HomeMy WebLinkAboutBOARD STANDING COMMITTEES - 12032012 - FHS Cte Agenda Pkt
FAMILY AND HUMAN
SERVICES COMMITTEE
December 3, 2012
1:30 P.M.
651 Pine Street, Room 101, Martinez
Supervisor Federal D. Glover, District V, Chair
Supervisor Candace Andersen, Vice Chair
Agenda Items: Items may be taken out of order based on the business of the day and preference of the Committee
1. Introductions
2. Public comment on any item under the jurisdiction of the Committee and not on this agenda (speakers may be limited to
three minutes).
APPOINTMENTS
3. Contra Costa Commission for Women – One appointment. (Page 3)
DISCUSSION
4. # 61 – HIV Prevention/Needle Exchange (Page 11)
Presenter – Christine Leiverman, Health Services Department
5. # 95 – Child Welfare System Improvement Plan (Page 45)
Presenter – Valerie Earley, Director, Children and Family Services
6. Year-End Closeout Report (Page 69)
Presenter – Dorothy Sansoe, County Administrator’s Office
The first meeting of the 2013 Family and Human Services Committee
has not been scheduled at this time
☺ The Family and Human Services Committee will provide reasonable accommodations for persons with disabilities planning to attend
Committee meetings. Contact the staff person listed below at least 72 hours before the meeting.
Any disclosable public records related to an open session item on a regular meeting agenda and distributed by the County to a majority
of members of the Family and Human Services Committee less than 96 hours prior to that meeting are available for public inspection at
651 Pine Street, 10th floor, during normal business hours.
Public comment may be submitted via electronic mail on agenda items at least one full work day prior to the published meeting time.
For Additional Information Contact: Dorothy Sansoe, Committee Staff
Phone (925) 335-1009, Fax (925) 646-1353
dorothy.sansoe@cao.cccounty.us
2
Glossary of Acronyms, Abbreviations, and other Terms (in alphabetical order):
Contra Costa County has a policy of making limited use of acronyms, abbreviations, and industry-specific language in its
Board of Supervisors meetings and written materials. Following is a list of commonly used language that may appear in
oral presentations and written materials associated with Board meetings:
AB Assembly Bill
ABAG Association of Bay Area Governments
ACA Assembly Constitutional Amendment
ADA Americans with Disabilities Act of 1990
AFSCME American Federation of State County and Municipal
Employees
AICP American Institute of Certified Planners
AIDS Acquired Immunodeficiency Syndrome
ALUC Airport Land Use Commission
AOD Alcohol and Other Drugs
BAAQMD Bay Area Air Quality Management District
BART Bay Area Rapid Transit District
BCDC Bay Conservation & Development Commission
BGO Better Government Ordinance
BOS Board of Supervisors
CALTRANS California Department of Transportation
CalWIN California Works Information Network
CalWORKS California Work Opportunity and Responsibility
to Kids
CAER Community Awareness Emergency Response
CAO County Administrative Officer or Office
CCHP Contra Costa Health Plan
CCTA Contra Costa Transportation Authority
CDBG Community Development Block Grant
CEQA California Environmental Quality Act
CIO Chief Information Officer
COLA Cost of living adjustment
ConFire Contra Costa Consolidated Fire District
CPA Certified Public Accountant
CPI Consumer Price Index
CSA County Service Area
CSAC California State Association of Counties
CTC California Transportation Commission
dba doing business as
EBMUD East Bay Municipal Utility District
EIR Environmental Impact Report
EIS Environmental Impact Statement
EMCC Emergency Medical Care Committee
EMS Emergency Medical Services
EPSDT State Early Periodic Screening, Diagnosis and
treatment Program (Mental Health)
et al. et ali (and others)
FAA Federal Aviation Administration
FEMA Federal Emergency Management Agency
F&HS Family and Human Services Committee
First 5 First Five Children and Families Commission
(Proposition 10)
FTE Full Time Equivalent
FY Fiscal Year
GHAD Geologic Hazard Abatement District
GIS Geographic Information System
HCD (State Dept of) Housing & Community Development
HHS Department of Health and Human Services
HIPAA Health Insurance Portability and Accountability Act
HIV Human Immunodeficiency Syndrome
HOV High Occupancy Vehicle
HR Human Resources
HUD United States Department of Housing and Urban
Development
Inc. Incorporated
IOC Internal Operations Committee
ISO Industrial Safety Ordinance
JPA Joint (exercise of) Powers Authority or Agreement
Lamorinda Lafayette-Moraga-Orinda Area
LAFCo Local Agency Formation Commission
LLC Limited Liability Company
LLP Limited Liability Partnership
Local 1 Public Employees Union Local 1
LVN Licensed Vocational Nurse
MAC Municipal Advisory Council
MBE Minority Business Enterprise
M.D. Medical Doctor
M.F.T. Marriage and Family Therapist
MIS Management Information System
MOE Maintenance of Effort
MOU Memorandum of Understanding
MTC Metropolitan Transportation Commission
NACo National Association of Counties
OB-GYN Obstetrics and Gynecology
O.D. Doctor of Optometry
OES-EOC Office of Emergency Services-Emergency
Operations Center
OSHA Occupational Safety and Health Administration
Psy.D. Doctor of Psychology
RDA Redevelopment Agency
RFI Request For Information
RFP Request For Proposal
RFQ Request For Qualifications
RN Registered Nurse
SB Senate Bill
SBE Small Business Enterprise
SWAT Southwest Area Transportation Committee
TRANSPAC Transportation Partnership & Cooperation (Central)
TRANSPLAN Transportation Planning Committee (East County)
TRE or TTE Trustee
TWIC Transportation, Water and Infrastructure Committee
VA Department of Veterans Affairs
vs. versus (against)
WAN Wide Area Network
WBE Women Business Enterprise
WCCTAC West Contra Costa Transportation Advisory
Committee
__________________________________________________________________________________________________________________
CONTRA COSTA
COMMISSION FOR WOMEN
P.O. Box 6695
Concord, CA 94520
E-Mail: womenscommission@gmail.com
DATE: November 19, 2012
TO: Family and Human Services Committee
FROM: Julianna Hynes, Contra Costa Commission for Women
SUBJECT: Recommended Appointments to the Contra Costa Commission for Women
The purpose of this memorandum is to forward to you the following recommendation from the Contra Costa
Commission for Women (CCCW):
• Appoint Kathi Reed, as At Large Seat 3 Commissioner on the CCCW
Background
The Contra Costa Commission for Women was formed to educated the community and advise the Contra Costa
County Board of Supervisors and other entities on the issues relating to the changing social and economic
conditions of women in the County, with particular emphasis on the economically disadvantaged.
