HomeMy WebLinkAboutBOARD STANDING COMMITTEES - 04242017 - FHS Cte Agenda Pkt
FAMILY & HUMAN SERVICES
COMMITTEE
April 24, 2017
10:30 A.M.
651 Pine Street, Room 101, Martinez
Supervisor John Gioia, 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 two minutes).
3. CONSIDER recommending to the Board of Supervisors the appointments of Tamara
Mello, Ella Jones and Debra Shorter-Jones to seats on the Contra Costa Managed Care
Commission, as recommended by the Health Services Department.
4. CONSIDER recommending to the Board of Supervisors the appointment of Keegan
Duncan to the Consumer of Any Age - Seat 4 on the In-Home Supportive Services
Public Authority Advisory Committee, as recommended by the IHSS Public Authority
Executive Director.
5. CONSIDER recommending to the Board of Supervisor the appointments of William
Mahoney and Robert Lilley to business representative seats on the Workforce
Development Board, as recommended by the Employment and Human Services
Department.
6. CONSIDER accepting the final report from the Employment and Human Services
Department on the Contra Costa County Covered California Call Center and directing
staff to forward the report to the Board of Supervisors for their information. (Kathy
Gallagher, Employment and Human Services Director)
7. CONSIDER accepting the report from the Employment and Human Services
Department on Innovative Community Partnerships and Whole Family Services, and
direct staff to forward the report to the Board of Supervisors for their information.
(Kathy Gallagher, EHSD Director; Devorah Levine, EHSD Assistant Director - Policy
and Planning)
8. CONSIDER approving the staff recommendations for fiscal years 2017-18, 2018-19,
F&HS Agenda Packet Page 1
8. CONSIDER approving the staff recommendations for fiscal years 2017-18, 2018-19,
and 2019-20 Community Development Block Grant Public Service and Emergency
Solutions Grant projects, and directing the Department of Conservation and
Development to prepare a staff report for Board of Supervisors consideration. (Gabriel
Lemus, CDBG Program Manager)
9. CONSIDER recommending to the Board of Supervisors the introduction and adoption
of the amended Tobacco Product and Retail Sales Control Ordinance and the Tobacco
Retailing Businesses Ordinance, and direct staff to report annually to the Family and
Human Services Committee on outreach and implementation activities and issues
associated with the new ordinances. (Daniel Peddycord, Public Health Director)
10. CONSIDER recommending to the Board of Supervisors the Health Services
Department's recommendation to reconvene the Assisted Outpatient Treatment (AOT)
Workgroup with structural changes as developed in collaboration with the Mental
Health Commission. (Cynthia Belon, Behavioral Health Director; Warren Hayes,
MHSA Program Manager)
11. CONSIDER accepting the report update from the Health Services Department on
children's mental health services and providing further direction to the department on
the future reporting expectations of Family and Human Services Referral No. 115 -
Child and Teen Psychiatric Services. (Cynthia Belon, Behavorial Health Director;
Patrick Godley, Health Services COO/CFO)
12.The next meeting is currently scheduled for May 22, 2017.
13.Adjourn
The Family & Human Services Committee will provide reasonable accommodations for persons
with disabilities planning to attend Family & Human Services 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 & 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:
Enid Mendoza, Committee Staff
Phone (925) 335-1039, Fax (925) 646-1353
enid.mendoza@cao.cccounty.us
F&HS Agenda Packet Page 2
FAMILY AND HUMAN SERVICES COMMITTEE 3.
Meeting Date:04/24/2017
Subject:Appointments to the Contra Costa Managed Care Commission
Submitted For: FAMILY & HUMAN SERVICES COMMITTEE,
Department:County Administrator
Referral No.: N/A
Referral Name: Appointments to Advisory Bodies
Presenter: Enid Mendoza, Senior Deputy County
Administrator
Contact: Enid Mendoza, (925)
335-1039
Referral History:
On December 13, 2011 the Board of Supervisors adopted Resolution No. 2011/497 adopting
policy governing appointments to boards, committees, and commissions that are advisory to the
Board of Supervisors. Included in this resolution was a requirement that applications for at
large/countywide seats be reviewed by a Board of Supervisors sub-committee.
The Managed Care Commission (MCC) was established in May 1995 and replaced the Contra
Costa Health Plan Advisory Board and the Medi-Cal Advisory Planning Commission. The
purpose of the Commission is to make recommendations to the Board of Supervisors, Health
Services Director and Chief Executive Officer of the Contra Costa Health Plan (CCHP) on
operational objectives, policies and procedures as well as revised service, product development,
marketing, and data-gathering priorities. Additionally, the MCC assures effectiveness, quality,
efficiency, access, acceptability of CCHP services by ongoing as well as periodic formal reviews
of Management Information System data.
The Managed Care Commissions consists of 15 seats: 9 At-Large, 4 subscriber, and 2 provider
seats. Each seat has a fixed 3 year term. Currently, there are: 6 filled seats, 3 expired
appointments pending reappointment, 3 expired appointments pending recommendation for
reappointment at a later date; and 3 vacant seats without pending candidates.
Referral Update:
The following seats on the Managed Care Commission are currently filled:
Seat Title
Term
Expiration
Date
Current
Incumbent
Incumbent
Supervisor
District
Meetings
Attended
Since
Appointment
Meetings
Held Since
Appointment
F&HS Agenda Packet Page 3
Other Provider 8/31/2018 Joan Lautenberger II 12 13
At-Large 3 8/31/2017 Kathleen Gage II 10 13
At-Large 5 8/31/2018 Jeffrey Kalin IV 10 13
At-Large 6 8/31/2018 Henry Tyson IV 11 13
At-Large 9 8/31/2018 Andy Li II 10 12
The department conducted interviews with the applicants for the vacant seats. The table below
includes the current vacant seats, with applicants and recommended appointments for
consideration by this committee.
Seat Title
Term
Expiration
Date
Applicant(s)Affiliation
Reappointment?
Applicant
Supervisor
District
Medi-Cal Subscriber 8/31/2018 Tamara Mello Self Employed No IV
Medicare Subscriber 8/31/2018 Ella Jones Volunteer- Advisory Council
on Aging No I
Commercial Subscriber 8/31/2018
Medical Indigent Needs 8/31/2019
Physician 8/31/2017
At-Large 1 8/31/2019
At-Large 4 8/31/2019
At-Large 7 8/31/2018 Debra Shorter-Jones City of Berkeley- Public
Health No I
At-Large 8 8/31/2019
There are no additional applicants for these seats.
Recommendation(s)/Next Step(s):
CONSIDER recommending to the Board of Supervisors the appointment of the following
individuals to the Contra Costa Managed Care Commission:
Appointee Seat title Affiliation
Term
expiration
date
District
Ella Jones Medicare Subscriber Seat Volunteer- Advisory Council on Aging 8/31/18 IV
Tamara Mello Medi-Cal Subscriber Seat Self Employed 8/31/18 I
Debra Shorter-Jones Member At Large Seat #7 City of Berkeley- Public Health 8/31/18 I
Attachments
Memo to Appoint E.Jones
E.Jones Application
T. Mello and D.Shorter-Jones Applications
F&HS Agenda Packet Page 4
F&HS Agenda Packet Page 5
F&HS Agenda Packet Page 6
F&HS Agenda Packet Page 7
F&HS Agenda Packet Page 8
F&HS Agenda Packet Page 9
F&HS Agenda Packet Page 10
F&HS Agenda Packet Page 11
F&HS Agenda Packet Page 12
01 /1 8 /2017 15:11 5109 815 385
Contra
Costa
County
PUBHLTH
For Office Use Only
Date Recei ved:
For Rev iBW9rs Use Only:
Accepted Rejeded
PAGE 02 /05~~
BOARDS,COMMITTEES,AND COMMISSIONS APPLICATION
MAIL OR DELIvER TO:
Con1m costsCcu1ty
CLERK OFTHE BOARD
651 PineS1reel,m .105
Martinez,Ce!lftxriB 94553-1292
PLEASE 1'YPE OR PRINT ININK
(Each ~R9quim8a~AppIIcaOOn)
iloA-RD,COMMiTTeE OR COMMISSION NAME ANDSEATTITLE YOU ARE APPLYING FOR:
.IManaged Care Commission I.1"'~-e-m-b-e-r-a-t-la-r-ge-#-7-----------
PRINT EXAC.T NAMEOF BOARD,COMMITTEe:,OR COMMISSiON PRINTEXACT SEb.T NAME(It applicable)
5 .EDUCATION ;Check appropriate box jf you possessone of the following :
High School Diploma a G.E .D.Certificate [j California High School Proficiency Certificate a
Give HIghest Grade or EducatIonal Level AchievedlI-M_a_st_e_rs _
THIS FORMISA PUBLIC DOCUMENT
F&HS Agenda Packet Page 13
~~0=1(18 /2017 15:11 5109815385 PUBHLTH
PAGE 03 /05
6.PLEASE FILL OUT THE FOLLOWING SECTION COMPLETELY.List ex:perience that relates to the qualifications needed to
serve on the local a·ppolntive body.Begin with your most recent experIence.A resume or other supporting documentation
may be attaclled but Jt may not b9 used as a substitute for completIng this section.
A)Dates (Month ,Day,Year)Title Duties Performed .
From .To
IRN<PHN<FNP :Imanage clIent caseloadand establish
II03/2i l19941 1present I priorltles,Participate on health team
Employer's Name and Address hat provides servicesto children
Total:Yrs.MQs,dolesc::ents and adults which includet=JQ .communicable disease,health
Icity of BerkeleyPublic Health Clinic
promotion.homeless services,service
~30 University Ave.
o the elderly, advice nurse•.
Hrs ,per week 0 .Volunteer [J Berkeley."cA 94710 anteparturn and postpartum care
immunizations..Knowledge of city,
county,state welfare and socialservice
B)Dates.(Month .Day,Year)Title Duties Performed
From To
IHouse~supervisor ,
Il\cts asthe on site-administrative
1,2/07/2oo71Ipresent ]
k:lesignee for the entire facility for off I
Employer's Name and Address ~hifts and we ekends.Managesall the
Total:Yrs. Mos.
pat ient care departments,ensuring
CJCJ appropriate quality care and
KalserSanLeandro Hospital
compliance with regulations. Identifies
2500 Merced St.
and implements best practices toIHrs,perwee~12-2.41.Volunteer []San leandro,CA 94577 provide quality careand services.
Assess and monitors staffing.for all
shifts .
C)Dates (Month ,Day.Year)T itle Duties Performed
From
,
IQ [RegisteredNurse :I
112 /06/19891 F3/01/20021
Provide assessmentand appropriate
Interventions for acute care patients .
Employer's Name and Address :ll.dminlster medications and mon itor
Total:Yrs..~effect iveness for the medications. GiveCJQ~Ita BatesMedica! Center
reatments aswell as follow up .Work
2.450 Ashby Ave.with multrd lsclpllnary health team to
Hrs.per week 0 .Volunteer C Berkeley,CA94705 return patIents to optlum level of
health.
D)Dates (Month,Day ,Year)Title Duties Performed
From I2 I ~].CJCJ ·Employer's Name and Address
Total:Yrs ,Mos,CJg
Hrs .per week .Volunteer 0
THIS FORM ISA PUBLIC DOCUMENT
F&HS Agenda Packet Page 14
___0_11:..-::1 8/2017 15;11 51 098 15385 PUBHLTH
PAGE 13 4/05
7 .How did you fearn about this vacancy?
eCCC HomepageO Walk-In C1NewGpaper Advertisement R10istrlct Supervisor Cother L.wm:._J!sr:::J
8 .Do you have a Familial or Financial Relationship with a member of the Board of Supervisors?(Please see Board
Resolution no.2011/55,attached):No -l.iL-Yes--C.-
If Yes, please identify the nature of the relationship:I;;;;';:;~----------------l
,.-:OJ ___
9. Do you have any financial relationships with the County such as grants,contracts,or other economic relations?
No~Yes~·
If Yes, please Identify the nat·ure of the relatlons~ip:11-.0.:-".~~l
I CERTIFY that the statements made by me In this application are true ,complete, and correct to the beat of my knowledge and
belief,and are made in good faith.I acknowledge and understand that all informatIon in this application Is publlcally
accessible.I understand and agree that misstatements 1 omIssions of materIal fact may cause forfeiture of my rights to serve
on a Board,Committee,or Commission in Contra Costa County.
Sig.Name Date:I-If!....r:?o/q .
Important Information
1.Thisapp6eation is a public document and is subject tothe Gafffomia Public Rea:x'ds Act(CAGOlf.Coda §625Q.6270).
2 .Send thecompeted paperapplication tothe Office of!heClerk of theBoard at 851 PineStreet,Room 106,Martinez,CA 94553.
3. A resume or other relevant informatiOl'l may be submitted with lhisappfJeation.
4. All members are required totake thefolloMng trainii'tg;1JThe 8rQ1MlAet,2)The Better Govemment Ortiinance,and3)Ethics Training.
5.Members ofboards,commissions,and committees maybe required to:1)1ile a Statement of Economic Interest Form also kClOlM1 as a Form
700.and2)complete the State ShiesTraining Course asrequire:l by M31234.
6 ,AdviSOlY bodymeetings maybe held in various locations and some locations maynotbe accessible by pubtic transportation.
7.Meeting dates ard times aresubject to diange and mayoccur upto two dai'S permonlh.
8.Some boards,commillees,or commissions mayassi9,n members tosubcommittees orwor1<grOups which mayrequire anadditiOnal
commitment oHime.
THIS FORM IS A PUBLIC DOCUMENT
F&HS Agenda Packet Page 15
______0_1~/18 /2 0 1 7 1 5 :11 5109815385 PUBHLTH
PAGE 05 /05
REAPPOINTM~NTREQUEST
.SIGNATURE V~
•.
CONTRA COSTA COUNlY ADVISORY BOARDS,COMMlSSI
APPLICATION FORM
Name of advisory board applying for:n1v1an~Ba~ed:gjC:dar~eJ:C~o~rnrmTI!]!!··~sSl~·Qon!l1W=-~
(App&atilln fm'1TJ must b~ryped or hlU2dprinted..)
Note:"Persons who are "involved as contractors with CCRP cannot be members of the MCC"nor can Health
Services De artmeilt em 10 ees,"
Please answer:
Me you currently employed by CCHP OI HSD"?ft Yes
If yes,please explain::--_-.,...--:"~=_--------------
..Are you or your employer now a contractor to CCHP?• Yes
Ifyes,please explain:~--__::__------_--_:_-----_::_~:__:_=_-------
Are you associated with an organization that is currently or has plans to contract with CCHP?
ft Yes "®Ifyes,please explain:-,-_
P'ease check all boxes lhat apply:
..Current CCHP Medi-Cal Subscriber ..Current CCHP Medicare Subscriber ...Physician
..."Other Provider "CU1'1'01t CCHP Commercial Subscriber II Represent Medical Indigent Needs
Debra A.Shorter-JonesNameofApplicant:_-=c..;::.::..::=-~~::::..::...:;;..:::.,;~__:...:...::_=__
Horne Address:
"1;licbmond ..CA.9480.4
Home Phone:
Business Address :Berkeley,.CA Work Phone:
Signature:_July 18,2012
Personal Experience.Skills,Interests:
EducationlBackground:
Samuel MeTrit~COllege-20oi-foJ~MSN/FNP
Sonoma Sta~e University 1986-1989/BSN/PHN "
Contra Cqsta ·Community College 1983-1986/AS!RN
Occupation:
Public Health Nurse
Community Activities:
.......
Ptesdient of·COTte2-Stege Negibboihood Council
Member of "-".'"Special Interests-"~-.."--- g .""""
Accivities for"children and teens.Health care issues .Ment.l health issues
INFORMAnON:
1,Rerum completed 02ppncatiOZl to Teresa O'Rivaoi Jiill.on-eJcavicb Co Co H lth PI ••CA94$S.3 ;FAX 11 (925)313-6580.•nrra Sla ea an,)9~Center AVClllJl:.Suilc 100,Maninez.
2.Membcs ofsome 2.Cvisory bodies may be required to file ~nnu.!ll Co~Jlicl oflnlCTest Statements.
......•_I ..._-"_..-
•••-~._~ ~----_.#--_.........-..-'-.:..-.._-
F&HS Agenda Packet Page 16
FAMILY AND HUMAN SERVICES COMMITTEE 4.
Meeting Date:04/24/2017
Subject:Appointments to the In-Home Supportive Services Public Authority
Advisory Committee
Submitted For: FAMILY & HUMAN SERVICES COMMITTEE,
Department:County Administrator
Referral No.: N/A
Referral Name: Appointments to Advisory Bodies
Presenter: Contact: Enid Mendoza, (925) 335-1039
Referral History:
On December 13, 2011 the Board of Supervisors adopted Resolution No. 2011/497 adopting policy
governing appointments to boards, committees, and commissions that are advisory to the Board of
Supervisors. Included in this resolution was a requirement that applications for at large/countywide seats
be reviewed by a Board of Supervisors sub-committee.
The In-Home Supportive Services Public Authority Advisory Committee serves as an advisory council to
the In Home Support Services Public Authority (IHSS), which is administered by the Employment and
Human Services Department. IHSS provides specialized support services to residents who are frail
elderly, blind, or disabled.
The Advisory Committee consists of 11 members: 4 Consumers aged 60 or older, 2 Consumers aged
under 60, and one member from each supervisorial district. Terms of appointment are four years. Currently
there are: 6 filled seats and 5 vacant seats, one of which has an applicant pending appointment approval as
requested below.
Referral Update:
Please see the attached memo from the In-Home Supportive Services Public Authority, which details their
request to fill one of the current five vacancies on the committee, and as stated in the recommendation
below.
The following seats on the In-Home Supportive Services Public Authority Advisory Committee are
currently filled:
Seat Title
Term
Expiration
Date
Current
Incumbent
Incumbent
Supervisor
District
Meetings
Attended
Since
Appointment
Meetings
Held Since
Appointment
District II 3/6/2018 John Roe II 3 3
District III 3/6/2020 Sidney Anderson III 4 4
Consumer 60 or Older - Seat 1 3/6/2018 Gary Gray I 22 22
Consumer Seat of Any Age - Seat 3 3/6/2018 Sarah Birdwell IV 20 22
Consumer Under 60 - Seat 1 3/6/2020 Wilson Cheng I 4 4
Consumer Under 60 - Seat 2 3/6/2018 Joe Juarez, Jr. V 21 22
F&HS Agenda Packet Page 17
On March, 21, 2017, the department conducted interviews with the applicant for the vacant seat.
The table below includes the current vacant seats, with applicants and recommended appointments for
consideration by this Committee:
Seat Title
Term
Expiration
Date
Applicant(s)Reappointment?
Applicant
Supervisor
District
District I 3/6/2020
District IV 3/6/2020
District V 3/6/2020
Consumer 60 or Older - Seat 2 3/6/2020
Consumer Seat of Any Age- Seat 4 3/6/2018 Keegan Duncan No IV
There are no additional applicants for the Consumer Seat of Any Age- Seat 4 or for the other vacancies.
Recommendation(s)/Next Step(s):
CONSIDER recommending to the Board of Supervisors the appointment of the following individual to
the In-Home Supportive Services Public Authority Advisory Committee.
Appointee Seat Name Term Expiration District
Keegan Duncan Consumer Seat of
Any Age- Seat 4 3/6/18 IV
Attachments
IHSS PA Appointment Memo
K.Duncan Application
F&HS Agenda Packet Page 18
Contra Costa County
IHSS Public Authority
500 Ellinwood Way. Suite 110 Pleasant Hill, CA 94523
Date: March 27, 2017
To: Family and Human Services Committee
From: Jan Watson, Executive Director
Subject: IHSS Public Authority Advisory Committee Recommendation for Appointment
Keegan Duncan – IHSS Consumer of Any Age – Seat 4
______________________________________________________________________________
The IHSS Public Authority Advisory Committee is pleased to recommend IHSS recipient Keegan
Duncan for appointment to Seat 4 for IHSS Consumer of Any Age. As an IHSS consumer, Mr.
Duncan is knowledgeable about and interested in improving the IHSS Program. Mr. Duncan is a
volunteer in his community and is currently training a service dog to meet his needs.
Mr. Duncan lives in Pleasant Hill. Two of the other IHSS consumer members live in El Cerrito;
one resides in Walnut Creek and the fourth lives in Pittsburg. There are currently two vacant
consumer seats.
If appointed, Mr. Duncan’s term would expire in March 2020. His application is attached to this
memo. Mr. Duncan was the only applicant for this seat.
Thank you for your consideration in this matter.
F&HS Agenda Packet Page 19
F&HS Agenda Packet Page 20
F&HS Agenda Packet Page 21
F&HS Agenda Packet Page 22
F&HS Agenda Packet Page 23
F&HS Agenda Packet Page 24
FAMILY AND HUMAN SERVICES COMMITTEE 5.
Meeting Date:04/24/2017
Subject:Appointments to the Workforce Development Board
Submitted For: FAMILY & HUMAN SERVICES COMMITTEE,
Department:County Administrator
Referral No.: N/A
Referral Name: Appointments to Advisory Bodies
Presenter: Contact: Enid Mendoza, (925) 335-1039
Referral History:
On December 13, 2011 the Board of Supervisors adopted Resolution No. 2011/497 adopting policy governing appointments to
boards, committees, and commissions that are advisory to the Board of Supervisors. Included in this resolution was a
requirement that applications for at large/countywide seats be reviewed by a Board of Supervisors sub-committee.
The Workforce Development Board (WDB) was created on pursuant to the Federal Workforce Investment Act of 1998 and has
the responsibility for overall workforce investment policy, mandated workforce investment policy and oversight of the
One-Stop Career Center system. The WDB implements federal requirements for programs to address the education, skills, and
employment needs for a skilled workforce, and that lead to an increase in the skills and earnings of Contra Costa residents.
January 21, 2016, the Executive Committee of the local Workforce Innovation and Opportunity Act (WIOA) board met and
approved a recommended WIOA Board configuration, subsequently approved by the Board of Supervisors on March 29, 2016.
The new configuration resulted in a 25 member board, which includes two alternate seats. Term appointments are for four years.
Currently, there are 20 filled seats and 5 vacant seats, two of which have an application pending appointment approval as
requested below.
Referral Update:
Please see the attached memo from the Employment and Human Services Department, which details their request to
fill two of the current five vacant seats.
The following seats on the Workforce Development Board are currently filled:
Seat Title
Term
Expiration
Date
Current
Incumbent
Incumbent
Supervisor
District
Meetings
Attended
Since
Appointment
Meetings
Held Since
Appointment
Business 1 6/30/2020 McGill, Michael II 4 4
Business 2 6/30/2020 Kan, Pamela V 2 4
Business 4 6/30/2020 Carrillo, Maggie III 1 4
Business 5 6/30/2020 Amin, Bhuphen B. IV 1 4
Business 6 6/30/2020 Carrascal, Jose III 4 4
Business 7 6/30/2020 Cox, Jason IV 3 4
Business 8 6/30/2020 Georgian, Ashley II 3 4
Business 10 6/30/2020 Rivera, Robert IV 3 4
Business 11 6/30/2020 Steele, Justin I 1 4
Business 12 6/30/2020 Adler, Paul V 4 4
Workforce Representative 2 6/30/2020 Williams III, Robert I 2 4
Workforce Representative 3 6/30/2020 Older, Steve IV 3 4
↵
F&HS Agenda Packet Page 25
Workforce Representative 4 6/30/2020 Hanlon, Margaret I
Workforce Representative 5 6/30/2020 Araby, James*3 4
Education 1: Adult Ed/Literacy 6/30/2020 Farwell, Kathy V 4 4
Education 2: Higher Education 6/30/2020 Tillery, Randal V 4 4
Education 3: Economic/Community Dev.6/30/2020 Connelly, Kristin II 3 4
Education 4: Employment Development 6/30/2020 Johnson, Richard IV 2 4
Additional/Optional #1 6/30/2020 Vega, Yolanda II 3 4
Education 5: Vocational Rehabilitation 6/30/2020 Asch, Carol IV 1 4
* Member resignation pending
The department conducted interviews with the applicants for the vacant seats. The table below includes the current
vacant seats, with applicants and recommended appointments for consideration by this Committee.
Seat Title
Term
Expiration
Date
Applicant(s)Applicant
Affiliation(s)
Applicant
Supervisor
District
Business 3 6/30/2020 William Mahoney Shell Oil, Inc.IV
Business 9 6/30/2020 Robert Lilley Contra Costa Electric, Inc.IV
Business 13 6/30/2020
Workforce Representative 1 6/30/2020
Additional/Optional #2 6/30/2020
There are no additional applicants for Business Seat 3 or Business Seat 9. There are no additional applicants for the other
vacancies.
Recommendation(s)/Next Step(s):
CONSIDER recommending to the Board of Supervisors the appointment of the following individuals to the
Workforce Development Board:
Appointee Seat Title Applicant
Affiliation
Term
Expiration
Date
Applicant
Supervisor District
William
Mahoney Business 3 Shell Oil, Inc.6/30/2020 IV
Robert Lilley Business 9 Contra Costa
Electric, Inc.6/30/2020 IV
Attachments
WDB Appointments Request Memo
W.Mahoney Application
R.Lilley Application
F&HS Agenda Packet Page 26
MEMORANDUM
DATE: February 24, 2017
TO: Family and Human Services Committee
CC: Kevin Corrigan, CAO Senior Management Analyst
Enid Mendoza, CAO Sr. Deputy County Administrator
FROM: Donna Van Wert, Interim Executive Director
SUBJECT: Appointment to Workforce Development Board
This memorandum requests the Family and Human Services Committee recommend to the Contra Costa County
Board of Supervisors the appointment of the following candidates to the new WIOA compliant Workforce
Development Board of Contra Costa County.
Background:
Local board structure and size:
Compared to predecessor legislation, the Workforce Innovation and Opportunity Act (WIOA) substantially
changes Local Board composition by reducing local workforce development board size while maintaining a
business and industry majority and ensuring representation from labor and employment and training
organizations.
The Executive Committee of the local WIOA board met January 21, 2016 and approved a recommended WIOA
Board configuration, subsequently approved by the Board of Supervisors on March 29, 2016. To meet the
categorical membership percentages, the WDB recommended a board of twenty-five (25) members. This option
represents the minimum required local board size under WIOA plus an additional six (6) optional representatives
in the following enumerated categories: 1) business; 2) workforce; 3) education and training.
Category – Representatives of Business (WIOA Section 107(b)(2)(A))
• Thirteen (13) representatives (52%)
Category – Representatives of Workforce (WIOA Section 107(b)(2)(A))
• Five (5) representatives (20%)
Category – Representatives of Education and Training (WIOA Section 107(b)(2)(C))
• One (1) Adult Education/Literacy Representative (WIOA title II)
• One (1) Higher Education Representative
• One (1) Economic and Community Development Representative
• One (1) Wagner Peyser Representative
• One (1) Vocational Rehabilitation Representative
Two (2) additional seats from the above categories, including constituencies referenced in
Attachment III of Training Employment & Guidance Letter (TEGL) 27-14.
DONNA VAN WERT
EXECUTIVE DIRECTOR
F&HS Agenda Packet Page 27
Recommendation:
a) Recommend approval of local board candidates for the vacant Business seats to the new WIOA-
compliant board (Attached applications & board roster)
• William Mahoney - Approved on November 1,2016 at the WDB Full Board Meeting
• Robert Lilley – Approved on January 24, 2017 at the Executive Committee Meeting
• No other candidate competed for the vacant Business Seats.
NEW APPOINTMENT
Seat Last Name First Name Address & District
#
Term of
Expiration
District
(Resident)
Business Seat #3 Mahoney William 3495 Pacheco Blvd.
Martinez, CA 94553
District 5
6/30/2020 District 4
Business Seat #9 Lilley Robert 825 Howe Rd.
Martinez, CA 94553
Disrict 5
6/30/2020 District 4
Thank you
DVW/rms
attachment
F&HS Agenda Packet Page 28
F&HS Agenda Packet Page 29
F&HS Agenda Packet Page 30
F&HS Agenda Packet Page 31
F&HS Agenda Packet Page 32
F&HS Agenda Packet Page 33
F&HS Agenda Packet Page 34
F&HS Agenda Packet Page 35
F&HS Agenda Packet Page 36
F&HS Agenda Packet Page 37
F&HS Agenda Packet Page 38
FAMILY AND HUMAN SERVICES COMMITTEE 6.
