HomeMy WebLinkAboutBOARD STANDING COMMITTEES - 09242018 - FHS Cte Agenda Pkt
FAMILY & HUMAN SERVICES
COMMITTEE
September 24, 2018
10:30 A.M.
651 Pine Street, Room 101, Martinez
Supervisor Candace Andersen, Chair
Supervisor John Gioia, Vice Chair
Agenda
Items:
Items may be taken out of order based on the business of the day and preference
of the Committee
1.Introductions
2.Public comment on any item under the jurisdiction of the Committee and not on this
agenda (speakers may be limited to three minutes).
3. RECEIVE and APPROVE the draft Record of Action for the July 23, 2018 Family &
Human Services Committee meeting. (Julie DiMaggio Enea, County Administrator's
Office)
4. CONSIDER recommending to the Board of Supervisors the appointments of Joshua
Aldrich to the Business #2 seat and Terry Curley to the Business #4 seat on the
Workforce Development Board to complete the current terms ending on June 30, 2020,
as recommended by the Employment and Human Services Department. (Donna Van
Wert, Workforce Development Board Executive Director)
5. CONSIDER recommending to the Board of Supervisors the appointment of Dennis
Yee, Brian O'Toole, and Kevin Donovan to At Large seats, and the re-appointment of
the following individuals to Local Committee seats with terms expiring September 30,
2020: Shirley Krohn, Patricia Welty, Deborah Card, Summer Selleck, Nuru
Neemuchwalla, Mary Rose, and Richard Nahm on the Advisory Council on Aging, as
recommended by the Council. (Jaime Ray, Employment and Human Services
Department)
6. CONSIDER recommending to the Board of Supervisors the appointment of Lisa
Johnson to a discipline specific seat, First 5 Commission seat, Karin Kauzer to a
discipline specific, School Representative seat, and Mary Flott to the At Large 1 seat on
the Family and Children's Trust Committee, as recommended by the Employment and
Human Services Director. (Juliana Mondragon, Employment and Human Services
Department)
7. CONSIDER accepting the joint update report from Behavioral Health Services and the
1
7. CONSIDER accepting the joint update report from Behavioral Health Services and the
Mental Health Commission on the public mental health care system, child and teen
psychiatric services, and Civil Grand Jury Report No. 1703. (Matthew P. White, M.D.,
Acting Director, Behavioral Health; Barbara Serwin, Chair, Mental Health
Commission)
8. CONSIDER accepting annual status report on the Continuum of Care Plan for the
Homeless. (Jaime Jennett, HSD Continuum of Care Planning and Policy Manager;
Joseph Mega, MPH, M.D., HSD Medical Director-Health Care for the Homeless)
9. CONSIDER accepting status report from the Employment and Human Services
Department and the Workforce Development Board on implementation of the
Workforce Innovation & Opportunity Act local and regional plans. (Donna Van Wert,
Workforce Development Board Executive Director)
10. CONSIDER accepting report from the Employment and Human Services Department
on the CalFresh program, formerly known as Food Stamps and federally known as the
Supplemental Nutritional Assistance Program. (Wendy Therrian, Workforce Services
Director)
11.The next meeting is currently scheduled for October 22, 2018.
12.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:
Julie DiMaggio Enea, Interim Committee Staff
Phone (925) 335-1077, Fax (925) 646-1353
julie.enea@cao.cccounty.us
2
FAMILY AND HUMAN SERVICES
COMMITTEE 3.
Meeting Date:09/24/2018
Subject:RECORD OF ACTION FOR THE JULY 23, 2018 F&HS MEETING
Department:County Administrator
Referral No.: N/A
Referral Name: N/A
Presenter: Julie DiMaggio Enea Contact: Julie DiMaggio Enea (925)
335-1077
Referral History:
County Ordinance requires that each County body keep a record of its meetings. Though the
record need not be verbatim, it must accurately reflect the agenda and the decisions made in the
meeting.
Referral Update:
Attached is the draft Record of Action for the July 23, 2018 Family & Human Services
Committee meeting.
Recommendation(s)/Next Step(s):
RECEIVE and APPROVE the draft Record of Action for the July 23, 2018 Family & Human
Services Committee meeting.
Fiscal Impact (if any):
None.
Attachments
DRAFT F&HS Record of Action 7-23-18
3
FAMILY AND HUMAN SERVICES
COMMITTEE
RECORD OF ACTION FOR
JULY 23, 2018
Supervisor Candace Andersen, Chair
Supervisor John Gioia, Vice Chair
Present: Candace Andersen, Chair
John Gioia, Vice Chair
Staff Present:Julie DiMaggio Enea, Senior Deputy County Administrator
Attendees: Susan Smith, County Administator's Office
Don Graves, EHSD
Kathy Gallagher, EHS Director
Kathy Marsh, EHSD
Susan Jeong, CCC Office of Education
1.Introductions
Chair Andersen called the meeting to order at 1:30 p.m. and self introductions were
made around the room.
2.Public comment on any item under the jurisdiction of the Committee and not on this
agenda (speakers may be limited to three minutes).
No one requested to speak during the public comment period.
3.RECEIVE and APPROVE the draft Record of Action for the June 25, 2018 Family &
Human Services Committee meeting.
The Committee approved the Record of Action for the June 25, 2018 meeting as
presented.
AYE: Chair Candace Andersen, Vice Chair John Gioia
Passed
4.RECOMMEND to the Board of Supervisors the appointment of Michelle Hernandez to
Consumer Seat of Any Age – Seat 3 on the In-Home Supportive Services Public
Authority Advisory Committee to complete the current term ending on March 7, 2022,
as recommended by the Committee.
The Committee approved the nomination of Michelle Hernandez to the Consumer
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4
The Committee approved the nomination of Michelle Hernandez to the Consumer
Seat of Any Age – Seat 3 on the In-Home Supportive Services Public Authority
Advisory Committee to complete the current term ending on March 7, 2022, and
directed staff to forward the recommendation to the Board of Supervisors.
AYE: Chair Candace Andersen, Vice Chair John Gioia
Passed
5.RECOMMEND to the Board of Supervisors the appointment of Carolyn Foudy to the
Employment and Human Services Department Representative seat on the Contra Costa
Council on Homelessness to complete the unexpired term ending on December 31,
2018 and to a new two-year term ending on December 31, 2020.
The Committee approved the nomination of Carolyn Foudy to the Employment and
Human Services Department Representative seat on the Contra Costa Council on
Homelessness to complete the unexpired term ending on December 31, 2018 and to
a new two-year term ending on December 31, 2020, and directed staff to forward
the recommendation to the Board of Supervisors.
AYE: Chair Candace Andersen, Vice Chair John Gioia
Passed
6.RECOMMEND to the Board of Supervisors the re-appointment of Elizabeth Anne
Sutherland, M.D., to the At Large 2 seat to a term ending on June 30, 2021; and the
appointment of Jonathan Ciampi to the At Large 1 seat to complete the current term
ending on June 30, 2020, on the Alcohol and Other Drugs Advisory Board.
The Committee approved the nominations of Elizabeth Anne Sutherland, M.D., to
the At Large 2 seat to a term ending on June 30, 2021; and Jonathan Ciampi to the
At Large 1 seat to complete the current term ending on June 30, 2020, on the
Alcohol and Other Drugs Advisory Board, and directed staff to forward the
recommendation to the Board of Supervisors.
AYE: Chair Candace Andersen, Vice Chair John Gioia
Passed
7.ACCEPT report on the FY 2016/17 activities and key accomplishments of the Local
Planning Council as they relate to membership and funding of local child care and
development planning in Contra Costa County.
Susan Jeong presented the report, noting that the report covered the 2017/18 fiscal
year. She advised that a needs assessment is completed every five years and the
current needs assessment is not quite complete. She highlighted that the current
needs assessment will include a facilities survey to help demonstrate in State grant
applications the unmet facilities needs in Contra Costa County. She estimated that
there is a need for 10,000 more infant/toddler slots and 2.700 more preschool slots.
She noted the upcoming annual forum and the struggle to expend $134,000 in
preschool teacher tuition funding, which can be used to reimburse tuition paid
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5
upfront by preschool teachers.