The Committee consists of 25 members and one alternate, including:
• Five district representatives; (one from each supervisorial; districts)
• Twenty at large members; and
• One at large alternate.
The five district representatives are nominated for a three year term by each other the five members of the Board
of Supervisors. The twenty at large members and one at large alternate are nominated by the CCCW
membership committee and forwarded to the full CCCW. All nominated appointments to the CCCW are
reviewed by the Family and Human Services Committee (FHS) and referred to the Board of Supervisors for
approval. CCCW terms are for three years and they are staggered across the membership. A current CCCW
roster, as of November 19, 2012, is attached for your information (Attachment A).
Current Status of Appointments
The CCCW has been recruiting applicants on an ongoing basis to fill the vacant seats.
The membership committee unanimously approved the above recommendation.
Page 3
S:\Committees\FHS\2012 FHS\December\Womens Commission Appointment Memo 111912.doc 2
As of November 19, 2012 there are 12 at large vacancies. The at large Alternate and the District I seats are also
vacant.
If the appointment recommended in this memorandum is ultimately approved, one at large seat will be filled.
The vacancies remaining after approval would be 11 at large seats, the District I seat and one alternate.
Since May 2004, the CCCW has had extremely limited staff support and no budget provided by the County.
However, the CCCW membership committee is continuing its recruiting efforts and plans to fill the remaining
vacancies within the next few months.
cc without attachment : CCCW Membership Committee
Dorothy Sansoe, CAO
Page 4
Page 5
Page 6
Page 7
Page 8
ROSTER
November 19, 2012
SEAT NAME APPOINTMENT TERM
EXPIRATION Residence
District I Vacant -- 02/28/2013 --
District II Judy Carney 4/24/12 02/28/2013 Lafayette
District III Dana Wellington 11/9/2010 02/28/2013 Danville
District IV Carlyn Obringer 02/24/2009 02/28/2012 Concord
District V Argentina Davila-Luevano 05/10/2011 02/28/2014 Antioch
At Large 1 Kerri Rider 3/27/12 02/28/2014 Concord
At Large 2 Joan E. Conley 02/23/2010 02/28/2013 Walnut Creek
At Large 3 Vacant -- 02/28/2013 --
At Large 4 Nati Flores 3/27/12 02/28/2014 Antioch
At Large 5 Vacant -- 02/28/2013 --
At Large 6 Marie McDonald 03/17/2009 02/28/2012 Walnut Creek
At Large 7 Sean Duckworth 8/14/12 02/28/2014 Pinole
At Large 8 Julianna Hynes 01/11/2011 02/28/2013 Pittsburg
At Large 9 Vacant -- 02/28/2013 --
At Large 10 Erin Beable 3/15/2011 02/28/2012 Pleasant Hill
At Large 11 Vacant -- 02/28/2012 --
At Large 12 Vacant -- 02/28/2012 --
At Large 13 Vacant -- 02/28/2011 --
At Large 14 Vacant -- 02/28/2011 --
At Large 15 Vacant -- 02/28/2011 --
At Large 16 Vacant -- 02/28/2012 --
At Large 17 Vacant -- 02/28/2012 --
At Large 18 Vacant -- 02/28/2012 --
At Large 19 Phyllis Gordon 03/15/2011 02/28/2014 Pittsburg
At Large 20 Vacant -- 02/28/2012 --
At Large Alternate Vacant -- 02/28/2013 --
Page 9
Page 10
Contra Costa Health Services
Needle Exchange Update Report to Family & Human Services Committee
November 2012
- 1 -
RECOMMENDATIONS
1) Accept this report on needle exchange as part of the comprehensive HIV Prevention
Program.
2) Direct the Health Services Department to continue supporting and monitoring needle
exchange services and reporting at least biennially as required by law.
SUMMARY
This report satisfies State regulatory requirements to maintain needle exchange services in
Contra Costa. Legislative changes taking effect in 2012 (SB41) allow pharmacies to dispense
up to 30 syringes without a prescription and removes Health Department responsibility for
certifying pharmacies to do so. AB 604 modifies reporting requirements from an annual to a
biennial report.
There are now more than 1900 individuals living with HIV or AIDS in Contra Costa. The
percentage of new HIV / AIDS infections attributed to Injection Drug Use has been gradually
decreasing over time.
Bobby Bowens, long time provider of needle exchange services, passed away suddenly this year
and interim management of the service has transitioned to HIV Education and Prevention
Project of Alameda County (HEPPAC). The Health Department continues to provide $54,000 in
County general funds annually to support the operation of Needle Exchange services. Condoms
and Health Education materials are provided by the AIDS Program. There has been an overall
reduction in the number of individuals served at needle exchange over time and three sites
remain operational on a weekly basis.
Having needle exchange services and syringes for purchase at pharmacies does not appear to
negatively impact law enforcement in terms of exposure to blood borne pathogens. The
availability of needle exchange as part of a comprehensive continuum of services for injection
drug users is a necessary Public Health measure to reduce transmission of blood borne
diseases, and needle exchange should remain available in Contra Costa County.
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Contra Costa Health Services
Needle Exchange Update Report to Family & Human Services Committee
November 2012
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BACKGROUND
In 1999 the Contra Costa Board of Supervisors endorsed needle exchange as a component of a
comprehensive HIV risk reduction strategy to reduce the transmission of HIV and other blood
borne diseases attributed to injection drug use. A continuous declaration of a State of
Emergency was enacted in accordance with Assembly Bill [AB] 136 (Mazzoni, Chapter 762,
Statutes of 1999). In 2005, AB 547 (Berg, Chapter 692, Statutes of 2005) simplified the
process for local authorization of Syringe Exchange Programs (SEPs) by replacing the
continuous declaration of a local state of emergency with an annual report.
On January 10, 2006, the Contra Costa Board of Supervisors:
TERMINATED the local State of Emergency first declared on December 14, 1999;
AUTHORIZED the Health Services Department to administer a clean needle and syringe
exchange project pursuant to Health and Safety Code section 121349 et seq; and
DIRECTED the Health Services Director to annually report to the Board on the status of
the clean needle and syringe exchange project, with a focus on reducing transmission
among women to their unborn children, reducing HIV and Hepatitis C transmission,
ensuring access to treatment services, and not increasing risk to law enforcement.
For a brief period of time in 2011/2012, the federal Centers for Disease Control (CDC) gave
permission to the State Office of AIDS to use federal pass-through dollars for the purpose of
syringe exchange. That permission was subsequently retracted and the ban of the use of
federal funds to support needle exchange remains in effect for the foreseeable future.