Meeting Date:04/24/2017
Subject:Final Report on the Contra Costa County Covered California Call Center
Submitted For: FAMILY & HUMAN SERVICES COMMITTEE,
Department:County Administrator
Referral No.: 108
Referral Name: Call Center Oversight and Health Care Reform
Presenter: Kathy Gallagher, Employment and Human
Services Director
Contact: Enid Mendoza, (925)
335-1039
Referral History:
On March 13, 2013, the Board of Supervisors authorized the Employment and Human Services
Department (EHSD) to execute a contract with Covered California’s Health Benefits Exchange
for call center services through January 31, 2015, which was later extended through June 30, 2017.
On April 16, 2013 the Board of Supervisors referred oversight and receipt of updates on the
establishment of the Contra Costa County Covered California Call Center (7Cs) to the Family and
Human Services Committee (F&HS). The Department has also reported on the Affordable Care
Act (ACA).
On July 29, 2016, EHSD received notification from Covered California that the contract budget
amount would be reduced by 72% for FY 16-17, which resulted in the call center closure effective
December 31, 2016, as agreed by both parties. The Board approved this action on August 16,
2016.
On January 17, 2017, the Board approved the recommendation of the 2016 F&HS to reduce the
frequency of this referral from biannual to annual and eliminate the referral after June 30, 2017
due to the closure of the call center.
Referral Update:
Please see the attached final report from EHSD on the essential issues, performance and other
pertinent information on the Contra Costa County Covered California Call Center.
Recommendation(s)/Next Step(s):
1. Accept the final report from the Employment and Human Services Department on the Contra
F&HS Agenda Packet Page 39
1. Accept the final report from the Employment and Human Services Department on the Contra
Costa County Covered California Call Center and direct staff to transmit the information to the
Board of Supervisors for their information; and
2. Recommend to the Board of Supervisors the closure of F&HS Referral No. 108 Call Center
Oversight and Health Care Reform due to the Call Center closure.
Fiscal Impact (if any):
There is no fiscal impact; the report is informational only.
Attachments
7Cs Final Report to F&HS
F&HS Agenda Packet Page 40
40 Douglas Drive, Martinez, CA 94553 • (925) 313-1500 • Fax (925) 313-1575 • www.ehsd.org
To: The Family and Human Services Committee
Contra Costa County Board of Supervisors
Date: March 27, 2017
From: Kathy Gallagher, Department Director
Subject: Final Closeout Report on the Contra Costa County Covered California Call
Center (7C’s)
1. Background/Update
This is the final closeout report for the operation of the Contra Costa County Covered
California Call Center (7C’s) operated by the County Employment and Human
Services Department from February 1, 2013 through December 31, 2016. It covers
essential issues, performance, and information pertaining to the Center’s operation.
What happened since our last report to your Committee?
Since the last report to your Board’s Family and Human Services Committee on April
11, 2016; Covered California announced they would not be renewing Contra Costa
County’s contract.
M E M O R A N D U M
Kathy Gallagher, Director
F&HS Agenda Packet Page 41
The existing contract was set to end June 30, 2017; however, due to a Covered
California generated budget reduction from $14.5 to $4 million (a 72.5%
reduction) in 2016, the 7C’s Call Center was forced to cease operations on
November 30, 2016 and the contract terminated on December 31, 2016.
In August of 2016 your Board approved the execution of the contract cancellation
clause to close the Center at the end of 2016 given this substantial funding
reduction.
A total of $31,714,379 million was spent on the operation of the 7C’s Call Center
(from beginning to end) of which no County funds were required or spent.
The entire operation of the Center was funded through the contract with Covered
California. This represents a substantial investment in the local and
regional area in terms of economic and employment generation.
Since the passage of the Affordable Care Act (ACA), the 7C’s Call Center has
been integral in all four (4) Open Enrollment periods with the last Open
Enrollment period extended to February 4, 2017 to allow for additional enrollees.
During this last Open Enrollment period from November 1, 2016 to February 4,
2017 (we stopped taking calls on November 30, 2016); it is estimated the 7C’s
Call Center took approximately 8.5% or 117,349 of the total calls received during
this period.
A total of 412,105 new consumers, statewide, were enrolled during the last Open
Enrollment period.
More than 130,000 (131,237) Contra Costa County residents have newly
enrolled with a health care provider since the Affordable Care Act went into
effect. That is a little less than double the number of seats available in Levi
Stadium.
F&HS Agenda Packet Page 42
Additionally, our Medi-Cal caseload grew from 64,443 (in 2013) to 131,080 (as
of 12-31-16) which reflects an increase of 103.4% as a result of the expanded
eligibility under the Affordable Care Act (ACA).
2. The Call Center’s Overall Performance
A. Total Number of Calls Handled and Total Number of Customers Assisted
During the operation of the 7Cs Call Center we answered statewide calls
and provided ongoing assistance to Covered California customers. During the
operation of the 7C's Call Center, we took almost 1 million calls.
This is close to almost one call for each person currently living in
Contra Cost County.
B. Breakout on the Type of Call Received – Speed of Call Answer and Average
Handle Time of Call
The top five (5) types of calls taken at the Call Center included:
Application assistance/enrollment
Coverage renewals
County contact information
General information inquiries
Questions regarding the IRS Form 1095-A and other information issued by
IRS or Covered California
Overall through the Covered California system from October 2013 through
November 2016, a total of 9,103,412 calls were taken. The Average Handle
Time (AHT) of these calls was 18 minutes which is reflected in the following chart.
F&HS Agenda Packet Page 43
Month/Year Total Call
Numbers for
All Call
Centers
Total Call
Numbers
for the 7C’s
Call Center
Average Call
Handle Time
(AHT) All
Centers –
Minutes*
Average Call
Handle Time
(AHT) for the
7C’s Call Center
– Minutes*
October 2013 216,497 49,390 14 18
November 2013 281,503 47,598 16 20
December 2013 420,820 44,813 54 18
January 2014 327,721 42,800 44 19
February 2014 308,007 37,452 44 17
March 2014 187,058 22,689 34 21
April 2014 236,444 12,689 11 17
May 2014 187,058 15,917 13 15
June 2014 189,123 11,668 1 15
July 2014 148,880 12,914 10 15
August 2014 76,450 16,366 53 17
September 2014 98,668 15,074 44 17
October 2014 177,885 15,716 23 19
November 2014 181,826 15,375 21 21
December 2014 309,736 20,987 11 21
January 2015 374,496 28,022 3 18
February 2015 449,985 28,456 5 16
March 2015 144,899 23,847 1 17
April 2015 279,813 20,775 14 17
May 2015 175,718 20,708 14 15
June 2015 144,844 22,922 15 15
July 2015 148,635 29,299 15 15
August 2015 166,357 28,646 16 15
September 2015 162,633 25,731 15 15
October 2015 289,243 23,791 2 18
November 2015 290,705 24,360 16 17
December 2015 406,928 33,078 13 16
January 2016 419,145 31,218 15 15
February 2016 344,242 29,693 15 14
March 2016 315,705 30,604 15 16
April 2016 210,891 27,875 17 17
May 2016 182,597 24,423 16 16
June 2016 168,517 24,218 16 16
July 2016 144,674 21,492 16 16
August 2016 157,318 29,315 15 16
September 2016 147,847 22,957 16 17
October 2016 221,628 19,497 18 18
November 2016** 196,048 15,289 18 18
* This is the average amount of talk time, hold time, and wrap time necessary to complete
the phone transaction. This is a performance indicator contained in our contract, which
allows up to 51 minutes of handle time per call.
** At closure the only data available was to November 20, 2016.
F&HS Agenda Packet Page 44
For the almost 1 million calls taken at the 7C's Call Center, the overall Average
Handle Time (AHT) over this same period was 17:00 minutes (lower than the
average for the system and much lower than the maximum allowed under our
contract of 51 minutes) and the Average Speed of Answer (ASA) (the
performance indicator reporting of which was discontinued by Covered
California) was 4.00 minutes (same as for the entire system).
That is faster than it takes to sew a button that has come loose from your
favorite jacket; or to take Bart from Pittsburg to Walnut Creek.
C. Monthly Schedule Adherence
Monthly Schedule Adherence was formally measured beginning July 2015 when
the Workforce Management Team (WFM) was developed by Covered CA.
Schedule Adherence is defined by individual agents logged into the phone
system and available for calls. Agents must log on timely at the beginning of their
shifts, and take their breaks and lunches as scheduled by the Covered California
Workforce Management.
The 7C's Call Center was recognized by Covered California as having the
highest consistent schedule adherence percentage of all of the Covered
California Centers. Following are 2015 and 2016 comparisons and our 2016
average.
50
54
58
62
66
70
74
78
82
86
90
July 2015 August 2015 September
2015
October 2015 November
2015
December
2015
2015 Monthly Schedule Adherence
Contra Costa Rancho Cordova Fresno
F&HS Agenda Packet Page 45
D. Other Performance Measures
We consistently maintained hours of operation and staffing ratios as
required under our contract with Covered California or the Health Benefit
Exchange.
Based on our internal performance assessment including informal
50
54
58
62
66
70
74
78
82
86
90
2016 Monthly Schedule Adherence
Contra Costa Rancho Cordova Fresno
70
75
80
85
90
87.31
80.05 78.79
Average Schedule Adherence
Contra Costa Rancho Cordova Fresno
F&HS Agenda Packet Page 46
feedback received from Covered California, all key performance measures
were either met, exceeded, or deemed acceptable in comparison to the
overall performance of all Covered California Call Centers.
A. Quality Monitoring which measures the overall quality of agent
interactions with customers, adherence to established procedures, and
overall accuracy of information provided and data entered: Set at 85%
Covered California and the 7C's Call Center staff continually monitored
all our agents on a monthly basis and we worked with Covered California
on the Quality Monitoring scores of calls reviewed.
Additionally, in February 2016, the Covered California Service Center
Management Team conducted an on-site visit at the 7C's Call Center. The
Covered California Service Center Director, Mavilla Safi, was impressed
with Contra Costa's Quality Monitoring guidelines. Ms. Safi was in
agreement with Contra Costa's standards and considered adopting the 7C's
reports for the entire system. In addition, Ms. Safi and her team were
impressed with the commitment and passion of the Customer Service Agent
Supervisors.
Covered California continued to examine, analyze, and calibrate the data
coming from call monitoring and worked on determining how the data would
best be measured, applied and used. Although there was no formal
promulgation of these data, we believe we met our 85% standard of quality
interactions with our customers.
B. Customer Satisfaction determined by independent customer surveys on
courtesy, understanding, knowledge and problem resolution: Set at 87%
The 7C’s Call Center maintained and recorded customer satisfaction when
provided; and both Covered California and Contra Costa County made
customer satisfaction a top priority at all the Call Centers including the
7C's Call Center. We also maintained our own complaints and
compliments' log and throughout the duration of our operation, we
experienced a steady stream of compliments coming in on a monthly
basis with very few complaints. From 2015 through August 2016,
approximately 300 compliments were received.
4. Staffing
During the approximately three (3) years the 7C’s Call Center was in operation,
over 350 individuals were employed at the Center.
F&HS Agenda Packet Page 47
This is close to the same number of people running the front office of the
San Francisco Giants organization.
Of the total of total 350 individuals hired at the 7C’s Call Center during the duration
of its operation, approximately 79% were Contra Costa residents with 19% residing
in West County, 37% in Central County, and 44% in East County. Of those who
were hired and left we estimate 70% were employed elsewhere.
We opened in July 2013 with 182 Agents and 24 support staff originally hired.
With the closure of the 7C’s Call Center, all Call Center staff were offered and
placed into other positions within the County with the exception of t wenty (20)
employees (who waived job offers and were subsequently laid -off). We had 45
Customer Service Agents (CSAs) start as Eligibility Worker (EW) trainees on
December 1, 2016. A total of 47 Call Center staff transferred to the E ligibility
Workers Training Unit (EWTU).
Forty-seven (47) Employees were with us from the first day to the last!
5. Contract and Fiscal
Since the initiation of the 7C's Call Center, the Department was successful in meeting
all terms of the Covered California contract. We followed the budget detail and
payment provisions as specified by the Board of Supervisors and under the contract
with there being no outlay of County General funds.
All invoices submitted for payment/reimbursement for contract expenditures incurred
from April 2013 through November 2016 were subsequently paid in full. We
experienced no problems or delays in our invoice submissions, and payment with our
final invoice in the amount of $428,285.05 is expected to be received shortly.
F&HS Agenda Packet Page 48
A total of $31,714,379 million was spent on the operation of the 7C's Call Center
(from beginning to end) of which no County funds were required or spent. The
entire operation of the Center was funded through the contract with Covered
California. This represents over one (1) million individuals being served.
6. Customer Feedback
As stated in the previous section throughout our approximate three (3) and half years
of operation, we received many consumer compliments for excellent customer
service. Below is a sampling of the comments received:
“She (Sherry) took my difficult phone call. Her customer service was more than
excellent, professional and kind. She was knowledgeable and patient with my
millions of questions. I was stressed out by picking a plan but her attitude and
demeanor calmed me down. I feel so much better about my health plan. She is a
star.”
“She (Nicole) was the epitome of good custo mer service. The website never
worked right and I am a difficult consumer, but she stayed strong and professional
and helped me through it.”
“I was hysterical and he (Marcus) was so wonderful and helped me so much. He
was calm and cool and I just want to say thank you to him. It meant the world to
me.”
“She (Claudia) was outstanding. She’s a keeper. She went above and beyond;
resolved all issues and answered all questions.”
“I want to give her (Kylie) a five-star rating for her help and patience. She is a great
person.”
“She (Katherine) was patient and extraordinarily clear. She was very, very helpful.
I wanted you to know that she did an outstanding job.”
“She (LaPorcha) was very nice and patient. The call went much smoother than I
had anticipated.”
“Fantastic rep, super articulate: it was a long call. I can’t remember a better
customer service experience. She fixed things that were very complicated.”
“She (Lianne) was patient, extremely knowledgeable and thorough. She helped
me tremendously, providing guidance where needed. She is wonderful employee
who is dedicated.”
F&HS Agenda Packet Page 49
We were trying to enroll my wife and found it very frustrating with the password
and the system not accepting our information. We called and spoke to her
(Theresa). She was wonderful. She did a fantastic job. She walked us through
every screen. She got my wife’s coverage all set up. Kudos to her for her excellent
job.”
7. Conclusion
As evidenced in this closeout report, the 7C’s Covered California Call Center operated
by the Contra Costa County Employment & Human Services Department was a highly
successful endeavor representing a unique and positive partnership between our
County and Covered California. With your Board’s direction, this successful
partnership allowed Contra Costa to be in the forefront of one of the most major Social
Service changes in our country’s recent history.
Most importantly and while we do not know what the future will be with the changing
political landscape, we assisted almost one (1) million consumers with obtaining
critical health care information and coverage that they and their families would not
have otherwise been able to have acquired. This project additionally put
approximately $31 million into our local and regional areas serving as a high stimulus
for economic generation and employment.
Approximately 131,237 Contra Costa County residents now have medical
coverage where before they were either unable to acquire or afford this insurance
prior to the enactment of the ACA.
On January 26, 2017, on behalf of Contra Costa County and the Employment and
Human Services Department; Wendy Therrian, W orkforce Services Bureau Director,
met with Peter Lee and the Covered California Board to receive an award of
recognition and resolution for the work performed by the 7C’s Covered California Call
Center. Mr. Lee and the Board recognized the performance of the Center staff and
the very positive working relationship and partnership with Contra Costa County.
Attached is a copy of the resolution received from Covered California and here is the
link of the video from the January 26, 2017 Covered California Board recognition of
Contra Costa County – https://youtu.be/n66E14D-MAU.
F&HS Agenda Packet Page 50
F&HS Agenda Packet Page 51
F&HS Agenda Packet Page 52
FAMILY AND HUMAN SERVICES COMMITTEE 7.
Meeting Date:04/24/2017
Subject:Report on Innovative Community Partnerships (Whole Family Services)
Submitted For: FAMILY & HUMAN SERVICES COMMITTEE,
Department:County Administrator
Referral No.: 110
Referral Name: Innovative Community Partnerships (Whole Family Services)
Presenter: Kathy Gallagher, Employment and Human
Services Director; Devorah Levine, Asst.
Director Policy and Planning
Contact: Enid Mendoza,
(925) 335-1039
Referral History:
On January 6, 2015 the Board of Supervisors referred oversight and receipt of updates on the
Employment and Human Services Department's Innovative Community Partnerships to the
Family and Human Services Committee (F&HS).
On June 7, 2016, the Board approved expanding F&HS Referral No. 110 "Innovative Community
Partnerships" to include the subject of Whole Family Services. This change was necessary to
incorporate a major Employment and Human Services Department (EHSD) initiative, which
refocuses client-facing benefit eligibility to assess the status and needs of the “whole family”
while they are also determining benefit eligibility. Key to the new initiative is working with
community partners to form a network of family resource centers in current place-based centers
such as SIT and SparkPoint sites, Family Justice Centers, First 5 centers, et al.
Referral Update:
Please see the attached report from EHSD with an update on the established partnerships and
safety net resources. This is the second report to F&HS on this referral.
Recommendation(s)/Next Step(s):
ACCEPT the report from the Employment and Human Services Department on Innovative
Community Partnerships and Whole Family Services, and direct staff to forward the report to the
Board of Supervisors for their information.
Fiscal Impact (if any):
There is no fiscal impact; the report is informational only.
Attachments
F&HS Agenda Packet Page 53
Community Partnerships and Whole Family Services Report
F&HS Agenda Packet Page 54
F&HS Agenda Packet Page 55
F&HS Agenda Packet Page 56
F&HS Agenda Packet Page 57
F&HS Agenda Packet Page 58
FAMILY AND HUMAN SERVICES COMMITTEE 8.
Meeting Date:04/24/2017
Subject:Community Development Block Grant Program Recommendations
Submitted For: FAMILY & HUMAN SERVICES COMMITTEE,
Department:County Administrator
Referral No.: 20
Referral Name: Public Service Portion of the Community Development Block Grant (CDBG)
Presenter: Gabriel Lemus, CDBG Program
Manager
Contact: Enid Mendoza, (925)
335-1039
Referral History:
On February 11, 1997, the Board of Supervisors referred to the Family and Human Services
Committee (F&HS) the subject of the Public Service Portion of the Community Services Block
Grant (CDBG) Program. Therefore, the Department of Conservation and Development reports to
F&HS at least annually regarding recommendations for the Public Services category and
Emergency Solutions Grant funding allocations.
Referral Update:
Please see the attached report from the Conservation and Development Department.
Recommendation(s)/Next Step(s):
CONSIDER approving the staff recommendations for fiscal years 2017-18, 2018-19, and 2019-20
Community Development Block Grant Public Service and Emergency Solutions Grant projects,
and directing the Department of Conservation and Development to prepare a staff report,
inclusive of the other CDBG categories, for Board of Supervisors consideration.
Fiscal Impact (if any):
Upon approval, grant projects totaling $708,875 for the Public Services and $249,543 for the
Emergency Solutions categories would be recommended to the Board. Grant project totals are
aligned with the Board's adopted guidelines for the allocation of CDBG funding.
Attachments
CDBG Public Service Category and Emergency Solutions Grants Funding Report
F&HS Agenda Packet Page 59
F&HS Agenda Packet Page 60
Recommendations spreadsheet and the project staff reports are attached. Thirty-six applications in the
CDBG PS category and five applications in the ESG category were submitted by the December 12, 2016
deadline.
Available Funding: The County, as an entitlement jurisdiction, receives an annual allocation of CDBG
and ESG funds directly from the U.S. Department of Housing and Urban Development (HUD). HUD
has a formula for both the CDBG and ESG Programs to determine the amount of CDBG and ESG funds
that an entitlement jurisdiction will receive for the program year. However, the formula is dependent on
an approved federal budget for each federal fiscal year. Currently, HUD and most other federal agencies
are currently being funded by a “Continuing Resolution” that extends through April 28, 2017. Based on
the most current information available regarding the “Continuing Resolution” for the Fiscal Year 2017
federal budget, the County’s CDBG grant amount for FY 2017/18 is estimated to be the same as it was
in FY 2016/17 with a 0.19 percent reduction, or approximately $4,049,929.
On November 4, 2014, the Board of Supervisors (Board) adopted funding guidelines for the allocation
of CDBG funds that require the County’s annual grant be allocated to the following CDBG eligible
categories:
Category of Use Allocation
Guidelines
CDBG Program
Available Funding**
Affordable Housing 45% $1,822,468
Public Services *17% $ 688,488
Economic Development 10% $ 404,993
Infrastructure/Public Facility 8% $ 323,994
Administration 20% $ 809,986
Total FY 2017/18 CDBG Grant $4,049,929
*As long as the amount does not go over HUD’s statutory cap for Public Services
**Estimates based on information from the “Continuing Resolution”
The CDBG/ESG Consolidated Plan operates under a five-year period. In October 2013, the Board
approved having two funding cycles for the ESG Program and for the non-housing categories of the
CDBG Program to align with the five-year period of the Consolidated Plan. The first cycle is a two-year
funding cycle (FY 2015/16 and FY 2016/17) for programs/projects in the CDBG public service and
economic development, infrastructure/public facilities categories, and the ESG Program. The second
cycle is a three-year funding cycle (FY 2017/18, FY 2018/19, and FY 2019/20) for the non-housing
CDBG categories and ESG Program to conclude the final three years of the 5-year Consolidated Plan
period.
Public Service Category: Pursuant to the Board’s guidelines, a total of $688,488 (17 percent of the
County’s grant amount) is available for PS projects. In addition, there is $40,387 available to be
recaptured from completed projects and $52,000 contributed from the “Affordable Housing” category to
help fund landlord/tenant and fair housing services. Consequently, there is a total of $780,875 available
and recommended to be allocated to 36 eligible Public Service projects as listed in Attachment A.
F&HS Agenda Packet Page 61
Given that the PS category operates under a three-year funding cycle to conclude the final three years of
the CDBG/ESG Consolidated Plan period, the recommended amounts reflected for each respective
agency/program for FY 2017/18 are also the recommended amounts for the same agencies/programs for
FY 2018/19 and FY 2019/20, contingent on the satisfactory performance of each respective
agency/program and the County receiving a similar allocation of CDBG funds from HUD.
Emergency Solutions Grants: Based on the “Continuing Resolution” information, the County
estimates receiving a total of $269,776 in ESG funding for FY 2017/18. Seven and a half percent (7.5%)
of the grant will be used for administration expenses resulting in a estimated total of $249,543 being
available for projects. All five applications for ESG funds are recommended for funding. Staff
recommendations for the use of ESG funds are listed in Attachment B.
Given that the ESG Program operates under a three-year funding cycle to conclude the final three years
of the CDBG/ESG Consolidated Plan period, the recommended amounts reflected for each respective
agency/program for FY 2017/18 are also the recommended amounts for the same agencies/programs for
FY 2018/19 and FY 2019/20 contingent on the satisfactory performance of each respective
agency/program and the County receiving a similar allocation of ESG funds from HUD.
Application Process and Evaluation Criteria: Each applicant was required to submit an application
describing the proposed project, need and target population, steps necessary to carry out the project, and
proposed budget. Applications are reviewed by staff for completeness and eligibility and against criteria
listed below. Applicants are also interviewed by staff to respond to or clarify any issues related to the
application. Below are the general criteria used by staff in evaluating applications:
Intended purpose (outcome) - The quantitative and qualitative goals of the project are achievable,
measurable and result in a desirable outcome.
Consistency with Priorities Established in the Consolidated Plan and County Policy – The project meets
goals and strategies of the Consolidated Plan. Secondarily, the project meets goals of other plans such
as Redevelopment Agency Plans, Capital Improvement Plans, community planning documents, etc.
Eligibility in Respect to Federal Regulation – The proposed use of CDBG funds is consistent with
federal regulations and is determined to be an eligible activity. The project meets one of the following
three national objectives: benefit to very-low and low-income persons, preventing blight, or emergency
need.
Target Population and Demonstrated Need – The project fulfills a well-defined need and has supporting
documentation that the need exists. The proposed project is responsive to the community and the target
population, and shows a relationship between the need and the action to be taken. The target population
or area is clearly defined, the project is accessible and outreach is effective.
Financial Analysis - Total project costs are reasonable, and are adequate to carry out the project through
the specified time period. The budget is well thought out with reasonable assumptions for completing
the project with federal funding. A reasonable relationship exists between the cost of the project and
the expected outcome. Sponsor has the capacity to secure all funds necessary to carry out the project
within normal standards. Volunteer or in-kind services are attainable and realistic. The project cost is
F&HS Agenda Packet Page 62
within normal range of similar projects. Projects are required to supply matching funds in order to
maximize the use of CDBG funds. Audits or other financial statements demonstrate success in securing
funds through grant proposals or other fund raising efforts.
Experience and Capacity to Carry out the Project – Components of the project are fully described and
goals and objectives are attainable. The project sponsor has demonstrated the ability to successfully
carry out the proposed project including providing a project manager, construction manager and/or
qualified licensed contractor. The applicant demonstrates that capacity exists to complete the project
and meet all the federal requirements of the CDBG program.
Project Readiness and Timeliness – All components of the project are in place or can be in place within
a specified period of time. Project can be implemented and completed in a timely manner. Particular
attention is given to these criteria due to specific HUD timeliness requirements.
Past Performance - Rate of progress toward completing contractual goals, ability to overcome and avoid
past problems. Inaccurate or incomplete performance reports, unresolved audit findings, delays in or
failure to submit required reports, persistent difficulties with payment request process, failure to correct
significant problems.
Environmental, Historic Preservation, Relocation, and/or Prevailing Wage Issues – Identification of
federal requirements that may be imposed on the project that require specific action to be taken.
Clarity and completeness of application - The application submitted was complete and lacked
inaccuracies and ambiguities.
Public Hearing and Transmittal of Recommendations: The Committee’s recommendations will be
forwarded to the full Board of Supervisors prior to the public hearing that is scheduled for May 9, 2017.
Final recommendations must be forwarded to HUD by May 15, 2017 for review to ensure consistency
with federal regulations.
Attachments
cc: John Kopchik, Director – Department of Conservation and Development
Kara Douglas, Assistant Deputy Director – Department of Conservation and Development
F&HS Agenda Packet Page 63
Community Development Block Grant
Public Services Category
FY 2017/18, 2018/19, and 2019/20
ATTACHMENT A
Project Name
Amount
Requested
Amount
Received in
FY 2016/17
County Staff
Recommendation for
FY 2017/18 Antioch Concord Pittsburg Walnut Creek
17-01-PS A Place of Learning
(APOL)
After School Tutoring
and Mentoring
Program
Provide free after-
school/Summer
mentoring/tutoring
services to 60 low-
income Urban County
students.
$10,000 N/A $10,000 $0 $0 $0 $0 $10,000 $37,950 26%
17-02-PS Bay Area Legal Aid
(BayLegal)
Landlord/Tenant
Counseling Program
Provide landlord/tenant
counseling and legal
services for 550
landlords/tenants.
$100,000 $80,000 $80,000 $30,000 $12,000 $0 $0 $142,000 $157,075 90%
17-03-PS
Community Housing
Development
Corporation of North
Richmond
Multicultural/Senior
Family Center
Provide 400 persons
with educational,
recreational and
nutritional programs at
community center.
$98,291 $55,000 $55,000 $0 $0 $0 $0 $98,291 $149,691 66%
17-04-PS
Community Housing
Development
Corporation
Contra Costa County
Home Equity
Preservation Alliance
(HEPA)
Provide foreclosure
counseling, education
and legal assistance to
120 clients.
$30,000 $25,000 $25,000 $0 $0 $0 $0 $30,000 $160,536 19%
17-05-PS Community Violence
Solutions (CVS)
CIC Child Sexual
Assault Intervention
Provide forensic
interview, case
management,
advocacy for 70
children and
caregivers.
$15,000 $15,000 $15,000 $5,000 $8,000 $5,000 $5,000 $38,000 $320,500 12%
17-06-PS
Contra Costa County
Health Services -
Health, Housing and
Homeless Services
Division, Homeless
Program
Coordinated Outreach,
Referral, and
Engagement Program
(CORE)
Provide day and
evening homeless
street outreach
services to at least 450
Urban County
individuals living
outside throughout the
County.
$25,000 $22,224 $22,300 $30,000 $30,000 $10,000 $20,000 $115,000 $669,265 17%
Public Service Projects
% Budget
(CDBG)
Total
Budget
Total CDBG
Requested
Contra Costa County
Amount Requested
(Other CDBG Jurisdictions)
CCC
Application
No.OutcomeApplicant
F&HS Agenda Packet Page 64
Community Development Block Grant
Public Services Category
FY 2017/18, 2018/19, and 2019/20
ATTACHMENT A
Project Name
Amount
Requested
Amount
Received in
FY 2016/17
County Staff
Recommendation for
FY 2017/18 Antioch Concord Pittsburg Walnut Creek
% Budget
(CDBG)
Total
Budget
Total CDBG
Requested
Contra Costa County
Amount Requested
(Other CDBG Jurisdictions)
CCC
Application
No.OutcomeApplicant
17-07-PS Contra Costa Crisis
Center
Crisis / 211 Contra
Costa
Provide telephone 24-
hour crisis intervention
and 211 referral
service for 8,200
clients.
