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COMMUNITY HEALTH SERVICES DIVISION
2023–2024 ANNUAL REPORT
2 2023–2024 COMMUNITY HEALTH SERVICES DIVISION ANNUAL REPORT
CONTENTS
I. INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3
II. ACCOMPLISHMENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5
HEALTHY COMMUNITIES, SYSTEMS & ENVIRONMENTS . . . . . . . . . . . . . . . . . .6
COMMUNITY HEALTH PROMOTION & PREVENTION . . . . . . . . . . . . . . . . . . .12
HEALTH NAVIGATION & CHRONIC DISEASE SUPPORTS . . . . . . . . . . . . . . . . .16
III. PROGRAMS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19
ASTHMA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20
CARE PARTNERS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22
HEALTHY BRAIN INITIATIVE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .24
HEALTHY NAIL SALON PROGRAM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .26
NUTRITION SERVICES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27
OFFICE OF DENTAL HEALTH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .30
OLDER ADULTS HEALTHY RESULTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .32
TOBACCO CONTROL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .34
WOMEN, INFANTS AND CHILDREN (WIC) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .36
2023–2024 COMMUNITY HEALTH SERVICES DIVISION ANNUAL REPORT 3
I. INTRODUCTION
In fiscal year 2023–2024, the Community Health Services (CHS) Division moved forward with bold new
campaigns and initiatives, as well as further refinements to our existing programs and services. Within the
larger Public Health Department, CHS is focused on strategic approaches to address chronic disease–which
continues to be the leading cause of death and disability, both nationally and in Alameda County. CHS offers a
comprehensive array of programs, services, and initiatives to prevent and mitigate chronic disease, especially
among populations who experience disparities in health outcomes.
We recognize that persistent disparities among our communities are most often driven by structural and
institutional factors, including the effects of racism and discrimination and stigma tied to race, ethnicity,
gender identity and expression, sexual orientation, and ability. Histories of discrimination, segregation, and
disinvestment also contribute to many of the structural drivers of inequity, including differences in access to
culturally and linguistically appropriate health care; insurance coverage and public benefits; healthy, fresh
food; affordable, safe housing options; high-quality education and childcare; living wage and safe employment
opportunities; transportation and public transit connections; and safe, livable, and accessible neighborhoods
with clean air and safe green spaces and walking routes.
We operate within the context of Public Health 3.0, which calls on each local health department to serve as the
chief health strategist for its jurisdiction. As such, we work closely with many community coalitions, advisory
bodies, and workgroups to understand community needs and shape and refine systems to better meet them.
CHS STRATEGIES
Our work in CHS employs a spectrum of prevention strategies:
Healthy Communities,
Systems &
Environments
We engage in upstream
approaches that change policies,
systems, and neighborhoods to
create communities where people
can live their healthiest lives.
Examples include our advocacy to
ban smoking in multi-unit housing;
our efforts to increase corner stores’
uptake of more produce and fewer
sugar-sweetened or alcoholic
drinks; and our certification of
nail salons that provide less-toxic
alternative products and better
ventilation to protect their workers
and their clients.
Community
Health Promotion
& Prevention
Community outreach
and health education efforts aim to
prevent chronic disease through
healthy nutrition and physical
activity. We also seek to increase
health literacy among residents
so that they are better aware of
steps they can take to manage and
improve their own health—from
monitoring their blood pressure
to regular cancer screenings to
advocating with their medical
providers.
Health Navigation
& Chronic Disease
Supports
We partner with residents
who are living with chronic
conditions or caring for others
with chronic illnesses to improve
their quality of life and their health,
through case management, patient
navigation, and disease self-
management education.
In keeping with Department, Agency, and County-wide priorities, CHS continues to center equity in all our
programs. We work closely with the Community Assessment, Planning, and Evaluation (CAPE) and the Health
Equity, Policy, and Planning (HEPP) units to ensure that our strategies and priorities are based on the most
current data available and focus on those populations experiencing the greatest inequities. This data-driven
approach informs CHS program planning and quality improvement efforts.
4 2023–2024 COMMUNITY HEALTH SERVICES DIVISION ANNUAL REPORT
VISION, VALUES AND PROGRAMS
DIVISION VISION:
We all work efficiently together for quality
and results that advance health and
racial equity in Alameda County.
CHS MANAGERS’ SHARED VALUES:
CHS PROGRAMS:
ASTHMA
CARE PARTNERS
HEALTHY BRAIN INITIATIVE
HEALTHY NAIL SALON PROGRAM
NUTRITION SERVICES
(includes Diabetes Program and
Healthy Retail)
OFFICE OF DENTAL HEALTH
OLDER ADULTS HEALTHY RESULTS
TOBACCO CONTROL
WOMEN, INFANTS AND CHILDREN
(WIC)
This report highlights the CHS program
accomplishments from fiscal year 2023–2024
as they relate to each of the major strategies
listed on page 3, followed by a more detailed
description of each CHS program.
RESPECT RESULTS
INTEGRITY
CULTURALLY
SENSITIVE
CULTURALLY
RESPONSIVE
CONTINUOUS
QUALITY
IMPROVEMENT
2023–2024 COMMUNITY HEALTH SERVICES DIVISION ANNUAL REPORT 5
II. ACCOMPLISHMENTS
Healthy
Communities,
Systems &
Environments
Community
Health Promotion
& Prevention
Health
Navigation &
Chronic Disease
Supports
6 2023–2024 COMMUNITY HEALTH SERVICES DIVISION ANNUAL REPORT
ACCOMPLISHMENTS:
HEALTHY COMMUNITIES, SYSTEMS
& ENVIRONMENTS
Implementing and sustaining equitable improvements in population health necessitates creating conditions
and environments that support optimal health for everyone. This section explores how Community
Health Services (CHS) programs are fostering healthier communities by reshaping policies, systems, and
environmental factors to enhance health outcomes. CHS programs collaborate with elected officials, schools,
small businesses, and strategic partners to better coordinate services and transform environments that impact
the health of priority populations. Through a diverse array of targeted programs, CHS is actively working to build
and sustain these vital community health improvements.
STRATEGIES FOR BUILDING HEALTHY COMMUNITIES, SYSTEMS, AND ENVIRONMENTS:
»Public Health Policy Development focuses on identifying health priorities, setting goals, and creating
guidelines and regulations to promote health and prevent disease.
»Systems Change includes integrating health promotion and prevention strategies into healthcare
settings, schools, workplaces, and communities. Systems change efforts often aim to improve access to
healthcare services, enhance the quality of care, and address disparities in health outcomes.
»Advocacy and Mobilization efforts may involve grassroots organizing, coalition building, media
campaigns, and engagement with policymakers to promote policies that support public health goals.
»Monitoring and Evaluation involves collecting and analyzing data on health outcomes, healthcare
utilization, policy implementation, and population trends to inform decision-making and policy
adjustments.
THE ASTHMA PROGRAM has recently been officially
recognized as a CalAIM provider by Alameda Alliance
for Health, a health plan within California’s Medi-Cal
program. CalAIM is an initiative aimed at enhancing and
innovating Medi-Cal services across the state, with a
focus on improving care delivery and coordination for
Medi-Cal beneficiaries. With this new status, the program
can now receive direct referrals from CalAIM and secure
authorization for their services through the health plan.
Additionally, this recognition enables the program to
incorporate home modifications into their Medi-Cal-funded
programming. These modifications are designed to
enhance clients’ living conditions, ensuring their homes are
safe and supportive for effective asthma management.
2023–2024 COMMUNITY HEALTH SERVICES DIVISION ANNUAL REPORT 7
THE HEALTHY BRAIN INITIATIVE has been
actively involved in assessing and addressing
Alzheimer’s disease and related dementias
(ADRD) across the County’s diverse communities.
Staff collaborated with the Alameda County
Public Health Department’s Community
Assessment, Planning, and Evaluation (CAPE)
team to compile a comprehensive Community
Needs Assessment. The program also worked
with CAPE to analyze qualitative data from
key informant interviews, focus groups, and
listening sessions with community members and
service providers. The findings were shared with
internal and external partners for feedback, and
the Strategic Plan was submitted to California
Department of Public Health on June 30, 2024.
Plan priorities include: 1) Training health, social
service providers and family care givers on
addressing the unique needs of the growing number of older adults with ADRD, and 2) Incorporating the needs
of adults with ADRD into emergency plans at the city and county levels in Alameda County.
THE HEALTHY NAIL SALON PROGRAM has made significant progress in improving working conditions in
nail salons. By equipping qualified salons with advanced ventilation units featuring adjustable arms, they can
effectively target the specific areas where chemicals are used, particularly during artificial nail services. This
exhaust ventilation system has the potential to cut chemical exposure for both workers and customers by
at least 50%. Additionally, the program has reached over 150 nail salons across the County, providing vital
information on toxic cancer-causing chemicals, guidance on safer nail products, and other safety protocols.