Additional legislation enacted this year SB 41 (Yee) allows nonprescription syringe sales or
distribution (NPSS) through licensed pharmacies, physicians and syringe exchange programs to
individuals aged 18 and older. AB 604 (Skinner) further streamlines the process for initiating
syringe exchange programs (SEP) in areas without local endorsement for exchange, and
decreases reporting requirements to every two years in areas with established SEPs in
California.
REDUCING TRANSMISSION OF DISEASE
HIV and AIDS Data
As of December 31 2011, more than 1900 individuals were reported living with AIDS or HIV in
Contra Costa. The number of newly reported AIDS cases has diminished over time and the
number of newly reported HIV cases has increased somewhat over the past 7 years. The spike
seen in the graphs below reporting cases in 2009 is in part attributed to transitioning to a new
statewide data collection system and in part to active case matching of individuals previously
reported (prior to 2006) by non names code to subsequent reporting of those same individuals
by name in other jurisdictions.
The distribution is largely unchanged over the past several years: Nearly 81% of those living
with HIV or AIDs are male; approximately 19% are female and nearly 1% transgender. African
Americans are 30% of those living with HIV or AIDS, Whites are about 47% and Hispanics are
about 19% of the caseload.
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Contra Costa Health Services
Needle Exchange Update Report to Family & Human Services Committee
November 2012
- 3 -
Approximately 60% of all transmission is among men who have sex with other men (MSM).
Heterosexual contact, largely in females, is approximately 13% of cases. Infection attributed to
injection drug use among men and women has continued a modest downward trend and is now
about 17% of all cases1.
Locations for needle exchange services were originally selected based on the areas most highly
impacted by HIV and AIDS in the county. The City of Richmond has the highest number of
indviduals with HIV or AIDS. Currently, of those living with HIV or AIDS, 36% are residents of
West County, 40% are residents of Central County, and 24% are residents of East County.
Cities with five or more cases are included in the chart below.
1 Source: Contra Costa Health Department Epidemiology, Planning and Evaluation Unit
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Contra Costa Health Services
Needle Exchange Update Report to Family & Human Services Committee
November 2012
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Other Data
Maternal Transmission
There is no comprehensive tracking of maternal transmission since the Stanford project closed
in 2009. However, of the 3,058 AIDS cases ever reported in Contra Costa, 24 have been
pediatric cases (1-12 years of age). Seventeen of the pediatric cases (0.56%) were born to
women with HIV/AIDS, and six were infected through blood/blood products. Of 725 HIV cases
ever reported in Contra Costa, there were eight pediatric cases. Five (0.69%) were born to
women with HIV/AIDS, and three have undetermined transmission.
Hepatitis C
Recognizing that Hepatitis C virus (HCV) is an increasing cause of morbidity and mortality in the
United States, and that many of those living with HCV infection are unaware they are infected
and do not receive care and treatment, the Centers for Disease Control (CDC) released
guidance calling for routine screening for the presence of Hepatitis C antibodies in all individuals
born between 1945 and 1965.
In Contra Costa, the number of Chronic Hepatitis C carriers continues to decline from a high of
1,400 cases reported in 1999. Data for the previous year (2010/2011) is underreported as a
result of transitions to a new State database that year. However, reporting data for Hepatitis C
is generally not considered reliable due to considerable variation in medical provider reporting
capacities. None-the-less, the number of cases in the most recent 7 fiscal years has increased
moderately, and may grow further due to CDC recommendations on testing.
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Contra Costa Health Services
Needle Exchange Update Report to Family & Human Services Committee
November 2012
- 5 -
Exposure Impact on Law Enforcement and First Responders
The Public Health Division provides assistance to law enforcement and first responders
potentially exposed to a communicable disease during the course of their work. The Public
Health Communicable Disease Control Unit reviews all reported exposures to ensure that law
enforcement and first responders have access to the information, care and treatment needed to
ensure their health and wellbeing following any exposure. Prepackaged kits containing all
necessary paperwork and blood collection tubes are provided to CML, the lab company under
contract with the Sherriff’s Department, to ensure the correct process is followed and proper
documentation provided. Printed materials are also available on our website at
http://cchealth.org/aids/syringe-exchange.php.
The number of needlestick exposures compared to all exposures reported by all responders
increased marginally last year but overall remains very small, with 5 needlestick injuries out of
96 potential exposures reported between July 1 2011 and June 30 20122. Three of these
injuries were to ambulance personnel transporting victims to an emergency room.
2 Contra Costa Health Department Communicable Disease Program
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Contra Costa Health Services
Needle Exchange Update Report to Family & Human Services Committee
November 2012
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A statewide evaluation found no statistically significant difference in needle stick injuries among
law enforcement officers between localities that had authorized pharmacies to dispense
syringes without prescriptions (disease prevention projects) and those that had not. The
report also found no evidence of elevated crime rates in areas that had active disease
prevention projects. 3
Needle Exchange Services
Needle exchange services in the region generally rely on some combination of county general
funds, foundation support, and other funding secured through community based organizations.
Some entities, such as the HIV Education and Prevention Project of Alameda County (HEPPAC)
have sufficient infrastructure to access larger amounts of funding from donor organizations.
Locally, Community Health Empowerment (CHE) struggles to keep operations going.
Community Health Empowerment Progress Report
Greater Richmond Interfaith Program (GRIP) remains the fiscal agent for Needle Exchange
services provided in Contra Costa by CHE. The FY 1213 budget from county general funds is
$54,000. Smaller pots of funding from agencies such as the Komer Foundation and others
augment needle exchange from time to time in Contra Costa.
Long time needle exchange advocate and CHE Director Bobby Bowens passed away in August
of this year. He had managed the syringe exchange program in Contra Costa since 1995. His
death was sudden and we were not able to locate data or reports for the final quarter of the
fiscal year. Consequently, data graphs for this year are based on three quarters of actual data
with one quarter of projected data added to the overall count for the year.
3 The full report is posted at the California Department of Public Health website at
http://www.cdph.ca.gov/programs/aids/Pages/OASyringeAccess.aspx
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Contra Costa Health Services
Needle Exchange Update Report to Family & Human Services Committee
November 2012
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Several agencies are interested in continuing the exchange work, and the Health Department
met with them in August and November to discuss options. HIV Education and Prevention
Project of Alameda County (HEPPAC), the Alameda county needle exchange provider, was
asked to provide interim management of exchange services while we review options. They
have retained exchange services in East and West County on a weekly basis.
HEPPAC, GRIP, and the Health Department program monitor completed an inventory of
remaining supplies, reviewed the budget, followed up with other funders, and made some
modest programmatic changes to ensure that services can remain intact through the end of the
current fiscal year. Data collection resumed in August of this year, and shows a roughly 200%
increase in service utilization between August and November of this year.