The Committee accepted the report on the FY 2017/18 activities and key
accomplishments of the Local Planning Council as they relate to membership and
funding of local child care and development planning in Contra Costa County, and
directed staff to forward the report to the Board of Supervisors for their
information.
AYE: Chair Candace Andersen, Vice Chair John Gioia
Passed
8.Accept this report from the Employment and Human Services Department on youth
services and the Independent Living Skills Program; and continue to support the
Children and Family Services Bureau and its efforts to serve foster youth in the ILSP
program.
Kathy Gallagher introduced the staff report. Don Graves presented the staff report,
elaborating on the attached slideshow report. He noted that the ILSP program is
now 30 years old and receives excellent community support through the network of
partners developed over the years. The program raises about $70,000 annually for
youth scholarships. Program alumni return year after year to coach and inspire
current program participants.
The Committee accepted the report from the Employment and Human Services
Department on youth services and the Independent Living Skills Program; and
continue to support the Children and Family Services Bureau and its efforts to
serve foster youth in the ILSP program.
AYE: Chair Candace Andersen, Vice Chair John Gioia
Passed
9.The next meeting is currently scheduled for September 24, 2018.
10.Adjourn
Chair Andersen adjourned the meeting at 11:22 a.m.
For Additional Information Contact:
Julie DiMaggio Enea, Interim Committee Staff
Phone (925) 335-1077, Fax (925) 646-1353
julie.enea@cao.cccounty.us
DRAFT
6
FAMILY AND HUMAN SERVICES COMMITTEE 4.
Meeting Date:09/24/2018
Subject:APPOINTMENTS TO THE WORKFORCE DEVELOPMENT BOARD
Submitted For: Kathy Gallagher, Employment & Human Services Director
Department:Employment & Human Services
Referral No.: N/A
Referral Name: Appointments to Advisory Bodies
Presenter: N/A Contact: Donna Van Wert, WDB Exec Director
Referral History:
On December 13, 2011, the Board of Supervisors adopted Resolution No. 2011/498 adopting policy governing
appointments to independent boards, committees, and commissions, and special districts. Included in this resolution
was a requirement that independent bodies initially conducting interviews for At Large/Countywide seats provide
appointment recommendations to a Board Committee for further review.
The Workforce Development Board 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. On March 14, 2016, the Family and Human Services Committee (FHS) accepted the Employment
and Human Services Department's recommendation to decertify the then current Workforce Investment Act Local
Board and re-certify a new board structure in compliance with the new Workforce Innovation and Opportunity Act
(WIOA). FHS approved these recommendations, and the Board did the same at its March 29, 2016 meeting. Under
new standards in WIOA (2016) and as adopted by the Board on March 29, 2016, the new Workforce Development
Board structure is: a total of 23 required seats and 2 "optional seats", consisting of: 13 Business representatives, 5
Workforce representatives, and 5 Education and Training representatives as follows: (1) Adult Education/Literacy;
(2) Higher Education; (3) Economic & Community Devl; (4) Wagner Peyser representative; (5) Vocational
Rehabilitation. Also two additional/ "optional" seats that may be filled from any of the 3 categories above.
Referral Update:
The Workforce Development Board currently has 19 filled seats and 6 vacancies. These vacant seats include:
Business #2, Business #4, Business #9, Business #12, Workforce Representative #5, and Education 2: Higher
Education. Below is the current roster:
Seat Title
Term
Expiration
Date
Current
Incumbent
Incumbent
Supervisor
District
No. of
Meetings
Attended
Since
Appointment
Date*
Total No. of
Meetings
Held Since
Appointment
Total No.
of
Absences
Allowable
in
Bylaws*
Business 1 6/30/2020 Michael McGill II 3 10
Business 2 6/30/2020 VACANT
Business 3 6/30/2020 William
Mahoney V 3 5
Business 4 6/30/2020 VACANT
Business 5 6/30/2020 Bhuphen Amin IV 4 10
Business 6 6/30/2020 Jose Carrascal III 4 10
Business 7 6/30/2020 Jason Cox IV 3 10
Business 8 6/30/2020 Ashley Georgian II 3 10
7
Business 9 6/30/2020 VACANT
Business 10 6/30/2020 Bob Rivera IV 1 10
Business 11 6/30/2020 Justin Steele I 3 10
Business 12 6/30/2020 VACANT
Business 13 6/30/2020 Melissa
Johnson-Scranton IV 0 1
Workforce
Representative 1 6/30/2020 Thomas Hansen V 2 4
Workforce
Representative 2 6/30/2020 Robert Williams
III I 0 10
Workforce
Representative 3 6/30/2020 Steve Older IV 1 10
Workforce
Representative 4 6/30/2020 Margaret
Hanlon-Gradie I 1 10
Workforce
Representative 5 6/30/2020 VACANT
Education 1: Adult
Ed/Literacy 6/30/2020 G. Vittoria
Abbate II 4 4
Education 2: Higher
Education 6/30/2020 VACANT
Education 3:
Economic/Community
Dev.
6/30/2020 Kristin Connelly II 4 10
Education 4:
Employment
Development
6/30/2020 Richard Johnson IV 4 10
Education 5: Vocational
Rehabilitation 6/30/2020 Carol Asch IV 2 10
Additional/Optional #1 6/30/2020 Yolanda Vega II 4 10
Additional/Optional #2 6/30/2020 John Montagh IV 4 6
* Bylaws do not allow three consecutive absences or an excessive number of excused absences
Note that the Workforce Representative 2 appointee has attended no meetings so far. The WDB should consider
vacating this seat and recruiting for an active member.
Recommendation(s)/Next Step(s):
RECOMMEND to the Board of Supervisors the appointments of Joshua Aldrich to the Business #2 seat and Terry
Curley to the Business #4 seat on the Workforce Development Board to complete the current terms ending on June
30, 2020, as recommended by the Employment and Human Services Department and approved by the Workforce
Development Board Executive Committee.
Fiscal Impact (if any):
There is no fiscal impact.
Attachments
WDB Recommendation Memo
J_Aldrich Application
T_Curley Application
8
W ORKFORCE DEVELOPMENT BOARD OF CONTRA COSTA COUNTY
4 071 Port Chicago Highway • Suite 250 • Concord, CA 94520
T el. (925) 671-4560 • Fax (925) 228-0238
W ebsite: www.wdbcc.com
MEMORANDUM
DATE: July 23, 2018
TO: Family and Human Services Committee
CC: Enid Mendoza, CAO Sr. Deputy County Administrator
FROM: Donna Van Wert, 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
9
Recommendation:
a) Recommend approval of local board candidates for the vacant
Business Seat #2 to the new WIOA-compliant board (Attached application & board roster)
• Interview Date – June 28 ,2018
• Joshua Aldrich- Approved on July 11, 2018 at the Executive Committee Meeting
• No other candidate competed for the vacant Business Seat # 2
b) Business Seat #4 to the new WIOA-compliant board (Attached application & board roster)
• Interview Date – June 20, 2018
• Terry Curley Approved on July 11, 2018 at the Executive Committee Meeting
• No other candidate competed for the vacant Business Seat # 4
c)
NEW APPOINTMENT
Seat Last Name First Name Address & District
#
Term of
Expiration
District
(Resident)
Business Seat
#2
Aldrich Joshua
Brentwood, CA
District # 3
6/30/2020 District #3
Business Seat
# 4
Curley Terry
Walnut Creek,
CA
District # 4
6/30/2020 District #2
Thank you
DVW/rms
attachment
10
Submit Date: Jun 20, 2018
Seat Name (if applicable)
First Name Middle Initial Last Name
Email Address
Home Address Suite or Apt
City State Postal Code
Contra Costa County Boards & Commissions
Application Form
Profile
Which Boards would you like to apply for?
Workforce Development Board: Submitted
Describe why you are interested in serving on this advisory board/commission (please limit
your response to one paragraph).