Three new salons achieved Healthy Nail Salon Certification in 2023–2024, switching to products with less
harmful chemicals and receiving personal protective equipment, including nitrile gloves, goggles, and N-95
masks.
The program continues to work closely with other Counties’ Healthy Nail Salon Program (HNSP) coordinators,
the State-level Healthy Nail Salon Program (Department of Toxic Substances Control), and the California Healthy
Nail Salon Collaborative to share experiences, information, updated legislation, and together make key policy
decisions to create a healthier and safer
salon environment for both workers and
customers.
Alameda County’s HNS staff attended to
the Health Is Beauty workshop hosted
by Santa Clara County’s HNSP, which
focused on workplace violence prevention
(nail salon setting) and California Safe
Cosmetics Program . Guest speakers
were from Santa Clara County’s HNSP,
CA Healthy Nail Salon Collaborative,
and CA Department of Public Health .
CA Department of Public Health, Alameda County’s HNSP,
San Francisco’s HNSP, Santa Clara’s HNSP, and
CA Healthy Nail Salon Collaborative.
Projected Number of People Living with Alzheimer’s Disease,
Related Disorders, or Senile Dementia, Alameda County
8 2023–2024 COMMUNITY HEALTH SERVICES DIVISION ANNUAL REPORT
NUTRITION SERVICES (NS) has a variety of programs focused on making healthy foods more accessible in
local neighborhoods. The Healthy Retail program has engaged over 9,000 community members through a
variety of retail activities. These included distributing $5 produce coupons, setting up Harvest of the Month
bulletin boards with recipes at select stores, offering education and taste tests at Healthy Snack and Rethink
Your Drink events, and providing nutrition labeling and shopping tips to Children’s Hospital medical residents
for sharing with their clients. They have also supported stores in removing and replacing alcohol and beer signs
with healthy food items.
In December 2023, Alameda County was notified of funding for four refrigeration units that were given to
General, Dallaq, Wah Fay, and Jalos local markets. Three other partner stores, Rancho, A&G, and Model Mart
were awarded new freezer/refrigerator units with the help of Green Biz, for a total of seven Alameda County
partner stores.
Former refrigeration recipient Royal Market now has produce delivered weekly and reports sales
have increased with the help of two refrigeration units located at the front of the store .
NS has also concentrated on developing and implementing health
and wellness policies in schools, working with the Oakland Unified
School District (OUSD) and San Lorenzo Unified School District
(SLZUSD). This effort has led to initiatives such as “Harvest of the
Month” taste tests at all OUSD schools and the creation of school
gardens in SLZUSD.
OUSD has introduced a revised health and wellness policy this school
year that emphasizes a whole-child approach and aims to eliminate
inequities. This policy has significantly increased students’ access to
locally sourced, seasonal produce through educational taste tests
and opportunities to grow produce in school gardens, thanks to the
expansion of the Harvest of the Month program. Additionally, OUSD
has expanded salad bars to over 75 schools, integrating these with
nutrition education and school garden programs under the Harvest of
the Month initiative.
The OUSD Harvest of the Month program has garnered
recognition from the California Department of Public
Health (CDPH) and will be featured in a video showcasing
exceptional programs and success stories.
Nutrition Services has also impacted environmental
sustainability. Gardens were sustained and continue to
grow at Satellite Affordable Housing Associates (SAHA)
sites even after CalFresh Healthy Living Funding ceased.
SAHA secured funding and resources to support the 21
edible gardens that were installed in partnership with
Nutrition Services. Persimmon trees were planted at 20
OUSD school sites. SLZUSD had a produce stand at an
elementary school and a food pantry was established at
the new Family Resource Center.
2023–2024 COMMUNITY HEALTH SERVICES DIVISION ANNUAL REPORT 9
THE OFFICE OF DENTAL HEALTH (ODH) has made significant
strides in integrating medical and dental practice and
building workforce capacity. As part of the Perinatal Dental
Demonstration Project, ODH has focused on transforming
dental care for pregnant and postpartum individuals and their
babies. This past year, ODH launched an initiative to integrate
dental care as a standard component of prenatal services. By
training prenatal care providers, ODH is raising awareness
of the critical role dental care plays during pregnancy and
its positive impact on children’s oral health. The training
is tailored specifically for prenatal care staff and includes
strategies for addressing oral health needs of pregnant
individuals and infants. Additionally, ODH is collaborating with Women’s Health Clinics to establish a streamlined
referral process, ensuring patients are connected to dental services and that utilization is monitored.
In a statewide effort to ensure that all children receive an oral health assessment before starting school, ODH,
in collaboration with a dedicated group of stakeholders, established the Kindergarten Oral Health Assessment
(KOHA) Committee. ODH staff have compiled baseline data on school district and student participation rates in oral
health assessments. This data is guiding the committee in developing strategies to effectively engage schools and
school districts to boost participation and impact. The committee plans to launch its campaign this fall.
ODH has enhanced its education and mobilization efforts through the Alameda County Community of Practice
(COP). This year, the COP organized a series of Continuing Education training courses in collaboration with the
Alameda County Dental Society, benefiting 228 dental professionals. The training covered essential topics such
as oral health care during pregnancy, special needs dentistry, and behavioral management of young children in
dental settings. Additionally, the COP provided Maternal Oral Health and Fluoride Varnish Application training to
six medical clinics and 45 medical professionals. This private and public partnership is unique and the first of its
kind aimed to increase the knowledge and confidence of general dentists to treat ODH priority populations.
THE WIC REGIONAL BREASTFEEDING LIAISON (RBL) PROGRAM
collaborated with La Clínica de La Raza San Antonio to pilot an evidence-
based infant feeding assessment and care coordination initiative. This
program, designed to promote breastfeeding through provider training,
has supported hundreds of breastfeeding families in their critical early
days, significantly improving both breastfeeding outcomes and the
quality of care. Due to its success, this model is now being replicated
across healthcare settings throughout Alameda County. Additionally,
RBL worked with hospitals and clinics to streamline messaging and
enrollment procedures for WIC. By co-creating and distributing a
multilingual brochure in five languages, the initiative has led to over 1,400
new enrollments this year.
This past year RBL supported Alta Bates Baby Friendly designation with
effective technical assistance for the Baby Friendly Taskforce and Baby
Friendly Education Committee.
RBL is an invaluable help in our journey to Baby Friendly, and has helped us to connect with
our WIC teams in Alameda County to improve our partnership to meet patient needs . . .““
10 2023–2024 COMMUNITY HEALTH SERVICES DIVISION ANNUAL REPORT
THE TOBACCO CONTROL PROGRAM (TCP) concentrated on advancing policy development, advocacy,
and mobilization this year. Partnering with concerned residents and community-based organizations, TCP has
delivered comprehensive education on tobacco control policies in Emeryville and Union City.
In Emeryville, these efforts culminated in the City Council adopting a new tobacco retail licensing policy. This
policy includes several key provisions designed to hold retailers accountable for adhering to local, state, and
federal tobacco sales laws and to reduce youth access to tobacco products.
Additionally, TCP continued to organize the Alameda County Tobacco Retail Enforcement Network (ACTREN)
on a quarterly basis. ACTREN facilitates the sharing of information, best practices, and cross-jurisdictional
partnerships among tobacco retail enforcement agencies throughout Alameda County. This network has
expanded to include participants from various Bay Area and Southern California counties, enhancing
collaboration and support. Through ACTREN, the program has also provided crucial assistance to enforcement
officials in addressing ambiguously labeled tobacco products.
LOCAL TOBACCO RETAIL LICENSING ORDINANCES (TRL) WITH YEAR OF ADOPTION
2023–2024 COMMUNITY HEALTH SERVICES DIVISION ANNUAL REPORT 11
CHS PARTICIPATION IN COMMUNITY COALITIONS
CHS could not achieve its goals without the active engagement of a diverse array of stakeholders—
including local organizations, businesses, government agencies, and community members. CHS
programs convene as well as participate in a broad range of coalitions, work groups, task forces and
councils to tackle common issues and achieve shared goals.
CARE PARTNERS
»Palliative Care & Hospice Providers Coalition
»Alameda County Age Friendly Council
• Embracing Aging Sub-Committee
»2024 Adult Protective Services Multi-disciplinary
Team Meeting
»Senior Injury Prevention Program Meeting
(CBOs & County Agencies)
»Older Adult Provider Meeting (ACBH & CBOs)
»Roundtable Meeting (AAA & CBOs)
HEALTHY BRAIN INITIATIVE
»Alameda County Age Friendly Council
• Data Sub-Committee
• Embracing Aging Sub-Committee—
serves as HBI Advisory Board
»Alameda County Access and Functional Needs
Advisory Committee
HEALTHY NAIL SALON
»California Healthy Nail Salon Collaborative
NUTRITION SERVICES
»Alameda County Nutrition Action Partnership (CNAP)
»Bay Area Nutrition and Physical Activity
Collaborative (BANPAC)
»Alameda County Diabetes Community Advisory
Council
»CalFresh Healthy Living Equity Strategic Framework,
Local Advisory Council, Stewardship Committee
• CalFresh Healthy Living Pilot Cohort
FFY 2023–2024
• San Lorenzo Unified Health and Wellness
Committee Member
• Hoover Neighborhood Senior Advocates via
Oakland Making Moves, Active Transportation
Program
• Health and Human Resource Education Center
Advisory Board
OFFICE OF DENTAL HEALTH
»Community of Practice Coalition (COP)— workforce
training for health providers.
