 44,377 44,377
Southern Alameda County Comitee for Raza 44,113 31,688
St. Mary's Center 3,583 3,583
2013-2014 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
141
MEASURE A ALLOCATION FY 13/14
EXPENDED/ENCUMBERED FY 13/14
GROUP 1: BEHAVIORAL HEALTH (CONTINUED)
West Oakland Health Council, Inc. 21,623 14,580
Unallocated 278,298 0
Total Allocation 738,480 394,112
Center for Empowering Refugees and Immigrants (CERI) 76,500 76,500
Center for Healthy Schools and Communities (School-Based Behavioral Health Initiative) 603,100 603,100
Chabot-Las Positas Community College 20,000 19,396
Criminal Justice Screening and In-Custody Services 4,306,000 4,306,000
Detoxification/Sobering Center 2,040,000 2,040,000
G.O.A.L.S for Women, Inc. 50,000 50,000
La Familia Counseling Service 12,000 12,000
Mental Health Services for Juvenile Justice Center 360,000 360,000
National Alliance on Mental Illness (NAMI) Tri-Valley 3,683 3,683
Safe Alternatives to Violent Environments (SAVE) 10,000 10,000
Senior Support Program of Tri-Valley 20,000 20,000
Tri-Valley Haven for Women 25,000 25,000
Youth Alive! 25,000 25,000
MEASURE A ALLOCATION FY 13/14
EXPENDED/ENCUMBERED FY 13/14
GROUP 2: HOSPITAL, TERTIARY CARE, OTHER
Direct Service Planning & Administration 400,000 249,979
San Leandro Hosptial 1,000,000 1,000,000
St. Rose Hospital 2,000,000 1,500,000
UCSF Benioff Children's Hospital Oakland 3,000,000 3,000,000
MEASURE A ALLOCATION FY 13/14
EXPENDED/ENCUMBERED FY 13/14
GROUP 3: PRIMARY CARE
Alameda County Dental Health 151,213 151,213
Center for Elders' Independence 51,000 51,000
Center for Healthy Schools & Communities (School Health Centers)
Alameda County Medical Center 105,000 105,000
Alameda Family Services 190,000 190,000
CHRCO 140,000 140,000
City of Berkeley 120,000 120,000
East Bay Asian Youth Center 70,000 70,000
La Clinica de La Raza, Inc. 280,000 280,000
Tiburcio Vasquez Health Center 140,000 140,000
2013-2014 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
142
MEASURE A ALLOCATION FY 13/14
EXPENDED/ENCUMBERED FY 13/14
GROUP 3: PRIMARY CARE (CONTINUED)
Unity Council Boys and Men of Color 110,100 110,100
University of California, San Francisco 314,000 314,000
Evaluation 417,900 417,900
Total Allocation 1,887,000 1,887,000
Fire Station Health Portals 750,000 262,099
Fremont Aging & Family Services 51,000 51,000
Health Enrollment for Children 300,000 300,000
Health Insurance Eligibility & Enrollment 200,000 200,000
Health Services for Day Laborers
Health Services for Day Laborers: Community Initiatives (Day Labor Center) 120,131 120,130
Health Services for Day Laborers: Multicultural Institute 85,000 85,000
Health Services for Day Laborers: Street Level Health Project 85,000 85,000
Total Allocation 290,131 290,130
Hospice: Getting The Most Out of Life Program 200,000 182,140
Indigent Care Stabilization (6 Providers)
Preventive Care Pathways 200,000 200,000
Healthy Communities, Inc. 200,000 200,000
Roots Community Center 150,000 150,000
Integrated Medical Assoicates of Alameda County 200,000 200,000
Davis Street Family Resource Center 200,000 200,000
West Oakland Health Council 200,000 200,000
Total Allocation 1,150,000 1,150,000
Medical Costs for Juvenile Justice Services 447,100 447,100
Medical Costs for Juvenile Justice Center: Direct Service Planning & Administration 261,000 261,000.0
Medical Costs for Juvenile Justice Center: Mind Body Awareness Project 56,100 56,100
Medical Costs for Juvenile Justice Center: Niroga Institute 40,000 40,000
Medical Costs for Juvenile Justice Center: Victims of Crime 144,000 90,000
Total Allocation 447,100 447,100
Preventive Care Pathways 204,000 204,000
Primary Care Community-Based Organizations
Alameda Health Consortium
Asian Health Services 724,975 710,760
AXIS Community Health Center 528,636 518,271
Healthy Communities 166,376 163,114
La Clínica de La Raza 1,381,636 1,354,546
LifeLong Medical Center 651,820 639,039
Native American Health Center 303,600 297,647
Tiburcio Vasquez Health Center 702,507 688,733