$18,000 $18,000 $18,000 $10,000 $10,000 $10,000 $10,000 $58,000 $1,204,578 5%
17-08-PS Contra Costa Family
Justice Alliance
West County Family
Justice Center
Provide one-stop
center services for 500
victims of abuse and
domestic violence.
$40,000 $32,000 $32,000 $0 $10,000 $0 $0 $50,000 $1,260,076 4%
17-09-PS
Contra Costa Health,
Housing and
Homeless Services
Homeless Program
Contra Costa Adult
Continuum of Services
Provide 24-hour
shelter/wrap-around
services for 150
homeless adults.
$54,000 $54,000 $54,000 $10,000 $10,000 $0 $6,000 $80,000 $2,067,741 4%
17-10-PS Contra Costa Senior
Legal Services
Legal Services for
Seniors
Provide legal
counseling services for
200 seniors.
$15,000 $12,000 $12,000 $10,000 $10,000 $11,000 $10,000 $56,000 $604,000 9%
17-11-PS
Contra Costa Service
Integration Program -
SparkPoint Contra
Costa
Community Career
Center
Provide services to
200 Urban County
residents to assist
them in obtaining and
maintaining
employment, improve
their careers.
$20,000 N/A $12,000 $0 $0 $0 $0 $20,000 $236,000 8%
17-12-PS
Court Appointed
Special Advocates
(CASA)
Children At Risk
Provide advocacy,
mentoring, and
representation services
for 37 abused and
neglected children.
$20,000 $18,000 $18,000 $14,000 $15,000 $8,000 $5,000 $62,000 $769,300 8%
F&HS Agenda Packet Page 65
Community Development Block Grant
Public Services Category
FY 2017/18, 2018/19, and 2019/20
ATTACHMENT A
Project Name
Amount
Requested
Amount
Received in
FY 2016/17
County Staff
Recommendation for
FY 2017/18 Antioch Concord Pittsburg Walnut Creek
% Budget
(CDBG)
Total
Budget
Total CDBG
Requested
Contra Costa County
Amount Requested
(Other CDBG Jurisdictions)
CCC
Application
No.OutcomeApplicant
17-13-PS ECHO Housing Fair Housing Services
Provide
comprehensive fair
housing counseling
services to
approximately 210
Urban County
residents.
$40,000 N/A $40,000 $25,000 $10,000 $0 $6,000 $81,000 $268,037 30%
17-14-PS East Bay Center for
the Performing Arts
Deep Roots, Wide
World Program
Provide literacy and
performing arts
summer programs to
150 children aged 3-9,
resulting in improved
academic
performance,
community building,
and exposure to
diverse global art
traditions.
$14,200 N/A $11,500 $0 $0 $0 $0 $14,200 $66,710 21%
17-15-PS Food Bank of Contra
Costa and Solano
Collaborative Food
Distribution
Provide food
distribution services for
9,300 low-income
clients.
$46,500 $46,500 $46,500 $0 $10,000 $0 $0 $56,500 $3,822,358 1%
17-16-PS Girls Inc.
Summer/Afterschool
and Education
Enrichment
Programming
Provide afterschool
and education
enrichment
programming to 495
youth from the City of
Richmond
$15,000 $11,000 $11,000 $0 $0 $0 $0 $15,000 $239,960 6%
17-17-PS
James Morehouse
Project / YMCA of the
East Bay (fiscal
sponsor)
James Morehouse
Project at El Cerrito
High School
Provide
comprehensive mental
health and support
services for 55
students.
$20,000 $10,000 $10,000 $0 $0 $0 $0 $20,000 $299,000 7%
F&HS Agenda Packet Page 66
Community Development Block Grant
Public Services Category
FY 2017/18, 2018/19, and 2019/20
ATTACHMENT A
Project Name
Amount
Requested
Amount
Received in
FY 2016/17
County Staff
Recommendation for
FY 2017/18 Antioch Concord Pittsburg Walnut Creek
% Budget
(CDBG)
Total
Budget
Total CDBG
Requested
Contra Costa County
Amount Requested
(Other CDBG Jurisdictions)
CCC
Application
No.OutcomeApplicant
17-18-PS Lamorinda Spirit - City
of Lafayette
Lamorinda Spirit Van
Senior Transportation
Program
Provide free or low-
cost transportation to
150 seniors living in
Moraga, Orinda and
Lafayette.
$10,000 $10,000 $10,000 $0 $0 $0 $0 $10,000 $183,298 5%
17-19-PS Lions Center for the
Visually Impaired
Independent Living Skills
for Blind and Visually
Impaired Adults
Provide in-home
independent living
skills and mobility
training for 42 visually
impaired persons.
$15,000 $10,000 $10,000 $10,000 $12,000 $10,000 $10,000 $57,000 $197,188 29%
17-20-PS Loaves and Fishes of
Contra Costa
Nourishing Lives in
Martinez, Antioch and
Pittsburg
Provide hot buffet-style
meal weekdays to 500
low-income/homeless.
$15,000 $15,000 $15,000 $5,000 $0 $13,810 $0 $33,810 $1,157,825 '0.02%
17-21-PS
Meals On Wheels and
Senior Outreach
Services
Care Management
Provide long-term care
services case
management for 120
seniors.
$20,000 $15,000 $15,000 $15,000 $15,000 $7,500 $10,000 $67,500 $347,500 19%
17-22-PS
Meals On Wheels and
Senior Outreach
Services
Senior Nutrition - CC
Cafes
Provide hot, weekday
lunches to 303 seniors
at six senior centers.
$18,750 $15,000 $15,000 $0 $20,000 $5,000 $0 $43,750 $313,973 14%
17-23-PS Monument Crisis
Center
Critical Safety Net
Resources for
Families and
Individuals
Provide wrap-around
safety net services for
2,766 low-income
clients.
$20,000 $15,000 $15,000 $0 $20,000 $0 $15,000 $55,000 $2,819,648 2%
17-24-PS Mount Diablo Unified
School District
CARES After School
Enrichment Program
Provide after-school
programing for 580
elementary and middle
school students.
$10,000 $10,000 $10,000 $0 $0 $0 $0 $10,000 $3,497,797 0.29%
F&HS Agenda Packet Page 67
Community Development Block Grant
Public Services Category
FY 2017/18, 2018/19, and 2019/20
ATTACHMENT A
Project Name
Amount
Requested
Amount
Received in
FY 2016/17
County Staff
Recommendation for
FY 2017/18 Antioch Concord Pittsburg Walnut Creek
% Budget
(CDBG)
Total
Budget
Total CDBG
Requested
Contra Costa County
Amount Requested
(Other CDBG Jurisdictions)
CCC
Application
No.OutcomeApplicant
17-26-PS New Horizons Career
Development Center
Education, Job
Training, Life Skills,
and Job Placement
Services
Provide job
training/placement,
GED prep, and life
skills for 300 clients.
$25,000 $25,000 $25,000 $0 $0 $0 $0 $25,000 $154,000 16%
17-27-PS Northern California
Family Center
Runaway Shelter
Services
Provide 1-5 nights of
emergency shelter,
mediation services,
clothing and food to 10
Urban County youth to
prevent homelessness
and long-term
institutionalization.
$20,000 N/A $11,500 $10,000 $10,000 $10,000 $0 $50,000 $220,000 23%
17-28-PS Ombudsman Services
of Contra Costa
Ombudsman Services
of Contra Costa
Provide
abuse/compliance
investigation for 775
seniors living in
nursing facilities.
$17,000 $10,000 $10,000 $11,000 $12,000 $5,000 $13,000 $58,000 $702,084 8%
17-29-PS
Pleasant Hill
Recreation & Park
District
Senior Service
Network
Provide on-site care
management and crisis
intervention for 150
seniors.
$15,000 $10,000 $10,000 $0 $0 $0 $0 $15,000 $60,650 25%
17-30-PS
Rainbow Community
Center of Contra
Costa
Kind Hearts
Community Support
Program
Provide congregate
meals, food pantry,
wellness calls, home
visits for 60 LGBT
seniors/ people with
HIV/AIDS.
$12,000 $10,000 $10,000 $0 $0 $0 $8,000 $20,000 $80,712 25%
17-31-PS RYSE, Inc.RYSE Career Pathway
Program
Provide career
development, media
arts education, paid
work exp, and
academic support for
115 low-income youth.
$40,000 $40,000 $40,000 $0 $0 $0 $0 $40,000 $280,995 14%
F&HS Agenda Packet Page 68
Community Development Block Grant
Public Services Category
FY 2017/18, 2018/19, and 2019/20
ATTACHMENT A
Project Name
Amount
Requested
Amount
Received in
FY 2016/17
County Staff
Recommendation for
FY 2017/18 Antioch Concord Pittsburg Walnut Creek
% Budget
(CDBG)
Total
Budget
Total CDBG
Requested
Contra Costa County
Amount Requested
(Other CDBG Jurisdictions)
CCC
Application
No.OutcomeApplicant
17-32-PS Richmond Public
Library Words on Wheels
Provide Mobile Library
Services to serve 125
seniors and low-
income residents living
in areas of Richmond
that have limited
access to computers
and library services.
$31,905 N/A $12,000 $0 $0 $0 $0 $31,905 $225,528 14%
17-33-PS SHELTER, Inc.
(CDBG)
Homeless Prevention
& Rapid Rehousing
Program
Provide homeless
prevention and rapid
rehousing for 270 low-
income clients.
$30,000 $25,075 $25,075 $15,000 $13,500 $15,500 $6,000 $80,000 $876,439 9%
17-34-PS St. Vincent de Paul of
Contra Costa County
RotaCare Pittsburg
Free Medical Clinic at
St. Vincent de Paul
Provide free urgent
and chronic medical
care to 480 uninsured
clients.
$13,500 N/A $12,000 $0 $0 $24,000 $0 $37,500 $261,010 14%
17-35-PS Village Community
Resource Center
Village Community
Resource Center
Program Support
Provide support for
afterschool program
for 115 students.
$17,550 $13,000 $13,000 $0 $0 $0 $0 $17,550 $282,650 6%
17-36-PS West County Adult
Day Care
West County Adult
Day/Alzheimer
Provide
comprehensive adult
day care services for
25 seniors with
Alzheimers.
$40,000 $40,000 $40,000 $0 $0 $0 $0 $40,000 $215,780 19%
17-37-PS YWCA of Contra
Costa/Sacramento
YWCA Family
Empowerment
Program
Provide mental,
physical, social, and
emotional health skills
training for 125
families.
$12,000 $10,000 $10,000 $0 $0 $0 $0 $12,000 $24,000 50%
$963,696 $671,799 $780,875 $200,000 $227,500 $134,810 $124,000 $1,650,006 $24,233,854 7%Total
F&HS Agenda Packet Page 69
Contra Costa County
Emergency Solutions Grant FY
2017/18, 2018/19, and 2019/20
ATTACHMENT B
Project Name
Amount
Requested
Amount
Received in
FY 2016/17
County Staff
Recommendation for
FY 2017/18
17-01-ESG
Contra Costa
Behavioral Health
Services Homeless
Program
Adult Interim Housing
Program Emergency shelter beds
and wraparound services
for 150 homeless.
$108,365 $108,365 $108,365 $108,365 $2,071,106 5%
17-02-ESG
Contra Costa
Behavioral Health
Services Homeless
Program
Calli House Youth
Shelter
Emergency shelter beds
and support services for
25 homeless youth.
$10,000 $10,000 $10,000 $10,000 $497,228 2%
17-03-ESG SHELTER, Inc. of
Contra Costa County
Homeless Prevention
and Rapid Rehousing
Program
Homelessness
prevention and rapid
rehousing services to 60
Extremely Low Income
households in the Urban
County.
$100,000 $87,678 $87,678 $87,678 $876,439 10%
17-04-ESG STAND! For Families
Free of Violence
Rollie Mullen
Emergency Shelter
Emergency shelter and
support services for 40
adults (both men and
women) and their
children.
$35,000 $31,000 $31,000 $31,000 $507,550 6%
17-05-ESG Trinity Center Walnut
Creek Trinity Center
Hygiene/food services
and day-use facility for
100 homeless clients.
$12,500 $12,500 $12,500 $12,500 $809,375 2%
$265,865 $249,543 $249,543 $249,543 $4,761,698 5%TOTALS
CCC Project
No.
Outcome (for Amount
Requested)Applicant
Emergency Solutions Grant Projects
% Budget
(ESG)
Total
Budget
Total
ESG
Contra Costa County
F&HS Agenda Packet Page 70
F&HS Agenda Packet Page 71
F&HS Agenda Packet Page 72
F&HS Agenda Packet Page 73
F&HS Agenda Packet Page 74
F&HS Agenda Packet Page 75
F&HS Agenda Packet Page 76
F&HS Agenda Packet Page 77
F&HS Agenda Packet Page 78
F&HS Agenda Packet Page 79
F&HS Agenda Packet Page 80
F&HS Agenda Packet Page 81
F&HS Agenda Packet Page 82
F&HS Agenda Packet Page 83
F&HS Agenda Packet Page 84
F&HS Agenda Packet Page 85
F&HS Agenda Packet Page 86
F&HS Agenda Packet Page 87
F&HS Agenda Packet Page 88
F&HS Agenda Packet Page 89
F&HS Agenda Packet Page 90
F&HS Agenda Packet Page 91
F&HS Agenda Packet Page 92
F&HS Agenda Packet Page 93
F&HS Agenda Packet Page 94
F&HS Agenda Packet Page 95
F&HS Agenda Packet Page 96
F&HS Agenda Packet Page 97
F&HS Agenda Packet Page 98
F&HS Agenda Packet Page 99
F&HS Agenda Packet Page 100
F&HS Agenda Packet Page 101
F&HS Agenda Packet Page 102
F&HS Agenda Packet Page 103
F&HS Agenda Packet Page 104
F&HS Agenda Packet Page 105
F&HS Agenda Packet Page 106
F&HS Agenda Packet Page 107
F&HS Agenda Packet Page 108
F&HS Agenda Packet Page 109
F&HS Agenda Packet Page 110
F&HS Agenda Packet Page 111
F&HS Agenda Packet Page 112
F&HS Agenda Packet Page 113
F&HS Agenda Packet Page 114
F&HS Agenda Packet Page 115
F&HS Agenda Packet Page 116
F&HS Agenda Packet Page 117
F&HS Agenda Packet Page 118
F&HS Agenda Packet Page 119
F&HS Agenda Packet Page 120
F&HS Agenda Packet Page 121
F&HS Agenda Packet Page 122
F&HS Agenda Packet Page 123
F&HS Agenda Packet Page 124
F&HS Agenda Packet Page 125
F&HS Agenda Packet Page 126
F&HS Agenda Packet Page 127
F&HS Agenda Packet Page 128
F&HS Agenda Packet Page 129
F&HS Agenda Packet Page 130
F&HS Agenda Packet Page 131
F&HS Agenda Packet Page 132
F&HS Agenda Packet Page 133
F&HS Agenda Packet Page 134
F&HS Agenda Packet Page 135
F&HS Agenda Packet Page 136
F&HS Agenda Packet Page 137
F&HS Agenda Packet Page 138
F&HS Agenda Packet Page 139
F&HS Agenda Packet Page 140
F&HS Agenda Packet Page 141
F&HS Agenda Packet Page 142
F&HS Agenda Packet Page 143
F&HS Agenda Packet Page 144
F&HS Agenda Packet Page 145
F&HS Agenda Packet Page 146
F&HS Agenda Packet Page 147
F&HS Agenda Packet Page 148
F&HS Agenda Packet Page 149
F&HS Agenda Packet Page 150
F&HS Agenda Packet Page 151
F&HS Agenda Packet Page 152
F&HS Agenda Packet Page 153
F&HS Agenda Packet Page 154
F&HS Agenda Packet Page 155
F&HS Agenda Packet Page 156
F&HS Agenda Packet Page 157
F&HS Agenda Packet Page 158
F&HS Agenda Packet Page 159
F&HS Agenda Packet Page 160
F&HS Agenda Packet Page 161
F&HS Agenda Packet Page 162
F&HS Agenda Packet Page 163
F&HS Agenda Packet Page 164
F&HS Agenda Packet Page 165
F&HS Agenda Packet Page 166
F&HS Agenda Packet Page 167
F&HS Agenda Packet Page 168
F&HS Agenda Packet Page 169
F&HS Agenda Packet Page 170
F&HS Agenda Packet Page 171
F&HS Agenda Packet Page 172
F&HS Agenda Packet Page 173
F&HS Agenda Packet Page 174
F&HS Agenda Packet Page 175
F&HS Agenda Packet Page 176
F&HS Agenda Packet Page 177
F&HS Agenda Packet Page 178
F&HS Agenda Packet Page 179
F&HS Agenda Packet Page 180
F&HS Agenda Packet Page 181
F&HS Agenda Packet Page 182
F&HS Agenda Packet Page 183
F&HS Agenda Packet Page 184
F&HS Agenda Packet Page 185
F&HS Agenda Packet Page 186
F&HS Agenda Packet Page 187
F&HS Agenda Packet Page 188
F&HS Agenda Packet Page 189
F&HS Agenda Packet Page 190
F&HS Agenda Packet Page 191
F&HS Agenda Packet Page 192
F&HS Agenda Packet Page 193
F&HS Agenda Packet Page 194
F&HS Agenda Packet Page 195
F&HS Agenda Packet Page 196
F&HS Agenda Packet Page 197
F&HS Agenda Packet Page 198
F&HS Agenda Packet Page 199
F&HS Agenda Packet Page 200
F&HS Agenda Packet Page 201
F&HS Agenda Packet Page 202
FAMILY AND HUMAN SERVICES COMMITTEE 9.
Meeting Date:04/24/2017
Subject:Tobacco Control Draft Ordinances to Protect Youth from Tobacco Influences
in the Retail Environment
Submitted For: FAMILY & HUMAN SERVICES COMMITTEE,
Department:County Administrator
Referral No.: 112
Referral Name: Policy Options to Protect Youth from Tobacco Influences in the Retail
Environment
Presenter: Daniel Peddycord, Public Health Director;
Denice Dennis, Tobacco Prevention Program
Manager
Contact: Enid Mendoza,
(925) 335-1039
Referral History:
The review of policy options to protect youth from tobacco influences in the retail environment
was first referred to the Family and Human Services Committee on May 5, 2015. At this meeting
the Board of Supervisors accepted the Health Services 2013 Health Stores for a Healthy
Community Report and directed staff to develop and present a report on recommendations.
On May 24, 2016, the Board accepted the second report on Policy Options to Protect Youth from
Tobacco Influences in the Retail Environment and directed staff to work with County Counsel to
draft ordinances with policy provisions and report to the Planning Commission if applicable.
Referral Update:
Please see the attached report and supporting documents regarding new provisions to the
Secondhand Smoke and Tobacco Product Control Ordinance and Zoning Code amendments.
Recommendation(s)/Next Step(s):
CONSIDER recommending to the Board of Supervisors:
1) The amended Tobacco Product and Retail Sales Control Ordinance and the Tobacco Retailing
Businesses Ordinance as recommended by the department, and
2) The Health Services Department to report annually to the Family and Human Services
Committee on outreach and implementation activities and issues on the new ordinances.
Attachments
Tobacco Control Report
Attachment I - May 24, 2016 Report to BOS on Policy Options to Protect Youth from Tobacco Influences
F&HS Agenda Packet Page 203
Attachment II - Draft Tobacco Product and Retail Sales Control Ordinance
Attachment III - Draft Tobacco Retailing Businesses Zoning Ordinance
Attachment IV - Summary of Draft Tobacco Control Provisions
Attachment V - CDPH Menthol Fact Sheet
Attachment VI - Planning Commission Staff Report
Attachment VII - Planning Commission Resolution
Attachment VIII - Retailer Input Summary
F&HS Agenda Packet Page 204
F&HS Agenda Packet Page 205
F&HS Agenda Packet Page 206
F&HS Agenda Packet Page 207
F&HS Agenda Packet Page 208
RECOMMENDATION(S):
ACCEPT the Health Services Department, Public Health Division, staff report on policy options to protect youth from
tobacco influences in the retail environment. DETERMINE which policy options, as recommended in Attachment II,
to include in an ordinance regulating tobacco retailers. DIRECT Public Health staff to work with the County
Counsel’s Office to draft the ordinance and present it to the Board of Supervisors for the Board’s consideration and
present to the Planning Commission, if applicable.
FISCAL IMPACT:
Should the Board direct the development of a revised ordinance, minimal fiscal impacts associated with staff time
costs, including County Counsel and other departments to develop the ordinance itself are expected. A portion of the
Prop 99 funding Contra Costa Health Services receives for its Tobacco Prevention Program could be allocated to
coordinating and implementing directions provided by the Board of Supervisors. Tobacco Retailer licensing fees,
currently $287 per retailer, can also be used to conduct outreach, education and compliance inspections to tobacco
retailers on the ordinance amendments and new requirements. These activities can be conducted with current funded
staff.
APPROVE OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD
COMMITTEE
Action of Board On: 05/24/2016 APPROVED AS RECOMMENDED OTHER
Clerks Notes:
VOTE OF SUPERVISORS
Contact: Dan Peddycord,
313-6712
I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the Board of
Supervisors on the date shown.
ATTESTED: May 24, 2016
David J. Twa, County Administrator and Clerk of the Board of Supervisors
By: , Deputy
cc: T Scott, M Wilhelm, Tracey Rattray
D.3
To:Board of Supervisors
From:William Walker, M.D., Health Services Director
Date:May 24, 2016
Contra
Costa
County
Subject:Accept Staff Report on Policy Options for Protecting Youth from Tobacco Influences in the Retail Environment
F&HS Agenda Packet Page 209
BACKGROUND:
On July 21, 2015, the Board of Supervisors accepted a Health Services Report on Policy Options to Protect Youth
from Tobacco Influences in the Retail Environment, which was forwarded from the Family and Human Services
Committee for discussion. The report highlighted how the tobacco retail environment influences youth smoking
behavior and described a range of fifteen optional policy provisions that would serve to strengthen the County’s
ordinance to protect youth from tobacco influences and to help prevent youth from initiating tobacco use.
Recommendations were made for which policy options were among the most impactful in reducing youth tobacco
influences in the retail environment. The report also referenced the results from the 2013 Healthy Stores for a
Healthy Community Store Survey, which was accepted by the he Board at the May 5, 2015 Board of Supervisors
meeting.
Based on the recommendations from the Family and Human Services Committee and the subsequent acceptance
of the recommendation by the Board of Supervisors on July 21, 2015, the Board directed staff to work with the
affected County Departments to evaluate these options as modifications to the County’s existing ordinances, and
to address fiscal and implementation considerations. Public Health staff met with staff from County Counsel and
the Department of Conservation and Development to review all of the options discussed with the Board at the July
21, 2015 meeting. This report provides the requested information as well as policy options deemed to be the most
effective to protect youth from tobacco influences in the retail environment, including strengthening the County’s
Tobacco Retailer Licensing Ordinance.
Since 90% of smokers begin smoking by the age of 18, tobacco use has been determined to be “fundamentally a
pediatric disease” by the United States Food and Drug Administration (FDA). In order to protect health and public
safety, Health Services has presented the following policy options for consideration as modifications to existing
county code to address youth tobacco influences in the retail environment:
Most Impactful Provisions to Reduce Youth Tobacco Influences in the Community
a) Revise the definition of “tobacco products” in the Tobacco Retailer License Ordinance to be inclusive of newer
electronic smoking devices and “liquids” that currently fall outside of the definition.
b) Prohibit the sale of flavored (non-cigarette) tobacco products
c) Prohibit the sale of menthol flavored cigarettes at least within 500 feet of schools
d) Require a minimum pack size of ten (10) for little cigars and cigarillos.
e) Prohibit new tobacco retailers from operating within 1000 feet of schools, parks, playgrounds and libraries
f) Prohibit new tobacco retailers from operating within 500 feet of new or existing tobacco retailers.
g) Prohibit the sale of tobacco products in pharmacies
Condition of License Suspension if a Violation of the Law Occurs
h) Require tobacco retailers who have their license suspended to remove tobacco advertising during license
suspension periods
i) Expand the time period reviewed for prior violations of the license (the “look-back” period) from 24 months (2
years) to 60 months (5 years) when considering the length of a license suspension for retailers found to be in
violation of the law.
Other Policy Considerations:
j) Prohibit new “Significant Tobacco Retailers”, including “vape” shops, hookah bars or smoke shops
k) Require tobacco retailers to comply with state and local storefront signage laws
l) Require tobacco retailers to comply with drug paraphernalia sales laws
m) Require tobacco retailers to check ID of customers who appear younger than 27
n) Limit or “cap” the number of retailers that can sell tobacco products at current number of licenses issued by the
County
o) Prepare a board order at a later date to adjust Tobacco Retailer Licensing fees to better capture and recover
updated and real costs associated with education, enforcement and monitoring of implementing the ordinance.
The summary table on Policy Options for Addressing Youth Tobacco Influences in the Retail Environment
(Attachment II) has been updated to reflect CA jurisdictions that have adopted similar provisions in the interim
period since our last report. Those provisions that were recommended by the department as the most impactful are
in shaded boxes. Regulation of menthol cigarettes has been included since the last report among those that are
most impactful, since being upheld in the courts. The option to raise Tobacco Retailer Licensing Fees to fully
F&HS Agenda Packet Page 210
cover law enforcement costs through licensing fees has been modified as County Counsel reports that it was not
allowable as proposed. Each provision found in Attachment II, as well as fiscal and implementation issues, are
discussed in more detail in Attachment I, Health Services Report on Policy Options and Recommendation for
Addressing Youth Tobacco Influences in the Retail Environment.
CONSEQUENCE OF NEGATIVE ACTION:
If this Action is not approved, the public's health may not be protected to the extent possible.
CHILDREN'S IMPACT STATEMENT:
Tobacco products are still being promoted to children through availability of youth-friendly flavored tobacco
products and inexpensive small packs of these products; exposure to tobacco marketing in the retail environment;
and the sale and marketing of tobacco products near schools and other youth sensitive areas. Policy options exist
to amend County Code to address these issues and will discourage youth from tobacco use and promote healthier
communities.
ATTACHMENTS
Attachment I
Attachment II
Attachment III
Attachment IV
Attachment V
powerpoint
F&HS Agenda Packet Page 211
∎ Contra Costa Community Substance Abuse Services ∎ Contra Costa Emergency Medical Services ∎ Contra Costa Environmental Health ∎ Contra Costa Health Plan ∎
∎ Contra Costa Hazardous Materials Programs ∎ Contra Costa Mental Health ∎ Contra Costa Public Health ∎ Contra Costa Regional Medical Center ∎ Contra Costa Health Centers ∎
Daniel Peddycord
ATTACHMENT I
WILLIAM B. WALKER, M.D.
HEALTH SERVICES DIRECTOR
DANIEL PEDDYCORD, RN, MPA
DIRECTOR OF PUBLIC HEALTH
C ONTRA C OSTA
P UBLIC H EALTH
597 CENTER AVENUE, SUITE 125
MARTINEZ, CALIFORNIA 94553
PH (925) 313-6808
FAX (925) 313-6840
To: Contra Costa Board of Supervisors
From: Daniel Peddycord, RN, MPA, Public Health Director, Contra Costa Health Services
Re: Policy Options and Recommendations to Protect Youth from Tobacco Influences in the Retail
Environment
Date: May 24, 2016
I. Background
On July 21, 2015, the Board of Supervisors accepted a Health Services Report on Policy Options to Protect Youth
from Tobacco Influences in the Retail Environment, which was forwarded from the Family and Human Services
Committee for discussion. The report highlighted how the tobacco retail environment influences youth
smoking behavior and described a range of fifteen optional policy provisions that would serve to strengthen
the County’s ordinance to protect youth from tobacco influences and to help prevent youth from initiating
tobacco use. Recommendations were made for which policy options were among the most impactful in
reducing youth tobacco influences in the retail environment. The report also referenced the results from the
2013 Healthy Stores for a Healthy Community Store Survey, which was accepted by the he Board at the
May 5, 2015 Board of Supervisors meeting.