The Contra Costa Board of Workforce Development is a contributing sector of the Public Workforce
system that supports economic expansion and development of the talent of the county’s workforce. The
Contra Costa Board of Workforce Development creates expansive, and ever-growing, opportunities to
workers and employers in the area. As a small business owner, it is important to become part of the
partnership that ensures workers are being trained and supported in ways that answer to the current
needs of local business. Additionally, as a small business owner located in a redeveloping corridor of the
county, becoming part of the workforce solution is vital to the success of the other businesses in the
areas of redevelopment and revitalization, but also to the community members that live within our
boundaries. There are an overwhelmingly number of people who want to work, but lack the necessary
understanding of what steps to take to take and what educational resources and job opportunities exist.
As a member of the Board of Workforce Development, I can proactively work to ensure sector strategies
of resource allocation answer to the training needs of the community and contribute to the development of
a workforce that is necessary within a growing economy. As we prepare for high growth in the community
and within the construction and renewable energy industry, appropriate training is imperative.
Communicating our needs as industry voices allows for training programs to truly be developed that align
with the business community at large. As a small business owner, I can openly and credibly contribute
labor market information to develop effective, appropriate and sustainable strategies for growth.
This application is used for all boards and commissions
Joshua L Aldrich
jaldrich@delsolnrg.com
538 2nd St
Brentwood CA 94513
Joshua L Aldrich Page 1 of 7
A1a
11
Primary Phone
Employer Job Title Occupation
If "Other" was Selected Give Highest Grade or
Educational Level Achieved
Name of College Attended
Course of Study / Major
Units Completed
Do you, or a business in which you have a financial interest, have a contract with Contra
Costa Co.?
Yes No
Is a member of your family (or step-family) employed by Contra Costa Co.?
Yes No
Education History
Select the highest level of education you have received:
High School Diploma
College/ University A
Type of Units Completed
None Selected
Home: (925) 350-1217
Del Sol NRG, Inc CEO Renewable Energy
Joshua L Aldrich Page 2 of 7
12
Degree Type
Date Degree Awarded
Name of College Attended
Course of Study / Major
Units Completed
Degree Type
Date Degree Awarded
Name of College Attended
Course of Study / Major
Degree Awarded?
Yes No
College/ University B
Type of Units Completed
None Selected
Degree Awarded?
Yes No
College/ University C
Joshua L Aldrich Page 3 of 7
13
Units Completed
Degree Type
Date Degree Awarded
Course Studied
Hours Completed
Dates (Month, Day, Year) From - To
Hours per Week Worked?
Type of Units Completed
None Selected
Degree Awarded?
Yes No
Other schools / training completed:
Certificate Awarded?
Yes No
Work History
Please provide information on your last three positions, including your current one if you are
working.
1st (Most Recent)
Joshua L Aldrich Page 4 of 7
14
Position Title
Dates (Month, Day, Year) From - To
Hours per Week Worked?
Position Title
Dates (Month, Day, Year) From - To
Volunteer Work?
Yes No
Employer's Name and Address
Duties Performed
2nd
Volunteer Work?
Yes No
Employer's Name and Address
Duties Performed
3rd
Joshua L Aldrich Page 5 of 7
15
Hours per Week Worked?
Position Title
Upload a Resume
If "Other" was selected please explain
Volunteer Work?
Yes No
Employer's Name and Address
Duties Performed
Final Questions
How did you learn about this vacancy?
Other
. Do you have a Familial or Financial Relationship with a member of the Board of
Supervisors?
Yes No
If Yes, please identify the nature of the relationship:
Do you have any financial relationships with the County such as grants, contracts, or other
economic relations?
Yes No
Bhupen Amit
Joshua L Aldrich Page 6 of 7
16
If Yes, please identify the nature of the relationship:
Joshua L Aldrich Page 7 of 7
17
Print Form J
Contra
Costa
County
r Office Use Only Date Received: For Reviewers Use Only:
Accepted Rejected
BOARDS, COMMITTEES, AND COMMISSION APPLICATION
MAIL OR DELIVER TO:
Contra Costa Cou1y
CLERK OF TIE BOARD
651 Pine Street. Rm. 106
Martnez, catfooia 94553-1292
PLEASE TYPE OR PRINT IN INK
(Each Position Requires a Separate Appication)
BOARD, COMMITTEE OR COMMISSION NAME AND SEAT TITLE YOU ARE AP LYING FOR: !Business Representatives Boar d r-lB-o -ar_d _M_e _m_b-er ------------,
PRINT EXACT NAME OF BOARD, COMMITTEE, OR COMMISSION PRINT EXACT SEAT NAME (if applicable)
2.Address:
3.Phones:r---I ---------. --·· -(Home No.) (Work No.)
I 4.Email Address: 1
5. EDUCATION: Check appropriate box if you possess
High School Diploma IE) G.E.D. Certificate D Californi,
Give Highest Grade or Educational Level Achieved!Gradu
(Cell No.)
pne of the following:
High School Proficiency Cert ificate □
�te Certificate
Names of colleges / universities Degree Course of Study/ Maj ,r Units Completed attended Awarded
A)I Laney CollegeI bakland CA
B)�ills Collegeakland CAC) Pac ific Coast Banking SchoolUniversity of WA
!MarketingI·�
Finance/Bank !Management
I I
Yes No IEIO
Yes No IEID
I Yes No IEID
Semester D D D
Quarter D D D
Degree Type
E] EJ EJ
I
I
Date Degree Awarded
11989
11992
l20os
D)Other schools / training Course Studied Hours Completed Ce rtificate Awarded: completed: •�redit Structure/I ��I Yes NolE)D CBA Lending School UnderwritingRex Beach UCA Cashflow
THIS FORM IS A PUBLIC DOCUMENT
I I I
A1b
18
6.PLEASE FILL OUT THE FOLLOWING SECTION COMPLE ELY. List experience that relates to the qualifications needed to
serve on the local appointive body. Begin with your most r, cent experience. A resume or other supporting documentation
may be attached but it may not be used as a substitute for ompleting this section.
A)Date s (M onth, Day, Yea r)From To
�� Total: Yrs. Mos.
CJCJ Hrs. per weekl55-60 I. Volunteer D
B)Dates (M on th, D ay, Year)From T o EJEJ r•I Yrs. I I�
Hrs. per wee�55-60 I . Volunteer D
C)Dates (M on th, Day, Year)Fr om ToEJEJ Total: Yrs. Mos.
���s�oL vL, .. , □
D)D ates (M onth, Da y, Year)From To�EJ Total: Yrs. M o s. 1:rs pe, Jl�S-60 I . VLntee, D
Title Duti es Perform ed
Executive Vice I resident I E mployer's Name and Addre ss Director of Labor Service Division 1-__;;;....;..: ___ :,.._-4-_______ __,
United Busines Bank 500 Ygnacio Va ley Rd. Walnut Creek, CA
Title
Responsible for $500 million dollar business line with six employees. Maintain and grow commercial banking for labor unions, trust funds, �ffiliates and business partners.
Dutie s Perform ed
Executive Vice I resident 1 k:hief Credit Officer/CCO
.,_ .... _-_-_-_-_-_-_-_-_-_-++----_-_-_-_-_-_-_-_-_-_-_-_-___ ___._I Responsible f or credit origination,
Em olover's N ame an d Address ladministration, loan service, loan .---=;.;.;.i;.�..;;;.;....:+--....;..;_.......;;...�---'-....;..;.-'----, policy and compliance. Liaison to
United Busines Bank 100 Hegenberger Road Oakland, CA
Title
BOD, Federal Regulators and auditors. Served on various com mittees; Loan, Compliance, ERM, ALCO, IAR Executive Mgmt. Strategic Planning
Duties Perfor me d
Executive Vice I resident I EVP/Credit Adm inistrator
I'-------+---------' Responsible for credit administration,1------+----------1 loan service and special assets. 1 ,--_.:;;E;.;..m-"1 P:..;.lo.:...>Y'-'e:..;.r....:'s+-N...;.a;;.;.;m.;..;..;.e....:a;.;..n;.;;;d_A_d_d _re_s_s'---, Partner to the CCO for Federal ExamsUnited Labor B, nk 100 Hegenberg�r Road !Oakland, CA
�nd audits. !Served on various committees;Loan, Compliance, ERM, ALCO, IARExecutive Mg mt. Strategic Planning
Title Duties Perfor me d !Senior Vice Pre ident Regional Sales Manager L-----➔-----------'I Responsible for growing and1------+----------1 maintaining client re lationships in the .--_E_m__,_p_lo..:.y_e_r·s➔-N_a_m_e_a_n_d_A_d _dr_e _s _s_.,1 labor communiti es. Also responsib le
United Labor B nk 100 Hegenber� er Road !Oakland, CA
THIS FORM IS A PUBLIC DOCUMENT
Wor all branch staffing and operations. !Managed a team of six sales/!Operations mgrs. in CA and WA.