Tri-City Health Center 589,508 577,949
West Oakland Health Council 539,882 529,323
Unallocated 22,895
Total Allocation 5,611,835 5,611,835
Tiburcio Vasquez Health Center 60,000 60,000
2013-2014 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
143
MEASURE A ALLOCATION FY 13/14
EXPENDED/ENCUMBERED FY 13/14
GROUP 4: PUBLIC HEALTH
Alameda Boys & Girls Club, Inc. 102,000 102,000
Alameda County Asthma Start 100,000 100,000
Berkely Food & Housing Project 25,000 25,000
Center for Early Intervention on Deafness 51,000 51,000
City of San Leandro Senior Services 51,000 51,000
Eden Youth and Family Center 160,000 160,000
EMS Corps 602,800 598,544
HIV Education & Prevention Project of Alameda County (HEPPAC) 31,000 31,000
Improve Field Sanitation Conditions/Nail Salons 0 12,319
LIFE ElderCare 10,000 10,000
LifeLong Medical Care: Heart 2 Heart 200,000 200,000
Public Health Prevention Initiative
Chronic Disease and Injury Prevention
Asthma 303,967 322,015
Community-Designed Initiative 81,513 70,389
Diabetes 262,097 239,650
EMS 300,135 155,762
Healthy Kids Healthy Teeth 295,839 259,080
Project New Start 17,479 4,661
Total 1,261,030 1,051,557
Health Inequities & Community Capacity Building
Community Nursing 95,037 246,500
Community-Designed Initiative 110,917 50,200
FHS-Healthy Passage System of Care 78,441 35,858
HIV Prevention 98,202 (7,772)
Immunization Registry 196,378 189,036
Office of Director / CAPE 481,465 438,541
Total 1,060,440 952,363
Obesity Prevention and School Health
Community-Designed Initiative 360,464 121,791
Nutrition Services 296,302 282,007
Public Health Nursing 176,814 198,566
Total 833,580 602,365
Total Allocation 3,135,037 2,278,231
School of Imagination 50,000 50,000
Senior Injury Prevention Program 100,000 100,000
Service Opportunity for Seniors (Meals-On-Wheels) 16,000 16,000
Spectrum Community Services, Inc. 90,000 90,000
Spectrum Community Services, Inc. 250,000 250,000
SSI Housing Trust (GA Clients) 0 346,292
Teleosis Institute 21,000 21,000
Viola Blyte Community Services 10,000 10,000
2013-2014 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
144
MEASURE A ALLOCATION FY 13/14
EXPENDED/ENCUMBERED FY 13/14
GROUP 4: PUBLIC HEALTH (CONTINUED)
Youth and Family Opportunity Initiatives
Alameda Family Services 100,000 100,000
Alternatives in Action (AIA) 250,000 250,000
Berkeley Youth Alternatives (BYA) 100,000 100,000
City of Fremont 150,000 150,000
East Bay Asian Youth Center (EBAYC) 100,000 100,000
Eden Youth and Family Center 100,000 100,000
Fremont Unified School District 100,000 100,000
La Familia 150,000 150,000
Newark Unified School District 100,000 100,000
New Haven Unified School District 100,000 100,000
REACH Ashland Youth Center 1,041,000 1,149,000
Westcoast 90,000 90,000
Youth Radio 100,000 100,000
Total Allocation 2,499,000 2,791,517
2013-2014 MEASURE A CITIZEN OVERSIGHT COMMITTEE REPORT
145
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l
e
y
Be
r
k
e
l
e
y
7
Ci
t
y
o
f
F
r
e
m
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n
t
Fr
e
m
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n
t
8
Da
y
b
r
e
a
k
A
d
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l
t
C
a
r
e
C
e
n
t
e
r
s
Oa
k
l
a
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d
9
Ea
s
t
O
a
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l
a
n
d
B
o
x
i
n
g
A
s
s
o
c
i
a
t
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n
Oa
k
l
a
n
d
10
Hi
g
h
e
r
G
r
o
u
n
d
N
e
i
g
h
b
o
r
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o
o
d
D
e
v
e
l
o
p
m
e
n
t
Oa
k
l
a
n
d
#
Pr
o
v
i
d
e
r
Ci
t
y
11
HI
V
E
d
u
c
a
t
i
o
n
a
n
d
P
r
e
v
e
n
t
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n
P
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j
e
c
t
o
f
A
l
a
m
e
d
a
C
o
u
n
t
y
Oa
k
l
a
n
d
12
Lo
t
u
s
B
l
o
o
m
Oa
k
l
a
n
d
13
Lu
c
i
l
e
P
a
c
k
a
r
d
C
h
i
l
d
r
e
n
'
s
H
o
s
p
i
t
a
l
S
t
a
n
f
o
r
d
Fr
e
m
o
n
t
14
Ma
n
d
e
l
a
M
a
r
k
e
t
P
l
a
c
e
Oa
k
l
a
n
d
15
Ni
r
o
g
a
I
n
s
t
i
t
u
t
e
,
I
n
c
.