»Oral Health Committee of the Alameda County
Public Health Commission
»Early Childhood Workgroup
»Homelessness Workgroup
»Special Health Needs Dentistry Workgroup
»Kindergarten Oral Health Assessment Committee
TOBACCO CONTROL
»Alameda County Tobacco Retail Enforcement
Network (ACTREN)
»Alameda County Tobacco Control Coalition—
policy advocacy
WIC
»Alameda County Breastfeeding Coalition
• Latina Chicana Lactation Task Force (LatCH)
• Asian Southeast Asian Pacific Islander Taskforce
(ASAP)
»Regional Breastfeeding Liaison Steering Committee
»California Breastfeeding Coalition
»Fremont Resource Center Resources and Benefits
Sub-Committee
»Fremont Resource Center Executive Council
»Bay Region WIC Directors
»Breastfeeding Cultural Outreach Task Force (BCOT)
12 2023–2024 COMMUNITY HEALTH SERVICES DIVISION ANNUAL REPORT
ACCOMPLISHMENTS:
COMMUNITY HEALTH PROMOTION
& PREVENTION
C ommunity Health Promotion and Prevention is a vital aspect of CHS services, focusing on proactive
strategies to enhance health and prevent disease within communities. CHS collaborates with County
residents at all stages of life to actively involve them in identifying health priorities, planning effective
interventions, and implementing strategic initiatives. The goals are to provide valuable information and
resources that empower individuals and communities to make informed health decisions, promote positive
health behaviors, and foster environments that support and encourage healthy choices.
STRATEGIES FOR COMMUNITY HEALTH PROMOTION AND PREVENTION:
»Empowerment and Participation: Community health promotion emphasizes the active participation of
community members in identifying health priorities, planning interventions, and implementing strategies.
Empowerment involves building community capacity, fostering leadership, and promoting ownership of
health initiatives to ensure sustainability and effectiveness.
»Education and Awareness: Education is a cornerstone of community health promotion. Health
education campaigns may focus on topics such as nutrition, physical activity, chronic disease
prevention, mental health awareness, substance abuse prevention, and sexual health.
»Health Behavior Change: Community health promotion aims to promote positive health behaviors
and prevent risky behaviors through targeted interventions. This may include implementing programs
to encourage smoking cessation, increase physical activity levels, improve diet quality, promote safe
sexual practices, and reduce substance abuse.
THE WIC PROGRAM provided breastfeeding support and peer counselling, through regular check-ins to 5,100
parents to ensure breastfeeding mothers achieve their infant feeding goals. WIC counselors provided nutrition
education to 71,800 unduplicated participants via phone, video, and in-person appointments. They provided
participants with $14 million worth of WIC benefits that were spent at local grocery stores, and issued $112,500
of Farmers’ Market vouchers enabling participants to purchase seasonal fresh fruits and vegetables.
They also collaborated
with the Office of Dental
Health offering dental
screenings on site at four
WIC locations and helped
WIC participants acquire
formula during this
year’s formula shortage.
Additionally, through a
partnership with Family
Health Services Division
(FHS), WIC screened
3,170 people for maternal
depression.
2023–2024 COMMUNITY HEALTH SERVICES DIVISION ANNUAL REPORT 13
THE OFFICE OF DENTAL HEALTH (ODH) carried out a range of
educational and prevention oriented clinical activities throughout
the community and in schools. They engaged over 5,661 community
residents through 28 outreach events. They provided presentations
and trainings on oral health to 21 organizations serving ODH priority
populations, in addition to a CE course on dental care during pregnancy
with the local Dental Society. They offered 13 oral health education
workshops to community members and trained 122 parents of young
children and pregnant individuals. They also conducted oral health
education for 754 elementary school and high school students at
Parenting Teens Program sites.
The ODH Clinical Program provided various preventive and diagnostic
services including conducting dental screenings for 261 students, applying fluoride varnish to 220 students,
placing dental sealants on the permanent molars of 65 students, performing teeth cleanings for 105 students,
and applying fluoride varnish to 109 infants’ and children’s teeth to prevent early tooth decay. They also
provided anticipatory guidance and oral health education to 120 parents of young children and conducted
dental assessments and provided fluoride varnish applications to 33 pregnant and postpartum clients. During
National Oral Health Month, ODH provided oral health education to 742 elementary school students across four
school districts and 12 high school Parenting Teens Program sites, and gave 10 Oral Health presentations and
participated in 12 outreach events conducted at Early Childcare Centers and elementary schools.
HEALTHY BRAIN INITIATIVE (HBI) staff actively collaborated with both internal and external partners across
Alameda County to ensure that their Strategic Plan reflects the needs and experiences of individuals living
with dementia and their caregivers, as well as the organizations that support them. As part of this effort, HBI
organized four listening sessions with community members who care for loved ones with Alzheimer’s disease
and related dementias (ADRD), and conducted 15 key informant interviews with County and community partners.
Additionally, HBI worked with the California Department of Public Health to successfully launch the state’s
Alzheimer’s awareness media campaign, TakeOnAlz, which was attended by representatives from 15 agencies,
received extensive media coverage and was featured in multiple news stories.
Lisa Gonzales, Communications & Prevention Lead, California Department of Public Health Alzheimer’s Disease
Program; Claudia Landau, PhD, MD, Chief of Geriatrics and Palliative Care Emeritus and consultant to Alameda Health
System; Jessie Spivey, Director of Elder Services, Oakland LGBTQ Community Center; Jenny Wang, MPH, MPP, Director,
Community Health Services Division, ACPHD; Taunuu Ve’e, Co-Chair/Co-Founder, Regional Pacific Islander Taskforce and
Director, Taulama for Tongans; David K. Johnson, PhD, Professor in Neurology, UC Davis School of Medicine, Director,
California Alzheimer’s Disease Center-East Bay, and Principal Investigator, The Good Life Program for Healthy Aging; Nalleli Albarran-Cruz, Senior Manager of Senior Wellness, The Unity Council; Mercel Amin, Senior Manager of Community
Outreach and Engagement, Alzheimer’s Association of Northern California/Nevada Chapter (East Bay)
14 2023–2024 COMMUNITY HEALTH SERVICES DIVISION ANNUAL REPORT
NUTRITION SERVICES has led a variety of disease- and population-specific health education initiatives
throughout the County.
The Happy Heart Campaign (HH) launched
a comprehensive set of educational and
outreach strategies to enhance heart health
awareness and combat hypertension. Over
the past year, the Campaign hosted 22 events,
collaborated with 34 partners, and reached
1,015 residents. It provided event materials,
virtual education, multilingual resources, and
a simplified nutrition label guide. To promote
regular self-testing, 350 free wrist monitors
and blood pressure logs were distributed. HH
utilized billboards, dedicated website pages,
social media challenges, posters, and flyers
to ensure that health behavior messages
effectively reached the target audience.
Cooking for Health Academy (C4HA) is a six-class series
designed for adults with limited time or financial resources to learn
how to prepare budget-friendly, nutritious meals. C4HA saw a 50%
increase in enrollment compared to last year, with 170 participants
this year. Of these, 123 graduated, 83 (67%) earned their California
Food Handler Certification, and five former graduates acted as
Community Champions, serving as co-educators or assistants.
Classes were offered in Spanish and English, both in person and
virtually.
Bingocize combines Bingo with nutrition education and physical
activity in an evidence-based program. It promotes increased
exercise, age-appropriate strength workouts, and intentional
movement. This year, participation grew by 25%, from 144 to 180
older adults. The program is available to low-income residents,
those at senior centers, and individuals in affordable senior
housing.
Oakland Making Moves (OMM) encourages physical activity
through purposeful walks/rolls supporting residents of 13
affordable family and senior housing sites in their efforts to sustain
a safe and welcoming environment. Program activities are funded
by California Transportation Commission through September
30, 2025. Like the Healthy Retail Program, OMM has been met
with challenges especially around safety in neighborhoods with
concerns ranging from drug dealing and residents witnessing
violence in broad daylight to inclement weather. Acting on walk
audit findings, staff offer safe alternatives such as Bingo with
physical activity or walking within the housing site to the garden.
2023–2024 COMMUNITY HEALTH SERVICES DIVISION ANNUAL REPORT 15
The Diabetes Self-Management Education (DSME) Program
forged new partnerships with various community and faith-based
organizations this year. Through these collaborations, the program
delivered nine diabetes presentations to 239 participants and four
hypertension presentations to 71 participants across the County.