The budget continues to support limited staff time, supplies and some operating expenses for
the 3 remaining exchange sites: Richmond, North Richmond, and Bay Point. The Pittsburg site
was eliminated earlier in the year by CHE due to a reported reduction in attendance at that site.
The following information on needle exchange services was provided by CHE for the first three
quarters of FY 11/12. Overall numbers have declined over time.
Ethnicity Totals
African American 194 31%
European American 346 55%
Latino/Hispanic 87 14%
Native American 0
Asian/Pacific Islander 0
Other 0
Total 627
A total of 627 individuals were served of which 403 (64%) were male. Approximately 3% of
those reached accepted referrals for health care, substance use treatment and other resources.
Location Total Referrals
Contacts Provided
East County 440 8
West County 187 8
Total 627 16
One-for-one syringe exchange is done. The number of individuals attending needle exchange,
as well as the number of individuals doing secondary exchange for others, has decreased over
the past 5 years. Even with the projection of an additional quarter’s data, the volume of
exchange services has dropped significantly over time. There are no immediate reasons for the
drop in services but some possible contributing factors may include: the closure of one site due
to poor attendance; the impact of provider health issues on overall site operations; greater
availability of syringes through local pharmacies; or a change in behaviors (better health
seeking behaviors or changing the drug of choice and/or drug use method).
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Contra Costa Health Services
Needle Exchange Update Report to Family & Human Services Committee
November 2012
- 8 -
Individuals bringing in syringes for others, referred to as a secondary exchange, are the
“Reported Number of People Reached by Needle Exchange Services”, below. These figures are
duplicated.
Finally, as with the other data provided by CHE, the total number of syringes distributed in the
year has also decreased.
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Contra Costa Health Services
Needle Exchange Update Report to Family & Human Services Committee
November 2012
- 9 -
Alcohol and Other Drug Services (AODS)
Data from AODS treatment sites shows a continued decline in service encounters: 3996
encounters for FY 11/12 (a decrease of 2.5% from the previous fiscal year), and an overall
decrease of 14% from the 4,664 encounters registered in FY 09/10. Demographics remain fairly
consistent with injection drug users comprising about 17% of all those served and women still
comprising slightly more than 36% of the caseload. The number of new clients served (never
enrolled in AODS services) is approximately 40%. While nearly 12% of all clients served are
between 12 and 18 years of age, only 4 individuals in that age group were injection drug users.
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Contra Costa Health Services
Needle Exchange Update Report to Family & Human Services Committee
November 2012
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More than 32% of all AODS enrollees indicated that they were homeless at entry into the AODS
program. Most participants identify as having a “dependent” living condition (reliant on
someone else or some other institution for their housing), with only 5% of all enrollees
indicating that they were independently housed at time of entry into AODS services.
The Public Health HIV/AIDS and STD Program offers Education, HIV rapid testing, and STD
testing at selected AODS residential and detox centers in Contra Costa. We serve both adult
and youth facilities. In FY 1112, 774 individuals received comprehensive HIV and STD health
education services. Of these, 523 individuals elected to receive an HIV test. There was only
one positive in the period. The Program also continues to offer limited Hepatitis C testing to
approximately 35-50 of the highest risk individuals per year.
Pharmacy Syringe Sales
Adults anywhere in California may now purchase and possess up to 30 syringes for personal use
when acquired from an authorized source. Senate Bill (SB) 41, effective January 1, 2012 –
January 1, 2015, allows licensed pharmacies to sell up to 30 syringes without requiring the
pharmacy register with a local government. Syringes must be stored in a manner that ensures
they are not accessible to unauthorized persons and providers must offer consumers
information on options for disposal. The code governing the Disease Prevention Demonstration
Project (SB 1159) – the law allowing registered pharmacies to distribute a smaller number of
syringes without a prescription - is rendered inoperative until SB 41 sunsets in 2015.
Due to changes in the law this year the Health Department no longer provides the registration
oversight that was previously required under SB 1159. Health Education resources for
consumers about injection drug use is available on our website at
http://cchealth.org/aids/syringe-sales.php. We have received no complaints from law
enforcement, business, pharmacies, or community members regarding syringes this year.
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Contra Costa Health Services
Needle Exchange Update Report to Family & Human Services Committee
November 2012
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Disposal
Environmental Health maintains a list of frequently asked questions on syringe and needle
disposal, a list of disposal sites in Contra Costa, and links to syringe disposal mail back services.
More information on disposal is located at http://www.cchealth.org/eh/medical_waste/. A
number of locations for safe disposal of syringes are now available in Contra Costa:
FACILITY NAME ADDRESS PHONE NUMBER
City of Clayton 6000 Heritage Trail
Clayton, CA 94517
(800) 646-1431
City of Orinda 22 Orinda Way
Orinda, CA 94563
(800) 646-1431
City of Walnut Creek 1666 North Main St.
Walnut Creek, CA 94598
(800) 646-1431
Community Health Empowerment 305 Chesley Ave
Richmond, CA 94807
(510) 236-8122
Concord Disposal Services 4080 Mallard Drive
Concord, CA 94520
(925) 682-9113
Contra Costa Fire Station 3338 Mt. Diablo Blvd.
Lafayette, CA 94549-4072
(000) 000-0000
Contra Costa Sheriff's Substation 150 Alamo Plaza, Suite C
Alamo, CA 94507
(000) 000-0000
Delta HHW Collection Facility (East County) 2550 Pittsburg-Antioch
Highway
Antioch, CA 94509
(925) 756-1990
Moraga-Orinda fire station 1280 Moraga Way
Moraga, CA 94556
(925) 941-3333
Mountain View Sanitation District 3800 Arthur Road
Martinez, CA 94553
(925) 671-5806
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Contra Costa Health Services
Needle Exchange Update Report to Family & Human Services Committee
November 2012
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Rossmoor Pharmacy 1220 Rossmoor Parkway
Walnut Creek, CA 94595
(925) 939-1220
San Ramon Valley Fire District headquarters 1500 Bollinger Canyon
Road
San Ramon, CA 94583
(925) 838-6600
San Ramon Veterinary Hospital 3480 San Ramon Valley
Blvd
San Ramon, CA 94583
(925) 837-0526
West Contra Costa County Hazardous Waste
Collection Facility
101 Pittsburg Avenue
Richmond, CA 94801
(888) 412-9277
Several companies also provide mail-back services and are listed as State-sanctioned mail in
systems. More information on mail-back services can be found at:
http://www.cdph.ca.gov/certlic/medicalwaste/Documents/MedicalWaste/SharpsMailBackList.pdf.