Based on the recommendations from the Family and Human Services Committee and the subsequent
acceptance of the recommendation by the Board of Supervisors on July 21, 2015, the Board directed staff to
work with the affected County Departments to evaluate these options as modifications to the County’s
existing ordinances, and to address fiscal and implementation considerations. Public Health staff met with
staff from County Counsel and the Department of Conservation and Development to review all of the
options discussed with the Board at the July 21, 2015 meeting. This report provides the requested
information as well as policy options deemed to be the most effective to protect youth from tobacco
influences in the retail environment, including strengthening the County’s Tobacco Retailer Licensing
Ordinance.
Since 90% of smokers begin smoking by the age of 18, tobacco use has been determined to be
“fundamentally a pediatric disease” by the United States Food and Drug Administration (FDA).1 In order to
protect health and public safety, Health Services has presented the following policy options for consideration
as modifications to existing county code to address youth tobacco influences in the retail environment:
Most Impactful Provisions to Reduce Youth Tobacco Influences in the Community
a) Revise the definition of “tobacco products” in the Tobacco Retailer License Ordinance to be inclusive
of newer electronic smoking devices and “liquids” that currently fall outside of the definition.
b) Prohibit the sale of flavored (non-cigarette) tobacco products
c) Prohibit the sale of menthol flavored cigarettes at least within 500 feet of schools
d) Require a minimum pack size of ten (10) for little cigars and cigarillos.
e) Prohibit new tobacco retailers from operating within 1000 feet of schools, parks, playgrounds and
libraries
1 Hilts, Philip J. “FDA Head Calls Smoking a Pediatric Disease.” The New York Times 9 Mar 1995.
F&HS Agenda Packet Page 212
2
f) Prohibit new tobacco retailers from operating within 500 feet of new or existing tobacco retailers.
g) Prohibit the sale of tobacco products in pharmacies
Condition of License Suspension if a Violation of the Law Occurs
h) Require tobacco retailers who have their license suspended to remove tobacco advertising during
license suspension periods
i) Expand the time period reviewed for prior violations of the license (the “look-back” period) from 24
months (2 years) to 60 months (5 years) when considering the length of a license suspension for
retailers found to be in violation of the law.
Other Policy Considerations:
j) Prohibit new “Significant Tobacco Retailers”, including “vape” shops, hookah bars or smoke shops
k) Require tobacco retailers to comply with state and local storefront signage laws
l) Require tobacco retailers to comply with drug paraphernalia sales laws
m) Require tobacco retailers to check ID of customers who appear younger than 27
n) Limit or “cap” the number of retailers that can sell tobacco products at current number of licenses
issued by the County
o) Prepare a board order at a later date to adjust Tobacco Retailer Licensing fees to better capture and
recover updated and real costs associated with education, enforcement and monitoring of
implementing the ordinance.
The summary table on Policy Options for Addressing Youth Tobacco Influences in the Retail
Environment (Attachment II) has been updated to reflect CA jurisdictions that have adopted similar
provisions in the interim period since our last report. Those provisions that were recommended by the
department as the most impactful are in shaded boxes. Regulation of menthol cigarettes has been included
since the last report among those that are most impactful, since being upheld in the courts. The option to
raise Tobacco Retailer Licensing Fees to fully cover law enforcement costs through licensing fees has been
deleted as County Counsel reports that it is not allowable under the law. Each provision found in
Attachment I, as well as fiscal and implementation issues, are discussed in more detail in this report.
II. Contra Costa County and Tobacco Prevention Efforts
Contra Costa County has been a leader in protecting the health of its residents, workers and visitors, and youth
in particular, from the devastating consequences caused by tobacco use and secondhand smoke exposure. In
2003, the Board adopted what was then a model Tobacco Retailer Licensing Ordinance to address illegal sales
of tobacco to minors, requiring all tobacco retailers to purchase a local license in order to sell tobacco
products, and allowing for a suspension of the license if tobacco sales laws, such as the no sales to minors law,
were violated. In 2006, the Board adopted what was one of the strongest and most comprehensive
secondhand smoke protections ordinances at the time, prohibiting smoking in many outdoor areas and in
certain areas of multi-unit housing properties. Most recently in 2013 the Board amended the code to require a
tobacco retailer license to sell electronic cigarettes and to prohibit the use of these devices where smoking is
prohibited.
F&HS Agenda Packet Page 213
3
While we have made good progress in Contra Costa in reducing adult and youth tobacco use2, 3, 4, youth are
still exposed to tobacco industry influences in their communities. The Campaign for Tobacco Free Kids, in
their fact sheet on Key State Specific Tobacco-Related Data and Rankings, reports that 16,800 youth begin smoking
in CA every year5 and 3.9 million Californians still smoke6. In 2011, the tobacco industry spent $605 million7
advertising and promoting tobacco products in California, with 90% of its marketing budget spent in the
retail store environment.8 Exposure to tobacco marketing in stores increases tobacco experimentation and
use by youth9 and has been shown to be more powerful than peer pressure.10 Research also shows that the
number of stores selling tobacco in a community can lead to higher rates of youth smoking. In addition to
advertising and marketing influences, some Contra Costa cities have illegal tobacco sales rates to youth that
are as high as 26%.11
III. The Problem of Youth Tobacco Use and the Retail Environment
In summer, 2013, in order to get a picture of what tobacco industry influences look like in Contra Costa,
Public Health’s Tobacco Prevention Project participated in a county-wide tobacco survey. Over 300 stores
that sell tobacco throughout the county were part of the randomized sample for the Contra Costa Store
Survey, including convenience, supermarket, liquor, tobacco, small market, discount, drug and big box stores.
Stores that prohibited youth from entry or that require membership were excluded from the survey. Photos
of these products can be found in the accompanying powerpoint. The Contra Costa Store Survey12 findings
confirmed that tobacco is still being promoted to youth and that:
Over 80% of stores near schools in Contra Costa sell flavored (non-cigarette) tobacco
products like “watermelon” and “tropical blast” flavored cigarillos and little cigars. Many of these
products sell for under a dollar, making them very attractive and affordable for youth.
Over eight in 10 stores sell packs of 5 or less of cigarillos/little cigars, and close to 70% of
stores sell these products as "singles". These products are also available very cheaply, making
them affordable for youth. Eighty-five percent of tobacco retailers sell the most popular brand of
cigarillos for under $1.
2 Gilpin EA, Emery SL, Farkas AJ, Distefan JM, White MM, Pierce JP. The California Tobacco Control Program: A Decade of
Progress, Results from the California Tobacco Surveys, 1990-1998. La Jolla, CA: University of California, San Diego; 2001.
3 Max W, Rice DP, Zhang X, Sung H-Y, Miller L. The Cost of Smoking in California, 1999, Sacramento, CA: California
Department of Health Services, 2002.
4 Max W, Sung H-Y, Shi Y, & Stark B. The Cost of Smoking in California, 2009. San Francisco, CA: Institute for Health & Aging,
University of California, San Francisco, 2014.
5 Based on the 2011 Federal Trade Commission Report and California state estimate methodology used by Campaign For Tobacco
Free Kids: http://www.tobaccofreekids.org/facts_issues/toll_us/california.
6 Max W, Sung H-Y, Shi Y, & Stark B. The Cost of Smoking in California, 2009. San Francisco, CA: Institute for Health & Aging, University of
California, San Francisco, 2014.
7 Based on the 2011 Federal Trade Commission Report and California state estimate methodology used by Campaign For Tobacco Free Kids:
http://www.tobaccofreekids.org/facts_issues/toll_us/california
8 U.S. Federal Trade Commission (FTC), Cigarette Report for 2007 and 2008, 2011, http://www.ftc.gov/os/2011/07/110729cigarettereport.pdf.
FTC, Smokeless Tobacco Report for 2007 and 2008, 2011, http://www.ftc.gov/os/2011/07/110729smokelesstobaccoreport.pdf. Data for top
6 manufacturers only.
9 DiFranza, J.R., Wellman, R.J., Sargent, J.D., Weitzman, M., Hipple, B.J., Winickoff, J.P., Tobacco promotion and the initiation of tobacco use:
assessing the evidence for causality. Pediatrics, 2006. 117(6): p. e1237-1248.
http://pediatrics.aappublications.org/content/117/6/e1237.abstract%20(25 and National Cancer Institute, The Role of the Media in
Promoting and Reducing Tobacco Use: TobaccoControl Monograph No. 19, 2008, U.S. Department of Health and Human Services, National
Institutes of Health: Bethesda, MD. http://cancercontrol.cancer.gov/brp/tcrb/monographs/19/index.html
10 Campaign for Tobacco-Free Kids. Toll of Tobacco in the United States of America. 2011.
http://www.tobaccofreekids.org/research/factsheets/pdf/0072.pdf.
11 California Department of Public Health, Food and Drug Branch, youth decoy operation results 2009.
12 2013 Healthy Stores for a Healthy Community (HSHC) Survey, California Department of Public Health.
F&HS Agenda Packet Page 214
4
Close to half of all stores that sell tobacco in Contra Costa sell e-cigarettes. The number of
stores that are selling e-cigarettes statewide has quadrupled, from just over 10% in 2011 to over 45%
in 2013. Electronic cigarette use among middle and high school youth tripled between 2013 and
201413. Many of these products are attractive to youth because they are relatively cheap and come in
flavors like cherry-limeade and mint.
Seven in 10 stores in Contra Costa have exterior advertising for unhealthy products like
tobacco, alcohol and sugary drinks. This compares with 1 in 10 stores with exterior advertising for
healthy items including fruits, vegetables and non-fat/low-fat milk.
Information on the location and density of stores selling tobacco across the county was also collected and
mapped. This data revealed that:
34% of stores selling tobacco throughout the County are located within 1000 feet of a school.
One-third of youth who buy tobacco purchase these products within 1000 feet of school.14 Every
school day, youth are exposed to tobacco influences such as advertising and product promotions on
their way to and from school. Many of the Contra Costa communities with high numbers of stores
selling tobacco near schools are low-income. Low-income communities have high rates of
smoking and tobacco-related diseases like heart disease, cancers and stroke.
The 2013 Contra Costa Store Survey provides concrete, scientific evidence on how the tobacco industry
continues to target youth and lower-income communities through the retail environment.
IV. Policy Considerations to Reduce Youth Tobacco Influences
The CA Department of Public Health Tobacco Control Program and the statewide Healthy Stores for a
Healthy Community Campaign recommend several effective policies to consider in reducing youth tobacco
influences in the community:
a) Include Electronic Smoking Devices and other emerging products in the definition of
“Tobacco Products”. In 2013, Contra Costa was among the first in the state to revise its existing
definition of tobacco products to include electronic cigarettes, requiring retailers who sell these
products to have a license in order to sell them, and prohibiting use where smoking of conventional
tobacco products is prohibited. Since then, new products have emerged such as “vape pens”,
electronic hookah, and refillable “mods” and “tanks” that fall outside of the current definition and
continue to be unregulated and may or may not contain nicotine. These products are attractive to
youth, mimic smoking, undermine community norms related to smoking, and serve as “starter
products” to a lifetime of addiction15. As such, The Family and Human Services Committee directed
staff to revise the definition of “Tobacco Products” at its April 15, 2015 Committee Meeting.
b) Prohibit the sale of flavored (non-cigarette) tobacco products, such as candy, fruit and spice
characterizing flavors in little cigars, hookah tobacco and dissolvable tobacco products, as
well as in electronic smoking devices and vapor solutions for these devices. Under the federal
Family Smoking Prevention and Tobacco Control Act, it is illegal for manufacturers to make cigarettes
that contain “characterizing flavors” other than that of tobacco. This includes flavors such as
13 Arrazola R, Singh T, Corey C, et al, Tobacco Use Among Middle and High School Students – United States, 2011-2014. MMWR. 4/17/2015;
Vol. 64 (#14): pp 381-385.
14 Lipton R, Banerjee A, Levy D, Manzanilla N, Cochrane M., The spatial distribution of underage tobacco sales in Los Angeles.
Subst Use Misuse. 2008;43(11):1594-614.
15 Ji-Yeun P., Dong-Chul S., and Hsien-Chang L.. E-Cigarette Use and Intention to Initiate or Quit Smoking Among US Youths. American
Journal of Public Health: April 2016, Vol. 106, No. 4, pp. 672-678. doi: 10.2105/AJPH.2015.302994
F&HS Agenda Packet Page 215
5
strawberry, grape, orange, clove, cinnamon, pineapple, and vanilla, coconut, licorice, cocoa or
chocolate. The Act was adopted in 2009 largely because these flavored products were attractive and
marketed to youth and young adults,16,17,18,19 and younger smokers were more likely to have tried these
products than older smokers.20 (Menthol flavoring in cigarettes was exempted and is discussed in
more detail below.)
Though there is a federal ban on flavored cigarettes (excluding menthol) flavored non-cigarette
tobacco products are not prohibited under federal law. They have become increasingly common and
are available in a variety of flavors that appeal to children and young adults.21 The U.S. Food and
Drug Administration and the U.S. Surgeon General have stated that flavored tobacco products are
considered to be “starter” products for youth and help establish smoking habits that can lead to long-
term addiction.22 Adding flavorings to tobacco products such as little cigars, cigarillos, and smokeless
tobacco can mask the natural harshness and taste of tobacco, making these products easier to use and
increasing their appeal among youth.23
The U.S. Centers for Disease Control and Prevention has reported that electronic cigarette use among
middle and high school students tripled between 2013 and 2014.24 Nicotine solutions, which are
consumed via electronic smoking devices such as electronic cigarettes, are sold in dozens of flavors
that appeal to youth, such as cotton candy and bubble gum.25 The California Attorney General has
stated that electronic cigarette companies have targeted minors with fruit-flavored products.26
16 Carpenter CM, Wayne GF, Pauly JL, et al. 2005. “New Cigarette Brands with Flavors that Appeal to Youth: Tobacco Marketing
Strategies.” Health Affairs. 24(6): 1601–1610;
17 Lewis M and Wackowski O. 2006. “Dealing with an Innovative Industry: A Look at Flavored Cigarettes Promoted by
Mainstream Brands.” American Journal of Public Health. 96(2): 244–251.
18 Connolly GN. 2004. “Sweet and Spicy Flavours: New Brands for Minorities and Youth.” Tobacco Control. 13(3): 211–212.
19 U.S. Department of Health and Human Services. 2012. Preventing Tobacco Use Among Youth and Young Adults: A Report of the Surgeon
General. Atlanta: U.S. National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, p.
537, www.surgeongeneral.gov/library/reports/preventing-youth-tobacco-use/full-report.pdf.
20 U.S. Department of Health and Human Services. 2012. Preventing Tobacco Use Among Youth and Young Adults: A Report of the Surgeon
General. Atlanta: U.S. National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, p.
539, www.surgeongeneral.gov/library/reports/preventing-youth-tobacco-use/full-report.pdf.
21 U.S. Department of Health and Human Services. 2012. Preventing Tobacco Use Among Youth and Young Adults: A Report of the Surgeon
General. Atlanta: U.S. National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, p.
164, 205, www.surgeongeneral.gov/library/reports/preventing-youth-tobacco-use/full-report.pdf; Morris DS and Fiala SC. 2013. “Flavoured,
Non-cigarette Tobacco for Sale in the USA: An Inventory Analysis of Internet Retailer s.” Tobacco Control. [Electronic publication
ahead of print], http://tobaccocontrol.bmj.com/content/early/2013/08/08/tobaccocontrol-2013-051059.full.
22 Food and Drug Administration. 2011. Fact Sheet: Flavored Tobacco Products,
www.fda.gov/downloads/TobaccoProducts/ProtectingKidsfromTobacco/FlavoredTobacco/UCM183214.pdf; U.S. Department of Health and
Human Services. 2012. Preventing Tobacco Use Among Youth and Young Adults: A Report of the Surgeon General . Atlanta: U.S. National
Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, p. 539,
www.surgeongeneral.gov/library/reports/preventing-youth-tobacco-use/full-report.pdf.
23 King BA, Dube SR, and Tynan MA. 2013. “Flavored Cigar Smoking Among U.S. Adults: Findings from the 2009–2010 National
Adult Tobacco Survey.” Nicotine & Tobacco Research. 15(2): 608–614; Nelson DE, Mowery P, Tomar S, et al. 2006. “Trends in
Smokeless Tobacco Use Among Adults and Adolescents in the United States.” American Journal of Public Health. 96(5): 897–905.
24 Arrazola R, Singh T, Corey C, et al, Tobacco Use Among Middle and High School Students – United States, 2011-2014.
MMWR. 4/17/2015; Vol. 64 (#14): pp 381-385.
25 Cameron JM, Howell DN, White JR, et al. 2013. “Variable and Potentially Fatal Amounts of Nicotine in E-cigarette Nicotine
Solutions.” Tobacco Control. [Electronic publication ahead of print],
http://tobaccocontrol.bmj.com/content/early/2013/02/12/tobaccocontrol-2012-050604.full; U.S. Department of Health and Human
Services. 2012. Preventing Tobacco Use Among Youth and Young Adults: A Report of the Surgeon General. Atlanta: U.S. National Center for
Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, p. 549,
www.surgeongeneral.gov/library/reports/preventing-youth-tobacco-use/full-report.pdf.
26 Press Release, State of California Department of Justice, Office of the Attorney General, Brown Announces Electronic Cigarett e
F&HS Agenda Packet Page 216
6
Jurisdictions have the authority to prohibit the sale of these products in the entire jurisdiction, and in
the interest of public health and to protect youth from these products, the Department recommends
that any flavored tobacco product regulations apply to the entire unincorporated area. In the Bay
Area, El Cerrito and Santa Clara County have adopted laws to restrict the sale of flavored (non-
cigarette) tobacco products throughout the entire jurisdiction, and Yolo County is currently
considering such regulations. Federal district courts outside of California have upheld similar bans,
and the cities of New York, Providence, Rhode Island and Manhattan Beach, CA also prohibit the
sale of these products throughout the entire city.
c) Prohibit the sale of menthol flavored cigarettes within 500 feet of schools. In a Resolution
signed on October 26, 2010, the Contra Costa Board of Supervisors urged the Food and Drug
Administration to ban menthol in cigarettes and in other tobacco products, stating the Board’s
“commitment to the health and well-being of its residents and particular concern about preventing
tobacco use among youth and in reducing health disparities.” Due to intense lobbying from the
tobacco industry, menthol flavored cigarettes were excluded from the federal ban on flavored
cigarettes, even though a 2006 study published in the Journal of Nicotine and Tobacco Research
showed that 50% of youth start smoking with menthol flavored cigarettes, and that these are “starter”
cigarettes for many youth to go on to become regular smokers. Youth who smoke menthol cigarettes
are significantly more likely to show signs of nicotine addiction than their peers who smoke non-
menthol brands.27 The tobacco industry has also targeted African Americans with mentholated
tobacco products and as a result nearly 83% of African American smokers smoke menthol, compared
with 24% of White smokers28,29,30. The City of Chicago and the City of Berkeley are the two
jurisdictions in the country that have adopted ordinances that prohibit the sale of menthol flavored
cigarettes within a certain distance of schools (Chicago within 500 feet and Berkeley within 600 feet.)
A federal district court has upheld Chicago’s ordinance. Berkeley’s ordinance has not been
challenged. Should the Board wish to prohibit the sale of menthol flavored cigarettes in the
unincorporated County, it would be the first County to do so in the nation.
County counsel reports that the county’s police power appears to authorize the County to prohibit the
sale of menthol cigarettes in the entire unincorporated County, or to regulate the sale of these
products within a certain distance of schools, following similar actions taken by Chicago and Berkeley.
Currently, there are a total of 93 licensed tobacco retailers in the unincorporated county, and nineteen
of these stores lay within 500 feet of a school. The table on Stores Selling Tobacco in Contra
Costa, 2015 (Attachment III) provides information on the number of stores selling tobacco products
that are within 500 feet of schools for each of the unincorporated communities.
d) Require a 10/pack minimum pack size for sale of cigars, including cigarillos and little cigars.
Small packages of tobacco products make these products more affordable and therefore more
Maker's Agreement to Stop Deceptive Marketing and Sales to Minors (Aug. 3, 2010), oag.ca.gov/news/press-releases/brown-announces-
electronic-cigarette-makers-agreement-stop-deceptive-marketing.
27 Hersey JC, Ng SW, Nonnemaker JM, et al. Are menthol cigarettes a starter product for youth? Nicotine & Tobacco Research.
2006;8:403-413.
28 Moolchan E. Adolescent menthol smokers: Will they be a harder target for cessation? Nicotine Tob Res (2004) 6(Suppl 1): S93-S95
doi:10.1080/14622203310001649522.
29 The National African American Tobacco Prevention Network. Blacks and Menthol Fact Sheet.
http://naatpn.org/resources/Blacks%20&%20Menthol.pdf. Accessed September 1, 2010.
30 Substance Abuse and Mental Health Services Administration, Office of Applied Studies. The NSDUH Report: Use of Menthol
Cigarettes. Rockville, MD. November 19, 2009.
F&HS Agenda Packet Page 217
7
accessible to youth. Youth are generally price-sensitive to the purchase of tobacco products.
Although federal and state law ban the sale of individual cigarettes, neither restrict the sale of
individual little cigars, cigarillos and cigars. These products are typically sold individually, making
them more affordable and appealing to youth.31 Health Services recommends exempting premium
cigars (those that retail for $5 or more each) from a minimum pack size ordinance. The cities of El
Cerrito, Hayward, Huntington Park and Sonoma currently require a minimum pack size of 5/pack,
however since cigarillos and little cigars currently sell for as low as “3 for 99 cents”, a 10/pack
minimum pack size may be a consideration if the Board decides to adopt this provision.
e) Prohibit any new tobacco retailers to be located within 1000 feet of schools, parks,
playgrounds, and libraries. Research has demonstrated that youth are more likely to experiment
with tobacco products when retailers are located near schools, and that the number of tobacco
retailers in a community affects youth smoking behaviors.32 The density of tobacco retailers,
particularly in neighborhoods surrounding schools, has been associated with increased youth smoking
rates.33 Restricting the location of all tobacco retailers near schools and other youth sensitive areas, as
well as within a certain distance to each other, creates tobacco-free zones and reduces tobacco
influences in the community. Twenty-five California cities and counties have adopted similar laws,
including El Cerrito, Santa Clara County and Union City.
Other youth sensitive areas, such as youth centers, could be added to this provision. Maps illustrating
a 1000 foot buffer around schools, parks, playgrounds and libraries were developed for one
community in each of the Supervisorial districts (Attachment IV).
District I: El Sobrante
District II: Saranap
District III: Byron and Discovery Bay*
District IV: Contra Costa Centre
District V: Bay Point
*As requested at the 7/21/15 meeting, the two retailers selling tobacco products at the intersection of Byron Highway and
Route 4 are approximately 3500 feet from Excelsior Middle School.
The maps also illustrate boundary areas within 500 feet of existing retailers, which is discussed below as
another policy option.
f) Reduce the density of tobacco retailers by prohibiting the location of new tobacco retailers
within 500 feet of existing tobacco retailers (density relative to other retailers). High density of
tobacco retailers has been associated with increased smoking rates, particularly among youth.34 A study
of California neighborhoods found that the density and proximity of tobacco retailers influence
smoking behaviors, including number of cigarettes smoked per day.35 Of additional concern,
widespread presence of tobacco in retail settings normalizes the use of tobacco products and triggers
31 California Department of Public Health. (2012). Tobacco in the Retail Environment,
www.cdph.ca.gov/programs/tobacco/Documents/Tobacco%20Retail%20Environment%20Fact%20Sheet_Easy%20Print.pdf
32 McCarthy, W.J., Mistry, R., Lu, Y., Patel, M., Zheng, H., Dietsch, B., Density of tobacco retailers near schools: effects on tobacco
use among students. American Journal of Public Health, 2009. 99(11): p. 2006 2013.
33 Henriksen L, Feighery EC, Schleicher NC, et al. 2008. “Is Adolescent Smoking Related to Density and Proximity of Tobacco
Outlets and Retail Cigarette Advertising Near Schools?” Preventive Medicine 47: 210-214.
34 Henriksen L, Feighery EC, Schleicher NC, et al. 2008. “Is Adolescent Smoking Related to Density and Proximity of Tobacco
Outlets and Retail Cigarette Advertising Near Schools?” Preventive Medicine 47: 210-214.
35 Chuang YC, Cubbin C, Ahn D, et al. 2005. “Effects of Neighbourhood Socioeconomic Status and Convenience Store
Concentration on Individual Level Smoking.” Journal of Epidemiology and Community Health 59: 568-573.
F&HS Agenda Packet Page 218
8
smoking urges among former smokers and those attempting to quit.36 California law limits alcohol
licenses based on density, and this policy applies that same rationale to tobacco retailers. Nine cities and
counties in CA have adopted similar laws.37
g) Prohibit the sale of tobacco products in Pharmacies. A recent gallop poll showed Pharmacists are
perceived by many as among the most trusted of health care professionals. Research indicates that by
selling tobacco products, pharmacies reinforce positive social perceptions and send a message that it is
not so dangerous to smoke38,39. Children and young people are particularly influenced by cues
suggesting that smoking is acceptable. The American Pharmacists Association, the California
Pharmacists Association, and the California Medical Association have called for state and local laws
prohibiting tobacco sales in drugstores and pharmacies because doing so supports the public health and
social welfare of the communities in which they practice. In the Bay Area, Richmond, San Francisco,
Berkeley, Marin County, Daly City and Santa Clara County prohibit the sale of tobacco products in all
pharmacies. A federal district court has upheld San Francisco’s ordinance prohibiting the sale of
tobacco products in pharmacies. Of the nine (9) licensed pharmacies in the unincorporated county,
there are currently six (6) that currently sell tobacco products.
Conditions of License Suspension if violation of the law occurs
h) Amend the County’s Tobacco Retailer Licensing Ordinance to require retailers to remove
tobacco advertising during the license suspension period. Over 60 jurisdictions, including
Richmond, Albany, Oakland, Pacifica, and Santa Clara County, require this provision during license
suspension period, when sales of tobacco products are prohibited, and it is now considered a best
practice provision to further support prevention of tobacco sales to minors. The adoption of the
Tobacco Retailer Licensing program has proved to be a very effective means of reducing illegal sales of
tobacco to minors. Sales in the unincorporated area of the County decreased from 37% to 7% within
the first year of enforcement.
i) Amend the County’s Tobacco Retailer Licensing Ordinance to expand the time period
reviewed for prior violations of the license from 24 months (2 years) to 60 months (5 years)
when considering the length of the license suspension. Nearly 70 other CA jurisdictions include
this provision, as it serves as a strong incentive for retailers to fully comply with tobacco control laws
over time.
Other Policy Considerations
j) Prohibit new “Significant Tobacco Retailers”, businesses that primarily sell tobacco products,
(defined by a certain percentage of gross revenue or floor space dedicated to tobacco products) including
hookah lounges, vape shops and tobacco shops, from obtaining a tobacco retailer license. Over 8
percent of all tobacco retailers statewide were witnessed unlawfully selling to minors in 2012, and
tobacco stores (defined as businesses in which at least 80 percent of merchandise was tobacco products)
36 McDaniel PA and Malone RE. 2011. “Why California Retailers Stop Selling Tobacco Produ cts, and What Their Customers and
Employees Think About It When They Do.” BMC Public Health 11: 848.
37 “Matrix of Local Ordinances Restricting Tobacco Retailers Near Schools, July 2013”, Center for Tobacco Policy and Organizing.
38 Katz MH. 2008. “Banning Tobacco Sales in Pharmacies: The Right Prescription.” Journal of the American Medical Association,
300(12):1451-1453.
39 Hudmon KS, Fenlon CM, and Corelli RL. 2006. “Tobacco Sales in Pharmacies: Time to Quit.” Tobacco Control, 15(1): 35 -38.
F&HS Agenda Packet Page 219
9
sold to minors at a much higher rate than the statewide average, as high as 20.5 percent.40 In the Bay
Area, El Cerrito and Richmond prohibit new significant tobacco retailers; Pittsburg has imposed a
moratorium on new “smoke shops” or “smoking lounges”; Antioch prohibits new significant tobacco
retailers from certain locations; and Concord prohibits new hookah shops.
k) Require compliance with local and state laws regarding storefront signage. This provision allows
for suspension of a retailer’s license if a retailer violates the state or local law setting a maximum
percentage of window space that can be covered by signs at retail establishments. Maximum allowable
signage laws have been enacted as a safety measure, as they may allow for law enforcement to view into
an establishment. This provision provides another mechanism for communities to bring retailers into
compliance with existing health and safety laws. Santa Clara County has a similar provision.
l) Making violations of state laws regarding drug paraphernalia or controlled substances a
violation of a tobacco retailer license. Many cigarette, tobacco, and other shops sell items that are
commonly known to be drug paraphernalia, including bongs and pipes used to smoke methamphetamine
and other illicit drugs, and claim that such items are intended for tobacco use. If adopted, drug
paraphernalia would be defined as it is in state law.
m) Require tobacco retailers to check ID of customers who appear younger than 27. Current law
requires tobacco retailers and their employees to check the age of purchasers up to the age of 18, the
legal age for tobacco product sales. Clerks and/or store owners who sell to minors sometimes appeal a
citation based on a claim that the customer “looked like” they were 18 or older. This claim would not be
allowable if this provision is adopted.
n) Cap the number of Tobacco Retailer Licenses issued at the current number of issued licenses.