The program also conducted 11 DSME classes, which benefited
105 individuals managing diabetes or prediabetes. It also facilitated
36 diabetes support groups, both in-person and virtual, reaching a
total of 371 participants throughout Alameda County. This year the
program passed all audit requirements by the American Diabetes
Association and gained their program recognition through 2026.
The curriculum was translated into Spanish and Chinese, with plans
to add more languages in the future.
Additionally, through dedicated County nutrition funding, contracted community-based partner organizations:
prepared and distributed 4,300 meals cooked by Resident Leaders and delivered to community sites; offered
42 free six-week-long Cooking Matters classes, benefiting 625 low-income adults, children, teens, and families;
conducted food demonstrations at six farmers’ markets; and distributed $1,356 in VeggieRx vouchers to 339
households.
CARE PARTNERS applies a health equity lens and approach to its diverse
health promotion training and educational forums, empowering vulnerable
populations to achieve equitable access to resources and improved health
outcomes. This year, Care Partners hosted 14 in-person Advance Care
Planning workshops to help older adults in Senior Centers and residential
facilities to become aware of and create advanced health care plans,
including developing directives for their future palliative, supportive, and
hospice care. These workshops, delivered in languages including Spanish,
Cantonese and others, reached 324 chronically ill and older adults, as well
as staff from Social Services Agency, Public Health and other agencies
throughout the County. They also offered monthly trainings on a variety of
wellness promotion and illness prevention topics, increasing knowledge and skills for 660 IHSS Recipients and
Care Providers.
Care Partners outreach efforts included participation in 33 community health fairs and events where they had
direct conversations with over 3,103 community residents, providing information on the program, rights to care,
and available resources. Additional outreach efforts included giving short (10–15 min.) presentations in 182
IHSS daily orientation sessions and 90 Public Authority trainings. Presentations were given in English, Spanish,
Vietnamese, and Chinese languages.
HEALTHY NAIL SALON program staff distributes informative handouts about
choosing safer chemicals and practices, a list of recognized healthy nail salons in
the County, and the impact of toxic chemicals on health during outreach and local
health fair events. More than 75 nail technicians and 100 Alameda County staff
have been trained in English and Vietnamese to protect themselves while working
directly with chemicals, to choose healthier nail products and personal protective
equipment, and to continue applying safer practices to maintain their wellbeing.
The program also partnered with District 3 to participate in District 3’s public events
to meet more residents and raise awareness about toxic chemicals in nail products
by distributing safety guidelines flyers and in-person training.
16 2023–2024 COMMUNITY HEALTH SERVICES DIVISION ANNUAL REPORT
ACCOMPLISHMENTS:
HEALTH NAVIGATION &
CHRONIC DISEASE SUPPORTS
C HS Health Navigators assist individuals in overcoming various challenges by guiding them through
the complexities of the healthcare system to ensure they access timely and appropriate care. CHS
also offers comprehensive support for populations managing chronic diseases including disease
management, patient education, self-management support, care coordination, and emotional and psychological
support.
HEALTH NAVIGATION
Health navigation and care coordination are
services that help individuals understand and
access the healthcare system more effectively.
Health navigators/care coordinators guide patients
through the complexities of healthcare services,
ensuring they receive timely and appropriate care.
Key functions include:
»Information and Guidance
»Coordination of Care
»Connection to Resources
»Advocacy for Needed Services
»Client Education
CHRONIC DISEASE SUPPORT
Chronic disease support refers to the ongoing
care and management provided to individuals with
chronic illnesses, aiming to improve their quality of
life, manage symptoms, and prevent complications.
Key strategies include:
»Disease Management
»Patient Education
»Self-Management Support
»Care Coordination
»Emotional and Psychological Support
THE OFFICE OF DENTAL HEALTH enrolled 811 children and
youth in care coordination, facilitating a total of 1033 dental
appointments. Over 220 children aged 0-5, and 392 pregnant
and postpartum individuals were enrolled in care coordination.
Of the 226 pregnant and postpartum individuals that were
scheduled appointments, 141 completed their first appointments
for a show-up rate of 62%.
2023–2024 COMMUNITY HEALTH SERVICES DIVISION ANNUAL REPORT 17
THE ASTHMA PROGRAM provided care navigation
and asthma remediation services to children—and
for the first time, adults—living with poorly controlled
asthma. The longstanding pediatric Asthma Start
program served 335 children and their families
this year. Some of this work included developing
individualized action plans to assist families in
controlling their children’s asthma, collaborating with
schools and day care providers to ensure that asthma
medication is available for every child with asthma
at the site, collaborating with medical providers at
local hospitals and clinics to support quality care, and
assisting families in accessing housing, employment,
and health insurance. Participants also learned about
asthma triggers, how to manage their child’s asthma,
and how to administer medication. They received
needed supplies, including HEPA vacuums and
mattress covers and, when needed, were able to
have minor home repairs conducted that assist with
mitigating their asthma.
The program yielded impressive results. This year,
prior to enrollment, 10% of the children served by
Asthma Start had been hospitalized within the past
12 months. During their time in the program, this
figure dropped to only 2%. Similarly, while 55% of the
children had visited the Emergency Department in the
year before joining the program, only 19% needed to
visit the Emergency Department while participating.
Furthermore, the Asthma Control Test, a validated
assessment tool, revealed that 58% of the children
initially had poorly controlled asthma. By the end of
the program, this percentage decreased significantly,
with only 10% of the children still having poorly
controlled asthma.
The Adult Asthma Remediation program launched in
February 2024, so program outcome data is not yet
available for the adult participants in what is usually a
4-6 month intervention.
PRE-INTERVENTION POST-INTERVENTION
10%of the children had been hospitalized 12 months
before entering program.2% had been hospitalized while in the program.
55% of the children had been in the Emergency
Department 12 months before entering program.19% had been in the Emergency Department
while in the program.
58%of the children according to the Asthma Control Test
(a validated test) were not in control of their asthma.10% would be considered not in control.
39% scored 80% or higher on Asthma Knowledge test.96% scored 80% or higher on Asthma
Knowledge test.
NUTRITION SERVICES’ Diabetes Self Management Education (DSME) program assisted over 476 individuals
with managing their diabetes. As a result of participating in DSME classes: 90% improved their Hemoglobin A1c
or maintained a reading under 7.0%, a key measure of well controlled blood sugar; 63% improved their blood
pressure or maintained a BP under 140/90; and 75% lost weight or maintained their weight.
Quotes from DSME Class Participants:
I like how the class
was geared to the
needs of our group .
Great instructor,
communicates clearly,
reassuring, informative,
and good at responding
to questions .
Enjoyed class!
Instructors respected students
at the level they were at .
Appreciated the wholistic
approach and specifically
the medication chapter .
““““““
18 2023–2024 COMMUNITY HEALTH SERVICES DIVISION ANNUAL REPORT
CARE PARTNERS, a multi-disciplinary team, connected 1,124 older
adults with a specific focus on adults who speak languages other than
English, to needed resources including health care, in home support
services, durable medical equipment, adult protective services, adult
care facilities, housing, and food resources among others. Over 99% of
clients who completed Satisfaction Surveys “strongly agreed” that Care
Partners’ compassionate and culturally responsive services increased
their access to care, support, and resources.
OLDER ADULTS HEALTHY RESULTS provided intensive “high touch” home-visiting nurse case management
for 101 older adult clients (60+) who have trouble managing complex health conditions due to psychosocial
challenges. This comprehensive care includes interpreting information from various sources, prioritizing self-
management strategies, navigating interactions with clinicians and healthcare systems, enhancing medication
understanding, and helping patients integrate and act on different care recommendations.
CASE MANAGEMENT ACTIVITIES
Cases 91
Consultations 85
Full time employees 2.5
nurses
Face-to-face encounters 380
Total encounters 1,270
FALL PREVENTION
At-risk clients who received an
individualized fall prevention
interventions to reduce risk
96%
QUALITY-OF-LIFE
Clients’ quality-of-life goals that were
met or partially met
96%
LIVING AT HOME
Clients who remained living safely in their
home at the time of reassessment and/or
case closure
94%
Care Partners’ advocacy enabled
this client to receive motorized
transportation.
2023–2024 COMMUNITY HEALTH SERVICES DIVISION ANNUAL REPORT 19
III. PROGRAMS
During the fiscal year 2023–2024, the CHS Division managed nine active programs:
ASTHMA
CARE PARTNERS
HEALTHY BRAIN INITIATIVE
HEALTHY NAIL SALON PROGRAM
NUTRITION SERVICES (includes Diabetes Program and Healthy Retail)
OFFICE OF DENTAL HEALTH
OLDER ADULTS HEALTHY RESULTS
TOBACCO CONTROL
WOMEN, INFANTS AND CHILDREN (WIC)
The following sections provide a detailed description of the services offered by each active
program, the populations they serve, and a snapshot of plans for the coming fiscal year.