Oa
k
l
a
n
d
16
Se
n
i
o
r
S
u
p
p
o
r
t
o
f
t
h
e
T
r
i
-
V
a
l
l
e
y
Pl
e
a
s
a
n
t
o
n
17
St
.
M
a
r
y
C
e
n
t
e
r
Oa
k
l
a
n
d
18
Ti
d
e
s
C
e
n
t
e
r
Oa
k
l
a
n
d
19
Un
i
t
e
d
S
e
n
i
o
r
s
o
f
O
a
k
l
a
n
d
a
n
d
A
l
a
m
e
d
a
Oa
k
l
a
n
d
Map 1
alaMeda County publiC HealtH prograMs
Funded by Measure a in Fy 13/14
NO
T
E
:
U
n
i
n
c
o
r
p
o
r
a
t
e
d
a
r
e
a
s
,
i
n
c
l
u
d
i
n
g
A
s
h
l
a
n
d
,
C
a
s
t
r
o
V
a
l
l
e
y
,
C
h
e
r
r
y
l
a
n
d
,
Fa
i
r
v
i
e
w
,
S
a
n
L
o
r
e
n
z
o
,
a
n
d
S
u
n
o
l
,
s
h
o
w
n
l
i
n
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d
.
C
i
t
i
e
s
s
h
o
w
n
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n
c
o
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o
r
.
Ma
p
2
al
a
Med
a
C
ou
n
t
y
be
Ha
Vio
r
a
l
H
ea
l
t
H
C
ar
e
se
r
ViCes
al
CoHol
an
d
ot
Her
dr
u
g
pr
o
Vid
e
r
s
Fun
d
e
d
by
M
ea
s
u
r
e
a in
F
y 1
3
/
1
4
#
Pr
o
v
i
d
e
r
Ci
t
y
1
Ad
o
l
e
s
c
e
n
t
T
r
e
a
t
m
e
n
t
C
e
n
t
e
r
s
,
I
n
c
.
Oa
k
l
a
n
d
2
Al
a
m
e
d
a
F
a
m
i
l
y
S
e
r
v
i
c
e
s
A
l
a
m
e
d
a
3
Ax
i
s
C
o
m
m
u
n
i
t
y
H
e
a
l
t
h
,
I
n
c
.
P
l
e
a
s
a
n
t
o
n
4
Be
r
k
e
l
e
y
A
d
d
i
c
t
i
o
n
T
r
e
a
t
m
e
n
t
S
e
r
v
i
c
e
s
,
I
n
c
.
B
e
r
k
e
l
e
y
5
Bi-
B
e
t
t
C
o
r
p
o
r
a
t
i
o
n
O
a
k
l
a
n
d
6
Ca
r
n
a
l
e
s
U
n
i
d
o
s
R
e
f
o
r
m
a
n
d
o
A
d
i
c
t
o
s
F
r
e
m
o
n
t
7
Co
m
m
u
n
i
t
y
H
e
a
l
t
h
f
o
r
A
s
i
a
n
A
m
e
r
i
c
a
n
s
O
a
k
l
a
n
d
8
Ea
s
t
B
a
y
C
o
m
m
u
n
i
t
y
R
e
c
o
v
e
r
y
P
r
o
j
e
c
t
O
a
k
l
a
n
d
9
Fi
l
i
p
i
n
o
A
d
v
o
c
a
t
e
s
f
o
r
J
u
s
t
i
c
e
O
a
k
l
a
n
d
#
Pr
o
v
i
d
e
r
Ci
t
y
10
Ho
r
i
z
o
n
S
e
r
v
i
c
e
s
,
I
n
c
.