OTHER PREVENTION ACTIVITIES FOR INJECTION DRUG USE
The Contra Costa HIV Prevention plan was updated earlier this year to more closely align our
activities with the new State HIV Prevention strategy. We anticipate continuing County General
Funds for needle exchange services to support the downward trend in HIV infections attributed
to injection drug use. The full plan can be found on the Public Health website at:
http://cchealth.org/aids/pdf/HIV-Prevention-Plan-Update-2012-2015.pdf
Other prevention activities include:
HIV testing services at community sites and in Alcohol and Other Drugs Services
programs, reaching approximately 2000 people per year. More than 99% of Public
Health HIV testing uses a rapid test, providing preliminary results in 20 minutes.
Clinical risk reduction services targeting high risk men through incremental behavior
change plans is available county wide through a subcontracted mental health provider
serving HIV positive individuals.
Partner Counseling services providing support for notification to partners of potential
exposure and testing available to HIV positive individuals and their providers.
Tighter linkages for making follow up medical appointments for new positives to reduce
the number of individuals falling out of care and increase adherence to HIV medications
is offered county wide.
Training to increase community capacity to provide prevention services in Contra Costa
is provided annually.
Three Evidenced Based Interventions prevention subcontracts to promote encourage
behavior changes and promote HIV testing among high risk communities were initiated
in July of this year.
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Contra Costa Health Services
Needle Exchange Update Report to Family & Human Services Committee
November 2012
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Hepatitis C testing is offered to the highest risk individuals in conjunction with HIV
testing of injection drug users.
Cross training between HIV, STD and HIV Surveillance staff is done to increase the pool
of individuals available to meet community demand for education services
CONCLUSIONS:
1. Access to clean needles is making a difference in Contra Costa and remains an
important component of the overall strategy to reduce transmission of blood borne
diseases. The number of infections attributed to injection drug use has declined over time and
the availability of needle exchange and pharmacy syringe sales has played a role in this trend.
2. Reported local law enforcement exposure to potential blood borne pathogens via
needle stick injury remains at the same level as prior to implementation of needle
exchange and pharmacy sales. Materials for Law Enforcement to document potential
exposure and request assistance remain available on the website.
3. The Health Department is no longer required to provide an annual status report,
but is required by law to provide a biennial report.
Page 23
Page 24
November 2012Prepared for the Contra Costa Board of Supervisors by Contra Costa Health DepartmentNeedle Exchange Update Page 25
NEEDLE EXCHANGE In 1999, the Contra Costa Board of Supervisors endorsed a State of Emergency with respect to HIV and AIDS to allow for the provision of needle exchange services. This report satisfies the legislative requirement for a biennial update to maintain needle exchange services in Contra Costa County. Page 26
2012 LegislationSB 41 (Yee) took effect in January this year and allows nonprescription syringe sales or distribution (NPSS) through licensed pharmacies, physicians and syringe exchange programs to individuals aged 18 and older. AB 604 (Skinner) also took effect this year and streamlines the process for initiating syringe exchange programs (SEP) in areas without local endorsement for exchange, and decreases reporting requirements to every two years in areas with established SEPs in California. Page 27
HIV/AIDS in Contra Costa County yAs of December 31 2011, more than 1,900 individuals were reported living with AIDS or HIV in Contra Costa. yApproximately 81% are male and 19% are female. African Americans are 30% of those living with HIV or AIDS, Whites 47% and Hispanics nearly 19%. yPredominant transmission among those living with HIV or AIDS remains men who have sex with other men (MSM). Injection Drug Use is about 17% of the caseload. Page 28
New HIV and AIDS Reports by Year01020304050607080901002005 2006 2007 2008 2009 2010 2011AIDSHIV Page 29
HIV/AIDS Attributed to Injection Drug Use (IDU) by Gender024681012141618202005200620072008200920102011MaleFemale Page 30
Children with HIV and AIDSInfant Exposure has not been tracked by Stanford University since 2009. Of the 3,058 AIDS cases ever reported in Contra Costa, 24 have been pediatric cases (1-12 years of age). Seventeen of those pediatric cases (0.56%) were born to women with HIV/AIDS, and six were infected through blood/blood products. Of 725 HIV cases ever reported in Contra Costa, there were eight pediatric cases. Five (0.69%) were born to women with HIV/AIDS, and three have undetermined transmission. Page 31
Reported Chronic Hepatitis C Cases Over Time5756805508106101537660100200300400500600700800900F 06F07F08F09F10F11F12number Page 32
Law Enforcement and First Responder Exposures02040608010012014005/06 06/07 07/08 08/09 09/10 10/11 11/12All ExposuresNeedlestick Page 33
Needle Exchange and CHEyServices continue under HEPPACyOne-for-one exchange offered in East and West County: roughly 70% of those served were at East County sites.yApproximately 55% of participants are White, 31% African American, and 14% Latino.yMen are 64% of those served.yApproximately 3% of those served accept referrals to health and support services. Page 34
Reported Contacts (Individuals) at Needle Exchange Sites Over Time050010001500200025003000350004050506060707080809091010111112 Page 35
Number of Syringes Distributed By CHE Over Time0500001000001500002000002500003000003500004000000405 0506 0607 0708 0809 0910 1011 1112
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Secondary Exchanges Reported By CHE Over Time01000200030004000500060007000800004050506060707080809091010111112 Page 37
AODS Service Enrollment 0500100015002000250030000607070808090910101111122011/2012 Enrollment n= 3996African AmWhiteHispanic Page 38
AODS IDU Service Enrollment IDU/Non IDU01000200030004000500060000607 0708 0809 0910 1011 1112IDUs are about 17% of All AODS Service UsersTotal ServedIDUIn FY 1112 the Total N was 3996 and 693IDUs were served. Page 39
AODS Service Enrollment By Gender0100020003000400050006000060707080809091010111112In 2011/2012 Women were Approximately 36% of Those Served By AODS Total ServedFemalein FY 1112 the Total N was 3996, and 1455 women were served. Page 40
Other Prevention Strategies to Reduce Transmission of HIV in IDUs>Partner counseling and Anonymous Partner notification and counseling services;>Hepatitis C testing for highest risk IDUs;>HIV and STD testing services in community and in Alcohol and Other Drugs Services programs;>New evidence-based interventions in three agencies;>Cross training of staff and agencies. Page 41
Syringe Disposal OptionsAdults anywhere in California may now purchase up to 30 syringes without a prescription. A number of locations for safe disposal of syringes are now available in Contra Costa. A link to the full list is maintained by the Contra Costa Environmental Health Program, as is a list of frequently asked questions on syringe and needle disposal and links to syringe disposal mail back services. More information on disposal is located at http://www.cchealth.org/eh/medical_waste/ Page 42
CONCLUSIONS1. Access to clean needles is making a difference in Contra Costa and remains an important component of the strategy to reduce transmission of blood borne diseases. The number of infections attributed to injection drug use has declined over time and the availability of needle exchange and pharmacy syringe sales has played a role in this trend. 2. Reported local law enforcement exposure to potential blood borne pathogens via needle stick injury remains at the same level as prior to implementation of needle exchange and pharmacy sales. Materials for Law Enforcement to document potential exposure and request assistance remain available on the website. 3. The Health Department is no longer required to provide an annual status report, but is required to provide a biennial report. No major impact is anticipated in Contra Costa. Page 43
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1
EMPLOYMENT AND HUMAN SERVICES
CONTRA COSTA COUNTY
TO: Family and Human Services DATE: Dec. 3, 2012
Committee Members
cc Theresa Speiker
David Twa
FROM: Valerie Earley, Director of Children & Family Services Bureau
SUBJECT: Child Welfare System Improvement Plan Update
Recommendation
Accept this presentation from the Employment and Human Services Department; and continue
to support the Children and Family Services Bureau efforts on Child Welfare Redesign and
implementing the System Improvement Plan required by the State's Child Welfare Performance
Outcomes and Accountability Act.