20 2023–2024 COMMUNITY HEALTH SERVICES DIVISION ANNUAL REPORT
ASTHMA
WHAT WE DO
The Asthma Program provides comprehensive, in-home case
management to people living with poorly controlled asthma
throughout Alameda County. Asthma Start, the award-winning,
research validated pediatric program, provides services to youth
throughout the County. Children who have been to the emergency room
or hospital, as well as those with other signs of poorly or uncontrolled
asthma, are referred to the program by hospitals, medical providers,
schools, and Alameda Alliance for Health. Asthma Program clients’
families learn about asthma triggers, how to manage their child’s asthma,
and how to administer medication. They also receive needed supplies—
including HEPA vacuums and mattress covers—and may receive minor
home repairs that assist with mitigating their asthma. Case managers
also link families to other services and health insurance, as needed.
I loved the program . The info and
supplies such as the air purifier were very
helpful . Grateful for the program .
The air purifier was very helpful . My
neighbor has a cat and the air purifier
helps with those smells . Alexa was very
informative and friendly and kind .
This year, the Asthma Program launched the Adult
Asthma Program to serve adults aged 19–80+ years.
They have partnered with the County’s Public Health
Nursing Division to serve as the first point of contact
for the adults via the Division’s Front Door program.
This partnership allows skilled nursing staff to identify
co-morbidities and other needs that the adult may
have before embarking on asthma remediation. For
adults who are Medi-Cal eligible, they too will have at
their disposal a lifetime allotment of funds that can be
applied to mitigation and remediation measures for
the homes.
I had a very good experience
in the program, and I learned a
lot from the asthma worker .
New floor installed in home to
reduce asthma triggers.
““
“
“
“
“
“
2023–2024 COMMUNITY HEALTH SERVICES DIVISION ANNUAL REPORT 21
POPULATIONS SERVED
The Asthma program serves children, youth, young adults, and adults throughout Alameda County. Between
July 2023 and June 2024, they served 335 client families. Of these, 166 were carried over from last fiscal year
and 169 clients opened new cases this fiscal year. (Adult clients are not reflected in the charts below.)
I felt respected,
and I appreciate the
simple way the worker
explained things .
My worker was very
helpful . We hope that
the program continues
to help more clients
in need .
My worker helped
me a lot, calmed me
a lot, and gave me
information .
THE ROAD AHEAD
Expand the Asthma Program’s reach and shorten client waiting times by deploying a team of Asthma
Specialists to interface with medical providers, schools, and families, and conduct outreach to
underserved communities.
Increase health promotion and awareness campaigns through new branding, participation in
health fairs and events, and supporting new partnerships with community based organizations and
Alameda County Health’s departments.
The Adult Asthma Program will expand its relationship with the Alameda County Public Health
Department’s Nursing Division’s Front Door program and the Alameda Alliance for Health to serve
the adult Medi-Cal population through CalAIM.
The Asthma Start Program will partner with UC Berkeley’s School of Public Health to provide
educational services and environmental resources for Medi-Cal parents of children with uncontrolled
asthma.
““““““
0
10
20
30
40
50
60
Native American <1%
Pacific Islander 1%White 2%Middle Eastern/North African 4%Asian
10%
African American/
Black
33%Multi-Race7%
Hispanic/
Latino/a/x/e
43%
Male59%
Female41%
AGE
6–12 13–18 19–250–5
51%
30.4%
17.9%
.6%
ASTHMA
22 2023–2024 COMMUNITY HEALTH SERVICES DIVISION ANNUAL REPORT
CARE PARTNERS
WHAT WE DOCare Partners (CP) applies a racial equity lens
to deliver holistic, supportive services using
a non-medical, culturally competent and
language-specific approach. CP seeks to eradicate
inequities in access to quality healthcare and social
services among the County’s older adult populations
and their caregivers. CP serves In-Home Supportive
Services (IHSS) Recipients and Care Providers, and
low-income older adults, and/or people living with
disabilities.
Through home or remote visits, CP conducts
biopsychosocial assessments, identifies issues
related to the social determinants of health, and
provides care coordination services with appropriate
information, resources and referrals on clients’ unmet
needs. CP’s educational training and emotional
support are designed to help reduce suffering and
build client knowledge, skillsets, and empowerment
to live their best quality of life. CP intentionally recruits
and develops linguistically and culturally competent
team members, including university student interns,
CalWorks employees, Pathways fellows, and
community champions to improve care delivery and
contribute to workforce diversity in their culture/
language specific communities.
CP also participates in community outreach events
to promote awareness of program services, available
resources, and Advance Care Planning to help
community members document the kind of care they
want and ensure their medical wishes are known in
case they cannot speak on their own behalf.
The Care Partners program maintains a website
that includes a program introduction, resources and
Advance Care Planning information.
BUILDING SUSTAINABLE
PARTNERSHIPS
To build relationships, reach more clients, and
collaborate to help mutual clients get connected to
needed resources, CP works with: Health Systems,
such as Highland, Stanford, and Kaiser; Internal
County programs, such as IHSS, Adult Protective
Services, Workforce & Benefits Administration, and
the Area Agency on Aging; and Community Based
Organizations, such as Food Bank and DayBreak Adult
Care.
Referrals stemming from these relationships allow
CP to support many older individuals to access both
health and social supports that are available.
CLIENT REFERRALS RECEIVED
Health Systems/Medical providers 23
Internal County programs 256
Community Based Organizations 21
CP also convenes and facilitates the Palliative Care and
Hospice Provider Coalition. This forum allows these
organizations to share resources, information, and
collaborate with health providers and health systems,
as well as to create access to care options for elders
who are facing the ends of their lives.
CP engages Veteran community champions and
community men’s groups to reach more men.
2023–2024 COMMUNITY HEALTH SERVICES DIVISION ANNUAL REPORT 23
TRAINING AND EDUCATION
CP provides education and conducts trainings on a
variety of topics for IHSS care providers who need
support and training to enhance their caregiving skills:
Loneliness, Isolation and Friendly Visitor Program
Capacitación Digital Nivel Básico/Basic Digital
Training (Spanish)
Doula: Companionship, Comfort and Guidance to
Those Facing a Terminal Illness or Death
Tips For IHSS Care Providers Who Care for People
With Complex Needs
提前護理計劃
(Advance Care Directive —Cantonese)
Holiday Self-Care and Free Resources
Financial Literacy: It’s Not How Much Money You
Make, It’s What You Keep!
Classes are given regularly through IHSS training
forums, as well as in residential facilities and senior
centers on request.
POPULATIONS SERVED
THE ROAD AHEAD
Create new training opportunities
for students.
Implement new client database.
Design and adopt an evaluation
strategy to assess the impact of CP
model on quality of life for older
adults.
Secure sustainable funding to
meet the growing demand for CP
services.
CARE PARTNERS (CP)
Native American 1%Pacific Islander 1%Middle Eastern/
North African 2%Unknown 3%
Multi-Race 3%
Asian34%
African
American/Black
32%
Hispanic/Latino/a/x/e17%
Male31%Female69%
White
10%
AGEUnknown Gender .4% • Transgender .1%
0–5 6–12 13–18 19–25 26–39 40–65 65+Unknown
0.4%0.6%3.3%
11.9%
37.4%36%
10.2%
0.2%
Native American 1%Pacific Islander 1%
Middle Eastern/North African 2%
Unknown 3%
Multi-Race 3%
Asian
34%
African
American/Black
32%
Hispanic/
Latino/a/x/e17%
Male31%Female69%
White
10%
50+
AGEUnknown Gender .4% • Transgender .1%
0–5 6–12 13–18 19–25 26–39 40–65 65+Unknown
36%
10.2%
0.2%
24 2023–2024 COMMUNITY HEALTH SERVICES DIVISION ANNUAL REPORT
HEALTHY BRAIN INITIATIVE
BACKGROUNDAlzheimer’s Disease and Related Dementias
(ADRD) are chronic diseases that deeply
affect Alameda County residents, and
prevalence is rapidly increasing. ADRD was the third
leading cause of death among people ages 65 and
older in Alameda County in 2021. This age group
is the fastest growing age group in the County and
comprises nearly 16% of the total population. There is
a 12.1% prevalence of Alzheimer’s Disease in this age
group, with approximately 31,000 people living with
the disease today. The number of people aged 65
and over with ADRD in Alameda County is estimated
to nearly triple to close to 90,000 by 2060.
Although ADRD affects Alameda County residents
of all races/ethnicities, there are stark disparities
in prevalence and health outcomes. According to
data analyzed by the Alameda County Public Health
Department’s Community Assessment, Planning, and
Evaluation (CAPE) Unit, there are disproportionate
impacts in the Black, Pacific Islander and American
Indian/Alaska Native populations, including
higher prevalence, emergency department visits,
hospitalizations and mortality as compared with
overall County rates. There are also disproportionate
health impacts in low-income neighborhoods.