19
7.H�d��u�ma����w���
Dccc Homepage□Walk-ln □Newspaper Advertiseme □District Supervisor IE!Other !Fellow Board Member
8.Do you have a Familial or Financial Relationship with a ember of the Board of Supervisors? (Please see BoardResolution no. 2011/55, attached): No __!El__ Yes
If Yes, please identify the nature of the relationship: ... N_l-t--________________
..._
9.Do you have any financial relationships with the County uch as grants, contracts, or other economic relations?No ___fil_ Yes_Il_
If Yes, please identify the nature of the relationship: -N _I_,_________________
...._
I CERTIFY that the statements made by me in this applicati n are true, complete, and correct to the best of my knowledge and belief, and are made in good faith. I acknowledge and unde stand that all information in this application is publically accessible. I understand and agree that misstatements/ o issions of material fact may cause forfeiture of my rights to serve on a Board, Committee, or Commission in Contra Costa C unty.
Sign Name: Date: _ ____,b,/4_� __ /i�'[ __
1.This application is a public document and is subject to the car ia Public Records Ad (CA Gav. Code §6250-6270).
2.Send the completed p� application to the Office of the Clerk the Board at 651 Pine Street, Room 106, Martinez, CA 94553.
3.A resume or cther relevant information may be submitted with th
4.All members are required to take the following training: 1) The Ad, 2) The Better Government Ordinance, and 3) Ethics Training.
5.Members of boards, commissons, and committees may be req ired to: 1) file a Statement of Econcrnic Interest Form also known as a Form
700, and 2) complete the State Ethics Training Course as requi by AB 1234.
6.Advisory body meetings may be held in various locations and
7.Meeting dates and times are subject to change and may ocx:ur to tv.o days per month.
8.Some boards, committees, or commissions may assign mem to subcommittees or 'M>l1< groups w,ich may require an additional
commitment of time.
THIS FORM IS A PUBLIC DOCUMENT
20
THE BOARD OF SUPERVISORS OF CONTRA C STA COUNTY, CALIFORNIA and for
Special Districts, Agencies and Authorities Gove ned by the Board Adopted Resolution
no. 2011/55 on 2/08/2011 as follows:
IN THE MATTER OF ADOPTING A POLICY MAKING FAM! Y MEMBERS OF THE BOARD OF SUPERVISORS INELIGIBLE
FOR APPOINTMENT TO BOARDS, COMMITTEES OR COM ISSIONS FOR WHICH THE BOARD OF SUPERVISORS IS THE
APPOINTING AUTHORITY
WHEREAS the Board of Supervisors wishes to avoid the reality o appearance of improper influence or favoritism;
NOW, THEREFORE, BE IT RESOLVED THAT the following p licy is hereby adopted:
I.SCOPE: This policy applies to appointments to any seats on bo ds. committees or commissions for which the Contra Costa Co unty
Board of Supervisors is the appointing authority.
II.POLICY: A person will not be eligible for appointment ifhe/s e is related to a Board of Supervisors' Member in any of the following
relationships:
I.Mother, father, son, and daughter;
2.Brother, sister, grandmother, grandfather. grandson, and grandda ghter;
3.Great-grandfather. great-grandmother, aunt. uncle, nephew, niec great-grandson. and great-granddaughter:
4.First cousin;
5.Husband, wife, father-in-law, mother-in-law, son-in-law, daughte -in-law, stepson, and stepdaughter;
6.Sister-in-law (brother's spouse or spouse's sister). brother-in-law sister's spouse or spouse's brother), spouse's grandmother,
spouse's grandfather, spouse's granddaughter, and spouse's gran son;
7.Registered domestic partner, pursuant to California Family Code ection 297.
8. The relatives, as defined in 5 and 6 above, for a registered domes! c partner.
9.Any person with whom a Board Member shares a financial intere t as defined in the Political Reform Act (Gov't Code §87103,
Financial interest). such as a business partner or business associat .
THIS FORM IS PUBLIC DOCUMENT
21
FAMILY AND HUMAN SERVICES COMMITTEE 5.
Meeting Date:09/24/2018
Subject:Appointments and Reappointments to the Advisory Council on Aging
Submitted For: Kathy Gallagher, Employment & Human Services Director
Department:Employment & Human Services
Referral No.: N/A
Referral Name: Appointment to Advisory Bodies
Presenter: N/A Contact: Jaime Ray, 925.677.3061
Referral History:
On December 6, 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 Advisory Council on Aging provides a means for county-wide planning, cooperation and coordination for individuals and groups
interested in improving and developing services and opportunities for the older residents of this County. The Council provides leadership and
advocacy on behalf of older persons and serves as a channel of communication and information on aging.
The Advisory Council on Aging consists of 40 members serving two-year staggered terms, each ending on September 30. The Council
consists of representatives of the target population and the general public, including older low-income and military persons; at least one-half of
the membership must be made up of actual consumers of services under the Area Plan.
The Council includes: 19 representatives recommended from each Local Committee on Aging, 1 representative from the Nutrition Project
Council, and 20 at-large representatives.
Referral Update:
There are currently 29 seats filled on the Advisory Council on Aging and 11 vacancies. These vacant seats include: Local Committee Pinole,
Local Committee Richmond, Local Committee Pittsburg, Local Committee Martinez, Local Committee Oakley, and Member-At-Large seats
6, 8, 14, 16, 17, and 19. The current membership is as follows:
Seat Title Term
Expiration
Date
Current incumbent Incumbent
Supervisor
District
Number of
Meetings
Attended Since
Appointment
Date
Total Number
of Meetings
Held Since
Appointment
Total
Number of
Absences
Allowable in
By-Laws
Nutrition Project Council 9/30/2018 Garrett Gail I 18 18 3
At-Large 1 9/30/2018 Adams Fred II 9 9 3
At-Large 2 9/30/2018 Krohn Shirley IV 17 18 3
At-Large 3 9/30/2019 Ed Benson 7 8 3
At-Large 4 9/30/2018 Welty Patricia V 12 18 3
At-Large 5 9/30/2018 Card Deborah V 16 18 3
At-Large 6 9/30/2018
At-Large 7 9/30/2019 Selleck Summer V 6 9 3
At-Large 8 9/30/2019
At-Large 9 9/30/2019 Xavier Rita I 8 9 3
At-Large 10 9/30/2018 Mikolaj Paul II 5 12 3
At-Large 11 9/30/2019 Jagjit Bhambra V 5 8 3
At-Large 12 9/30/2018 Neemuchwalla Nuru IV 15 18 3
At-Large 13 9/30/2018 Dunne-Rose Mary D II 17 18 3
At-Large 14 9/30/2019
At-Large 15 9/30/2019 Bruns Mary IV 8 9 3
At-Large 16 9/30/2019
At-Large 17 9/30/2018
At-Large 18 9/30/2018 Nahm Richard III 18 18 3
At-Large 19 9/30/2019
At-Large 20 9/30/2019 Frederick Susan I 9 9 3
Local Committee Lafayette 9/30/2019 McCahan Ruth II 7 9 3
22
Local Committee Orinda 9/30/2019 Clark Nina II 6 9 3
Local Committee Antioch 9/30/2018 Fernandez Rudy III 19 20 3
Local Committee Pleasant Hill 9/30/2019 Van Ackern Lorna IV 8 9 3
Local Committee Pinole 9/30/2018
Local Committee Concord 9/30/2018 Fuad Omran IV 6 8 3
Local Committee Richmond 9/30/2018
Local Committee El Cerrito 9/30/2018 Kim-Selby Joanna I 13 20 3
Local Committee Hercules 9/30/2018 Doran Jennifer 13 14 3
Local Committee Pittsburg 9/30/2019
Local Committee San Ramon 9/30/2018 Fehrenbach Anna II 9 12 3
Local Committee Clayton 9/30/2019 Tervelt Ron IV 6 9 3
Local Committee Alamo-Danville 9/30/2018 Janes Donnelly II 9 9 3
Local Committee Walnut Creek 9/30/2019 Jessica Thomas IV 4 5 3
Local Committee Moraga 9/30/2019 Katzman Keith II 5 9 3
Local Committee San Pablo 9/30/2018 Charlene Harlen-Ogbeide I 3 3 3
Local Committee Martinez 9/30/2018
Local Committee Brentwood 9/30/2019 Kee Arthur III 8 9 3
Local Committee Oakley 9/30/2018
Recommendation(s)/Next Step(s):
RECOMMEND to the Board of Supervisors the appointment of Dennis Yee to the Member At-large #14 seat and Brian O'Toole to the
At-Large #16 seat to complete the unexpired terms ending on September 30, 2019, Kevin Donovan to the At-Large #17 seat to a term ending
on September 30, 2020, and the re-appointment of the following individuals to terms expiring September 30, 2020: Shirley Krohn to At-Large
#2 seat, Patricia Welty to At-Large #4 seat, Deborah Card to At-Large #5 seat, Summer Selleck to At-Large #7 seat, Nuru Neemuchwalla to
At-Large #12 seat, Mary Rose to At-Large #13 seat, and Richard Nahm to At-Large #18 seat, to the Advisory Council on Aging as
recommended by the Council.