In 2003 when the County’s Tobacco Retailer Licensing Ordinance was first instituted, there were 107
tobacco retailers in the unincorporated County. The number of retailers selling tobacco has gradually
decreased to 92 licensed tobacco retailers in 2015, with an average of 1-2 new retailers applying for
licenses annually. In the Bay Area, the city of Sonoma recently adopted a law that restricts new tobacco
retailers to the 15 existing licensed tobacco retailer locations. San Francisco has adopted an ordinance
which caps the total number of tobacco retailers at the current level for each of the supervisorial
districts.
V. Fiscal Impacts.
Minimum fiscal impacts to the County are expected. Should the Board direct development of a revised
ordinance there will be cost in staff time, including County Counsel and other county departments to develop
the ordinance itself. A portion of the Prop 99 funding Contra Costa Health Services receives for its Tobacco
Prevention Program could be allocated to coordinating and implementing directions provided by the Board
of Supervisors. Tobacco Retailer licensing fees, currently $287 per retailer, can also be used to conduct
outreach and education to tobacco retailers on the ordinance amendments and new requirements. These
activities can be conducted with current funded staff.
The July 21, 2015 report to the Board included the option to increase the Tobacco Retailer License Fee to
fully cover the cost of enforcement and monitoring of all tobacco control laws, including youth decoy
40 Chapman R. 2012. State Health Officer’s Report on Tobacco Use and Promotion in California. California Department of Public Health,
California Tobacco Control Program, p. 8,
www.cdph.ca.gov/Documents/EMBARGOED%20State%20Health%20Officers%20Report%20on%20Tobacco.pdf
F&HS Agenda Packet Page 220
10
operations. The current Tobacco Retailer License fee reflects costs related to administration of the license
and site compliance checks. It does not cover the cost of youth decoy operations through the Sheriff’s Office
for enforcement of the “no sales to minors” law, which are funded at approximately $18,000 annually with
County general funds. County Counsel reports that fees may be charged to recover reasonable regulatory
and administrative costs for issuing licenses and performing inspections. Fees may not be charged for general
governmental services, including law enforcement services. Given that multiple jurisdictions are funding
enforcement efforts through tobacco retailer licensing fees, the Department recommends that a Board Order
be presented at a later date adjusting the fee to better capture and recover updated and real costs.
Location and density policy options under consideration restrict new tobacco retail establishments only from
locating within a certain distance of schools and other youth sensitive areas and of each other. If location
restrictions are adopted, (prohibiting new tobacco retailers to be located within 1000 feet of schools, parks,
playgrounds, and libraries; prohibiting new tobacco retailers to be located within 500 feet of an existing
tobacco retailer; and/or prohibiting the sale of menthol cigarettes within a certain distance of schools) County
Counsel has recommended that these provisions be included in the County’s Zoning Code. As such, the
County’s Department of Conservation and Development will be included in the process of reviewing and
approving new tobacco retailers in the County. If any of the location restrictions are adopted, the applicant
would need to first get approval through the Department of Conservation and Development, which will also
apply an administration fee to the applicant.
Retailer Industry Concerns. Staff were directed to respond to concerns expressed in a letter dated July 16,
2015 to the Board from representatives of the tobacco retail industry, most specifically the American
Petroleum and Convenience Store Association (APCA), indicating their concerns over the financial impact of
placing restrictions on flavored tobacco products and prohibiting the sale of tobacco products within 1000 feet
of youth sensitive areas. Their correspondence cites that, on average, 30% of annual sales come from tobacco.
The density and location policy options discussed in this report apply to new retailers only, which appears to
address this concern from this retail association. However, there may be associated financial impacts on some
retailers, especially on small businesses that rely primarily on sale of flavored non-cigarette tobacco products
throughout the county, and possibly for those selling menthol cigarettes within 500 feet of schools This is
balanced against the significant medical cost and human toll that tobacco related disease continues to exact on
counties and their corresponding communities, which have resulted in over $334 million annually in excess
healthcare costs in our county alone41.
Some tobacco retailer associations also point to adults buying flavored products and small pack sizes. This
may be true in some cases, however it is also true that these products target youth in Contra Costa
communities. While the tobacco industry is prohibited from directly marketing and advertising to young
people by the 1998 Master Settlement Agreement, brightly packaged, flavored tobacco products are a way to
indirectly appeal and attract youth tobacco and e-cigarette users. Prohibiting flavored cigars and requiring
minimum pack size will reduce tobacco use by creating an environment that has fewer tobacco influences and
supports a tobacco-free community.
Resources are available to assist small businesses in revising their business plans in order to comply with any
new regulations, and County staff will continue to identify additional resources to support small businesses in
this transition. (Attachment V)
41 Max W, Sung H-Y, Shi Y, & Stark B. The Cost of Smoking in California, 2009. San Francisco, CA: Institute for Health & Aging, University of
California, San Francisco, 2014.
F&HS Agenda Packet Page 221
11
VI. Implementing new tobacco prevention provisions
If adopted, most of proposed new regulations for sales of tobacco products will be included in the current
Tobacco Retailer Licensing Ordinance, which is administered and enforced through the County’s Public
Health Division. An educational approach to compliance will be prioritized over the first year including a
mailing to all affected tobacco retailers following final Board adoption of any new regulations, notifying
retailers of the requirements under the new ordinance.
The department recommends that most of the provisions go into effect within 30 days of adoption of an
ordinance, with the exception of the provisions prohibiting the sale of flavored tobacco products, menthol
cigarettes and small packs of cigars. A longer implementation period of 180 days for these provisions will
allow retailers to sell off product that they currently stock, as well as develop any alternative business plans, if
necessary to comply with new health and public safety regulations.
Implementation, including outreach and education activities would be integrated into ongoing
Tobacco Retailer Licensing implementation activities conducted by Tobacco Prevention Program staff.
Specifically, implementation would include:
--developing an educational materials for direct mailing to all existing licensed tobacco retailers, including
information on resources available to address business planning to comply with the new regulations.
--working with the affected County departments to develop operational protocols and to assure that any
intersecting ordinances requirements are addressed in communications to the public.
--work with the Business License Office to review new license applications for approval and to provide
educational materials through the Business License Office application and renewal mechanisms to both
current and new retailers.
--updating and maintaining the Tobacco Prevention Program webpages with the new regulations and
educational materials, as well as both State and County information on Tobacco Retailer Licensing and
requirements.
--conducting site inspections, education and follow-up with owners if stores are not compliant with the new
regulations.
-- promoting and responding to calls received on the Tobacco Violations Reporting Line--collaborating with
the Sheriff’s Office to plan retailer compliance inspections. The Sheriff’s Office will continue to conduct
youth decoy operations through an MOU with Health Services
-- continuing to coordinate license suspension hearings for those retailers that have been found to be in
violation of the law.
Implementation of Tobacco Retailer Density and Location Restrictions. Public Health staff has met with
County Counsel and Department of Conservation and Development staff to discuss options for
implementation of the proposed tobacco retailer density and location restrictions. County Counsel reports that
State law authorizes the county to establish density and location restrictions in its Zoning Code. Therefore, the
Department of Conservation and Development will have a role in license approval through determining
distance to schools, other youth sensitive areas, and to other retailers, if these provisions are adopted. However,
Health Services staff has recommended that the density and location restrictions be reference in the amended
Tobacco Retailer License Ordinance. The Public Health Department will maintain coordination of all aspects
of the license approval process to assure that all tobacco related regulations are complied with prior to annual
licensing of tobacco retailers and over the annual licensing period.
Communication with the Cities. Members of the Board expressed interest in communications with the
cities on these policies. The Public Health Department will make every effort to make a presentation to the
F&HS Agenda Packet Page 222
12
Mayors Conference on any new ordinance provisions that are adopted, and staff will provide information and
technical assistance to those cities that are interested in protecting health and public safety through addressing
youth tobacco influences in the retail environment.
F&HS Agenda Packet Page 223
Policy Options for Addressing Youth Tobacco Influences in the Retail Environment
Contra Costa Health Services, Public Health Division
For Presentation to Contra Costa Board of Supervisors, May 24, 2016
Most Impactful Policies for Addressing Youth Tobacco Influences in the Retail Environment
Provision Description CA Jurisdictions with Similar Protection
a. Require a Tobacco Retailer License for all
retailers selling traditional and/or
emerging tobacco products.
Revises definition of “Tobacco Product” to include all “emerging products”
including all electronic smoking devices (whether or not they contain nicotine).
Current definition fails to capture a number of vaping products that have
emerged since the County tobacco retail ordinance was adopted. If adopted, the
new definition would cover all electronic devices which mimic smoking or can
be used to deliver a dose of nicotine or other substances, and all components,
parts or accessory of a “tobacco product”.
El Cerrito, Richmond, Albany, Oakland, San Jose and Santa
Clara County for a total of close to 100 jurisdictions in CA.
Family and Human Services Committee directed staff to develop
updated definition for current ordinance at 4/13/15 Committee
Meeting.
b. Prohibit the sale of flavored (non-
cigarette) tobacco products
Prohibits the sale of flavored (non-cigarette) tobacco products within the entire
unincorporated County. The Food and Drug Administration has banned candy,
fruit and spice as characterizing flavors for cigarettes only. Other tobacco
products (smokeless, little cigars, hookah tobacco, and dissolvable tobacco
products) with these flavors are exempt from the federal ban. If adopted, the
ban on flavored product would extend to these other non-cigarette tobacco
products.
El Cerrito, Berkeley, Santa Clara County, Hayward,
Manhattan Beach and Sonoma (Also New York City;
Providence Rhode Island, and Chicago.) Under consideration
in Yolo County.
c. Prohibit the sale of menthol flavored
cigarettes near schools (added to “most effective”
list since the 7/21/15 report based on recent court
decision)
Would prohibit the sale of menthol flavored cigarettes within a certain distance
of a school. The Food and Drug Administration has exempted “menthol”
flavor from its ban on “characterizing flavors” in cigarettes. Staff recommends
a distance no less than 500 feet. If adopted, this provision would affect 19
tobacco retailers across the unincorporated county.
Berkeley (within 600 feet of schools) Also Chicago (within
500 feet of schools)
d. Require minimum pack size for cigars Although federal and state law ban the sale of individual cigarettes, neither
restrict the sale of individual cigars, including cigarillos and little cigars. Options
include requiring minimum pack size (current regulation for cigarettes is 20) for
all cigars. Staff recommend a package size of 10. Could exempt premium cigars
that cost $5 or more.
El Cerrito, Hayward, Sonoma, Huntington Park, Gardena,
Union City.
e. Restrict location of new tobacco retailers
near schools and other “youth-sensitive”
areas such as parks, playgrounds and
libraries.
Prohibits a license to new tobacco retailers if located within a certain distance
(e.g., 500-1500 feet) of a school or other area frequented by youth (e.g.,
playground, church, recreation center, park, etc.). Staff recommend a distance of
1000 feet, which is consistent with multiple jurisdictions.
Near Schools and other Youth Sensitive Areas: El Cerrito,
Antioch, Berkeley, Dublin, Union City, Vallejo, Albany,
Oakland, Marin County, and San Rafael (plus 14 other
jurisdictions). Near schools only: San Francisco, Santa
Barbara County, Sacramento, Santa Clara County, Manhattan
Beach, plus 5 other jurisdictions.
F&HS Agenda Packet Page 224
f. Prohibit new tobacco retailers from
locating within certain proximity of other
retailers
This density measure would restrict new tobacco retailers from locating within a
certain distance (e.g., 500-1500 feet) of another new or existing tobacco retailer.
Staff recommends 500 feet, which is consistent with multiple jurisdictions.
El Cerrito, San Francisco, Santa Cruz, Hayward, Dublin,
Santa Clara County, Union City, Vallejo, Fairfield, Saratoga,
Rohnert Park, Temple City, Westminster, Selma, El Cahon
g. Prohibit sale of tobacco
products in pharmacies
Prohibiting the sale of tobacco products in pharmacies is consistent with the
public’s perception of pharmacies as a place to go for health-related service and
advice. Of the 9 pharmacies in the unincorporated county, three have already
made corporate decisions to not sell tobacco products (2 CVS stores and Park
Rexall).
Richmond, San Francisco, Santa Clara County, Berkeley,
Healdsburg, Daly City, Hollister, Marin County
Conditions of License Suspension if violation of law occurs:
h. Remove tobacco advertising during
license suspension
Requires retailers to remove or cover all tobacco-related advertising, in addition
to tobacco products, during the period that their tobacco retailer license is
suspended. Would also apply to Electronic Smoking Devices and paraphernalia
if definition of “tobacco products” is revised.
Richmond, Concord, Albany, Oakland, Pacifica, Santa Clara
plus 56 other jurisdictions
i. Expand time period reviewed for prior
violations of license
Would expand time period reviewed for prior violations of license from 24
months (2 years) to 60 months (5 years) when considering length of license
suspension.
El Cerrito, Richmond, Albany, Oakland plus 64 other
jurisdictions
Other Policy Considerations:
j. Prohibit new “Significant
Tobacco Retailers”
Prohibits a new “Significant Tobacco Retailer”—a business that primarily sells
tobacco products—from obtaining a tobacco retailer license. Definition of
“Significant Tobacco Retailer” is based on either amount of floor space or
percentage of sales devoted to tobacco products. Would also apply to retailers
selling Electronic Smoking Devices and paraphernalia if definition of “tobacco
products” is revised, as recommended above. This provision would effectively
prohibit any new ‘vape’ shops, hookah bars, or tobacco shops.
El Cerrito; Huntington Park; Richmond; Carpinteria;
Concord (no new hookah shops); Dublin (no vapor lounges
or hookah bars); Hayward (no vapor lounges); Union City
(no vapor lounges or hookah bars); and Pittsburg
(moratorium on any new “smoke shops”)
k. Require tobacco retailers to comply with
storefront signage laws
Allows for suspension of retailer’s license if a retailer violates the state law or
local law setting a maximum percentage of window space that can be covered
by signs at retail locations. These laws exist for safety purposes, as they
provide for more visibility into stores for law enforcement. This would
provide a means to bring retailers into compliance with health and safety laws.
Santa Clara County
l. Require tobacco retailers to comply
with drug paraphernalia sales laws
Makes violations of state laws regarding drug paraphernalia or controlled
substances a violation of a tobacco retailer license. Definition of what
constitutes drug paraphernalia would be as defined in state law.
Oakland, Richmond, Union City plus 8 other cities and
counties (Firebaugh, Grass Valley, Huntington Park,
Montebello, Parlier, Riverbank, Santa Cruz County, and
Watsonville) (as of June, 2012)
F&HS Agenda Packet Page 225
m. Require tobacco retailers to check ID of
customers who appear younger than 27
Requires retailers to check the age of purchasers who appear to be
under the age of 27. This measure helps insure that tobacco is not
sold to youth and will become even more relevant should the State
advance the legal age to purchase tobacco from 18 to 21 years of
age.
Concord, Richmond, Albany, Oakland, Santa Clara (age 30)
plus 35 other jurisdictions
n. Limit or “cap” the number of retailers
that can sell tobacco products.
This density measure, limits the total number of tobacco retailer licenses that are
issued. At present time there are 92 tobacco retailers in the Unincorporated area
of the county. The Cap recommended by staff is 92.
Sonoma, Orville, Lynwood, Huntington Park, San Francisco
o. Increase the Tobacco Retailer License
Fee to fully cover the cost of education,
enforcement and monitoring of any
new provisions adopted by the County.
The current Tobacco Retailer License was set at $287 in 2010. It reflected the
cost at that time related to the administration of the license and some site
compliance checks. Staff recommend that a separate board order be presented
at a later date adjust the license fee to better capture and recover updated and
real cost. Fees may be charged to recover reasonable regulatory and
administrative costs for issuing licenses and performing inspections. Fees may
not be charged for general governmental services, including law enforcement
services.
98 of 110 jurisdictions in CA have Tobacco Retailer
Licensing enforcement programs, including youth decoy
operations, that are fully funded through tobacco retailer
licensing fees (as of September, 2013).
F&HS Agenda Packet Page 226
F&HS Agenda Packet Page 227
F&HS Agenda Packet Page 228
F&HS Agenda Packet Page 229
F&HS Agenda Packet Page 230
F&HS Agenda Packet Page 231
F&HS Agenda Packet Page 232
ATTACHMENT V
Prepared by Tobacco Prevention Project on 4.20.16
Resources for Small Business Owners in CC County
The following resources are currently available to small business owners in Contra Costa County:
Contra Costa County Small Business Development Center
The Small Business Development Center (SBDC) offers free workshops and advising on a variety of
business topics, including:
Adapting a business practice in response to new laws
Support in navigating licensing and permit issues
Accessing loans
Sales and marketing
Strategic planning
Identifying resources
SBDC also provides personalized, one-on-one advising and access to experts in many fields that can
help business adapt to changes in the business environment, such as laws restricting sales of certain
tobacco products. Services are provided free of charge to all small business owners in Contra Costa
County. Contra Costa SBDC is grant funded and assesses each business for eligibility before one-on-one
services are offered.
Tobacco retailers interested in the individualized advising services would be assessed for
the potential to achieve economic impact (such as job retention) in the next 6-12 months, then a Scope
of Work would be developed for individualized services. The expectation is that for every hour the
Center invests in a project, the retailer will work approximately 5 hours. For example, the retailer
should plan to spend 25 hours working on their goals (such as a business plan to diversify products
sold) in exchange for five hours of individual consulting. The Contra Costa County SBDC advising
services are available to small businesses, such as businesses with less 500 employees and less than
$15M annual revenue.
More information about applying for advising services with Contra Costa SBDC is available on their
website: http://contracostasbdc.org/node/20289
“Professional guidance as you grow your business is critical to success. Our team of advisors is at your
service to assist with the opportunities and issues related with growing your business. This service is
free to all owners of existing businesses and entrepreneurs who are actively launching a business.” –
SBDC
Contact:
Oscar Dominguez, Contra Costa SBDC Director
Workforce Development Board of Contra Costa
300 Ellinwood Way, Suite 300 Pleasant Hill, California 94523
925-602-6810
odominguez@ehsd.cccounty.us
F&HS Agenda Packet Page 233
ATTACHMENT V
Prepared by Tobacco Prevention Project on 4.20.16
Small Business Administration (SBA)
https://www.sba.gov/
The SBA offers general and technical assistance to new and established businesses. Services include
loan programs, business counseling, management training, conferences, referrals and reference
libraries.
Small Business Information Center:
(800) 827-5722 national answer desk
Email: answerdesk@sba.gov
Service Corps of Retired Executives (SCORE)
Retired business professionals volunteer to provide free counseling to individuals starting small
businesses. Counseling and workshops are available at a cost.
(510) 273-6611
http://eastbayscore.org/
Renaissance Entrepreneurship Center
The Renaissance Entrepreneurship Center is a non-profit that works to increase the entrepreneurial
capacities of individuals, and thereby strengthen communities through the creation of sustainable new
businesses, new jobs, and the promotion of financial self-sufficiency.
They offer classes, workshop and one on one consulting in Richmond. Their beginner class, “Start
Smart” is a 4-week program (12 hours) and costs $120 with financially-based scholarships available.
Their intermediate class, “Business Prep” is a nine-week program (27 hours) and costs $240 with
financially-based scholarships available. They also offer workshops for advanced entrepreneurs (people
who have launched their business) ranging from Quickbooks to e-commerce to social media marketing.
Contact:
Bret Alexander Sweet, Program Manager
Renaissance Entrepreneurship Center - Richmond
1500 Macdonald Avenue, Richmond, CA 94801
510-221-2002
bsweet@rencenter.org
www.rencenter.org
F&HS Agenda Packet Page 234
Policy Options for Addressing Youth Tobacco Influences in the Retail Environment
Contra Costa Health Services, Public Health Division
For Presentation to Contra Costa Board of Supervisors May 24, 2016
F&HS Agenda Packet Page 235
Vape penMechanical modsBox modE-cigarE-HookahsCigalikesE-cigarettes Mods/tanksVape pens
Includes cigalikes, e-
hookah, e-cigars and
cartridges
E-liquids
Cartridges
a. Require a Tobacco Retailer License for all retailers selling
traditional and/or emerging tobacco products.
F&HS Agenda Packet Page 236
b. Prohibit the sale of flavored
(non-cigarette) tobacco products
Candy or liquid nicotine?
F&HS Agenda Packet Page 237
c. Prohibit the sale of menthol flavored
cigarettes near schools
F&HS Agenda Packet Page 238
d. Require minimum pack size for cigars
F&HS Agenda Packet Page 239
e. Restrict location of tobacco retailers near
schools and other youth sensitive areas
f. Prohibit new tobacco retailers from
locating within certain proximity of other
retailers
F&HS Agenda Packet Page 240
Insert map here
F&HS Agenda Packet Page 241
F&HS Agenda Packet Page 242
F&HS Agenda Packet Page 243
F&HS Agenda Packet Page 244
F&HS Agenda Packet Page 245
F&HS Agenda Packet Page 246
F&HS Agenda Packet Page 247
F&HS Agenda Packet Page 248
F&HS Agenda Packet Page 249
F&HS Agenda Packet Page 250
F&HS Agenda Packet Page 251
F&HS Agenda Packet Page 252
F&HS Agenda Packet Page 253
F&HS Agenda Packet Page 254
F&HS Agenda Packet Page 255
F&HS Agenda Packet Page 256
F&HS Agenda Packet Page 257
F&HS Agenda Packet Page 258
F&HS Agenda Packet Page 259
F&HS Agenda Packet Page 260
F&HS Agenda Packet Page 261
F&HS Agenda Packet Page 262
F&HS Agenda Packet Page 263
F&HS Agenda Packet Page 264
F&HS Agenda Packet Page 265
F&HS Agenda Packet Page 266
F&HS Agenda Packet Page 267
F&HS Agenda Packet Page 268
F&HS Agenda Packet Page 269
F&HS Agenda Packet Page 270
F&HS Agenda Packet Page 271
F&HS Agenda Packet Page 272
F&HS Agenda Packet Page 273
SUMMARY OF NEW PROVISONS UNDER THE CHANGES TO THE COUNTY’S
SECONDHAND SMOKE AND TOBACCO PRODUCT CONTROL ORDINANCE and
ZONING CODE AMENDMENTS
Contra Costa Health Services, Public Health Division
For Presentation to Family and Human Services Committee of the
Contra Costa Board of Supervisors, April 24, 2017
Tobacco Product and Retail Sales Control Ordinance (Amendments to Division 445, Secondhand Smoke and Tobacco Product Control)
Provision Description CA Jurisdictions with Similar Protection
a. Require a Tobacco Retailer License for all
retailers selling traditional and/or
emerging tobacco products.
Revises definition of “Tobacco Product” to include all “emerging products”
including all electronic smoking devices (whether or not they contain nicotine).
The new definition covers all electronic devices that can be used to deliver a
dose of nicotine or other substances, and all components, parts or accessory of
a “tobacco product”.
El Cerrito, Richmond, Albany, Oakland, San Jose and Santa
Clara County for a total of close to 100 jurisdictions in CA.
b. Prohibit the sale of flavored (non-
cigarette) tobacco products
Prohibits the sale of flavored (non-cigarette) tobacco products within the entire
unincorporated County. The Food and Drug Administration has banned candy,
fruit and spice as characterizing flavors for cigarettes only. Other tobacco
products (smokeless, little cigars, hookah tobacco, and dissolvable tobacco
products) with these flavors are exempt from the federal ban.
El Cerrito, Berkeley (within 600 feet of schools), Santa Clara
County (except adult-only shops), Hayward, Manhattan
Beach, Sonoma, and Yolo County (Also New York City;
Providence Rhode Island, and Chicago.) Under
consideration in Oakland (citywide).
c. Prohibit the sale of menthol flavored
cigarettes
Would prohibit the sale of menthol flavored cigarettes within the entire
unincorporated jurisdiction. The Food and Drug Administration has exempted
“menthol” flavor from its ban on “characterizing flavors” in cigarettes.
Yolo County (county-wide). Santa Clara County
(County-wide, except adult-only shops). Berkeley (within
600 feet of schools) and Chicago (within 500 feet of high
schools). Under consideration in Oakland (citywide).
d. Require minimum pack size for cigars Require minimum pack size of 10 (current regulation for cigarettes is 20).
Although federal and state law ban the sale of individual cigarettes, neither
restrict the sale of individual cigars, including cigarillos and little cigars that are
the same size as cigarettes. Exempts premium cigars that cost $5 or more.
El Cerrito, Hayward, Sonoma, Huntington Park, Gardena,
Union City. Under consideration in Oakland.
e. Prohibit sale of tobacco products in
pharmacies
Prohibits the sale of tobacco products in pharmacies, consistent with the
public’s perception of pharmacies as a place to go for health-related service and
advice. Of the 9 pharmacies in the unincorporated county, three have already
made corporate decisions to not sell tobacco products (2 CVS stores and Park
Rexall).
Richmond, San Francisco, Santa Clara County, Sonoma
County, Berkeley, Healdsburg, Daly City, Hollister, Marin
County, Novato. Under consideration in Oakland.
f. Require tobacco retailers to comply with
storefront signage laws
Allows for suspension of retailer’s license if a retailer violates the state law or
local law setting a maximum percentage of window space that can be covered
by signs at retail locations. These laws exist for safety purposes, as they
provide for more visibility into stores for law enforcement. This provides a
means to bring retailers into compliance with health and safety laws.
Santa Clara County and Yolo County.
F&HS Agenda Packet Page 274
g. Require tobacco retailers to comply with
drug paraphernalia sales laws
Makes violations of state laws regarding drug paraphernalia or controlled
substances a violation of a tobacco retailer license. Definition of what
constitutes drug paraphernalia will be consistent with state law.
Oakland, Richmond, Union City plus 8 other cities and
counties (Firebaugh, Grass Valley, Huntington Park,
Montebello, Parlier, Riverbank, Santa Cruz County, and
Watsonville) (as of June, 2012)
h. Require tobacco retailers to check ID of
customers who appear younger than 27
Requires retailers to check the age of purchasers who appear to be under the age
of 27. This measure helps insure that tobacco is not sold to youth and is even
more relevant since the State advanced the legal age to purchase tobacco from
18 to 21 years of age.
Concord, Richmond, Albany, Oakland, Santa Clara (age 30)
plus 35 other jurisdictions
i. Limit or “cap” the number of retailers
that can sell tobacco products.
This density measure limits the total number of County Tobacco Retailer
Licenses that are issued to the current number of licenses.
Sonoma, Orville, Lynwood, Huntington Park, San Francisco
j. Remove tobacco advertising during
license suspension
Requires retailers to remove or cover all tobacco product-related advertising, in
addition to tobacco products, during the period that their tobacco retailer
license is suspended.
Berkeley (remove products), Richmond, Concord, Albany,
Oakland, Pacifica, Santa Clara plus 56 other jurisdictions
k. Expand time period reviewed for prior
violations of license
Expands time period reviewed for prior violations of license from 24 months (2
years) to 60 months (5 years) when considering length of license suspension.
Berkeley, El Cerrito, Richmond, Albany, Oakland plus 64
other jurisdictions
Tobacco Retailing Businesses (Amendments to Zoning Code Chapter 88-26)
l. Prohibit location of a new
tobacco retailer near
schools, parks, playgrounds
and libraries.
Prohibits a license to new tobacco retailers if located within a 1000 feet of a
school, park, playground, or library. Existing tobacco retailing businesses that do
not meet the location standards will become nonconforming uses. A
nonconforming use will be allowed to continue operating under the
ordinance. However, if a change in ownership in the business occurs more than
10 years after the effective date of the ordinance, or more than 10 years after the
date the use becomes nonconforming, then the use (tobacco retailing) must be
discontinued.
Near Schools and other Youth Sensitive Areas: El Cerrito,
Antioch, Dublin, Hayward, Union City, Vallejo, Albany,
Oakland, Marin County, and San Rafael (plus 14 other
jurisdictions). Near schools only: Berkeley, San Francisco,
Santa Barbara County, Sacramento, Santa Clara County,
Manhattan Beach, plus 5 other jurisdictions.
m. Prohibit new tobacco
retailers from locating within
certain proximity of other
retailers
Requires that no new tobacco retailers locate within a certain distance 500 feet of
another tobacco retailer. Existing tobacco retailing businesses that do not meet
the location standards will become nonconforming uses. A nonconforming use
will be allowed to continue operating under the ordinance. However, if a change
in ownership in the business occurs more than 10 years after the effective date of
the ordinance then the use (tobacco retailing) must be discontinued.