WHAT WE DO
The Healthy Brain Initiative (HBI) seeks to create
a better coordinated, aligned, and equity-focused
system of care for those at-risk for or living with
Alzheimer’s Disease and Related Dementias (ADRD).
Funded by the California Department of Public Health
(CDPH) Alzheimer’s Disease Program (ADP) and
working in partnership with Alameda County’s Age
Friendly Council, the Embracing Aging/HBI Workgroup
was formed. This group considered and selected the
following priorities from among the recommended
Action Steps (Components) in The Healthy Brain
Initiative Road Map developed by the Alzheimer’s
Association and the Centers for Disease Control and
Prevention:
1. Community Needs Assessment, Surveillance,
Evaluation: The Community Needs Assessment and
Strategic Plan for ADRD were completed by June
2024. Ongoing surveillance and evaluation will be
built into priority action steps.
2. Community Advisory Coalition: The Age-Friendly
Council’s Embracing Aging/HBI workgroup serves
as HBI’s Community Advisory Coalition, bringing
expertise and guidance to the work.
Alameda County hospitalization rate for Alzheimer’s and related dementias
per 100,000 people among people 65 and older, by race and ethnicity
2023–2024 COMMUNITY HEALTH SERVICES DIVISION ANNUAL REPORT 25
3. ADRD Trainings for Providers:
HBI will expand the Alameda County
Embracing Aging Training Initiative to
include up to 20 trainings for health
care professionals, community-based
organization (CBO) service providers,
other stakeholders, and County staff
focused on the “4Ms” of geriatrics
(mobility, mentation, what matters, and
medication), with particular attention to
ADRD.
4. Emergency Planning and
Preparedness: HBI will work with
Alameda County and its 14 cities to
ensure that emergency plans at all levels
address the specific needs of people
with dementia and their caregivers.
After the program was launched and HBI conducted key informant interviews, focus groups, and listening
sessions with community members and service providers, additional themes emerged for new areas of
development, capacity building, and quality improvement, as follows:
Address critical gaps in caregiver supports and respite slots, and generally increase system capacity for
services
Widely increase access to culturally and linguistically appropriate services
Expand training and cognitive screenings for primary health care providers
Increase case management and support for patient navigation
Expand housing and legal services for people with dementia and their caregivers
Develop age-friendly shelters
THE ROAD AHEAD
Ensure that Alameda County’s Emergency Operations Plan is up-to-date and support at least two to
five agencies or jurisdictions to adopt and integrate recommendations that ensure inclusion of ADRD
individuals into their emergency protocols, guidelines, and/or formal emergency plans.
Continue to work with County and community partners to implement ADRD trainings for providers
and support local emergency plans to incorporate the needs of people with dementia and their
caregivers.
The program will also continue to work with the community to develop strategies to address the
additional gaps identified after HBI was launched.
HEALTHY BRAIN INITIATIVE
26 2023–2024 COMMUNITY HEALTH SERVICES DIVISION ANNUAL REPORT
THE ROAD AHEAD
HNS plans to increase the number of recognized nail salons in Alameda County each year and to be
able to provide the training to more nail staff.
In the next year HNS will bring up to three mobile healthy nail salons that could travel to large
health fairs in Alameda County to demonstrate safer practices and the use of safer products and to
encourage residents to urge their regular salons to get certified as healthy nail salons.
HNS will work on additional publicity for the program, which includes possible outdoor media in
selected areas and targeted ads and articles in Vietnamese media.
HEALTHY NAIL SALON PROGRAM
BACKGROUNDCalifornia has the largest number of nail salon businesses
and nail technicians in the country. In Alameda County,
there are over 400 nail salons. According to a study
by the California Healthy Nail Salon Collaborative in 2015,
an estimated 80% of nail salon workers in California, and in
Alameda County, are Vietnamese immigrants. The Alameda
County Public Health Department partners with the California
Healthy Nail Salon Collaborative to implement the Healthy Nail
Salon program to ensure the safety of nail salon owners, staff,
and customers.
WHAT WE DO
The Healthy Nail Salon Program (HNS) is a free, voluntary
program that educates and supports nail salon owners and
workers in choosing less toxic products and creating a safer and
healthier working environment. The program provides bilingual
training and guidance (English and Vietnamese) about safe
practices and safer nail care products. The training is open to
any nail technicians who want to learn more about health and
safety guidance in a nail salon setting. All nail salons in Alameda
County are eligible for the training.
Once a salon’s staff completes the training, a site visit is conducted to assess all the products used in the salon
and review safety procedures and the ventilation system. If needed, recommendations are made to improve
the working environment, and qualified nail salons are provided with a specialized ventilation unit and other
personal protective equipment to reduce chemical exposure during any nail services. After a follow-up visit, if
the salon meets all of the program criteria, they become formally recognized as a Healthy Nail Salon.
2023–2024 COMMUNITY HEALTH SERVICES DIVISION ANNUAL REPORT 27
NUTRITION SERVICES
WHAT WE DOThe Alameda County Nutrition Services (NS)
program advances health and racial equity
by providing healthy eating and physical
activity supports, including diabetes education
to reduce chronic disease and improve long-
term health. NS does this through implementing
County staffed programs and services and through
committed community partnerships that ideally lead
to sustainable policy, systems, and environmental
(PSE) change. NS envisions that all people live in safe,
connected neighborhoods that offer fresh, affordable
foods, are choosing active healthy lifestyles, and
are engaged in their communities. NS serves
children ages 3–5 to older adults throughout the
County. ACNS and partners service CalFresh-eligible
households and underserved, under-resourced
geographic communities. Programs and services
are held on site and virtually in classrooms and in
community throughout the County.
PROGRAMS
ACNS provides educational, fun, and interactive
ways to teach healthy eating and physical activity for
Early Childhood Education (ECE) students through
their families and staff. Partners such as Community
Association for Preschool Education, Inc. (CAPE, Inc.)
and Room to Bloom connected NS with about 200
families and staff who experienced healthy snack
demonstrations, Healthy Heart resources and
materials, and Rethink Your Drink
Day information on reducing
sugar sweetened beverage
consumption. Also, their partner
CoCoKids shared ECE resources
for families in both Alameda
County and sister county, Contra
Costa, via organizations through
the CNAP collaborative.
NS Youth and School Programming is accomplished
though partner school districts and their health and
wellness policies and local recreation and community
center programs that expand experiences in nutrition,
cooking, gardening, physical activity, and healthy
messaging. Their CalFresh funding supports Oakland
Unified School District and San Lorenzo Unified
School District, and summer brings Rethink Your Drink
programming in partnership with non-profit, Fam
D.N.A, to eight Oakland Recreation and Park Centers
reaching hundreds of school aged children each
summer.
Adult and Older Adult Programs Cooking for Health
Academy (C4HA) provides nutrition knowledge,
food safety awareness, and cooking techniques.
Interactive classes educate and encourage
participants to increase fruit and vegetable intake and
decrease sugar sweetened beverage consumption.
The C4HA offers cooking skills through a United
States Department of Agriculture (USDA) approved,
community informed, hands-on, engaging curriculum.
Each class includes:
The importance of healthy eating
Nutrition education
Shopping for fresh produce
Safe food preparation
Culinary skill techniques
A practice session and recipe tasting
Bingocize is an evidence-
based program combining
Bingo with physical activity and
nutrition education encouraging
increased time spent exercising,
28 2023–2024 COMMUNITY HEALTH SERVICES DIVISION ANNUAL REPORT
strengthening workouts, and intentional movement. Bilingual
English/Chinese classes reached 201 older adults, including low-
income residents, residents at senior centers, and those living in 10
affordable senior housing sites.
Diabetes Self-Management Education (DSME) provides classes,
support groups, presentations, and informational newsletters to
County residents. The program focuses on individuals aged 18 and
over diagnosed with prediabetes and type 2 diabetes.
NS and partners provide healthy messaging, community resources,
and technical assistance. Alameda County Community Foodbank
(ACCFB) provides nutrition and/or physical activity workshops at 10
Member Agency sites for staff, volunteers, and community members;
reviews and revises wellness policies, training, and nutrition education
materials for volunteers and staff at four Member Agency sites; and
dives deeper with assessment, coaching, and technical assistance at
a minimum of three Member Agency sites that are working to adopt
nutrition and wellness improvements that lead to policy, system, or
environmental (PSE) changes.
NS staff host special educational events—both in person and virtually. This year brought 17 Foodie Friday online
sessions featuring healthy recipes. And NS staff, partners, and community champions hosted the annual Rethink
Your Drink campaign at 17 sites with materials about the impact of sugar sweetened beverages.
COMMUNITY CHAMPIONS
NS could not do this work without the active involvement of communities! Community Champions, residents
who have graduated from NS programs, are trained and support or co-lead programs alongside staff. They
represent the communities in which they live and lead. Champions have been active in the Cooking for Health
Academy, the Diabetes Program, Oakland Making Moves, community health fairs, and more. ACNS also works
with short term volunteers and interns on special projects. 20+ Community Champions, volunteers and interns
have worked with NS this year.