Fiscal Impact (if any):
There is no fiscal impact.
Attachments
Memo Recommending D. Yee
Memo Recommending Brian O'Toole
Memo Recommending K. Donovan
Memo Recommending Reappointments
Brian O'Toole Application
D. Card Application
M. Rose Application
N. Neemuchwalla Application
P. Welty Application
R. Nahm Application
S. Krohn Application
S. Selleck Application
K. Donovan Application
D. Yee Application
23
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Kathy Gallagher, Director
40 Douglas Dr., Martinez, CA 94553 Phone: (925) 313-1579 Fax: (925) 313-1575 www.cccounty.us/ehsd.
MEMORANDUM
DATE: 4-24-18
TO: Family and Human Services Committee
CC: Victoria Tolbert, Director Aging and Adult Services
FROM: Jaime Ray, Staff Representative for the Advisory Council on Aging
SUBJECT: Advisory Council on Aging – Appointment Requested
The Contra Costa Area Agency on Aging (AAA) recommends for immediate appointment to the
Contra Costa Advisory Council on Aging (ACOA) the following applicant: Mr. Dennis Yee for the
Member at Large #14 seat. The MAL #14 seat is undesignated and has remained vacant since July
11, 2017. Ms. Ella Jones who previously was appointed to MAL #14 has resigned.
Recruitment has been handled by both the Area Agency on Aging, the ACOA and the Clerk of the
Board using CCTV. AAA staff has encouraged interested individuals including minorities to apply
through announcements provided at the Senior Coalition meetings and at the regular monthly
meetings of the ACOA. The Contra Costa County EHSD website contains dedicated web content
where interested members of the public are encouraged to apply and are provided an application with
instructions on whom to contact for ACOA related inquiries, including application procedure.
Mr. Yee submitted an application on September 10, 2017; this document is provided as a separate
attachment. At the time of his selection by the ACOA Membership Committee to fill one of two
vacancies there were no other applicants qualified to serve. Two applicants had contacted the Area
Agency on Aging regarding membership; one rescinded her application and the other was not a
resident of Contra Costa County.
Thank You
24
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Kathy Gallagher, Director
40 Douglas Dr., Martinez, CA 94553 Phone: (925) 313-1579 Fax: (925) 313-1575 www.cccounty.us/ehsd .
MEMORANDUM
DATE: 9/6/2018
T O: Family and Human Services Committee
CC: Victoria Tolbert, Director Aging and Adult Services
FROM : Jaime Ray, Aging and Adult Services Bureau
SUBJECT: Advisory Council on Aging – Appointment Requested
The Contra Costa Area Agency on Aging (AAA) recommends for immediate appointment to the
Contra Costa Advisory Council on Aging (ACOA) the following applicant: Mr. Brian O’Toole for
the Member at Large #16 Seat. The MAL #16 Seat is undesignated and has remained vacant since
May 22, 2018. Dr. Robert Leasure who previously was appointed to MAL #16 has resigned.
Recruitment has been handled by both the Area Agency on Aging, the ACOA and the Clerk of the
Board using CCTV. AAA staff has encouraged interested individuals including minorities to apply
through announcements provided at the Senior Coalition meetings and at the regular monthly
meetings of the ACOA. The Contra Costa County EHSD website contains dedicated web content
where interested members of the public are encouraged to apply and are provided an application with
instructions on whom to contact for ACOA related inquiries, including application procedure.
Kevin Donovan submitted an application on January 29, 2018; this document is provided as a
separate attachment. At the time of his selection by the ACOA Membership Committee to fill one of
two At Large vacancies, there was one other MAL applicant; both applicants were approved by the
Council and will be recommended for appointments to fill the MAL vacancies that remain.
Thank You
25
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Kathy Gallagher, Director
40 Douglas Dr., Martinez, CA 94553 Phone: (925) 313-1579 Fax: (925) 313-1575 www.cccounty.us/ehsd .
MEMORANDUM
DATE: 9/6/2018
T O: Family and Human Services Committee
CC: Victoria Tolbert, Director Aging and Adult Services
FROM : Jaime Ray, Aging and Adult Services Bureau
SUBJECT: Advisory Council on Aging – Appointment Requested
The Contra Costa Area Agency on Aging (AAA) recommends for immediate appointment to the
Contra Costa Advisory Council on Aging (ACOA) the following applicant: Mr. Kevin Donovan for
the Member at Large #17 Seat. The MAL #17 seat is undesignated and has remained vacant since
March 20, 2018. Kathryn Ames who was previously appointed to MAL #17 has resigned.
Recruitment has been handled by both the Area Agency on Aging, the ACOA and the Clerk of the
Board using CCTV. AAA staff has encouraged interested individuals including minorities to apply
through announcements provided at the Senior Coalition meetings and at the regular monthly
meetings of the ACOA. The Contra Costa County EHSD website contains dedicated web content
where interested members of the public are encouraged to apply and are provided an application with
instructions on whom to contact for ACOA related inquiries, including application procedure.
Kevin Donovan submitted an application on January 8, 2018; this document is provided as a separate
attachment. At the time of his selection by the ACOA Membership Committee to fill one of two At
Large vacancies, there was one other MAL applicant; both applicants were approved by the Council
and will be recommended for appointments to fill the MAL vacancies that remain.
Thank You
26
1 of 1
Kathy Gallagher, Director
40 Douglas Dr., Martinez, CA 94553 Phone: (925) 313-1579 Fax: (925) 313-1575 www.cccounty.us/ehsd .
MEMORANDUM
DATE: 0 9/10/2018
T O: Family and Human Services Committee
CC: Laura Cepoi, Program Manager Area Agency on Aging
Tracy Murray, Deputy Director Aging and Adult Services
FROM : Jaime Ray, Aging and Adult Services Bureau
SUBJECT: Advisory Council on Aging – Appointment Requested
The Contra Costa Area Agency on Aging (AAA) recommends the following (7) individuals for reappointment
to At-Large Seats assigned to the Contra Costa Advisory Council on Aging (ACOA) with terms expiring on
September 30, 2018:
At-Large Seat #2: Shirley Krohn
At-Large Seat #4: Patricia Welty
At-Large Seat #5: Deborah Card
At-Large Seat #7: Summer Selleck
At-Large Seat #12: Nuru Neemuchwalla
At-Large Seat #13: Mary Rose
At-Large Seat #18: Richard Nahm
Recruitment is handled by both the Area Agency on Aging, the ACOA Membership Committee and the Clerk
of the Board using CCTV. Members of the AAA staff have encouraged interested individuals including
minorities to apply through announcements distributed to the senior centers, Contra Costa libraries, the East,
Central and West County Senior Coalitions and among the active ACOA membership. The ACOA
Membership Committee has developed a survey and will continue work to populate the Council with members
who are also consumers of services provided by the Older Americans Act. The Contra Costa County EHSD
website contains dedicated web content where interested members of the public are encouraged to apply. The
website provides access to the Board of Supervisors official application with instructions on whom to contact
for ACOA related inquiries, including application procedure.