H
a
y
w
a
r
d
11
Hu
m
a
n
i
s
t
i
c
A
l
t
e
r
n
a
t
i
v
e
s
t
o
A
d
d
i
c
t
i
o
n
O
a
k
l
a
n
d
12
La
t
i
n
o
C
o
m
m
i
s
s
i
o
n
o
n
A
l
c
o
h
o
l
a
n
d
D
r
u
g
O
a
k
l
a
n
d
13
Ma
g
n
o
l
i
a
W
o
m
e
n
'
s
R
e
c
o
v
e
r
y
P
r
o
g
r
a
m
s
,
I
n
c
.
H
a
y
w
a
r
d
14
Na
t
i
v
e
A
m
e
r
i
c
a
n
H
e
a
l
t
h
C
e
n
t
e
r
,
I
n
c
.
O
a
k
l
a
n
d
15
Ne
w
B
r
i
d
g
e
F
o
u
n
d
a
t
i
o
n
,
I
n
c
.
B
e
r
k
e
l
e
y
16
Se
c
o
n
d
C
h
a
n
c
e
,
I
n
c
.
N
e
w
a
r
k
17
St
.
M
a
r
y
'
s
C
e
n
t
e
r
O
a
k
l
a
n
d
18
We
s
t
O
a
k
l
a
n
d
H
e
a
l
t
h
C
o
u
n
c
i
l
,
I
n
c
.
O
a
k
l
a
n
d
Map 2
alaMeda County beHaVioral HealtH Care serViCes
alCoHol and otHer drug proViders
Funded by Measure a in Fy 13/14
NO
T
E
:
U
n
i
n
c
o
r
p
o
r
a
t
e
d
a
r
e
a
s
,
i
n
c
l
u
d
i
n
g
A
s
h
l
a
n
d
,
C
a
s
t
r
o
V
a
l
l
e
y
,
C
h
e
r
r
y
l
a
n
d
,
Fa
i
r
v
i
e
w
,
S
a
n
L
o
r
e
n
z
o
,
a
n
d
S
u
n
o
l
,
s
h
o
w
n
l
i
n
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d
.
C
i
t
i
e
s
s
h
o
w
n
i
n
c
o
l
o
r
.
Ma
p
3
al
a
Med
a
C
ou
n
t
y
be
Ha
Vio
r
a
l
H
ea
l
t
H
C
ar
e
se
r
ViCes
ME
N
T
A
L
H
E
A
L
T
H
C
O
M
M
U
N
I
T
Y
-
B
A
S
E
D
O
R
G
A
N
I
Z
A
T
I
O
N
P
R
O
V
I
D
E
R
S
Fun
d
e
d
by
M
ea
s
u
r
e
a in
F
y 1
3
/
1
4
#
Pr
o
v
i
d
e
r
Ci
t
y
1
Al
a
m
e
d
a
C
o
u
n
t
y
M
e
n
t
a
l
H
e
a
l
t
h
A
s
s
o
c
i
a
t
i
o
n
B
e
r
k
e
l
e
y
2
As
i
a
n
C
o
m
m
u
n
i
t
y
M
e
n
t
a
l
H
e
a
l
t
h
S
e
r
v
i
c
e
s
O
a
k
l
a
n
d
3
Bo
n
i
t
a
H
o
u
s
e
,
I
n
c
.
O
a
k
l
a
n
d
4
Bu
i
l
d
i
n
g
O
p
p
o
r
t
u
n
i
t
i
e
s
f
o
r
S
e
l
f
-
S
u
f
f
i
c
i
e
n
c
y
B
e
r
k
e
l
e
y
5
Ce
n
t
e
r
f
o
r
I
n
d
e
p
e
n
d
e
n
t
L
i
v
i
n
g
B
e
r
k
e
l
e
y
6
Cr
i
s
i
s
S
u
p
p
p
o
r
t
S
e
r
v
i
c
e
s
o
f
A
l
a
m
e
d
a
C
o
u
n
t
y
O
a
k
l
a
n
d
7
So
u
t
h
e
r
n
A
l
a
m
e
d
a
C
o
u
n
t
y
C
o
m
m
i
t
e
e
f
o
r
R
a
z
a
(
L
a
F
a
m
i
l
i
a
Co
u
n
s
e
l
i
n
g
S
e
r
v
i
c
e
)
H
a
y
w
a
r
d
Map 3
alaMeda County beHaVioral HealtH Care serViCes
MENTAL HEALTH COMMUNITY-BASED ORGANIZATION PROVIDERS
Funded by Measure a in Fy 13/14
NO
T
E
:
U
n
i
n
c
o
r
p
o
r
a
t
e
d
a
r
e
a
s
,
i
n
c
l
u
d
i
n
g
A
s
h
l
a
n
d
,
C
a
s
t
r
o
V
a
l
l
e
y
,
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h
e
r
r
y
l
a
n
d
,
Fa
i
r
v
i
e
w
,
S
a
n
L
o
r
e
n
z
o
,
a
n
d
S
u
n
o
l
,
s
h
o
w
n
l
i
n
e
d
.