Background
As the Committee may recall, Contra Costa Children & Family Services Bureau began a formal
process in 2001 to “redesign” many of our Child Welfare practices with the goal of improving
outcomes for children. The Federal government also passed the Adoptions and Safe Families
Act which requires all states to address specific federal child safety, permanence and well-being
outcomes in order to receive Federal Child Welfare funding. California passed the Child
Welfare Performance Outcomes and Accountability Act which sets specific performance goals
for all California counties, and requires self assessments, program audits, system improvement
plans, and outcome measurement data collection and reporting.
In the latter half of 2009 and Spring of 2010 as Contra Costa was completing the Peer Quality
Case Review and County Self Assessment, budgetary constraints continued to be a primary
factor in the workplace environment. Recovery from severe staff cut-back and changes in
procedures and organizational structure to address the reduced staff impacted bureau decisions
and direction. Focus for performance was directed at a basic level: assuring safety of children,
sustaining improvement in timely compliance of response for referrals and visits to children, and
meeting court objectives and timelines. The disruption to service delivery was minimal only due
to the dedication of staff. Those areas that had been targeted as best and innovative practice
were put on temporary hold as staff learned new jobs and adjusted to the revised work
structure. Measures selected for the Systems Improvement Plan included continued efforts to
assure all children were seen each month, to improve the measure where we had the poorest
performance in Permanence, and to not loose the forward momentum we had gained in
addresses racial disparity and disproportionality.
Summary/Conclusion
The CFS Bureau continues to meet Federal and State performance improvement expectations
and goals. We have been able to continue our Redesign efforts by utilizing funding from a
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variety of sources: State Redesign Pilot grant, Promoting Safe and Stable Families, Federal
Comprehensive Family Assessment Grant, and smaller grants from the Stuart Foundation and
Hedge Funds Care.
With the Board’s continuing support and the commitment of our CFS staff, we are confident that
Contra Costa will lead Child Welfare System changes that will positively impact outcomes for
children and families.
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System Improvement Plan2012Contra Costa County, Children & Family ServicesDec. 3, 2012Family & Human Services CommitteeValerie Earley, Director, Children & Family Services Page 47
Background•Assembly Bill 636 know as the Child Welfare System Improvement and Accountability Act of 2001, is also known as the California Child And Family Services Review (C‐CFSR). •The legislation directed counties to undergo a process of self‐assessment and system improvement in order to improve performance on key child welfare outcome indicators. •Modeled after the Federal Child and Family Services Review process which was designed to assess state‐level performance on child welfare outcomes, the C‐CFSR process consists of three components. Page 48
Components of C‐CFSR•Peer Quality Case Review (PQCR)This collaborative process between Children & Family Services (CFS), Juvenile Probation, Bay Area Academy and California Department of Social Services and is designed to highlight a practice area on which CFS and Probation would like to focus to better understand each agency’s performance and to plan how to improve services.•County Self‐Assessment (CSA)The self-assessment process presents an opportunity to learn what is and what is not working in the delivery of child welfare services within that county. The self-assessment process is conducted by the county with input from stakeholders that include parents, youth, child welfare staff, and partners from other child-serving departments such as probation, education, mental health, public health, and prevention network partners.•System Improvement Plan (SIP)This is the plan developed as a result of the self-assessment and PQCR process. Each SIP component looks much like a case plan or an action plan; encompassing an identified area for improvement, an improvement goal, strategies and rationales for each strategy and a list of milestones to be attained in completion of the strategy.•Annual Update on SIP Progress (***)This annual progress report documents Contra Costa’s performance for the Systems Improvement Plan submitted to California Department of Social Services in April 2010. The Systems Improvement Plan was originally slated as a tri-annual plan, however in May 2012, CDSS revised the schedule and extended all existing plans to five years. Thus this current Systems Improvement Plan will now end in December 2014 Page 49
Complete A Peer Quality Case ReviewConduct a Self AssessmentReview Current System ImprovementDevelop System Improvement PlanImplement and Monitor System ChangeComplete Annual Updates of Outcome Step 1Step 2Step 3Step 4 Page 50
The goal of the child welfare system is to improve outcomes for children and families in the areas of safety, permanency, and well‐being. The entire community is responsible for the child, youth and family welfare, not just the child welfare agency. The child welfare agency has the primary responsibility to intervene when a child’s safety is endangered. To be effective, the child welfare system must embrace the entire continuum of child welfare services, from prevention through after care services. Engagement with consumers and community is vital to promoting safety, permanency and well‐being. Fiscal strategies must be considered that meet the needs identified in the County Self‐Assessment (CSA) and included in the SIP. Transforming the child welfare system is a process that involves removing traditional barriers within programs, within the child welfare system, and within other systems. Guiding Principles of the Systems Improvement Plan Page 51
Increasing Timely Social Worker Visits (Safety)Exit to Permanency (24 Months in Care) Increasing the percentage of youth who have been in care at least 2 years who exit to permanency (Permanency)Decreasing the disproportionate number of African American children who enter foster care (Systemic Factors)2010-2014 System Improvement Measures Page 52
Timely Social Worker Visits with Child (Safety)Measure2C Timely Social Worker Visits with ChildMethodologyThe percent of children who received a monthly visit.National StandardTimeliness of Social Work Contacts is not a national measure andtherefore a National Standard is not set.Target Improvement Goal (as stated in the 2010 SIP)“Though Contra Costa ultimately seeks to have 100% compliancein Social Worker contacts, the goal set for this Improvement Planperiod is a sustained 90% or greater compliance for the at the finalyear of the SIP.”Current PerformanceMonth 1: 92.8%Month 2: 93.0%Month 3: 90.9%This performance meets the Target Improvement goal as stated in the 2010 Systems Improvement Plan. It’s important to note that at the time the SIP was written, performance was at 78.7%, thus the performance improvement is significant. Page 53