All MAL applicants recommended for reappointment were interviewed by members of the ACOA
Membership Committee. The Membership Committee and the Council’s current President, Shirley Krohn
recommend the reappointment of the above list of MAL members who are interested in serving an additional
term. Please find copies of the members’ applications provided as separate attachments.
Thank You
27
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29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
Submit Date: Jul 30, 2018
Seat Name (if applicable)
First Name Middle Initial Last Name
Email Address
Home Address Suite or Apt
City State Postal Code
Primary Phone
Employer Job Title Occupation
Contra Costa County Boards & Commissions
Application Form
Profile
Which Boards would you like to apply for?
Advisory Council on Aging: Submitted
Describe why you are interested in serving on this advisory board/commission (please limit
your response to one paragraph).
I am a retired person and wish to give my community the advantage of my experience. I also enjoy
looking after the interest of Seniors. It also compliments my other Volunteer service.
This application is used for all boards and commissions
Do you, or a business in which you have a financial interest, have a contract with Contra
Costa Co.?
Yes No
ML
Nuruddin A Neemuchwalla
NA NA Retired
Nuruddin A Neemuchwalla Page 1 of 6
45
If "Other" was Selected Give Highest Grade or
Educational Level Achieved
Name of College Attended
Course of Study / Major
Units Completed
Degree Type
Date Degree Awarded
Is a member of your family (or step-family) employed by Contra Costa Co.?
Yes No
Education History
Select the highest level of education you have received:
Other
College/ University A
Type of Units Completed
None Selected
Degree Awarded?
Yes No
College/ University B
= Graduate (4 year college)
T.S.Dufferin
Merchant Marine Academy
Nuruddin A Neemuchwalla Page 2 of 6
46
Name of College Attended
Course of Study / Major
Units Completed
Degree Type
Date Degree Awarded
Name of College Attended
Course of Study / Major
Units Completed
Degree Type
Type of Units Completed
None Selected
Degree Awarded?
Yes No
College/ University C
Type of Units Completed
None Selected
Degree Awarded?
Yes No
Nuruddin A Neemuchwalla Page 3 of 6
47
Date Degree Awarded
Course Studied
Hours Completed
Dates (Month, Day, Year) From - To
Hours per Week Worked?
Position Title
Other schools / training completed:
Certificate Awarded?
Yes No
Work History
Please provide information on your last three positions, including your current one if you are
working.
1st (Most Recent)
Volunteer Work?
Yes No
Employer's Name and Address
Maersk Pacific Ltd. 909 Ferry St. Oakland CA 94607
Duties Performed
Responsible for Terminal and ship operation for the Bay Area.
1998 - 2001
50
General Manager
Nuruddin A Neemuchwalla Page 4 of 6
48
Dates (Month, Day, Year) From - To
Hours per Week Worked?
Position Title
Dates (Month, Day, Year) From - To
Hours per Week Worked?
Position Title
2nd
Volunteer Work?
Yes No
Employer's Name and Address
Maersk Pacific Ltd. 909 Ferry Street., Oakland CA 94607
Duties Performed
Managed ship and terminal operatons at the Port of Oakland terminal.
3rd
Volunteer Work?
Yes No
Employer's Name and Address
Marine Terminal Corporation. Stuart St. San Francisco CA
1994 -1998 Approx
55 hours
Stevedore Manager
1980 - 1994 (Approx)
60 hours per week
Terminal Manager
Nuruddin A Neemuchwalla Page 5 of 6
49
Upload a Resume
If "Other" was selected please explain
Duties Performed
Operated the Maersk Terminal at the port of Oakland under contract to Marine Terminal Corp.
Final Questions
How did you learn about this vacancy?
Other
. Do you have a Familial or Financial Relationship with a member of the Board of
Supervisors?
Yes No
If Yes, please identify the nature of the relationship:
Do you have any financial relationships with the County such as grants, contracts, or other
economic relations?
Yes No
If Yes, please identify the nature of the relationship:
MAL 12 ... Dis 4
Nuruddin A Neemuchwalla Page 6 of 6
50
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52
53
54
Submit Date: Aug 22, 2018
Seat Name (if applicable)
First Name Middle Initial Last Name
Email Address
Home Address Suite or Apt
City State Postal Code
Primary Phone
Employer Job Title Occupation
Contra Costa County Boards & Commissions
Application Form
Profile
Which Boards would you like to apply for?
Advisory Council on Aging: Submitted
Describe why you are interested in serving on this advisory board/commission (please limit
your response to one paragraph).
Currently a member, I wish to continue.
This application is used for all boards and commissions
Do you, or a business in which you have a financial interest, have a contract with Contra
Costa Co.?
Yes No
Member at Large
Richard A Nahm
Richard A Nahm Page 1 of 7
55
If "Other" was Selected Give Highest Grade or
Educational Level Achieved
Name of College Attended
Course of Study / Major
Units Completed
Degree Type
Date Degree Awarded
Is a member of your family (or step-family) employed by Contra Costa Co.?
Yes No
Education History
Select the highest level of education you have received:
Other
College/ University A
Type of Units Completed
Quarter
Degree Awarded?
Yes No
College/ University B
Master of Public Administration
CSUH
Public Administration
MPA
September 2003
Richard A Nahm Page 2 of 7
56
Name of College Attended
Course of Study / Major
Units Completed
Degree Type
Date Degree Awarded
Name of College Attended
Course of Study / Major
Units Completed
Degree Type
Type of Units Completed
None Selected
Degree Awarded?
Yes No
College/ University C
Type of Units Completed
None Selected
Degree Awarded?
Yes No
Ohlone College
Liberal Arts
Associate of Arts
1980
Richard A Nahm Page 3 of 7
57
Date Degree Awarded
Course Studied
Hours Completed
Dates (Month, Day, Year) From - To
Hours per Week Worked?
Position Title
Other schools / training completed:
Certificate Awarded?
Yes No
Work History
Please provide information on your last three positions, including your current one if you are
working.
1st (Most Recent)
Volunteer Work?
Yes No
Employer's Name and Address
Social Security Administration 1111 Jackson St Oakland, CA 94611
10/1974
40
Technical Expert
Richard A Nahm Page 4 of 7
58
Dates (Month, Day, Year) From - To
Hours per Week Worked?
Position Title
Dates (Month, Day, Year) From - To
Hours per Week Worked?
Position Title
Duties Performed
Claims, Post-entitlement review, Public Information Liaison, Trainer, Public Speaker, Fraud Investigations,
Computer Systems
2nd
Volunteer Work?
Yes No
Employer's Name and Address
Duties Performed
3rd
Volunteer Work?
Yes No
Richard A Nahm Page 5 of 7
59
Upload a Resume
If "Other" was selected please explain
Employer's Name and Address
Duties Performed
Final Questions
How did you learn about this vacancy?
Other
. Do you have a Familial or Financial Relationship with a member of the Board of
Supervisors?
Yes No
If Yes, please identify the nature of the relationship:
Do you have any financial relationships with the County such as grants, contracts, or other
economic relations?
Yes No
If Yes, please identify the nature of the relationship:
Current Member
Richard A Nahm Page 6 of 7
60
Please Agree with the Following Statement
I understand that this form is a public document and is subject to the California Public
Records Act.
I Agree
Richard A Nahm Page 7 of 7
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65
66
67
68
69
70
71
72
Submit Date: Jan 08, 2018
Seat Name (if applicable)
First Name Middle Initial Last Name
Email Address
Home Address Suite or Apt
City State Postal Code
Primary Phone
Employer Job Title Occupation
Contra Costa County Boards & Commissions
Application Form
Profile
Which Boards would you like to apply for?