El Cerrito, San Francisco, Santa Cruz, Hayward, Dublin,
Santa Clara County, Union City, Vallejo, Fairfield, Saratoga,
Rohnert Park, Temple City, Westminster, Selma, El Cajon
n. Prohibit new “Significant
Tobacco Retailers”
Prohibits a new “Significant Tobacco Retailer” – a business that primarily sells
tobacco products – from obtaining a tobacco retailer license. “Significant Tobacco
Retailer” means any tobacco retailing business for which 20 percent or more of
floor or display area is devoted to tobacco products, tobacco paraphernalia, or
both. Prohibits any new ‘vape’ shops, hookah bars, or tobacco shops.
El Cerrito; Huntington Park; Richmond; Carpinteria;
Concord (no new hookah shops); Dublin (no vapor lounges
or hookah bars); Hayward (no vapor lounges); Union City
(no vapor lounges or hookah bars); and Pittsburg
(moratorium on any new “smoke shops”)
BOLDED jurisdictions adopted these provisions since the last report to the Board of Supervisors on 5/24/16. F&HS Agenda Packet Page 275
F&HS Agenda Packet Page 276
1
California Tobacco Control ProgramMenthol and Cigarettes
What is Menthol and How is it Used?
• Menthol is a naturally occurring compound derived
from mint plants and is also synthetically produced.
[1] Because of its cool, minty candy-like fl avor and
fresh odor, it is used as an additive in many products
including tobacco, lip balm, cough medication,
mouthwash, toothpaste, chewing gum, and candy, as
well as in beauty products and perfumes. [2]
• Menthol’s anesthetizing effect makes the smoke
“smooth” and easier to inhale while masking the
harshness of tobacco, making menthol cigarettes more
appealing to young and beginner smokers. [1]
• Menthol allows smokers to inhale more deeply and
for harmful particles to settle deeper inside the lungs.
[2] By reducing airway pain and irritation, continuous
menthol smoking can mask the early warning
symptoms of smoking-induced respiratory problems. [3]
• Menthol decreases the metabolism of nicotine and
increases the amount of the addictive substance in the
blood, making cigarettes even more dangerous and
diffi cult to quit. [4]
• Many menthol-only smokers underestimate the dangers
of menthol in cigarettes and believe that menthol
cigarettes are less harmful than regular cigarettes as
compared to non-menthol-only smokers. [5]
• Menthol cigarettes are not safer than regular
cigarettes. Menthol cigarettes only mask the harshness
of tobacco smoke, making it easier for new smokers to
start and more challenging to quit. [6]
• Menthol smokers show greater signs of nicotine
dependence and have higher rates of quit attempts, [7]
but are less likely to successfully quit smoking than other
smokers. [8]
• Menthol cigarettes are not safer than regular
cigarettes. Menthol cigarettes have been shown to
increase youth initiation, inhibit cessation, and promote
relapse. [9] Scientifi c studies have shown that because
of its sensory effects and fl avor, menthol may enhance
the addictiveness of cigarettes. [10]
• Menthol cigarettes account for approximately 25
percent of all cigarette sales in the U.S. [11] Moreover,
more than 90 percent of all tobacco cigarettes
contain menthol, regardless of being marketed as a
mentholated cigarette. [12]
90 %
of all tobacco cigarettes contain some
menthol, regardless of being marketed
as a mentholated cigarette [12]
Menthol smokers
show greater signs of nicotine dependence
have
higher
rates
of quit
attempts
but are less
likely to
successfully
quit
smoking
than other
smokers
[ 7, 8 ]
F&HS Agenda Packet Page 277
2
California Tobacco Control Program
Who Smokes Menthol Cigarettes?
• In a national study conducted in 2009-10, 71 percent
of lesbian, gay, bisexual, and transgender young adult
smokers (18-25) reported smoking menthol cigarettes. [16]
• Generally, menthol smokers tend to be female,
younger, members of ethnic minorities, have only a
high school education, and buy packs rather than
cartons. [17]
• Menthol cigarettes are used disproportionately in
communities of color. In combined 2004 to 2008
data, 82.6 percent of African American, 53.2 percent
of Native Hawaiian/Pacifi c Islander, 32.3 percent of
Hispanic/Latino, 31.2 percent of Asian, 24.8 percent
of American Indian/Alaska Native, and 23.8 percent
of white smokers aged 12 years and older reported
using menthol cigarettes in the past month. [14]
Menthol Cigarette Smoker Use by Age [13]
• A 2013 study found that, among cigarette smokers,
menthol cigarette use was more common among
12-17 year olds (56.7 percent) and 18-25 year olds
(45 percent) than among older persons (30.5-34.7
percent). [13]
• Approximately 19 million Americans smoke menthol
cigarettes, including 1.1 million adolescents. [14]
• More than 50 percent of menthol cigarette smokers are
female (52.2 percent) and nearly 30 percent of all menthol
smokers are African American (29.4 percent). [15]
• Although the use of cigarettes is declining in the United
States (U.S.), sales of menthol cigarettes have steadily
increased in recent years, especially among young
people and new smokers. [14]
0
10
20
30
40
50
60
PercentAge
12-17
56.7%
18-25
45.0 %
26-34
34.7%
35-49
30.5 %
50+
30.7%
Menthol Cigarette Smoker
Use by Race/Ethnicity [14]
Race/Ethnicity
0
10
20
30
40
50
60
70
80
90
African
American
82.6 %
Native
American
/Pacific
Islander
53.2%
Hispanic
/Latino
32.3%
Asian
31.2%
American
Indian
/Alaska
Native
24.8 %
White
23.8 %Percent54.5%
of high school
and 48.4 %
of middle school
current tobacco users smoked menthol cigarettes. [18]
F&HS Agenda Packet Page 278
3
California Tobacco Control Program
Predatory Marketing Tactics Target
Young, Female, and Minority Populations
• Menthol cigarettes were originally developed for and
promoted to women. [20] In order to appeal to women,
menthol cigarette advertisements often contain images
of romantic couples, flowers, and springtime. [20]
• Cigarette packaging design and color are carefully
chosen by the tobacco industry to create specific
associations. An example of this is the green packages
for mentholated cigarettes which suggest coolness and
freshness. [19]
• Tobacco retailers in low income, urban communities
having high menthol sales are more likely to place
larger exterior tobacco advertisements and have more
menthol advertisements on their store fronts. [1]
• Tobacco retailers in low income, urban communities
offer higher discount rates on mentholated cigarette
brands, including between $1.00 and $1.50 off per
pack or buy one (1) get one (1) free promotions, while
more affluent white neighborhoods see discounts on
menthols of only about $0.50 off per pack or buy two
(2) get one (1) free offers. [9]
• Camel brand smokers and menthol smokers (Newport
and Kool), who are more often young adults and African
Americans, are much more likely to use promotional
offers than those who smoke other brands. [21]
• Young adults and African Americans are also less
likely to switch from menthol to non-menthol cigarettes
regardless of higher product price. [22]
Menthol brands like Newport have specifically
targeted adolescents and young adults with their
marketing messages [20], through “youthful imagery,
messages promoting an appealing sensory
experience, and peer group acceptance.” [6]
F&HS Agenda Packet Page 279
4
California Tobacco Control Program
4
Why Mentholated Tobacco Products Matter to
the Health of the African American Community
• African Americans have been one of the main target
groups of menthol cigarette advertising. [24] Tobacco
industry documents reveal aggressive menthol tobacco
product marketing in urban, low-income, African
American neighborhoods through marketing; such
as advertising more desirable menthol promotions;
dedicating a greater store display space for menthol
products; and allowing more menthol interior and
exterior signage in stores. [25]
• Historically, African Americans have been exposed
to hundreds of tobacco advertisements and the
tobacco industry has placed proportionately more
menthol cigarette advertisements in African American
magazines than in mainstream magazines. [26] Many
of these targeted advertisements incorporate elements
of African American culture, music, and messages
related to racial identity and urban nightlife. [32]
• Today, menthol cigarettes are the overwhelming
favorite tobacco product among African Americans. A
2015 CDC report found that among current cigarette
smokers, 70.5 percent of African Americans reported
menthol cigarette use; about 20 percentage points
higher than whites and Hispanics. [18]
• The tobacco industry has been highly infl uential in the
African American community for decades, providing
funding and other resources to community leaders and
emphasizing publicly its support for civil rights causes
and groups, while ignoring the negative health effects
of its products on those it claims to support. Tobacco
industry support for African American communities is
estimated to be as high as $25 million per year. [27]
• For decades, the tobacco industry has donated
generous amounts of money to members of the
Congressional Black Caucus Foundation, the National
Urban League, the National Association for the
Advancement of Colored people and the United
Negro College Fund. [28]
• Many African American organizations opposing
the ban on menthol in tobacco products continue to
receive money from the tobacco industry. In 2014,
Lorillard Tobacco donated campaign cash to half of
all African American members of Congress, making
African American lawmakers (all but one of whom are
Democrats) 19 times as likely as their Democratic peers
to get a donation. [29]
0
10
20
30
40
50
60
70
80
Hispanic White
Non-Hispanic
Other Races
Non-Hispanic
BlackPercent52.3 %51.4 %58.1%
70.5 %
Race/Ethnicity
According to the Food and Drug Administration’s (FDA)
Tobacco Products Scientific Advisory Committee, by 2020
the African American population will have suffered more
than 4,700 excess deaths due to menthol in cigarettes,
and more than 460,000 more African Americans will
have started smoking due to the impact of menthol. [23]
Menthol Use Among Current
Smokers by Race/Ethnicity [18]
F&HS Agenda Packet Page 280
5
California Tobacco Control Program
Menthol and Cessation
• A leading model of smoking in the U.S. predicts that
a 10 percent quit rate among menthol smokers would
save thousands of lives, preventing more than 4,000
smoking-attributable deaths in the first ten years, and
that more than 300,000 lives would be saved in over
40 years. Approximately 100,000 of those lives saved
would be African American. [30]
• Another model predicts that if menthol were prohibited,
between 2010 and 2020, over 2.2 million people
would not start smoking. By 2050, the number of
people who would not start smoking would reach 9
million. [6]
• Among African American smokers, menthol cigarette
smoking is negatively associated with successful
smoking cessation. [31]
• Quitting menthol cigarettes is particularly difficult,
because menthol smokers have to get over their
dependence on nicotine as well as positive
associations with menthol itself such as the minty taste,
cooling sensation, and sensory excitation. [9]
• Youth who initiate smoking with menthol cigarettes
are more likely to become regular, addicted smokers
and are more likely to show higher measures of
dependence than youth who initiate with non-menthol
cigarettes. [32]
• Menthol smokers in the U.S. who report consuming
6-10 cigarettes per day show greater signs of nicotine
dependence (i.e., shorter time to first cigarette in the
day) than comparable non-menthol smokers. [33]
• Menthol smokers in general and African American
smokers in particular, have a difficult time quitting
despite smoking significantly fewer cigarettes per
day compared to non-menthol smokers. [26], [34]
Compared to non-menthol African American light
smokers, menthol smokers are younger and have less
confidence to quit smoking. [35]
More than half of Americans support a ban on
menthol [36], and a national study found that 44.5
percent of African Americans and 44 percent of
females would quit smoking if menthol cigarettes
were prohibited. [23]
[30]
10 %
Quit rate
over 40 years
would save 300,000 lives
100,000 of those lives would be African American
Menthol Smokers
F&HS Agenda Packet Page 281
6
California Tobacco Control Program
Food and Drug Administration
Regulation of Menthol Tobacco Products
• In 2009, Congress passed the Family Smoking
Prevention and Tobacco Control Act (FSPTCA) granting
the FDA with regulatory authority over tobacco
products. [37]
• Effective September 22, 2009, the FSPTCA banned
artificial or natural flavorings, as well as herbs or
spices, which produce characterizing flavors in
cigarettes. This included flavors such as strawberry,
grape, orange, clove, cinnamon, pineapple, vanilla,
coconut, licorice, cocoa, chocolate, cherry, and coffee.
Menthol, however, was exempt from the ban. [38]
• The FDA has the ability to prohibit menthol as an
ingredient in cigarettes and other tobacco products.
Tobacco Products Scientific Advisory Committee
(TPSAC) was established and charged with developing
a report assessing the impact of the use of menthol
in cigarettes on public health and proposing
recommendations to the FDA on whether menthol
should be regulated or not. [37]
• The TPSAC report and recommendations were
submitted to the FDA on March 23, 2011. The TPSAC
report found that the availability of menthol cigarettes
has an adverse impact on public health in the U.S. and
recommended removal of menthol cigarettes from the
marketplace. [37]
• On April 12, 2013, 20 leading national organizations
and advocates filed a formal Citizen Petition urging the
FDA to prohibit menthol as a characterizing flavoring
in cigarettes. More than 1,000 public comments were
submitted to the FDA. [37]
• In July of 2013, the FDA released a preliminary
scientific review that found that menthol made it easier
to start smoking and allowed for a faster progression
to regular use of cigarette smoking; it also found that
menthol made it harder to quit smoking, especially
among African American menthol smokers. The FDA
solicited public comment on the “potential regulation”
of menthol cigarettes. [39]
• In July of 2014, a Federal District Court Judge, Justice
Richard Leon, issued a decision requiring the FDA to
appoint new members to the TPSAC and to prohibit the
agency from using the 2013 scientific review prepared
by the TPSAC. The judge ruled that the new TPSAC
members must be unbiased and impartial, following
a 2011 lawsuit by Lorillard Tobacco Company
and R.J. Reynolds Tobacco Company against the
FDA. The lawsuit sought a court order to require
the FDA to reconstitute the TPSAC’s membership,
alleging that three TPSAC members had conflicts
of interest because of their ongoing work as expert
witnesses against tobacco companies in tobacco
litigation and due to their consulting fees paid by
pharmaceutical companies in connection with certain
smoking cessation products. The FDA was ordered
to reconstitute the advisory panel’s membership and
refrain from using the prior advisory panel’s report on
menthol cigarettes. [39]
• In September of 2014, the U.S. Department of Justice
filed an appeals motion on behalf of the FDA in
response to Circuit Court Justice Leon’s ruling in favor of
the Tobacco Industry. [40]
• In January 2016, a panel for the U.S. Court of Appeals
for the District of Columbia Circuit overturned the lower
Federal District Court ruling, holding that Lorillard and
R.J Reynolds Tobacco Companies lacked standing
to bring the case to the courts. The court found that
the injuries alleged by the plaintiffs were “too remote
and uncertain…insufficiently imminent” and that the
inclusion of the three members of the TPSAC committee
with an alleged conflict of interest “by no means
rendered the risk of eventual adverse FDA action
substantially probable or imminent.” [41]
• The FDA has still not made a recommendation on
whether to ban or limit menthol cigarettes. [39]
F&HS Agenda Packet Page 282
7
California Tobacco Control Program
1/2017
References
1. Kreslake, J.M., et al., Tobacco industry control of menthol in
cigarettes and targeting of adolescents and young adults. American
Journal of Public Health, 2008. 98 (9): p. 1685.
2. Kreslake, J.M. and V.B. Yerger, Tobacco industry knowledge of
the role of menthol in chemosensory perception of tobacco smoke.
Nicotine & Tobacco Research, 2010. 12 : p. 98-101.
3. Garten, S. and R.V. Falkner, Continual smoking of mentholated
cigarettes may mask the early warning symptoms of respiratory
disease. Preventive Medicine, 2003. 37(4): p. 291-296.
4. Benowitz, N.L., B. Herrera, and P. Jacob, Mentholated cigarette
smoking inhibits nicotine metabolism. Journal of Pharmacology and
Experimental Therapeutics, 2004. 310 (3): p. 1208-1215.
5. Unger, J.B., et al., Menthol and non–menthol cigarette use among Black
smokers in Southern California. Nicotine & Tobacco Research, 2010.
6. Tobacco Product Scientific Advisory Committee (TPSAC), Menthol
cigarettes and the public health: Review of the scientific evidence
and recommendations., US Department of Health and Human
Services Food and Drug Administration, Editor. 2011: Rockville, MD.
7. Levy, D.T., et al., Quit attempts and quit rates among menthol and
nonmenthol smokers in the United States. 2011.
8. U.S. Food and Drug Administration, Preliminary scientific evaluation
of the possible public health effects of menthol versus nonmenthol
cigarettes. July 2013.
9. Gardiner, P. and P.I. Clark, Menthol cigarettes: moving toward a
broader definition of harm. Nicotine & Tobacco Research, 2010.
12 : p. 85-93.
10. Henningfield, J.E., et al., Does menthol enhance the addictiveness
of cigarettes? An agenda for research. Nicotine & Tobacco
Research, 2003.
11. Giovino, G.A., et al., Epidemiology of menthol cigarette use.
Nicotine & Tobacco Research, 2004. 6: p. 67-81.
12. Wickham, R., Focus: Addiction: How Menthol Alters Tobacco-
Smoking Behavior: A Biological Perspective. The Yale Journal of
Biology and Medicine, 2015. 88 (3): p. 279.
13. Giovino, G.A., et al., Differential trends in cigarette smoking in the
USA: is menthol slowing progress? Tobacco Control, 2013.
14. Substance Abuse and Mental Health Services Administration, The
NSDU Report: Use of Menthol Cigarettes. 2009: Rockville, MD.
15. Rock, V.J., et al., Menthol cigarette use among racial and ethnic
groups in the United States, 2004–2008. Nicotine & Tobacco
Research, 2010. 12 : p. 117-124.
16. National Youth Advocacy Coalition, Coming Out about Smoking: A
Report from the National LGBTQ Young Adult Tobacco Project 2010:
Washington, DC.
17. Fernander, A., et al., Are age of smoking initiation and purchasing
patterns associated with menthol smoking? Addiction, 2010.
105 (1): p. 39-45.
18. Corey, C.G., et al., Flavored tobacco product use among middle
and high school students—United States, 2014. Morbitity Mortality
Weekly Report, 2015. 64(38): p. 1066-1070.
19. Davis, R.M., et al., The role of the media in promoting and reducing
tobacco use. 2008.
20. Sutton, C.D. and R.G. Robinson, The marketing of menthol cigarettes
in the United States: populations, messages, and channels. Nicotine
& Tobacco Research, 2004. 6(1): p. 83-91.
21. White, V.M., et al., Cigarette promotional offers: who takes
advantage? American Journal of Preventive Medicine, 2006.
30(3): p. 225-231.
22. Tauras, J.A., et al., Menthol and non-menthol smoking: the impact of
prices and smoke-free air laws. Addiction, 2010. 105 (1): p. 115-123.
23. Tobacco Control Legal Consortium et al., Citizen Petition to Food
and Drug Administration, Prohibiting Menthol As A Characterizing
Flavor in Cigarettes (April 12, 2013).
24. Gardiner, P.S., The African Americanization of menthol cigarette use in
the United States. Nicotine & Tobacco Research, 2004. 6(1): p. 55-65.
25. Cruz, T.B., L.T. Wright, and G. Crawford, The menthol marketing
mix: targeted promotions for focus communities in the United States.
Nicotine & Tobacco Research, 2010. 12 (suppl 2): p. S147-S153.
26. American Heart Association, Tobacco industry’s targeting of youth,
minorities and women.
27. Yerger, V.B. and R.E. Malone, African American leadership groups:
smoking with the enemy. Tobacco Control, 2002. 11 (4): p. 336-345.
28. Myron Levin, Lorillard, other tobacco companies use politics to
protect menthol brands, in Fairwarning. November 18, 2015, News
and Record: Greensboro, North Carolina.
29. Levin, M., Racial Politics Flavor Debate Over Banning Menthol
Cigarettes, in Fair Warning November 17, 2015.
30. Pearson, J.L. and K. Blackman, Modeling the future effects of a
menthol ban on smoking prevalence and smoking-attributable
deaths in the United States. American Journal of Public Health,
2011. 101(7): p. 1236.
31. Stahre, M., et al., Racial/ethnic differences in menthol cigarette
smoking, population quit ratios and utilization of evidence-based
tobacco cessation treatments. Addiction, 2010. 105 (1): p. 75-83.
32. Nonnemaker, J., et al., Initiation with menthol cigarettes and youth
smoking uptake. Addiction, 2013. 108 (1): p. 171-178.
33. Fagan, P., et al., Nicotine dependence and quitting behaviors
among menthol and non-menthol smokers with similar consumptive
patterns. Addiction, 2010. 105 (1): p. 55-74.
34. Trinidad, D.R., et al., Menthol cigarettes and smoking cessation
among racial/ethnic groups in the United States. Addiction, 2010.
105 (1): p. 84-94.
35. Okuyemi, K.S., et al., Relationship between menthol cigarettes
and smoking cessation among African American light smokers.
Addiction, 2007. 102 (12): p. 1979-1986.
36. Hartman, A.M. What menthol smokers report they would do if
menthol cigarettes were no longer sold. in FDA Tobacco Products
Scientific Advisory Committee Meeting. 2011.
37. Public Health Law Center. Federal Regulation of Menthol Tobacco
Products.38. Family Smoking Prevention And Tobacco Control Act,, in Public
Law No. 111-31, 123 Stat. 1776 (codified, in relevant part, at 15
U.S.C.A. §§ 1333-34 and 21 U.S.C.A. § 301 et seq.). 2009.
39. Sabrina Tavernise, F.D.A. Closer to Decision About Menthol
Cigarettes, in The New York Times. July 23, 2013.40. FDA Appeals Court Ruling on TPSAC Conflict of Interest, in American
Thoracic Society News. September 22, 2014.
41. Stern, M.B., et al., R.J. Reynolds Tobacco Company, et al. v. United
States Food and Drug Administration, et al., in 14-5226, United
States Court of Appeals for the District of Columbia Circuit, Editor.
January 15, 2016.
F&HS Agenda Packet Page 283
F&HS Agenda Packet Page 284
F&HS Agenda Packet Page 285
F&HS Agenda Packet Page 286
F&HS Agenda Packet Page 287
F&HS Agenda Packet Page 288
F&HS Agenda Packet Page 289
F&HS Agenda Packet Page 290
F&HS Agenda Packet Page 291
1
Tobacco Retailer 3/2/17 Educational and Input Session:
Comment Summary and Public Health Department Responses
Background.
A notice of the tobacco retailer educational and input session was mailed out to licensed tobacco retailers in
the unincorporated County on 2/16/17. The session was held on 3/2/17 from 1:00pm to 2:30pm at 597
Center Ave, Room 120, Martinez. Contra Costa Tobacco Prevention Project staff, Denice Dennis and
Jennifer Grand, led the session. Staff presented an overview of youth tobacco influences in the retail
environment and draft revisions to the County Tobacco Retailer Licensing Ordinance and Zoning Code that
staff had been directed to prepare by the Contra Costa County Board of Supervisors.
a) Revise the definition of “tobacco products” in the Tobacco Retailer License Ordinance to be inclusive of
newer electronic smoking devices and “liquids” that currently fall outside of the definition
b) Prohibit the sale of flavored (non-cigarette) tobacco products
c) Prohibit the sale of menthol flavored cigarettes within at least 1000 feet of schools
d) Require a minimum pack size of ten (10) for little cigars and cigarillos
e) Prohibit new tobacco retailers from operating within 1000 feet of schools, parks, playgrounds and libraries
f) Prohibit new tobacco retailers from operating within 500 feet of new or existing tobacco retailers
g) Prohibit the sale of tobacco products in pharmacies
j) Prohibit new “Significant Tobacco Retailers”, including “vape” shops, hookah bars or smoke shops
k) Require tobacco retailers to comply with state and local storefront signage laws
l) Require tobacco retailers to comply with drug paraphernalia sales laws
m) Require tobacco retailers to check ID of customers who appear younger than 27
n) Cap the number of retailers that can sell tobacco products at current number of licenses issued by the
County
h) Require tobacco retailers who have their license suspended to remove tobacco advertising during license
suspension periods
i) Expand the time period reviewed for prior violations of the license (the “look-back” period) from 24
months (2 years) to 60 months (5 years) when considering the length of a license suspension for retailers
found to be in violation of the law
Staff described the process for review of the proposed changes to county ordinances, and that the Family and
Human Services Committee would discuss the proposed ordinances at the April 24, 2017 public meeting. The
meeting was then opened up for input from the tobacco retailers. In an effort to delineate concerns from
tobacco retailers in the unincorporated County, Staff asked tobacco retailers with businesses in the
unincorporated county speak first, and others in attendance save their comments until after all local retailers
had spoken. It became clear later on that many individuals who were from outside of the County spoke
during the time set aside for local retailers, so it was not possible to separate the input and concerns.
Thirty-seven people signed in on the sign-in sheet, however many people in attendance did not sign-in. Staff
estimated over 50 people in attendance. The following individuals signed in at the meeting:
Thirteen individuals representing 8 tobacco retailing businesses in the unincorporated county.
Ten other individuals representing tobacco retailers and vape shops from Contra Costa cities.
Six tobacco retailers and vape shops from other Counties, including 7-Eleven Corporate.
Representatives from Log Cabin Republicans, other Industry groups (R Street Institute and Not
Blowing Smoke), and the Greater Bay Franchise Owners Association.
F&HS Agenda Packet Page 292
2
Overview of Concerns.
Several themes emerged from the concerns voiced by meeting attendees. These are summarized below with
responses from Health Services staff.
1) Why is the County restricting sale of flavored electronic smoking devices which the tobacco
and vape industry have stated are “safer products”?
Research demonstrates that electronic smoking devices are not safe products, and are now known to
be a “gateway” product to a lifetime of addiction among youth.i,ii,iii,iv A large national study found that
the odds of a heart attack increased by 42% among people who used e-cigarettes.v Vape liquids
contain nicotine and chemicals known to cause cancer and produce an aerosol that can harm the
lungs.vi Vaping causes as much short-term inflammation in the lungs as regular cigarettes,vii and
nicotine-free vapor may cause even more.viii The proposed prohibition on the sale of flavored
tobacco products applies to flavored electronic smoking devices and flavored vape liquids that are
used in electronic smoking devices because these flavored products are very attractive to youth.
These flavors (e.g., strawberry, chocolate, licorice) are currently banned in cigarettes in the U.S. due
to their appeal to youth.ix Sale of “tobacco” flavored electronic smoking devices and vape liquids
would still be allowed for sale. Electronic smoking devices are the most common tobacco product
used among high school and middle school students.x Teens that vape are three times more likely
than their peers to smoke cigarettes one year later,xi and eighth graders who vape are 10 times more
likely than their peers to eventually smoke cigarettes.xii
In 2013, the Contra Costa Board of Supervisors voted to prohibit the use of electronic smoking
devices in areas where smoking of conventional tobacco products is prohibited, because these
products were (and still are) unregulated, and have been demonstrated to lead young people to try
other tobacco products, including conventional cigarettes, which are known to cause disease and lead
to premature death. In addition to the possible health risk associated with these products, the Board
of Supervisors were concerned that use of e-cigarettes in public places and places of employment
could increase social acceptance of smoking.
2) Why is the County restricting a product that people use for smoking cessation?
Electronic smoking devices are not approved by the Federal Drug Administration (FDA) as a
smoking cessation product. FDA-approved smoking cessation products are available, and the
proposed revisions to this ordinance do not impact sale of those products. While there is anecdotal
evidence that some people have successfully used electronic smoking devices to quit smoking
cigarettes, research has found that many people who attempt to quit smoking by using electronic
smoking devices end up with dual use of both traditional tobacco and electronic smoking devices.xiii
Recent declines in the prevalence of cigarette smoking among youth have coincided with an
increased use of e-cigarettes and hookah tobacco.xiv
3) Minimum pack size of 10 little cigars and cigarillos is unreasonable.
Although the sale of individual cigarettes is banned by federal and state law,xv neither federal nor
state laws restrict the sale of small packs of cigars. While cigarette use is decreasing, the use of other
tobacco products is increasing.xvi Little cigars and cigarillos are sold individually and in small packs
for as little as 5 for 99 cents, making them more affordable and appealing to youth.xvii 50% of Contra
Costa retailers sell these products as singles.xviii This proposed ordinance would exempt premium
cigars costing $5 or more.
4) Tobacco 21 already passed, why does the County need new laws?
The California state Tobacco 21 law addresses tobacco sales to youth, while the proposed County
ordinance changes address a more comprehensive approach to reducing youth smoking by
addressing youth tobacco influences in the retail environment. Research shows that teens are more likely
to be influenced to use tobacco products by tobacco marketing than by peer pressure,xix and the U.S.