C
i
t
i
e
s
s
h
o
w
n
i
n
c
o
l
o
r
.
Ma
p
4
sCH
oo
l
H
ea
l
t
H
C
en
t
e
r
s
F
un
d
e
d
by
M
ea
s
u
r
e
a in
F
y 1
3
/
1
4
#
Pr
o
v
i
d
e
r
Ci
t
y
1
Al
a
m
e
d
a
H
i
g
h
S
c
h
o
o
l
-
B
a
s
e
d
H
e
a
l
t
h
C
e
n
t
e
r
Al
a
m
e
d
a
2
Be
r
k
e
l
e
y
H
i
g
h
S
c
h
o
o
l
H
e
a
l
t
h
C
e
n
t
e
r
Be
r
k
e
l
e
y
3
B-
T
e
c
h
H
e
a
l
t
h
C
e
n
t
e
r
Be
r
k
e
l
e
y
4
Ch
a
p
p
e
l
l
H
a
y
e
s
H
e
a
l
t
h
C
e
n
t
e
r
Oa
k
l
a
n
d
5
El
m
h
u
r
s
t
/
A
l
l
i
a
n
c
e
W
e
l
l
n
e
s
s
C
e
n
t
e
r
Oa
k
l
a
n
d
6
En
c
i
n
a
l
H
i
g
h
S
c
h
o
o
l
-
B
a
s
e
d
H
e
a
l
t
h
C
e
n
t
e
r
Al
a
m
e
d
a
7
Fr
e
m
o
n
t
T
i
g
e
r
C
l
i
n
i
c
Oa
k
l
a
n
d
8
Fr
i
c
k
M
i
d
d
l
e
S
c
h
o
o
l
-
B
a
s
e
d
H
e
a
l
t
h
C
e
n
t
e
r
Oa
k
l
a
n
d
9
Fu
e
n
t
e
W
e
l
l
n
e
s
s
C
e
n
t
e
r
(
R
E
A
C
H
A
s
h
l
a
n
d
Y
o
u
t
h
C
e
n
t
e
r
)
Sa
n
L
e
a
n
d
r
o
10
Ha
v
e
n
s
c
o
u
r
t
C
a
m
p
u
s
H
e
a
l
t
h
C
e
n
t
e
r
Oa
k
l
a
n
d
11
Ha
w
t
h
o
r
n
e
H
e
a
l
t
h
C
e
n
t
e
r
Oa
k
l
a
n
d
12
Is
l
a
n
d
/
B
A
S
E
H
i
g
h
S
c
h
o
o
l
-
B
a
s
e
d
H
e
a
l
t
h
C
e
n
t
e
r
Al
a
m
e
d
a
#
Pr
o
v
i
d
e
r
Ci
t
y
13
Lo
g
a
n
H
e
a
l
t
h
C
e
n
t
e
r
Un
i
o
n
C
i
t
y
14
Ma
d
i
s
o
n
H
e
a
l
t
h
C
e
n
t
e
r
Oa
k
l
a
n
d
15
Ro
o
s
e
v
e
l
t
H
e
a
l
t
h
C
e
n
t
e
r
Oa
k
l
a
n
d
16
Sa
n
L
o
r
e
n
z
o
H
i
g
h
H
e
a
l
t
h
C
e
n
t
e
r
Sa
n
L
o
r
e
n
z
o
17
Sh
o
p
5
5
W
e
l
l
n
e
s
s
C
e
n
t
e
r
Oa
k
l
a
n
d
18
Sk
y
l
i
n
e
H
i
g
h
S
c
h
o
o
l
H
e
a
l
t
h
C
e
n
t
e
r
Oa
k
l
a
n
d
19
Te
c
h
n
i
C
l
i
n
i
c
Oa
k
l
a
n
d
20
Te
n
n
y
s
o
n
H
e
a
l
t
h
C
e
n
t
e
r
Ha
y
w
a
r
d
21
Un
i
t
e
d
f
o
r
S
u
c
c
e
s
s
/
L
i
f
e
A
c
a
d
e
m
y
H
e
a
l
t
h
C
e
n
t
e
r
Oa
k
l
a
n
d
22
We
s
t
O
a
k
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Map 5
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