This year, Champions:
Co-led the inaugural Happy Heart Campaign
Presented Food Waste Reduction strategies to
18 County Nutrition Action Partnership member
organizations
Shared personal stories of experience living with
pre-diabetes or diabetes with support group
participants
Led regular walking/rolling groups from senior
affordable housing sites to healthy destinations such
as Lake Merrit, local museums and more.
Participated/staffed in over 20 community
health fairs
MY FAVORITE PART ABOUT BEING A
RETHINK YOUR DRINK CHAMPION IS…
… reaching out to and educating the community
about nutritional health and the resource
options our County provides .
—R . GREENWELL
… cuando los niños se sorprem dem de la
cantidad de azúcar que contiene las bebidas
(when children are surprised by the amount
of sugar in drinks) .
—N . CASTILLO
POPULATION SERVED
NUTRITION SERVICES
“
“
2023–2024 COMMUNITY HEALTH SERVICES DIVISION ANNUAL REPORT 29
THE ROAD AHEAD
Commit to health and racial equity by enhancing community participation in programmatic
decision making.
Commit to exploration and bridging of direct health education to creating sustainable and
equitable organizational, policy, systems and/or environmental changes.
Increase the number of participants who start and graduate from the DSME classes and have
completed pre and post clinical measures.
NUTRITION SERVICES
Middle Eastern/North African 1%
Asian
10%
African
American/
Black
22%
Hispanic/Latino/a/x/e
42%
Unknown
19%
Male48%Female52%
White
5%
AGE
6–12 13–18 19–25 26–39 40–65 65+
64.9%
14.8%12.9%7.1%0%.3%
Male48%Female52%
White
5%
AGE
6–12 13–18 19–25 26–39 40–65 65+
64.9%
14.8%12.9%
7.1%0%.3%
30 2023–2024 COMMUNITY HEALTH SERVICES DIVISION ANNUAL REPORT
OFFICE OF DENTAL HEALTH
WHAT WE DO
The Office of Dental Health (ODH) works to
improve the oral health of Alameda County
residents by:
9 Connecting residents to dental care
9 Providing preventive dental services at schools and
WIC sites
9 Building capacity of dental and medical providers
9 Expanding the oral health workforce
9 Collaborating with community partners
CARE COORDINATION
ODH offers dental care coordination, which focuses on
increasing access to oral health through the utilization
of preventative dental care. The priority population
groups of this program are children, youth (ages 0–20
years), and perinatal individuals who are Medi-Cal
eligible. ODH Family Support Care Coordinators (FSCC)
work with clients referred by internal program partners
(WIC, Asthma, DCDCP, etc.) and various external
community agencies (Early Childcare Programs—Early
Head Start, Head Start, and Alameda Health System
Wellness Clinics). Once referrals are received, FSCCs
assess the level of dental care each client needs. The
services rendered can range from providing oral health
education to scheduling dental appointments and
linking clients to any other necessary resources. The
partnerships and connections ODH has established
in the community have contributed to dental care
coordination that better serves priority populations in
Alameda County.
SCHOOL-BASED DENTAL SEALANT PROGRAM
To improve access to care and reduce the prevalence
of tooth decay, ODH provides preventive dental
services at 14 elementary schools in three school
districts. These services include dental screening,
fluoride varnish applications, teeth cleaning, dental
sealants, and oral health education. Dental care
coordination is provided for students with urgent dental
care needs.
WIC DENTAL DAYS
ODH collaborates with WIC sites to provide preventive
dental services. This program aims to help connect
children, pregnant, and postpartum clients to a dental
home. Clients receive oral health education, dental
screening, and a fluoride varnish application. Dental
care coordination is provided to all clients needing help
in establishing a dental home.
PERINATAL DENTAL DEMONSTRATION PROJECT
The project aims to improve access to dental care for
pregnant and postpartum people in Alameda County.
The program is working with organizations that serve
this population to enhance the awareness about safety
and importance of dental care for pregnant individuals
and their infants. Through improving and expanding
the existing ODH care coordination program, ODH
assists Medi-Cal eligible pregnant and postpartum
individuals in scheduling dental appointments and
tracks their appointment attendance.
2023–2024 COMMUNITY HEALTH SERVICES DIVISION ANNUAL REPORT 31
ODH works closely with and is guided by organizations
serving priority populations in Alameda County. The
Advisory Committee, the Oral Health Committee of the
Public Health Commission, meets once every quarter
to support the strategic plan objectives. ODH has also
formed workgroups that include local organizations and
community members that understand the unique oral
health needs of priority populations:
Early Childhood Oral Health Workgroup:
children 0–5 and pregnant/postpartum individuals
Oral Health for Homeless Children and Families
Special Needs Dentistry Workgroup:
individuals with special health care needs
POPULATION SERVED
OFFICE OF DENTAL HEALTH
THE ROAD AHEAD
ODH will expand its program to provide preventive dental services and oral health education to
elementary schools.
ODH will strengthen collaborations with Alameda County’s three local dental societies to offer
Kindergarten Oral Health Assessment (KOHA) dental screenings at additional schools.
Continue to collaborate with WIC to assist clients in establishing a dental home and increase
awareness on the importance of dental visits/checkups for prevention of dental disease among new
parents and parents of children 0–5 years old.
Asian
6%Multi-race
4%
Middle Eastern
or North African9%
African American/Black14%
Hispanic/
Latino/a/x/e
40%
Male34%Female66%
White7%
Unknown
21%
AGE
0–5 6–12 13–18 19–25 26–39 40–65 65+Unknown
32.3%32.1%
3.4%
10.2%
15.5%
3.6%.6%2.3%0%
Male34%Female66%
White
7%
Unknown
21%
AGE
0–5 6–12 13–18 19–25 26–39 40–65 65+Unknown
32.3%32.1%
3.4%
10.2%
15.5%
3.6%.6%2.3%0%
32 2023–2024 COMMUNITY HEALTH SERVICES DIVISION ANNUAL REPORT
OLDER ADULTS HEALTHY RESULTS
WHAT WE DO
O lder Adults Healthy Results (OAHR)
provides intensive home-visiting nurse
case management to older adults 60+
who are having trouble managing complex health
conditions due to psychosocial challenges. The
heavy burden of chronic disease in the OAHR
client population reflects larger societal trends that
disproportionately impact communities of color and
recent immigrants. By developing care plans that
prioritize client values, facilitating healthcare access,
and linking isolated clients to culturally appropriate
and available resources, OAHR combats intersecting
systems of ageism and racism that negatively impact
older adult communities and lead to premature
functional decline.
OAHR’s primary goals are to:
Keep people living at home as long and as safely as
possible
Improve function and support independence
Strengthen services that support health and
wellbeing
Improve quality of life
To accomplish this, OAHR provides comprehensive
home-based nurse case management, including:
Care coordination with healthcare providers
Referrals and linkage to services and supports
Caregiver stabilization, training, and support
Healthcare navigation
Advocate for patient-focused treatment that aligns
with OAHR’s clients’ priorities and capabilities
Fall prevention
Maximize health benefits
Health education
Medication review
Ensure that planned interventions, benefits, or
services are in place, appropriate, and effective
OAHR services are free to all Alameda County
residents who qualify based on income, medical
complexity, and functional status.
2023–2024 COMMUNITY HEALTH SERVICES DIVISION ANNUAL REPORT 33
POPULATION SERVED
Many of OAHR’s clients require in-person
services provided by trained nurses
who understand the complex interplay
of medical and psychosocial needs.
This year, 80% of the referrals OAHR
received became clients.
Many of the clients OAHR takes care of
are:
Very low income
Extremely socially isolated
Medically fragile
Struggling with cognitive, hearing, and/
or visual impairments
Facing language and cultural barriers
Experiencing premature onset of chronic disease
and functional decline influenced by social
determinants of health
At high risk of nursing home placement
OAHR’s caseload includes clients who speak English,
Spanish, Cantonese, Mandarin, ASL, Vietnamese,
Korean, Tagalog, and Japanese. OAHR utilizes
both on-site and telephonic interpreters so that all
referred clients are assured the clear and accurate
communication necessary for high quality, equitable
service.
THE ROAD AHEAD
Further develop knowledge of Medi-Cal eligibility requirements amidst a changing health benefits
landscape.
Forge strategic partnerships with experts and advocacy agencies to help clients gain access to
long-term services and supports like caregiving and respite services.
Find OAHR’s niche alongside CalAIM; fill in gaps in care and reach clients who may fall through the
cracks of larger managed-care systems.
Continue to expand OAHR’s reach across the County.