Advisory Council on Aging: Submitted
This application is used for all boards and commissions
Do you, or a business in which you have a financial interest, have a contract with Contra
Costa Co.?
Yes No
Is a member of your family (or step-family) employed by Contra Costa Co.?
Yes No
Education History
Kevin D D Donovan
CA
Retired, previously US Bank Formerly Senior Vice President Finance/Banking
Kevin D D Donovan Page 1 of 6
73
If "Other" was Selected Give Highest Grade or
Educational Level Achieved
Name of College Attended
Course of Study / Major
Units Completed
Degree Type
Date Degree Awarded
Name of College Attended
Course of Study / Major
Units Completed
Select the highest level of education you have received:
Other
College/ University A
Type of Units Completed
Quarter
Degree Awarded?
Yes No
College/ University B
Master of Business Administration
UC Berkeley
Economics
180+
Bachelor of Arts
June 1974
University of Southern California
Finance
72 (estimate on my part)
Kevin D D Donovan Page 2 of 6
74
Degree Type
Date Degree Awarded
Name of College Attended
Course of Study / Major
Units Completed
Degree Type
Date Degree Awarded
Course Studied
Type of Units Completed
None Selected
Degree Awarded?
Yes No
College/ University C
Type of Units Completed
None Selected
Degree Awarded?
Yes No
Other schools / training completed:
Master of Business Administration
June 1976
N/A
Kevin D D Donovan Page 3 of 6
75
Hours Completed
Dates (Month, Day, Year) From - To
Hours per Week Worked?
Position Title
Dates (Month, Day, Year) From - To
Certificate Awarded?
Yes No
Work History
Please provide information on your last three positions, including your current one if you are
working.
1st (Most Recent)
Volunteer Work?
Yes No
Employer's Name and Address
US Bank 1333 N. California St., Suite 50SL Walnut Creek, Ca. 94596
Duties Performed
Area Manager for the Pacific Northwest and Western Regional Sales Manager for US Bank's Equipment
Finance Division. This position was focused on the development of identifying new opportunities,
proposing and winning them and then coordinating their closing. Transaction sizes ranged from $500,000
to $99,000,000.
2nd
5/1/2006 to 10/1/2017
40 hours +
Senior Vice President
2/1/2002 to 5/1/2006
Kevin D D Donovan Page 4 of 6
76
Hours per Week Worked?
Position Title
Dates (Month, Day, Year) From - To
Hours per Week Worked?
Position Title
Volunteer Work?
Yes No
Employer's Name and Address
Royal Bank of Scotland ("RBS") 401 California St. San Francisco, Ca. 94111
Duties Performed
Development of new financing opportunities for RBS throughout the West Coast of the US.
3rd
Volunteer Work?
Yes No
Employer's Name and Address
Heller Financial Inc. 1 Montgomery St. San Francisco, Ca. 94111
Duties Performed
Managed a sales team in the development of new business in the non-investment grade equipment
financing business throughout the West Coast.
40 hours +
Senior Vice President
2/1/2992 to 1/31/2002
40 hours +
Senior Vice President
Kevin D D Donovan Page 5 of 6
77
If "Other" was selected please explain
Final Questions
How did you learn about this vacancy?
District Supervisor
. Do you have a Familial or Financial Relationship with a member of the Board of
Supervisors?
Yes No
If Yes, please identify the nature of the relationship:
Do you have any financial relationships with the County such as grants, contracts, or other
economic relations?
Yes No
If Yes, please identify the nature of the relationship:
Kevin D D Donovan Page 6 of 6
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FAMILY AND HUMAN SERVICES
COMMITTEE 6.
Meeting Date:09/24/2018
Subject:Appointments to the Family and Children's Trust Committee
Submitted For: Kathy Gallagher, Employment & Human Services Director
Department:Employment & Human Services
Referral No.: N/A
Referral Name: APPOINTMENTS TO ADVISORY BODIES
Presenter: N/A Contact: Juliana Mondragon,
925-608-4941
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 committee.
The purpose of the Family and Children's Trust (FACT) Committee is to establish priorities and
make funding recommendations to the Board of Supervisors on the allocation of specific funds
for the prevention/amelioration of child abuse and neglect, and the promotion of positive family
functioning. These funds include: Child Abuse Prevention, Intervention, and Treatment funds
funds (AB 1733), Birth Certificate revenue to the County Children’s Trust (AB 2994), the Ann
Adler Children’s Trust funds, Community-Based Child Abuse Prevention funds, and other funds
that may be subsequently directed by the Board of Supervisors. The FACT Committee also
provides information and data to the Employment and Human Services Department on the
effectiveness of current and proposed programs for families and children and on recent or pending
legislation that would potentially impact family and children’s services programs, clients, or
funding mechanisms.
FACT Committee is composed of 15 members from three different categories: Five At-Large
seats (one representative from each of the five Supervisorial Districts), Five discipline/sector
specific seats, and representatives from committees, commissions, or boards.
Referral Update:
There are currently 14 seats filled and one vacancy on FACT. The Committee vacancy is in the
85
There are currently 14 seats filled and one vacancy on FACT. The Committee vacancy is in the
discipline-specific Seat 3, Local Planning Council. Current FACT Committee seat members live
or work in the following areas of the county: East (2): One At-Large, District III; Central/South
(11): Four discipline specific, Four At-Large, Districts II, IV and V; West (1): District I.
Candidates for appointment to the FACT Committee will serve a two-year term. Attached is a
memo from the Employment and Human Services Director, transmitting her nomination of Lisa
Johnson, Karin Kauzer, and Mary Flott for reappointment to FACT's First Five Commission,
School Representative, and At Large 1 seats, respectively. Their current appointments are set to
expire September 30, 2018.
Recommendation(s)/Next Step(s):
RECOMMEND to the Board of Supervisors the appointment of Lisa Johnson to a discipline
specific, First 5 Commission seat, Karin Kauzer to a discipline specific, School Representative
seat, and Mary Flott to the At Large 1 seat on the Family and Children's Trust Committee to terms
that will expire on September 30, 2020.
Attachments
Memo Recommending Re-Appointments
K. Kauzer Application
L. Johnson Application
M. Flott Application
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40 Douglas Drive, Martinez, CA 94553 • (925) 608-5000 • Fax (925) 313-9748 • www.ehsd.org
To:
Family and Human Services Committee
Supervisor Candace Andersen, District II, Chair
Supervisor John Gioia, District I, Vice-Chair
Date: September 24, 2018
CC:
From: Kathy Gallagher, EHSD Director
Juliana Mondragon, FACT Staff
Subject: Family and Children’s Trust (FACT) Committee Seat Membership Recommendation
The Employment and Human Services Department Director, Kathy Gallagher, respectfully
requests that the Family and Human Services Committee accept recommendations to re-appoint
the following members to one At -Large seat and two discipline specific seats (Seat 1; First 5
Commission and Seat 2; School Representative) on the Family and Children’s Trust (FACT) Committee, for a total of three (3) open seats .
Name Seat Area
Lisa R. Johnson First 5 Commission Central County
Karin Kauzer School Representative Central County
Mary Flott At -Large Seat 1 South County
PURPOSE OF COMMITTEE _________________________________________
The purpose of this Committee is to establish priorities and make funding recommendations to the
Board of Supervisors on the allocation of specific funds for the prevention/amelioration of child
abuse and neglect, and the promotion of positive family functioning. These funds include: Child
Abuse Prevention, Intervention, and Treatment funds (CAPIT) funds, (AB 1733), Birth Certificate
revenue to the County Children’s Trust (AB2994), the Ann Adler Children’s Trust funds, Community-Based Child Abuse Prevention funds (CBCAP) and other funds as may be
subsequently directed by the Board of Supervisors.
The FACT Committee also provides information and data to the Employment and Human Services
Department on the effectiveness of current and proposed programs for families and children and
on recent or pending legislation that would potentially impact family and children’s serv ices
programs, clients, or funding mechanisms.