Timely Social Worker Visits (Safety)2C Timely Social Worker Visits with Child405060708090100BaselineOct-09Jan-10Apr-10Jul-10Oct-10Jan-11Apr-11Jul-11Oct-11Jan-12Apr-12Jul-12Oct-12Percent of CasesContra Costa Month 1Contra Costa Month 2Contra Costa Month 3 Page 54
Timely Social Worker Visits Improvement StrategiesEnhance use of Safe Measures by staff to manage visits; provide ongoing trainingto staff and supervisors¾Assess ongoing use of Safe Measures by SW’s and Supervisors.¾Retrain all staff in the use of Safe Measures to ensure they have a full understanding of the way the tool can assist in managing their caseload.Continue Geographical assignment of cases and/or explore ways of reducing travelwhile increasing contact compliance.¾Provide caseload data with location of families/children to staff.¾Assess ability to manage visits for out of county placements which ensures primary assigned worker completes 75% visits. ¾Monitor/refine geographic assignment considering workflow and different needs based on geographic area and strategy (i.e. TDM, DR, etc). Page 55
Timely Social Worker Visits Improvement StrategiesTrain Staff to policy changes regarding face to face contacts and waivers/exceptionsand implement changes¾Assess training needs for social worker contacts.¾Develop and train staff on regulations & policies related to timely SW contacts.¾Provide visit exception report for mgrs and sups.Develop Quality Assurance program for timeliness and quality of contacts anddevelop a recognition program for staff and supervisors demonstrating excellence inperformance.¾Recognize staff for compliance in timeliness of contacts¾Evaluate quality of contacts. ¾Develop strategies for supervisors to monitor and increase quality of SW visits.¾Determine criteria for ongoing staff recognition that incorporates timeliness, quality of visits, and acknowledges appropriate staff for performance Page 56
Exits to PermanencyMeasureC3.1 Exits to Permanency after 24 months in CareMethodologyThe percentage of children who have been in Foster Care for the 24 monthsor longer who are discharged to a permanent home prior to turning 18 andby the last day of the year before the child’s18thbirthday. A home isconsidered permanent when the child reunifies with parents or primarycaretakers, establishes a guardianship, or adoption.National Standard29.1%Contra Costa Target Improvement Goal (as stated in the 2010 SIP)“Increase the percentage of youth reaching permanency by 5% the firstyear and 10% the following years. At the end of year 3, performance wouldbe 18.1%.”Current PerformanceContra Costa’s performance when the SIP was written was 14.2%; the October 2012 quarter report shows current performance at 13.3%. This is below the National Standard of 29.1% and below the state average of 24.2% for the same year . Page 57
C3.1 Exits to Permanency (24 Months in Care)05101520253035BaselineOct-09Jan-10Apr-10Jul-10Oct-10Jan-11Apr-11Jul-11Oct-11Jan-12Apr-12Jul-12Oct-12Percent of ChildrenContra CostaNational StandardExits to Permanency Page 58
Strategies to ImproveExits to Permanency (24 Months in Care)Enhance family and caregiver engagement activities to support reunification and facilitatediscussions about permanency options should reunification not be effective.¾Develop staff training/education focusing on permanency options and conversations about permanency with parents and caregivers.¾Increase use of team meetings to enhance permanency¾Implement visitation policy including transition from supervised to unsupervised for enhanced family reunification.Improve individualized, culturally competent reunification services with multi-agency casecoordination¾Continue Linkages; develop partnerships for streamlining services for families preparing to reunify.¾Increase use of wrap around services.¾Continue work on cultural awareness through use of Parent Partners.Identify at least one relative and send Notification of Relative information.¾Develop and train staff team responsible for family finding activities.¾Maintain contract with internet database search engine to search for relatives and absent parents.¾Train staff on how to have permanency discussions with located families. Page 59
Strategies to ImproveExits to Permanency (24 Months in Care)Develop strategies and practice expertise in early and continuous Concurrent Planning.¾Maintain continuous focus on permanency & concurrent planning process ¾Identify challenges and delays in concurrent planning and address issues.¾Measure performance in concurrent planning and Permanency Outcomes Engage fathers and extended families of fathers.¾Develop and implement fatherhood initiative survey.¾Using survey results, plan strategies and train staff to engagement of fathers and families of fathers.¾Measure contacts and listings of father relationships in CWS/CMS to evaluate effectiveness of strategy.¾Provide education/training to Bench and Bar on Father involvementProvide transition planning meetings for youth including assessment of educational needs.¾Develop coordinated data exchange to sups and staff regarding youth age 17 or older.¾Hold life planning/transition meeting with youth within 6 months of emancipation.¾Utilize CWS/CMS to track accurate educational outcomes for youth. Page 60
Strategies to ImproveExits to Permanency (24 Months in Care)Increase recruitment of families that can offer permanence¾Complete a demographic profile and data analysis for children currently in care for 24 months or longer to support recruitment planning.¾Increase use of community partners and regional offices in recruiting families to offer permanence.Engage incarcerated parents to support case planning and permanency.¾Establish working relationship with detention facilities to facilitate engagement of incarcerated parents¾Provide training and support for incarcerated parents.¾Support staff communication with incarcerated parents. Establish Learning Community environment to facilitate staff discussions relevant to familyengagement and permanency(new)¾Implement ongoing Learning Community meetings; plan conversations to support best practice, family engagement, and permanency. Page 61
Exits to Permanency Page 62
Systemic FactorsMeasureReducing Disparity, Entries of African American Children to Foster CareNational StandardA National Standard has not been set to track Disproportionality/Disparity.Contra Costa Target Improvement Goal as stated in the 2010 SIP“Reduce the incidence rate of removals for African American children by 5% per year. Performance when SIP created was 11.4/1000 children removed; goal at end of 3-year SIP is 10/1000.”Current PerformanceReports for disparity/disproportionality are adjusted annually. For 2011, entries for black children entering care are at a rate of 8.42 per 1,000 children. This appears to be down from the performance at the beginning of the SIP but the 2011 Census shifted population counts. Current reports indicate a rate of 7.2 for 2010 so, disparity may, be increasing. Further analysis is needed to see if this shift upwards is similar to all ethnicities or if this is, in fact, an increase in disparity. Page 63
Systemic FactorsThe following chart displays the Baseline data (from January 2004) Disparity Entries of Black Children to Foster Care024681012BaselineJul-04Apr-05Jan-06Oct-06Jul-07Apr-08Jan-09Oct-09Jul-10Apr-11Jan-12Oct-12Rate per 1,000 ChildrenContra Costa Page 64