F&HS Agenda Packet Page 293
3
Surgeon General reports that “tobacco industry advertising and promotion cause youth and young
adults to start smoking, and nicotine addiction keeps people smoking past those ages.”xx The reasons
for prohibiting sale of flavored tobacco products and small packs of little cigars and cigarillos are
delineated above. Prohibiting new tobacco retailers from locating near schools, parks, playgrounds
and libraries, and close to existing retailers helps reduce the amount of tobacco product marketing
and promotions that youth are exposed to throughout our communities.
5) Why is the County putting the burden on (regulating/penalizing) tobacco retailers when
youth are getting tobacco from other sources?
The intent of the proposed ordinances is to reduce youth tobacco product use through changes in
the retail environment. The County Board of Supervisors has the authority to adopt regulations that
protect the health and safety of residents in its jurisdiction. Ninety percent of adult smokers begin
smoking while in their teens, or earlier; and two-thirds become regular, daily smokers before the age
of 19.xxi Tobacco advertising and products that youth see in the retail environment have a greater
effect on influencing youth to start smoking than peer pressure.xxii A study evaluating the effect of
the ban on flavored tobacco products in New York City showed a 37% reduction in teens having
tried flavored tobacco and a 28% lower chance of teens use of any type of tobacco product, even
when surrounding jurisdictions do not also ban flavored tobacco.xxiii
6) The 5-year look-back period for violations of tobacco retailer license is too long, and some
corporations may penalize local franchise owners for previous tobacco retailer license
violations.
The term “look-back period” refers to the time period reviewed for prior violations of the existing
Tobacco Retailer License when considering length of license suspension for a current violation. The
draft ordinance increases this period from 2 years to 5 years. A five-year look-back period is well
established as the current best practice for tobacco retailer licensing in California. El Cerrito,
Richmond, Albany, Berkeley Oakland, and 64 other jurisdictions in California have this provision
included in their tobacco retailer licensing ordinance.
7) The 10-year “sunset” clause affects retirement, hurts tobacco retailers.
The County’s existing Tobacco Retailer Licensing Ordinance requires retailers that sell tobacco products to
renew their license on an annual basis, and prohibits transfer of the license to any other owner or location.
The draft Tobacco Retailing Businesses Ordinance that is in the Zoning Code allows existing tobacco
retailers that are located within 1000 feet of schools, parks, playgrounds and libraries, (or within 500 feet
of an existing retailer) to renew their tobacco retailer license annually into perpetuity, as long as they
comply with the County’s Tobacco Retailer Licensing Ordinance. Existing retailers, within 1000 feet of
schools, parks, playgrounds and libraries (or within 500 feet of another retailer), who wish to sell their
business as eligible to apply for a new County tobacco retailer license, must sell within ten years of
adoption of the Tobacco Retailing Businesses Ordinance. If a new school, park, playground or library is
established within 1000 feet of an existing tobacco retailer, and that existing retailer wishes to sell their
business as eligible to apply for a new County Tobacco Retailer License, the business must be sold within
ten years of the establishment of the new school, park, playground or library.
Some jurisdictions in the state with similar laws do not allow existing store sites within 1000 feet of
schools, parks, playgrounds and/or libraries that are sold to be eligible for a Tobacco Retailer License at
all. According to the American Lung Association, nine California jurisdictions enacted similar
tobacco retailing density provisions between 2011 and 2015. Three of these jurisdictions prohibit
tobacco retailing at the locations after the business is sold (no matter when the sale occurs); one
“sunsets” the provision at 5 years; and one has a similar 10-year sunset provision. The other 4
jurisdictions allow the location to be sold as eligible to apply for a tobacco retailer license at any time.
The 10-year “sunset” clause in the draft ordinance allows retailers the time to develop an alternative
F&HS Agenda Packet Page 294
4
business plan, and the County Tobacco Prevention Program has developed a list of resources to help with
this.
8) Distance restrictions should be state law, not local county law.
Local jurisdictions have the authority to create local land use regulations. Additionally, California’s
successes in reducing youth smoking rates and overall community tobacco use over the past three
decades have been built on local tobacco control laws. The Contra Costa Board of Supervisors have
been leaders in local tobacco control laws for some 30 years, from smoke-free restaurant sections, to
comprehensive outdoor secondhand smoke protections, to requiring a tobacco retailer license for
those who sell tobacco products.
9) Adults use these products, not just youth.
Ninety percent of adult smokers begin while in their teens, or earlier; and two-thirds become regular,
daily smokers before the age of 19.xxiv Young people are much more likely to use candy-and-fruit-
flavored tobacco products than adults.xxv In 2015, 80% of youth age 12-17 who ever-reported
experimenting with tobacco started with a flavored tobacco product.xxvi The tobacco industry has
strategically used flavored little cigars and cigarillos to replace the banned flavored cigarette market,
which are the same size and shape as cigarettes and packaged as cheaply as 5 for 99 cents.xxvii
10) Chicago recently rolled back buffer zones for sale of flavored tobacco products because it
hurt retailers. Why is the County doing this?
Chicago was the first city in the country to regulate the sale of flavored tobacco products, and
prohibited the sale of these products, including menthol cigarettes, within 500 feet of all schools.
Recently, the city decided to change the law to include only high schools, due to pressures from
retailers. California has learned a great deal from Chicago’s experience, and best practice is now
jurisdiction-wide regulations. A study conducted by the Centers for Disease Control and Prevention
(CDC) found that 42% of middle and high school students who smoke reported either using
flavored little cigars or flavored cigarettes.xxviii Prohibiting the sale of flavored tobacco products
jurisdiction-wide not only protects all youth from tobacco influences in the retail environment, it
provides a level playing field for retailers who choose to sell tobacco products.
11) Why is the County proposing more restrictions on tobacco retailers when the state has
tobacco control laws already?
The California Board of Equalization requires all tobacco retailers in the state to purchase a license to
sell cigarettes and other tobacco products. This license was established to ensure compliance with
cigarette and other tobacco product tax laws and the Board of Equalization is only charged with
enforcing tax laws.
The State also prohibits the sale of tobacco products to anyone under the age of 21. Local
jurisdictions have authority to enact stronger laws in order to protect the health and safety of their
residents. The County Board of Supervisors have been leaders in tobacco control for over thirty
years, and the draft ordinances apply a comprehensive approach to address youth tobacco influences
in the retail environment.
12) Why is the County proposing more regulations when the FDA already regulates tobacco
products including electronic nicotine delivery systems (ENDS), hookah, dissolvables,
cigars, and future tobacco products?
After considerable pressure from national tobacco control advocates across the country, the FDA
issued a rule, effective August 2016, to include these non-cigarette products in the definition of
“tobacco products” under the Family Smoking Prevention and Tobacco Control Act (Tobacco
Control Act of 2009). The FDA expects that manufacturers will continue selling their products for
up to two years while they submit a new tobacco product application and review is expected to be at
F&HS Agenda Packet Page 295
5
least an additional year.xxix However, there is still a backlog for regulations enacted in 2009, making
any real change in FDA regulation based on the new rule still many years out. The draft ordinances
provide the opportunity to protect youth from tobacco influences in the community now, rather than
waiting for an unsure future with FDA regulations.
13) We need education for children, not more restrictions on business.
Education programs for children about the dangers of tobacco already exist in the statewide Tobacco
Use Prevention Education (TUPE) program. Education alone is not enough, and both the Centers
for Disease Control and the Tobacco Education and Research and Oversight Committee of
California recommend comprehensive approaches for tobacco prevention efforts that include both
education and local policy. xxx,xxxi The draft provisions are best practices to reduce youth tobacco
influences in the retail environment.
14) Tobacco Retailers are doing a good job complying with the no-sales-to-minors law.
The ordinances under consideration were written to address a comprehensive approach to addressing
youth tobacco influences in our communities, which are linked to youth uptake of smoking,
including use of electronic smoking devices. No-sales-to-minors laws are one part of this
comprehensive approach. One of the Retailer Association representatives presented information
from the American Lung Association that the County’s illegal sales rates were very low. Sales rates
vary greatly year by year, with sales rates over a 5 year period for the unincorporated county ranging
from 7% in 2004 to 16% in 2015. The proposed ordinances are intended to supplement no-sales-to-
minors laws with a more comprehensive approach to addressing youth tobacco influences in the
community.
Some individual comments included:
Concern regarding distance being calculated “as the crow flies.”
The provision banning pharmacies from selling tobacco was welcome.
Tobacco products should be taxed instead of regulated in the ways the proposed provisions suggested.
Will tobacco retailers be able to sell marijuana?
Note: California law states that a business cannot sell alcohol or tobacco as well as marijuana xxxii
i Cardenas, V. M., Evans, V. L., Balamurugan, A., Faramawi, M. F., Delongchamp, R. R., Wheeler, J. G.. (2016). Use of
electronic nicotine delivery systems and recent initiation of smoking among US youth. International Journal of
Public Health.
ii Wills, T. A., Knight, R., Sargent, J. D., Gibbons, F. X., Pagano, I., and Williams, R. J. Longitudinal study of e-cigarette
use and onset of cigarette smoking among high school students in Hawaii. Tobacco Control, 2016.
iii Leventhal, A. M., Strong, D. R., Kirkpatrick, M. G., Unger, J. B., Sussman, S., Riggs, N. R., Stone, M. D., et al. (2015).
Association of Electronic Cigarette Use with Initiation of Combustible Tobacco Product Smoking in Early
Adolescence. The Journal of the American Medical Association, 314(7):700-707. doi:10.1001/jama.2015.8950.
iv Primack, B. A., Soneji, S., Stoolmiller, M. Fine, M. J., and Sargent, J. D. (2015). Progression to Traditional Cigarette
Smoking After Electronic Cigarette Use Among US Adolescents and Young Adults. JAMA Pediatrics, 169 (11):
1018-1023. doi:10.1001/jamapediatrics.2015.1742.
v Temesgen, N, et al., A cross sectional study reveals an association between electronic cigarette use and
myocardial infarction. Poster. George Washington University School of Medicine and Health Sciences Poster
Presentations. Spring 2017.
vi Goniewicz, M. L., et al., Levels of selected carcinogens and toxicants in vapour from electronic cigarettes. Tobacco
Control, 2014. 23(2): p. 133-139.
vii Vardavas, C.I.; Anagnostopoulos, N.; Kougias, M.; Evangelopoulou, V.; Connolly, G.N.; Behrakis, P.K. “Short -term
Pulmonary Effects of Using an Electronic Cigarette: Impact on Respiratory Flow Resistance, Impedance, and
Exhaled Nitric Oxide.” CHEST, June 2012
F&HS Agenda Packet Page 296
6
viii Grana, Rachel, et al. “E-Cigarettes: A scientific Review.” Circulation (2014): 1,2,5,7,12. US National Library of
Medicine.
ix US Department of Health and Human Services, US Food and Drug Administration, Family Smoking Prevention and
Tobacco Control Act, Section 2 Findings, June 22, 2009, available at:
https://www.fda.gov.TobaccoProducts/Labeling?RulesRegulationsGuidance?ucm261832.htm .
x US Department of Health and Human Services. “E-Cigarette Use Among Youth and Young Adults, A Report of the
Surgeon General, 2016” https://e-cigarettes.surgeongeneral.gov/documents/2016_SGR_Fact_Sheet_508.pdf.
Accessed March 2017.
xi Cardenas, V. M., Evans, V. L., Balamurugan, A., Faramawi, M. F., Delongchamp, R. R., Wheeler, J. G. (2016). Use of
electronic nicotine delivery systems and recent initiation of smoking among US youth. International Journal of
Public Health.
xii Miech, R. A., et al., E-cigarettes and the drug use patterns of adolescents, Nicotine and Tobacco Research, 18(5),
654-659 (2016).
xiii Borderud, S. P., Li, Y., Burkhalter, J. E., Sheffer, C. E. and Ostroff, J. S. (2014), Electronic cigarette use among
patients with cancer: Characteristics of electronic cigarette users and their smoking cessation outcomes. Cancer,
120: 3527–3535. doi:10.1002/cncr.28811. See Also: Center for Disease Control and Prevention, “Dual Use of
Tobacco Products”. https://www.cdc.gov/tobacco/campaign/tips/diseases/dual-tobacco-use.html. Accessed
March 2017.
xiv Arrazola, R. A., et al., Tobacco use among middle and high school students – United States, 2011-2014. MMWR
Morbidity and Mortality Weekly Report, 2015. 64(14): p. 381-5.
xv 21 C.F.R. § 1140.14(d); Cal. Penal Code § 308.2
xvi Cullen J, Mowery P, Delnevo C, et al. 2011. “Seven-Year Patterns in US Cigar Use Epidemiology Among Young
Adults Aged 18-25 Years: A Focus on Race/Ethnicity and Brand.” American Journal of Public Health 101(10): 1955-
1962.
xvii California Department of Public Health. 2012. Tobacco in the Retail Environment,
www.cdph.ca.gov/programs/tobacco/Documents/Tobacco%20Retail%20Environment%20Fact%20Sheet_Easy%20
Print.pdf
xviii Healthy Stores for a Healthy Community. 2016 Contra Costa County Local Data.
xix Evans, N, et al., “Influence of Tobacco Marketing and Exposure to Smokers on Adolescent Susceptibility to
Smoking.” Journal of the National Cancer Institute , October 1995.
xx HHS, The Health Consequences of Smoking – 50 Years of Progress: A Report of the Surgeon General, 2014.
http://www.surgeongeneral.gov/library/reports/50-years-of-progress/.
xxi SAMHSA. Center for Behavioral Health Statistics and Quality. National Survey on Drug Use and Health (NSDUH),
2014.ICPSR36361-v1. Ann Arbor, MI: Inter-university Consortium for Political and Social Research [distributor],
2016-03-22. http://doi.org/10.3886/ICPSR36361.v1.; See also, HHS, Preventing Tobacco Use Among Youth and
Young Adults, A Report of the Surgeon General, 2012. HHS, Youth and Tobacco: Preventing Tobacco Use among
Young People: A Report of the Surgeon General, 1994. http://profiles.nlm.nih.gov/NN/B/C/F/T/_/nnbcft.pdf
xxii Pollay, R. et al., “The Last Straw? Cigarette Advertising and Realized Market Shares Among Youths and Adults,”
Journal of Marketing 60(2): 1-16, April 1996.
xxiii Farley and Johns, Tobacco Control, “New York City flavored tobacco product sales ban evaluation,” Jan 26, 2017.
78-84.
xxiv SAMHSA. Center for Behavioral Health Statistics and Quality. National Survey on Drug Use and Health (NSDUH),
2014.ICPSR36361-v1. Ann Arbor, MI: Inter-university Consortium for Political and Social Research [distributor],
2016-03-22. http://doi.org/10.3886/ICPSR36361.v1.; See also, HHS, Preventing Tobacco Use Among Youth and
Young Adults, A Report of the Surgeon General, 2012. HHS, Youth and Tobacco: Preventing Tobacco Use among
Young People: A Report of the Surgeon General, 1994. http://profiles.nlm.nih.gov/NN/B/C/F/T/_/nnbcft.pdf
xxv King, B.A., et al., Flavored Cigar Smoking among US Adults; Findings from the 2009-2010 National Adult Tobacco
Survey. Nicotine and Tobacco Research, 2013. 15(2): p. 608-614.
xxvi Ambrose, B. K., et al., Flavored Tobacco Product Use Among US Youth Aged 12-17 Years, 2013-2014. JAMA,
2015: p 1-3.
F&HS Agenda Packet Page 297
7
xxvii Kostygina et al., MBJ Journals Tobacco Control, Tobacco industry use of flavours to recruit new users of little
cigars and cigarillos, 2014, 25(1), abstract available at: http://tobaccocontrol.bmj.com/content/25/1/66.
xxviii King, B.A., et al., Flavored little cigar and flavored cigarette use among US middle and high school students.
Journal of Adolescent Health, 2014. 54(1): p. 40-46.
xxix US Food and Drug Administration, 2016. “FDA takes significant steps to protect Americans from dangers of
tobacco through new regulation”
https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm499234.htm . Accessed March 2017.
xxx Centers for Disease Control and Prevention. Best Practices for Comprehensive Tobacco Control Programs—2014.
Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National
Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014.
xxxi Tobacco Education and Research Oversight Committee. Changing Landscape: Countering New Threats, 2015-
2017. Toward a Tobacco-Free California Master Plan. Sacramento, CA: Tobacco Education and Research Oversight
Committee. 2014.
xxxii California Health and Safety Code Division 10, Uniform Controlled Substances Act Chapter 6, Article 2.
Marijuana (11357-11362.9)
Prepared by the Tobacco Prevention Program, Contra Costa Public Health
4/13/17
F&HS Agenda Packet Page 298
FAMILY AND HUMAN SERVICES COMMITTEE 10.
Meeting Date:04/24/2017
Subject:Laura's Law - AOT Workgroup Proposal
Submitted For: FAMILY & HUMAN SERVICES COMMITTEE,
Department:County Administrator
Referral No.: 107
Referral Name: Laura's Law
Presenter: Cynthia Belon, Behavioral Health Director;
Warren Hayes, MHSA Program Manager
Contact: Enid Mendoza,
(925) 335-1039
Referral History:
The Assisted Outpatient Treatment Demonstration Project Act (AB 1421), known as Laura’s
Law, was signed into California law in 2002 and is authorized until January 1, 2017. Laura’s Law
is named after a 19 year old woman working at a Nevada County mental health clinic. She was
one of three individuals who died after a shooting by a psychotic individual who had not engaged
in treatment.
AB 1421 allows court-ordered intensive outpatient treatment called Assisted Outpatient Treatment
(AOT) for a clearly defined set of individuals that must meet specific criteria. AB 1421 also
specifies which individuals may request the County Mental Health Director to file a petition with
the superior court for a hearing to determine if the person should be court ordered to receive the
services specified under the law. The County Mental Health Director or his licensed designee is
required to perform a clinical investigation, and if the request is confirmed, to file a petition to the
Court for AOT.
If the court finds that the individual meets the statutory criteria, the recipient will be provided
intensive community treatment services and supervision by a multidisciplinary team of mental
health professionals with staff-to-client rations of not more that 1 to 10. Treatment is to be
client-directed and employ psychosocial rehabilitation and recovery principles. The law specifies
various rights of the person who is subject of a Laura’s Law petition as well as due process
hearing rights.
If a person refuses treatment under AOT, treatment cannot be forced. The Court orders meeting
with the treatment team to gain cooperation and can authorize a 72 hour hospitalization to gain
cooperation. A Laura’s Law petition does not allow for involuntary medication.
AB 1421 requires that a county Board of Supervisors adopt Laura’s Law by resolution to
authorize the legislation within that county. AB 1421 also requires the Board of Supervisors to
make a finding that no voluntary mental health program serving adults or children would be
F&HS Agenda Packet Page 299
reduced as a result of implementation.
At its June 3, 2013 meeting, the Legislation Committee requested that this matter be referred to
the Family and Human Services Committee (F&HS) for consideration of whether to develop a
program in the Behavioral Health Division of the Health Services Department that would
implement assisted outpatient treatment options here in Contra Costa County.
On July 9, 2013, the Board of Supervisors referred the matter to F&HS for consideration. F&HS
received reports on the implementation of Laura's Law on October 16, 2013 and March 10, 2014,
and on February 3, 2015 the Board accepted the recommendations to implement Laura's Law. In
February 2016, Laura's Law was implemented and the Department provided F&HS with a
6-month implementation report on September 12, 2016 and a data report on the 6-month
implementation on December 12, 2016. Both reports were accepted by the Board on September
27, 2016 and December 20, 2016, respectively.
At the December 20, 2016 Board meeting, direction was given to staff to return to F&HS with a
recommendation on incorporating community input within the implementation model to provide a
forum for the Department and members of the community to maintain communications and for
the community to express their concerns regarding emergent issues.
Referral Update:
Please see the attached AOT Workgroup Plan as recommended by the Health Services
Department.
Recommendation(s)/Next Step(s):
ACCEPT the Health Services Department's recommendation to reconvene the initial Assisted
Outpatient Treatment (AOT) Workgroup with structural changes as developed in collaboration
with the Mental Health Commission and outlined in the attached memo and report, and direct
staff to forward to the Board of Supervisors for approval.
Fiscal Impact (if any):
There is no fiscal impact; the report and recommendations are informational.
Attachments
AOT Workgroup Recommendation Memo
AOT Workgroup Plan
F&HS Agenda Packet Page 300
1 | Page
William B. Walker, M.D.
HEALTH SERVICES DIRECTOR
Cynthia Belon, L.C.S.W.
BEHAVIORAL HEALTH DIRECTOR
Contra Costa
Behavioral Health
Administration
1340 Arnold Drive, Suite 200
Martinez, CA 94553-4639
Ph (925) 957-5201
Fax (925) 957-5156
Recommendation:
The Behavioral Health Division recommends reconvening the initial Assisted Outpatient Treatment
(AOT) Work Group with structural changes. This recommendation from the Division was developed in
partnership with the Mental Health Commission who unanimously supported the developed
framework.
Background:
Beginning in June 2013 the Board of Supervisors began consideration of whether to develop a program
in the Behavioral Health Division of the Health Services Department that would implement assisted
outpatient treatment options in Contra Costa County. This item was referred to the Family and Human
Services Committee who accepted the report and recommendation from the Department to pilot an
Assisted Outpatient Treatment program for a period of three years. The Board of Supervisors
considered the item on October 7, 2014; February 3, 2015 and, on December 15, 2015 the Board
approved continuing implementation and authorized the use $2.25 million per year and directed the
Department to report back to the Board after six months of full implementation.
In keeping with this requirement, the Department contracted with Research Development Associates
(RDA) to provide on‐going evaluation of the newly implemented program. In December of 2016 RDA
delivered the 6‐month evaluation report through presentations to the Family and Human Services
Committee December 12th, the Mental Health Commission on December 14th, and was placed on the
consent calendar for the December 20th meeting of the Board of Supervisors. During, and subsequent
to, these presentations, members of the Mental Health Commission identified the need to provide an
opportunity for stake holder feedback and quality improvement during the implementation of the
program. In light of this request, Supervisor Andersen requested the department develop a
recommendation for an ongoing outlet for community concerns and quality review and return that
recommendation to the Family and Human Services Committee.
Assisted Outpatient Treatment Work Group:
From the beginning of the County’s consideration of AOT, the Assisted Outpatient Treatment Work
Group has played an important role in facilitating stakeholder input through the various stages of
implementation. This work group was developed by the Behavioral Health Division and consists of
stakeholders including Health Services staff, judicial and public safety partners, community based
organizations as well as members of the community. As the concept matured, the role of the Work
Group changed as well. Initially, the Work Group was a source of advocacy to demonstrate the need for
the AOT program in Contra Costa County. After authorization from the Board of Supervisors, the Work
Group was instrumental as the vehicle to allow stakeholder input with regard to program design and the
F&HS Agenda Packet Page 301
2 | Page
William B. Walker, M.D.
HEALTH SERVICES DIRECTOR
Cynthia Belon, L.C.S.W.
BEHAVIORAL HEALTH DIRECTOR
Contra Costa
Behavioral Health
Administration
1340 Arnold Drive, Suite 200
Martinez, CA 94553-4639
Ph (925) 957-5201
Fax (925) 957-5156
early stages of implementation. This Work Group last met in April 2016.
The absence of an outlet for stakeholder feedback was of concern to a majority of the Mental Health
Commission, who advanced and approved a proposal to create a Task Force in accordance with the
Mental Health Commission By‐laws. However the Behavioral Health Director provided an alternate
recommendation that would build on the existing AOT Work Group structure.
Seeking to bridge the gap in these strategies, the Chair and Vice‐Chair of the Mental Health Commission
met with the Behavioral Health Division leadership and formed, in partnership, an agreement as to the
structure and format of a reconstituted AOT Work Group. This agreement is attached and is supported
by the Behavioral Health Department and was unanimously approved by the Mental Health Commission
on March 1, 2017.
Agreement Outline:
The agreement reached in partnership between the Behavioral Health Division and the Mental Health
Commission makes several structural changes. Key aspects of the agreement include:
Agreement to using a “steering committee” approach towards agenda setting. In this model any
member of the community may come to a steering committee prior to the convening of the full
Work Group and propose an agenda item for the next meeting of the Work Group.
Agreement to co‐facilitate. The first meeting of the work group will be chaired by the
Behavioral Health Director and the Chair of the Mental Health Commission. This model will
continue with a member of the Behavioral Health staff and a member of the Commission acting
as co‐facilitators for each meeting.
Agreement to hold quarterly meetings.
Agreement to allow for the creation of sub‐work groups should an issue be identified that
requires extra attention.
Maintain existing membership with service provider partners
Conclusion:
The Behavioral Health Division is recommending that the AOT Work Group reconvene under the frame
work outlined in the attached document. This document is a product of the partnership between the
Behavioral Health Division and the Mental Health Commission. The Division is pleased with this
partnership and to work under this framework that allows for meaningful exchange of ideas between
service providers, partners and members of the community while allowing for maximum community
participation.
F&HS Agenda Packet Page 302
AOT Workgroup Plan
On February 3, 2017, the Contra Costa Behavioral Health Services (CCBHS) staff and Chair and
Vice-Chair of the Mental Health Commission (MHC) met to work together to define key aspects
of the Assisted Outpatient Treatment (AOT) Workgroup. Those present: MHC Chair Duane
Chapman and Vice-Chair Barbara Serwin, CCBHS Director Cynthia Belon, Deputy Director
Matthew Luu, MHSA Program Manager Warren Hayes, Administrative Services Assistant III
Adam Down and MHC Executive Secretary Liza Molina-Huntley.
The AOT Workgroup was created to provide input to the AOT Program during its initial design
phase. The Workgroup is now evolving as the AOT Program moves into its implementation
phase. This document outlines how the Workgroup will be structured and operate during this
next phase.
This plan will be submitted to the MHC for approval at the full Commission meeting in March.
Upon approval from the MHC, the agreement will be submitted to the Board of Supervisor’s
Family and Human Services Committee for consideration.
Objectives
The purpose of the AOT Workgroup is to provide an open forum to enable Workgroup members
and the public to voice and address issues pertaining to the AOT Program. This includes
problem solving, supporting transparency and accountability, and providing input to major
policies and strategies.
Constituencies
The broad set of stakeholders from the first phase AOT Workgroup will continue to
participate. An inclusive list of stakeholder groups will be provided by CCBHS staff.
Members will be determined by and in accordance with representation of stakeholder bodies.
The MHC Chair and CCBHS Director will define the maximum number of members.
Meetings
The first meeting will be facilitated by the MHC Chair and CCBHS Director. It will
tentatively be held in April, 2017 at 50 Douglas Drive in Martinez.
The first agenda will be set by the MHC Chair and the CCBHS Director.
At the first AOT Workgroup meeting, the MHC Chair and CCBHS Director will solicit input
and participation from stakeholders as to protocol for setting future meeting agendas. Input
will also be solicited for the selection of person(s) to co-facilitate meetings on a rotation
basis, along with the MHC Chair.
Meetings will be held on a quarterly basis.
Sub-committees may be formed to study and/or problem-solve specific issues or challenges
that arise from the AOT Program. Input from Workgroup stakeholders will be solicited for
determining guidelines for subcommittees.
F&HS Agenda Packet Page 303
In Addition
Administrative CCBHS staff will be assigned to provide continuity and support for
organizing the meeting, agenda, minutes, postings and copies.
CCBHS will provide a report by Research Development Associates with a summary and
evaluation of the AOT Program’s first year of operation; the report is due this spring.
The AOT Workgroup will adhere to the provisions of Better Government Ordinances and the
Brown Act.
F&HS Agenda Packet Page 304
FAMILY AND HUMAN SERVICES COMMITTEE 11.
Meeting Date:04/24/2017
Subject:Children's Mental Health Services
Submitted For: FAMILY & HUMAN SERVICES COMMITTEE,
Department:County Administrator
Referral No.: 115
Referral Name: Child and Teen Psychiatric Services
Presenter: Cynthia Belon, Behavioral Health Director;
Vern Wallace, MH Program Chief
Contact: Enid Mendoza, (925)
335-1039
Referral History:
At the April 26, 2016 Board of Supervisors meeting the topic of child and teen psychiatric
services and the utilization planning of the 4-D Unit was referred to the Family and Human
Services Committee (F&HS) for follow up.
On February 22, 2017, the Health Services Department provided the first report to F&HS on this
referral. At this meeting, the Department was asked to return to the next F&HS meeting with
additional information regarding current children's mental health services provided at County
operated clinics; contracts providing Early and Periodic Screening, Diagnostic and Treatment
(EPSDT) services; an overview of the MHSA plan; and EPSDT revenues and billing rates.