OLDER ADULTS HEALTHY RESULTS
0
20
40
60
80
100 65+
40-65
40–65 65+
AGE
93%
7%
Multi-race 1%
Middle Eastern/North African 2%
Asian
24%African
American/Black
19%
Hispanic/
Latino/a/x/e
25%
Male45%Female56%
White
25%
Unknown 5%
0
20
40
60
80
100 65+
40-65
40–65 65+AGE
93%
7%
Multi-race 1%Middle Eastern/North African 2%
Asian24%African
American/Black
19%
Hispanic/
Latino/a/x/e
25%
Male45%Female56%
White
25%
Unknown 5%
34 2023–2024 COMMUNITY HEALTH SERVICES DIVISION ANNUAL REPORT
TOBACCO CONTROL
OVERVIEW
The Tobacco Control Program (TCP) seeks to de-normalize tobacco products and their use through multi-
level strategies that includes upstream local policy development. TCP focuses policy work on two core
areas—tobacco retail and smoke-free protections.
THE TOBACCO RETAIL ENVIRONMENT
Local jurisdictions can pass ordinances that require
tobacco retailers in their community to obtain a
license to sell tobacco products; this helps hold
businesses accountable to follow all local, state, and
federal tobacco sales laws. The local jurisdiction
can also set standards for those retailers such as
prohibiting the sale of all flavored tobacco products or
vape products, setting a minimum price and package
size for tobacco products, prohibiting the sale of
tobacco in pharmacies, and limiting the density of
tobacco retail locations near youth-sensitive areas
(e.g., schools/parks) or other tobacco retailers. Local
jurisdictions can also create a graduated penalty
structure that includes significant fines on the
business owner, license suspension, and even license
revocation for repeated
violations. These local
laws serve to limit
tobacco access among
youth and maximize
health protections
for other groups that
the tobacco industry
disproportionately
targets.
SMOKE-FREE PROTECTIONS
Drifting secondhand smoke continues to impact the
health of many residents in Alameda County. The
most common place for people to be exposed to
secondhand smoke is now the home, particularly
in multi-unit housing settings. Smoke-free multi-unit
housing policies prohibit all types of smoking in
housing complexes. Smoking in multi-unit housing
can travel through the building—under doors, through
electrical outlets, along plumbing pipes, and through
shared ventilation. Secondhand smoke exposure
can cause asthma attacks and increase health risks
for medically vulnerable residents, including seniors
and young children. Thirdhand smoke is the harmful
residue of smoke on walls, surfaces, and furniture—
and it can also impact the health of residents.
2023–2024 COMMUNITY HEALTH SERVICES DIVISION ANNUAL REPORT 35
WHAT WE DO
TCP is available to provide community education around tobacco control issues, as well as technical assistance
to support local jurisdictions adopting or implementing tobacco control laws.
SMOKE-FREE MULTI-UNIT HOUSING COMPLAINTS
For the jurisdictions of Emeryville, City of Alameda,
and the urban communities of the Unincorporated
areas (Castro Valley, San Lorenzo, Ashland,
Cherryland, Fairview, and Hayward Acres), TCP will
verify smoking complaints in multi-unit housing and
send out warning letters to alleged violators. If the
smoking continues after three warning letters, then
the complaint is forwarded to the relevant code
enforcement agency for enforcement and fines. To
make a complaint, visit acphd.org/tobacco-control/
smoke-free-multi-unit-housing.
TOBACCO SALES VIOLATIONS COMPLAINTS
TCP receives complaints if a resident suspects a
retailer is illegally selling flavored tobacco products
or selling to underage persons. Complaints about
tobacco retailers violating tobacco sales laws are
forwarded to the relevant enforcement agency.
TOBACCO CONTROL COALITION
The Alameda County Tobacco Control Coalition
is a diverse, grassroots coalition of educators,
professionals, and community members that work to
prevent, reduce, and limit tobacco use in Alameda
County through education, advocacy, and policy. The
Coalition is committed to the de-normalization of
tobacco use in Alameda County. More information on
the Alameda County Tobacco Control Coalition can be
found at tobaccofreealamedacounty.org.
RESOURCES FOR TOBACCO TREATMENT AND
CESSATION
The Tobacco Control Program does not provide direct
services to clients. TCP does link residents to existing
resources for tobacco cessation:
Kickitca.org Statewide phone and text-based tobacco
treatment counseling in multiple languages
Tobaccofreealamedacounty.org
Local listings of no-cost tobacco treatment classes.
THE ROAD AHEAD
Outreach to Hayward residents to ensure that their voices are heard as Hayward City Council
gathers information for drafting a proposed Smoke-free Multi-Unit Housing Ordinance.
Continue conversations with stakeholders to determine how a possible ban on the sale of all
commercial tobacco products might be passed and implemented in local jurisdictions.
Engage Newark residents in exploring a potential tobacco retail licensing ordinance to reduce youth
access to tobacco.
TOBACCO CONTROL
36 2023–2024 COMMUNITY HEALTH SERVICES DIVISION ANNUAL REPORT
WOMEN, INFANTS AND CHILDREN (WIC)
WHAT WE DO
W IC, officially called Supplemental Nutrition
Program for Women, Infants, and Children,
is a nutrition education program for
pregnant and postpartum women, infants, and children
under the age of five. WIC provides nutrition education
and breastfeeding support as well as food benefits to
reduce infant mortality, lower incidence of anemia and
obesity, and promote healthy eating. Within WIC, there
are several other programs to serve the community:
The WIC Regional Breastfeeding Liaison (RBL)
Program contributes to community health by facilitating
inclusive and effective collaborations to strengthen
the continuum of quality breastfeeding care for all
WIC eligible families. This work includes resource
development and promotion; education of clinicians,
health care providers, and health educators; and
technical assistance to hospitals, health centers,
and community organizations. Evaluation surveys
from community coalition leaders and RBL program
partnerships show that 100% report improved
coordination of care for WIC participants.
Partnering with the community and Alameda County
Public Health Department’s Community Assessment,
Planning, and Evaluation (CAPE) epidemiologists,
RBL facilitated special data reports on South Asian,
Asian American, and Native Hawaiian and Pacific
Islander populations to better understand their unique
community risks, potential needs, and opportunities.
RBL also assists the development of a growing series
of Latina Chicana (LatCh) breastfeeding education
videos and the promotion of the flyers with QR codes
through the Child Health and Disability Prevention
Program (CHDP), Comprehensive Perinatal Services
Program (CPSP), health centers, and hospitals.
The Local Vendor Liaison (LVL) Program was
established in April 2008. The goal was to educate
and support vendors during the implementation of new
WIC foods. Since then, the role of LVLs has evolved
to provide WIC Authorized Vendors with technical
assistance on program requirements and updates,
and to conduct store surveys. WIC local agencies have
designated one or more staff as an LVL to provide
technical assistance and reinforce education for WIC
Authorized Vendors. LVLs serve as a local resource
to WIC Authorized Vendors and play a critical role to
support vendors in their success in providing healthy
foods to WIC families. The efforts of LVL staff help
to quickly resolve vendor program participation and
customer service issues to create a positive shopping
experience for both the vendor and WIC family.
The Breastfeeding Peer Counseling (BFPC)
Program utilizes peers to encourage and support
WIC mothers to breastfeed their infants via
a mother-to-mother connection. The goal of the
program is to increase the initiation, exclusivity, and
duration of breastfeeding with the support of Peer
Counselors (PCs) in WIC local agencies. Alameda
County has six PCs and two board-certified Lactation
Consultants.
2023–2024 COMMUNITY HEALTH SERVICES DIVISION ANNUAL REPORT 37
POPULATION SERVED
THE ROAD AHEAD
Work with USDA and CDPH/WIC to implement the food package changes approved by USDA in
2024.
Provide staff training and participant education to support transitioning to the new WIC foods.
Make available the convenience of online shopping to all WIC participants; though there is no
specific date, this is definitely coming in the future.
Developmental screenings for babies as young as 6 months to children ages 1–4 years will be
restarted following pandemic closures. Staff will be retrained to complete these in the year
ahead.
WOMEN, INFANTS AND CHILDREN (WIC)
Native American 1%
Pacific Islander 2%Asian
6%
Multi-race6%
African
American/
Black
24%
Hispanic/
Latino/a/x/e
24%
Male32%Female68%
White
25%
Unknown
11%
AGE
0–5 6–12 13–18 19–25 26–39 40–65 65+
46.4%
0%0%0%3.3%
15%
37.4%36%
10.2%
0.9%0.9%
Pacific Islander 2%Asian
6%
Multi-race
6%
African
American/
Black
24%
Hispanic/
Latino/a/x/e
24%
Male32%Female68%
White
25%
Unknown
11%
AGE
0–5 6–12 13–18 19–25 26–39 40–65 65+
46.4%
0%0%0%3.3%
15%
37.4%36%
10.2%
0.9%0.9%
score & fold score & fold
COMMUNITY HEALTH SERVICES DIVISION
1100 San Leandro Blvd., 4th Floor, San Leandro, CA 94577
(510) 208-5900
acphd.org/about/our-organization/community-health-services-division