Systemic FactorsDisparity (Entries to Foster Care)02468101214162004 2005 2006 2007 2008 2009 2010 2011Rate per 1000 Children by Ethnicity in CensusTotalBlackWhiteHispanicAsianNative AmericanOther/Missing Page 65
Continue to support staff in culturally and ethnically competent Family Engagement.¾Provide ongoing training for cultural knowledge and competence in communication and engagement of families, peers, and community partners including family culture not just ethnicity/race.¾Explore non-traditional resources and services relevant to case plan goals and support families in attaining goals in a manner that best matches the cultural values of the family.¾Develop conversation guides for supervisors to lead staff in discussions of disproportionality at all unit and review meetings every other month.Strategies to Reduce Disparity, Entries of African American Children to Foster CareUtilize feedback from consumers (parents and youth) to assist in improving culturallyinformed services¾Develop feedback mechanism from parents and youth who have been in our system.¾Analyze consumer information and look for ways to improve service delivery and service gaps. Page 66
Strategies to Reduce Disparity, Entries of African American Children to Foster CareAfrican American children ages 5 and under will receive a TDM prior to entering care or within7 days of being in care.¾Continue TDM’s for African American children under age 5 who are at risk of removal or immediately following removal.¾Review compliance with children eligible for TDM vs. those served.¾Explore reasons TDM’s not held and address issues.¾Develop case review process for African American children who have been removedProvide a forum for discussion cultural and ethnic issues. Raise disproportionality anddisparity awareness of staff, community and agency partners, legal entities, andcommunity members.¾Reconvene the Cultural Competency Oversight Committee¾Address issues of personal bias and support staff in strength based language in written case documentation.¾Present information to mandated reporters to enhance awareness of how bias may impact families reported within their own organizations.¾Present regular data reports to staff on topics of disproportionality.¾Re-establish regular training which addresses staff personal biases related to poverty vs. neglect and standards for adequate care of children. Page 67
Questions? Page 68
County of Contra Costa
OFFICE OF THE COUNTY ADMINISTRATOR
MEMORANDUM
DATE: December 3, 2012
TO: Family and Human Services Committee
Supervisor Federal D. Glover, Chair
Supervisor Candace Andersen, Vice Chair
FROM: Dorothy Sansoe, Staff
Sr. Deputy County Administrator
SUBJECT: 2012 YEAR-END REPORT ON REFERRAL ITEMS
RECOMMENDATION(S):
I. ACKNOWLEDGE that the Board of Supervisors referred one new item to the Family and
Human Services Committee (FHS) for their review and consideration during the 2012
calendar year in addition to the referrals carried over from the prior year.
II. ACCEPT the recommendation to carry forward the following sixteen referrals from the 2012
Family and Human Services Committee to the 2013 Committee:
a. Referral #1 – Child Care Affordability Fund
b. Referral #2 – Oversight of the Service Integration Team
c. Referral #5 – Continuum of Care Plan for the Homeless/Healthcare for the Homeless
d. Referral #20 – Public Service Portion of the CDBG
e. Referral #25 – Child Care Planning/Development Council Membership
f. Referral #44 – Challenges for EHSD
g. Referral #45 – Elder Abuse
h. Referral #56 – East Bay Stand Down for Homeless Veterans (Bi-annual)
i. Referral #61 – HIV Prevention/Needle Exchange Program
j. Referral #78 – Community Services Bureau/Head Start Oversight
k. Referral #81 – Local Child Care & Development Planning Council Activities
l. Referral #82 – Secondhand Smoke Ordinance
m. Referral #92 – Local Planning Council – Child Care Needs Assessment
n. Referral #93 – Independent Living Skills Program
o. Referral #101 – FACT Committee At-Large Appointments
p. Referral #103 – SNAP (Food Stamp Program)
III. ACCEPT the recommendation to close five referrals: Referral #95 – Child Welfare
Improvement Plan, Referral #100 – Child Poverty, Referral #104 – Subsidized Employment
Program, Referral #105 – Bed Bugs, and Referral #106 – Foster Youth Services Between 18
and 21.
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BACKGROUND/REASONS FOR RECOMMENDATION(S):
Between January and December 2012, the Board of Supervisors referred one new item to the
Family and Human Services Committee (FHS) in addition to twenty referrals carried forward from
the 2012 year. The FHS Committee heard twenty-two separate reports during the calendar year in
addition to making recommendations for appointments to various County boards and commissions.
It is recommended that the following items be closed-out as noted:
A. Referral #95 – Child Welfare Improvement Plan
The State of California has changed the requirements for submission of this plan to
once every five years. The Plan has been in place and functioning since this referral
was first made in 2007. The Department feels that the Board of Supervisors can
provide sufficient oversight directly when the five year plan update is due.
B. Referral #100 – Child Poverty
This referral was first made in 2009 at the request of the former Supervisor Susan
Bonilla in response to the downturn in the economy and the impact on children in the
community. The Department presented reports on April 12, 2010; April 11, 2011; and
April 2, 2012. As the information presented is no longer changing as quickly as in the
past, the Department would like to close this referral and report directly to the Board of
Supervisor if additional significant information is obtained.
C. Referral #104 – Subsidized Employment Program
A review of this program was originally referred to FHS on March 22, 2011. Reports
were provided to the Committee on August 17, 2011 and May 7, 2012. This program
was made possible through special American Recovery and Reinvestment Act
funding. Based on the success of this funding throughout the State, the Legislature
passed SB 72 to allow counties to incorporate some of the services into the services
provided to CalWORKs participants. This has been accomplished.
D. Referral #105 – Bed Bugs
This referral was made on July 26, 2011 at the request of Supervisor Karen Mitchoff.
During the preceding years bed bugs had become a serious issue in a number of
Contra Costa Communities. Since the date of the referral, the District staff gathered
additional information on the infestation, health risks, prevention, and information
dissemination. At this time District staff does not feel that a continuing referral and
report to FHS is necessary.
E. Referral #106 – Foster Youth Services Between 18 and 21
This referral was an outcome of a report to the Board of Supervisors on June 5, 2012
regarding services to foster youth during the gap period some youth experienced
between aging out of foster care at 18 and the date of implementation of AB 12 and
AB 1712. A status report was provided to FHS on November 5, 2012. At that time the
legislation had been implemented and the gap period has passed.
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