Referral Update:
Please see the attached report from the Health Services Department detailing the additional
information on children's mental health services, as requested by F&HS at their February 22,
2017 meeting.
Recommendation(s)/Next Step(s):
Attachments
Follow Up Report on Children's Mental Health Services
F&HS Agenda Packet Page 305
RESPONSE TO FOLLOW-UP QUESTIONS FROM THE
FAMILY AND HUMAN SERVICES COMMITTEE
MEETING OF FEBRUARY 22, 2017
Report to the
Family and
Human Services
Committee
Contra Costa County Mental Health Services
Children’s Mental Health Program Chief Vern Wallace, LMFT
March 27, 2017
F&HS Agenda Packet Page 306
(1) What services are currently provided at our County operated clinics for children’s mental health?
Answer: Please see Attachment A.
(2) What CBO contracts/contractors do we have providing EPSDT services?
(a) How much are those contracts?
(b) What population are those contracts serving?
Answer: Please see Attachment B.
(3) Provide an overview of what is included in the draft MHSA plan for expanded EPSDT services and the
MHSA planning process.
(a) General description.
Answer: Please see Attachment C.
(b) What is the MHSA Budgeted amount?
Answer: The total budgeted amount for Fiscal Year 2016/17 is $43,114,745. The total pending
budgeted amount for Fiscal Year 2017/18 is $51,574,566.
(4) How much EPSDT revenue does Mental Health receive?
Answer: The projected collection amount for Fiscal Year 2016/17 is $61,788,182. The total pending
budgeted amount for Fiscal Year 2017/18 is $66,894,032. Fifty percent of these amounts are
Federally funded.
(5) What is the process to increase funding/billing rates for EPSDT services?
Answer: EPSDT is a Medi-Cal service that is paid based on the County Maximum Allowance (CMA)
rates. The CMA establishes the unit price the Behavioral Health Division will pay for services
provided by all contracted Community Based Organizations (CBO).
The CMA applies to services rendered to the entire client population (Adult and Children's services).
No age distinction and no distinction by funding source exists within the CMA.
The Behavioral Health Division can increase the CMA rates as service demand and finances allow.
The Recommended Budget includes a 3% COLA for the CBO's. Below are the CMA rates before and
after the COLA.
Service Function Time Base
FY 16/17 CMA with
3% COLA
FY 17/18 Proposed
3% CMA Rate Increase
Day Treatment Intensive Half Day Client Half Day $148.45 $152.90
Day Treatment Intensive Full Day Client Full Day $208.50 $214.75
Day Treatment Rehabilitation Half Day Client Half Day $86.60 $89.19
Day Treatment Rehabilitation Full Day Client Full Day $135.18 $139.23
Case Management, Brokerage Staff Minute $2.08 $2.14
Mental Health Services Staff Minute $2.69 $2.77
Medication Support Staff Minute $4.96 $5.10
Crisis Intervention Staff Minute $4.00 $4.12
Therapeutic Behavioral Services (TBS) - various Staff Minute $0.44, $1.66, $1.81,
$1.99, $2.06, $2.69
$0.45, $1.70, $1.86,
$2.04, $2.12, $2.77
F&HS Agenda Packet Page 307
(6) Are the EPSDT Rates the maximum we can claim?
Answer: The CMA rates are established at the maximum amount the Division can afford to fund
across all service lines (Adult and Child). The CMA rates are not established by funding source; the
Division does not charge or pay for services differently based on the payor (note: this is a consistent
practice throughout the Health Services Department).
(7) Would more general purpose revenues allow for greater Federal match draw down?
Answer: Yes. Similar to other operating divisions of the Health Services Department payment for
Medi-Cal services requires the County to provide the match to receive the Federal Funding. The
more match available the larger the Federal draw down. Potential changes at the Federal level
concerning the movement to a Medicaid block grant may alter this process in the future.
F&HS Agenda Packet Page 308
Service Type West County Children’s Mental Health Clinic Antioch Children’s Behavioral Health Central County Children’s Mental Health Clinic
Approximate Number of Active Charts 1112 832 808
Psychiatric Services x x x
Outpatient Service x x x Individual x x x Family x x x Group x x x Crisis x x x Collateral x x xSchool Service and Consultation x x x
Parent Partners x x x
PIP Program x
Wrap Around Services x x x
Dialectical Behavior Therapy x x x
Triple P Parenting x x x
Head Start Program x x x
Parent Project x
Wrap Around Services x x x
Cognitive Behavioral Therapy x x x
Trauma Focused Cognitive Behavioral Thera x x x
Family Based Therapy Eating Disorder x x x
NA/AA x
Dialectic Behavioral Therapy x x
The target population for each of the three Regional Clinics is the same. All serve the moderate to severe Seriously Emotionally Disturbed child and youth population 0 to 18/21 years old.
Children's Behavioral Health
Service by Clinic
Attachment A
F&HS Agenda Packet Page 309
CONTRACT
NUMBER
# of
Prgms CONTRACTOR CONTRACT TYPE and Service Description Population Served:LOCATION 16-17 CPL REALIGNMENT MHSA
74-317 1 Alternative Family Services EPSDT: MTFC & ITFC EBP: Foster Care Population Santa Rosa $976,087 $488,044
74-402 1 Aspiranet EPSDT: TBS Adolescent Population 12-18 yrs.Turlock $250,000 $125,000
74-321 2 Bay Area Community Resources EPSDT: School-Based OP Adolescent population 12-18 yrs Richmond $1,640,148 $820,074
74-399 1 CCC Interfaith Housing EPSDT: Residential Homeless Families Pleasant Hill $206,963 $103,482
24-927 5 CHAA EPSDT: WA; School Based; CoOccuring Adolescents 12-18 yrs. East&West County Richmond $1,585,124 815,737
74-526 1 Community Options for Families EPSDT: Functional Family Therapy (FFT)EBP: Incarcerated Youth, Juvenile Hall, Ranch Walnut Creek $551,362 -
74-315 2 Community Options for Families EPSDT TBS/Multi Systemic Therapy/ (MST)EBP: Incarcerated Youth, Juvenile Hall, Ranch Walnut Creek $2,353,912 $674,831 669,500.00$
74-495 1 Berkeley Youth Alternatives EPSDT: School-Based OP Adolescent population 12-18 yrs Berkeley $100,066 $50,033
24-707 4 CCARC EPSDT: Katie A; W/A; Substance Abuse;OP 0-5 Population Pittsburg $2,045,722 $1,022,861
74-525 1 Center for Psychotherapy EPSDT: Outpatient Latency Age population East County Antioch $400,000 $200,000
74-182 1 Chamberlain Children's Center EPSDT: Group Home Adolescent Group Home Population Hollister $86,520 $43,260
74-128 2 Charis Youth Center EPSDT: Group Home Adolescent Group Home Population Auburn $309,000 $154,500
74-517 1 Child Theraphy Institute EPSDT: Outpatient Svcs.Options/ MDFT/IHBS San Rafael $325,000 $162,500
74-218 1 Desarrollo Familias EPSDT: Outpatient Svcs.Outpatient Services West County Richmond $365,342 $182,671
24-308 3 Early Childhood Mental Health EPSDT: Katie A; Wraparound 0-5 Population East County Richmond $2,746,654 $1,373,327
24-859 2 Edgewood Childrens Center EPSDT: Group Home Crisis Residential for latency age population San Francisco $123,600 $61,800
24-928 3 Fred Finch Youth Center EPSDT: DD Res; School Based Svc.; TBS County wide Res; Adolescent population 12-18 Oakland $1,256,714 $623,357
74-452 1 La Clinica EPSDT; Outpatient Clinic Spanish Speaking adolescent population Antioch $412,000 $206,000
24-133 3 LaCheim School, Inc.EPSDT: Group Home; School Based Adolescents 12-18 yrs. East&West County Richmond $2,347,052 $1,173,526
24-925 4 Lincoln Child Center EPSDT MHSA: Katie A./MDFT/SEP EBP: MDFT/Options/IHBS East County $7,032,087 $2,688,823 540,751$
24-773 2 Mountain Valley ( formerly Milhous)EPSDT Group Home Adolescent Group Home Population Nevada City $839,450 $419,725
74-371 2 Mount Diablo Unified School District EPSDT: School-Based OP Mt. D Collaborative Alliance/Sunrise Concord $2,922,491 $1,396,475
74-058 8 Seneca Center EPSDT MHSA: MRT; School Based; W/A;Adolescents 12-18 yrs. All County Concord $7,732,518 $3,770,606 360,123$
74-249 2 St. Vincent's Home for Boys EPSDT: Group Home; TBS Adolescent 12-18 hrs. San Rafael $333,720 $166,860
74-051 1 STAND Against Domestic Violence EPSDT: Respite & Mentoring Adolescents 12-18 yrs. All County Concord $1,421,400 $710,700
74-031 1 Summitview Child Treatment Center EPSDT: Group Home Adolescents 12-18 yrs.Placerville $154,500 $77,250
24-941 1 TLC Child & Family Services EPSDT: Group Home Adolescents 12-18 yrs.Sebastopol $75,000 $37,500
24-778 2 UPLIFT (Families First)EPSDT: School Based Adolescents 12-18 yrs.Solara $462,382 $228,691
74-345 1 Victor Community Support Svcs EPSDT: TBS Adolescents in Group Home 12-18 Shasta County $20,600 $10,300
24-682 2 Victor Treatment EPSDT: Group Home Adolescents 12-18 yrs.Chico/Redding $347,800 $173,900
74-191 1 West Contra Costa Unified School EPSDT: School-Based; W/A Clinic Adolescents 12-18 yrs.Richmond $578,710 $286,855
24-705 3 We Care EPSDT: W/A; OP; Katie A 0-5 Population Central County Concord $1,779,635 $889,818
24-409 2 West CC Youth Services Bureau EPSDT: W/A; School Based Svcs.Adolescents 12-18/ West County population Richmond $3,135,384 $1,567,692
24-315 4 YMCA Collaborative EPSDT: School Based Adolescents 12-18/ West County population Richmond $984,464 $511,759
74-322 3 Youth Homes, Inc.EPSDT: Group Home;TBS; KatieA Adolescents 12-18/ All County population Concord $3,737,320 $1,868,660
Total:75 $49,638,727 $23,086,616 $1,570,374
CHILDREN SYSTEM OF CARE CONTRACTS
Attachment B
F&HS Agenda Packet Page 310
SED Seriously emotionally disturbed
0-5 0 to 5 years old
DD Dual Diagnosis
EBP Evidence Based Practice Model
EPSDT Early Periodic Screening & Diagnostic Treatment
FFT Functional Family Therapy
IHBS In Home Behavioral Services
ITFC Intensive Treatment Foster Care
MHSA Mental Health Services Act
MTFC Multi Treatment Foster Care
SEP School Engagement Program
TBS Therapeutic Behavioral Health
W/A Wrap Around
Note:Population consists of multi-cultural population
Contracts funded with MHSA highlighted in yellow
Attachment B
F&HS Agenda Packet Page 311
Presentation – Proposed EPSDT Expansion Funded by MHSA Three Year Plan
Board of Supervisors’ Family and Human Services Committee - March 27, 2017
The FY 17-20 MHSA Three Year Program and Expenditure Plan proposes to increase budget
authority in total from $43.1 million in current year to $51.5 million annually for the three year
period. New proposed programming includes $3.7 million in MHSA funding for Children’s
services to supplement the required expansion of the Early and Periodic Screening, Diagnosis
and Treatment (EPSDT) program. (Note: $3.7 million in matching federal funds included in the
Mental Health operational budget.)
Recently the Department of Health Care Services has clarified that the continuum of EPSDT
services are to be provided to any specialty mental health service beneficiary who needs it. In
addition, newly enacted Assembly Bill 403 mandates statewide reform for care provided to
foster care children, to include the County’s responsibility to provide Therapeutic Foster Care
(TFC) services. This significant expansion of care responsibility, entitled Continuing Care Reform
(CCR), proposes to utilize MHSA funds as the up-front match for the subsequent federal
reimbursement that enables the County to provide the full scope of services, and includes
adding County mental health clinicians, family partners and administrative support.
The total increase in MHSA budget authority, to include the EPSDT expansion, is to be paid for
by a combination of anticipated increases in revenue from the state Mental Health Services Act
Trust Fund, projected Medi-Cal reimbursements, and spending down a portion of the County’s
unspent MHSA fund balance.
Sufficient MHSA funds are available to fully fund all proposed new and existing programs for
the duration of this three year period. The estimated unspent MHSA Fund balance is
forecasted to be needed at the end of this three year period in order to ensure sustainability of
programs in the event of changes in the economy, federal financial participation, and/or
emerging programming, such as the No Place Like Home Initiative.
Prior to MHSA Three Year Plan development a comprehensive quantitative needs assessment
as well as a robust community program planning process was conducted. The needs
assessment indicated that there was an equitable distribution of mental health services and
funding for each of the three regions of the county, as well as self-identified race/ethnicities,
age groups and gender. Across all three regions services to children ages 0-5 were slightly
underrepresented. Stakeholders and interested community members came together in three
community forums in East, Central and West County, where input was discussed and heard,
and service needs prioritized. Services to young children remain a high priority.
As per statute this MHSA Three Year Program and Expenditure Plan is posted for public
comment for 30 days until April 21. The Mental Health Commission will host a Public Hearing
on May 3, with Contra Costa Behavioral Health Services responding to all significant public and
Commission input. Board of Supervisor consideration of the Three Year Plan is anticipated for
some time in June.
Attachment C
F&HS Agenda Packet Page 312
Mental Health Services Act
(MHSA) FY 2017-20 Three Year
Program and Expenditure Plan
OUTLINE OF DRAFT PLAN
Attachment C
F&HS Agenda Packet Page 313
FY 2017-20 Plan Summary
•The Three Year Plan proposes to set aside $51.6 million
for fiscal year 2017-18 to fund 85 programs and plan
elements. This is a proposed $8.5 million annual increase
in budget authority from the previous Three Year Plan.
•This increase will be offset by estimated additional Medi-
Cal reimbursement, increase in state MHSA Trust Fund
revenue, and use of unspent funds from previous years.
•It is anticipated that current total budget spending
authority will not need to be reduced in order to fully fund
MHSA programs and plan elements in the foreseeable
future.
F&HS Agenda Packet Page 314
Plan Outline Summary
•Introduction
•Table of Contents
•Vision
•Community Program Planning Process
•The Plan
•The Budget
•Evaluating the Plan
•Acknowledgements
•Appendices
o Mental Health Service Maps
o Program and Plan Element Profiles
o Glossary
o Certifications, Funding Summaries
o Public Comment and Hearing
o Board Resolution
F&HS Agenda Packet Page 315
Introduction
•Describes MHSA, MHSA values, statutory and regulatory requirements
•Outlines changes to the current Three Year Plan
o A description of this year’s Needs Assessment and Community Program Planning Process
o Addition of outcome indicators for FSP programs and PEI categories
o Planning for re-purposing the County’s Oak Grove facility
o Introduces the “No Place Like Home Initiative”
o Adds the Special Needs Housing Program
o Funds the EPSDT expansion requirements
o Expands children and adult mobile crisis response capacity
o PEI programs are aligned with new required PEI categories
o First Hope is adding a first psychotic break program
o Two new innovative projects are introduced
o A Family Support Program is added to the WET component
o Mental Health First Aid is linked to community first responders
o A Loan Forgiveness Program added to address workforce shortages
o Funds added to allow for programs’ increased cost of doing business
F&HS Agenda Packet Page 316
Vision
We intend to utilize MHSA funding to assist Behavioral Health Services in addressing three key areas:
•Access – improve assistance with eligibility, transportation, shorten wait times, increase availability after hours, provide services that are culturally and linguistically competent
•Capacity – take the time to partner with the individual and his/her family to determine the level and type of care needed, coordinate necessary health, mental health and other needed resources, and then successfully work through challenging mental health issues
•Integration – work with our health, behavioral health and community partners as a team to provide multiple services coordinated to a successful resolution.
We need to continually challenge ourselves to improve our response to individuals and their families who need us the most, and may have the most difficult time accessing care.
F&HS Agenda Packet Page 317
Needs Assessment
•In 2016 CCBHS conducted a data driven assessment of public
mental health needs to complement the planning process.
•Prevalence and penetration rates were used to determine that
the County is proportionally serving all three regions as well as
by race/ethnicity, age group and identified gender.
Asian/Pacific Islanders, Latina/os, children ages 0-5 and the
elderly are slightly underrepresented. All service rates exceed
state averages.
•Expenditure data indicate significant services available at all
levels of care, with an oversubscription of funds paying for
locked facilities.
•Workforce analysis indicate a critical shortage of psychiatry
time, with an underrepresentation of Latina/os in the CCBHS
workforce.
F&HS Agenda Packet Page 318
Community Program Planning Process
•Describes the process
•Describes the Consolidated Planning and Advisory
Workgroup and ongoing stakeholder participation
•Describes and summarizes results of the recently
completed Community Program Planning Process for FY
2017 -18
•Links prioritized needs to MHSA funded programs, projects
and plan elements contained in the Three Year Plan
F&HS Agenda Packet Page 319
Community Program Planning Process
Highlights (1)
•CPAW planned and hosted three community forums
•Over 300 individuals attended forums in San Pablo (West), Pleasant
Hill (Central), and Bay Point (East)
•Attendees self identified:
o 23% as a consumer
o 32% as a family member
o 39% as a service provider
o 14% as a community member
•Small group discussions addressed topical questions developed by
consumer, family member and service provider representatives
•Attendees prioritized identified mental health needs
F&HS Agenda Packet Page 320
Community Program Planning Process
Highlights (2)
Prioritized Needs:
1.More housing and homeless services
2.More support for family members
3.Better coordination of care
4.Children and youth in-patient and residential beds
5.Finding the right services when you need it
6.Improved response to crisis and trauma
7.Support for peer and family partners
8.Intervening early in psychosis
9.Getting care in my community, my culture, my language
10.Assistance with meaningful activity
11.Getting to and from services
12.Care for homebound frail and elderly
13.Serve those who need it the most
14.Help moving to a lower level of care as one gets better
15.Better program and fiscal accountability
F&HS Agenda Packet Page 321
The Plan
•Community Services and Supports (CSS)
•Prevention and Early Intervention (PEI)
•Innovation (INN)
•Workforce Education and Training (WET)
•Capital Facilities and Technology (CF/TN)
Each component leads with a short description of the
component and categories within the component, and then
lists and describes each program or plan element, cost
allocated, and number to be served.
F&HS Agenda Packet Page 322
Community Services and Supports
$37.6 million to fund programs and plan elements that provide services to approximately 2,000 individuals - children who are seriously emotionally disturbed, transition age youth (TAY), adults and older adults who are seriously mentally ill.
•Full Service Partnerships ($23.7m):
o 9 Full Service Partnership Programs serving all age groups and all county regions
o Assisted Outpatient Treatment
o FSP support staff at all children and adult clinics
o 3 Wellness and Recovery Centers
o Hope House (transitional residential center)
o Oak Grove Youth Residential Center (in planning)
o MHSA funded housing services (temporary, supported or permanent)
•General System Development ($13.8m):
o Children’s Wraparound and EPSDT expansion
o Older Adult Program
o Clinical staff at the Miller Wellness Center, Concord Health Center
o Clinic support and liaison staff to PES and CCRMC
o Administrative support and quality assurance staff
F&HS Agenda Packet Page 323
Prevention and Early Intervention
$8.7 million to fund 25 MHSA programs that provide prevention and early
intervention services to approximately 13,000 individuals. All are designed to
prevent mental illness from becoming severe and debilitating, and 1) creates
access and linkage to mental health services, 2) reduces stigma and
discrimination, and 3) provides outreach and engagement to underserved
populations. All programs are in the following 7 categories:
1.Seven programs provide Outreach for Increasing Recognition of Early Signs of
Mental Illness ($1m)
2.Five programs provide Prevention Services that reduce risk factors and
increase protective factors ($1.6m)
3.The First Hope program provides Early Intervention Services for youth at risk of
or who are experiencing early onset of psychosis ($2.6m)
4.Four programs provide Access and Linkage to Mental Health Services ($1.1m)
5.Six programs Improve Timely Access to Mental Health Services for
Underserved Populations ($1.5m)
6.The Office for Consumer Empowerment (OCE) provides leadership and staff
support that addresses efforts to Reduce Stigma and Discrimination ($.3m)
7.Contra Costa Crisis Center and County staff address Suicide Prevention ($.6m)
F&HS Agenda Packet Page 324
Innovation
$2.1 million in FY 2017-18 to fund new or different patterns of service that contribute to informing the mental health system of care as to best or promising practices that can be subsequently added or incorporated into the system.
•4 projects are approved and will be in operation for FY 17-18 ($1.4m):
o Recovery Through Employment Readiness. Contra Costa Vocational Services adding pre-vocational services for consumers as part of their mental health treatment plan
o Coaching to Wellness. Adding peer wellness coaches to the adult clinics
o Partners in Aging . Support for frail, homebound older adults
o Overcoming Transportation Barriers. Assisting consumers overcome transportation barriers to accessing services
•2 projects are in development, and are expected to be in operation during the Three Year Plan ($.7m – estimated):
o CORE – multi-disciplinary treatment team to serve youth with mental health and substance use disorders
o CBSST – bringing cognitive behavioral social skills training to clients living in augmented board and care facilities
F&HS Agenda Packet Page 325
Workforce Education and Training
$2.6 million annually from Contra Costa’s MHSA unspent funds to recruit, support and retain a diverse, qualified paid and volunteer workforce. The five WET categories are:
1.Workforce Staffing Support. ($1.23m) Funds the county operated senior peer counseling program, a new contract operated family support volunteer program, and WET administrative staff
2.Training and Technical Assistance. ($.23 m) Funds Mental Health First Aid, Crisis Intervention Training, NAMI Basics/Faith Net/Familia de Familia and various county and contract staff trainings
3.Mental Health Career Pathway Programs. ($.44m) Funds the college accredited SPIRIT course where approximately 50 individuals yearly are trained as peer providers and family partners
4.Internship Programs. ($.35m) Provides approximately 75 graduate level clinical intern placements in county and contract operated community mental health programs to increase workforce diversity
5.Financial Incentive Programs. ($.3m) Establishes a locally administered loan forgiveness program to address critical workforce shortages, such as psychiatrists, and supports upward mobility of community support workers
F&HS Agenda Packet Page 326
Capital Facilities and Information
Technology
This component enables counties to utilize MHSA funds on a
one-time basis for major infrastructure costs necessary to
implement MHSA services and supports, and to generally
improve support to the County’s community mental health
service system. For FY 17-20:
•$696,00 remaining of MHSA funds to complete and
integrate Behavioral Health Services’ electronic records
system with the Epic system currently in use by the
County’s Health Services
o Completion forecasted for FY 18-19
o As per the provisions of the 2010 proposal any costs that exceed
the originally approved $6 million will be born by the County’s
Health Services Department
F&HS Agenda Packet Page 327
Program Component Changes
Due to component fidelity the following programs and plan
elements have changed component funding from current (FY 14-
17) to proposed (FY 17-20) Three Year Plan:
•The Older Adult Senior Peer Counseling program has moved
from CSS to WET
•Funding for the mental health clinicians at the Concord Health
Center have moved from PEI to CSS
•Rainbow Community Center has moved from INN to PEI
•The Perinatal Depression (WELL) Project has moved from INN to
PEI
•OCE staff supporting the SPIRIT program has moved from PEI to
the WET component
F&HS Agenda Packet Page 328
The Budget
•Provides estimated available funds, revenues, expenditures and projected fund
balances by component for Fiscal Years 2017-18, 18-19 and 19-20
•Projected fund balances will be updated in subsequent FY 18-19 and 19-20
MHSA Plan Updates as revenues and expenditures actualize
•Projected revenues include state MHSA Trust Fund distribution, interest
earned, and federal financial participation (Medi-Cal reimbursement)
•The County maintains a prudent reserve of $7,125,250 to ensure that
services do not have to be significantly reduced in years in which revenues are
below the average of previous years. This is in addition to available unspent
funds from previous years.
NOTE: This current draft version contains dollar amounts that are approximate.
This is because Finance is in the process of finalizing the Funding Summaries that
will be included as Appendix E. The Budget in the Plan needs to match the
Funding Summaries, and will be adjusted accordingly.
F&HS Agenda Packet Page 329
The Budget (2)
•$7.8m in unspent CSS funds from previous years is transferred to the WET component in order to finance the proposed WET category expenditures for the three year period
•The $1.7m received in 2016 for the Special Needs Housing Program has been added to the CSS budget for FY 17-18. Any of these funds not spent during FY 17 -18 will be added to the FY 18-19 budget when the Three Year Plan is updated in 2018
•A collective increase in budget authority for FY 18-19 and 19-20 allows for an increase in the cost of doing business. Subsequent Three Year Plan annual budget authority will be reviewed based upon actual costs and adjusted, if appropriate, for Board of Supervisor review and approval
•It is projected that the requested total budget authority for the Three Year Plan period enables the County to fully fund all proposed programs and plan elements while maintaining sufficient funding reserves (prudent reserve plus unspent funds from previous years) to offset any reduction in state MHSA Trust Fund distribution or federal financial participation (Medi-Cal reimbursement)
F&HS Agenda Packet Page 330
Evaluating the Plan
•Describes a program and fiscal review process with written
report to determine whether MHSA funded programs:
o Meet the letter and intent of MHSA
o Support the needs, priorities and strategies identified in the
community program planning process
o Meet agreed upon outcomes and objectives
o Are cost effective
•Includes a quarterly MHSA financial report to enable
ongoing fiscal accountability.
F&HS Agenda Packet Page 331
Acknowledgements
A thank you to individuals who shared their stories, provided
input, and who are working to make the system better.
F&HS Agenda Packet Page 332
Appendix A - Mental Health Service Maps
Provides six one page pictorial of all Contra Costa Mental Health’s services broken down by the following:
•East County adult, older adult and transitional age youth
•East County Children’s
•Central County adult, older adult and transitional age youth
•Central County Children’s
•West County adult, older adult and transitional age youth
•West County Children’s
F&HS Agenda Packet Page 333
Appendix B - Program Profiles
Provides a profile of each MHSA funded program or plan
element according to the following outline:
•Organization contact information
•Brief organization description
•Title(s) and brief description(s) of MHSA funded program or
plan element
o Total MHSA funds allocated
o FY 15-16 outcomes
•Contains an alphabetized Program and Plan Element
Profile Table of Contents
F&HS Agenda Packet Page 334
Appendix C - Glossary
Provides an alphabetical listing and definition of terms and
acronyms used in the document.
F&HS Agenda Packet Page 335
Appendix D – Certifications
Appendix E - Funding Summaries
•County Behavioral/Mental Health Director Certification
•County Fiscal Accountability Certification
•MHSOAC required funding summaries
F&HS Agenda Packet Page 336
Appendix F - Public Comment, Hearing
Appendix G – Board Resolution
•Will include evidence of Public Comment period and
Hearing, and summary of public comments.
•Mental Health Commission’s review of draft plan and
recommendations.
•Contra Costa Behavioral Health Service’s response to
public comments and Mental Health Commission
recommendations.
•Board of Supervisor Resolution
F&HS Agenda Packet Page 337
Timeline
•MAR 2 - 1st DRAFT Three Year Plan shared with
CPAW/MHC for input
•MAR 20 - 2D DRAFT Three Year Plan posted for 30 day
public comment period
•MAY 3 - Mental Health Commission (MHC) hosts Public
Hearing on Three Year Plan
•MAY (early) – Public Comment, Hearing and MHC
recommendations addressed
•MAY (late) - Three Year Plan submitted to County
Administrator for inclusion on Board of Supervisors’ (BOS)
agenda
• JUNE – BOS considers Three Year Plan
F&HS Agenda Packet Page 338
Issues for MHSA FY 17-20 Three Year
Program and Expenditure Plan
•Any additional uses for MHSA funds that is not currently
depicted in the Three Year Plan will eventually deplete the
County’s unspent reserve and potentially trigger a contraction of
programs
•The County’s level of participation in the “No Place Like Home”
initiative is currently unknown
•Level of future federal financial participation for California is
unknown
•Full budget impact of new initiatives is unknown
o Re-purposing of Oak Grove facility
o Full impact of Continuum of Care reform requirements for
Children’s System of Care
o mobile crisis response teams
F&HS Agenda Packet Page 339
Your Input Is
Most Welcome!
Point of Contact:
Warren Hayes
MHSA Program Manager
1340 Arnold Drive
925-957 -5154
warren.hayes@hsd.cccounty.us
F&HS Agenda Packet Page 340