SUMMARY OF RECRUITMENT EFFORTS/NOMINIEES FOR MEMBERSHIP
The FACT Committee, in conjunction with the County Administrator’s Office, continues to make
every effort to fill its vacant seats. These efforts include contacting each district Supervisor’s office
M E M O R A N D U M
Kathy Gallagher, Director
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and releasing a public notice, inviting interested parties to consider membership and soliciting the
support of current members to outreach to potential candidates for consideration for membership.
FACT Committee membership consists of the following:
Five At-Large seats
One representative from each of the five Supervisorial Districts
Five discipline/sector specific seats
There are currently 14 seats filled and there is one vacancy on FACT. The Committee has a
vacancy in the discipline-specific Seat 3, Local Planning Council. Seat 3, Local Planning Council
was declared vacant due to committee member resignation on October 18, 2016. The FACT
Committee is actively recruiting to fill Seat 3.
Current FACT Committee seat members live or work in the following areas of the county:
East (2): One At-Large, District III
Central/South (11): Four discipline specific, Four At -Large, Districts II, IV and V
West (1): District I
Presently, the Committee has scheduled vacancies in Seat 1; First 5 Commission, Seat 2; School Representative, and Seat 3; Local Planning Council; and two At-Large Seats, all of which are due
to expire on September 30, 2018.
The FACT Committee recommends re-appointing current Seat 1 member, Ms. Lisa Johnson, Seat
2 member, Ms. Karin Kauzer, and At-Large Seat member, Ms. Mary Flott, as their seats’ term w ill
expire on September 30, 2018.
Candidates for re-appointment to the FACT Committee will serve a two-year term.
All candidates have expressed a sincere interest in continuing to serve on the Committee and are
dedicated to fulfilling the mission and goals as outlined in the Committees’ policies and procedures.
Based on the above information, the Director of EHSD on behalf of the FACT Committee
respectfully recommends that the FHS Committee re-appoint all three (3) candidates to continued
membership on the FACT Committee.
Enc. Board, Committees, and Commission Application for Lisa R. Johnson
Board, Committees, and Commission Application for Karin Kauzer
Board, Committees, and Commission Application for Mary Flott
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90
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Use Only celved: For Reviewers Use Only:
Accepted Rejected
BOARDS; COMMITTEES, AND COMMISSIONS APPLICATION
MAIL OR DELIVER TO:
Conlra Costa County
CLERK OFTHE BOARD
651 Pine.Slree!,Rm.106
Martinez, Ca&romla 94553-1292
. PLEASE TYPE OR PRINT IN INK
(Each Position Requires a Separate Appftcat!on)
BOARD, COMMlmE OR COMMISSION NAME AND SEAT 'l'ITLE YOU ARE APPLYING FOR: ---------------
PRINT EXACT NAME OF BOARD, COMMITTEE, OR COMMISSION PRINT EXACT SEAT NAME (If applicable)
1.Name:...,IFl .. ot�t-=�======---=-="":=:=M=a�ry=�=-==-=-=-======-=Fr�an�k�lin�. -.=-===...:! (Last Name) (First Name) (Mfddle Name)
2.Address: W=A-=�· ============�=============:=="'==='(No.) (Street) (Apt) (City) (State)
3.Phones:I -(Home No.) (Work No.) (Cell No.)
4. Email Address: .........
· (Zip Code)
.,._,. . ._. ,.....,., .. _..,.._..,..,.,,,___., ___ ,__,_,� ............ .,..-, ____ ,...,. _____ .., ___ , ____ .... , .... -,.,..--.... ---••-IOl ____ �-•--...,�-• ... •rP, -..-. --•-'" • ............. �•- ... ...,_,,.,...,..�-. •�-,
5. EDUCATION: Check appropriate box if you possess one of the following:
High School Diploma e] G.E.D. Certificate tJ California High School Proficiency Certific�te D
Give Highest Grade or Educational Level Achievect!Bachelo�,-De..,;g ... re_e ______________ ...J.
Names of colleges / universities Degree Degree Date attended Course of Study / Major Awarded Units Completed Type Degree Awarded Semester Quarter.
A) ·University of Maryland Radio, Television & Film Yes No FBJ □ CJ D EJ f�une1978 I
B)I I
C)I I D) Other schools / trainingcompleted: I I Course Studied I
Yes No DO
Yes No DD
CJ CJ Hours Completed
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THIS FORM IS A PUBLIC DOCUMENT
D DI D D �.
Certificate Awarded: Yes No OD
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FAMILY AND HUMAN SERVICES COMMITTEE 7.
Meeting Date:09/24/2018
Subject:Public Mental Health Care Systems; Child and Teen Psychiatric Services; and
Grand Jury Report No. 1703
Submitted For: Anna Roth, Health Services Director
Department:Health Services
Referral No.: 115/116
Referral Name: Public Mental Health Care System
Presenter: Matthew P. White, M.D.; Barbara Serwin,
Chair, Mental Health Commission
Contact: Warren Hayes (925)
957-2616
Referral History:
On October 30, 2017 the Family and Human Services Committee accepted the report from the
Health Services Department addressing various mental health service issues and concerns raised
by the Family and Human Services Committee, the Board of Supervisors, the Mental Health
Commission’s White Paper, the Civil Grand Jury, and members of the public. These issues and
concerns centered upon the difficulty in accessing mental health care, particularly for children and
youth experiencing serious emotional disturbances. Indicative to this lack of access was the 1)
increase in Psychiatric Emergency Services visits, 2) long wait times to access care, and 3)
shortage of clinical staff, especially psychiatrists. The Health Services Department report
addressed these issues and concerns, and reported upon the initiatives and progress made to date.
The Family and Human Services Committee asked the Department to provide an update to the
Mental Health Commission in six months, and to the Family and Human Services Committee
thereafter.
Referral Update:
The Department has complied by meeting with the Mental Health Commission regarding these
issues on several occasions in 2018. The attached report summarizes the most current update, and
articulates a partnership plan between the Department and the Commission to work together
going forward to resolve these issues.
Recommendation(s)/Next Step(s):
ACCEPT the joint update report from Behavioral Health Services and the Mental Health
Commission on the public mental health care system, child and teen psychiatric services, and
Civil Grand Jury Report No. 1703.
100
Fiscal Impact (if any):
There is no fiscal impact.
Attachments
Joint Behavioral Health Services and Mental Health Commission Report
Mental Health Commission Response to BHS Update to Civil Grand Jury Report 1703 and FHS Referrals on the
Public Mental Health System
Civil Grand Jury Report 1703 "Mental Health Services for At Rick Children in CCC"
BOS Response to Grand Jury Report 1703
101
102
103
104
105
106
107
108
Mental Health Commission Response to Behavioral Health Services Update, 10/30/17 1
Contra Costa County Mental Health Commission
Response to Behavioral Health Services Update to
Grand Jury Report No. 1703 and Referrals 115 and 116
October 30th, 2017
This document is a response from the Mental Health Commission to the update by
Behavioral Health Services to the Board of Supervisors Family and Human Services
Committee regarding the Grand Jury Report No. 1703 and the White Paper published in
March, 2016.
The process of updating the Family and Human Services Committee has been collaborative
and fruitful. Over the past year, Behavioral Health has been working to address key
challenges identified in the White Paper and more recently by the Grand Jury Report 1703.
Over the past month and a half, the Commission and Behavioral Health have worked
together to identify key improvements as well as ongoing challenges. This has involved a
great deal of research, information exchange , and problem solving, and the development of
a shared vision of how problem resolution can move forward in a positive direction. The
process has resulted in the Behavioral Health Update and the ensuing Commission
Response.
The Commission thanks the Board of Supervisors for giving serious consideration to the
Grand Jury and Commission co ncerns and encouraging open discussions and collaboration.
Thanks also to Behavioral Health for working so diligently to make strong headway and for
the information sharing and frank discussions that have enabled us to air our differences of
opinion and find common ground. We are grateful as well to Psyche Emergency Services for
updating us on its current operations and challenges.
The remainder of this document consists of a Commission review of progress, questions,
and suggested follow-up by the Commission and Board of Supervisors.
Upgrading the Current West County Children’s Clinic Facility
The Commission recognizes that Behavioral Health is working diligently to improve the
West County Children’s Clinic, bringing together the necessary resources to make critical
improvements as quickly as possible. The Commission is glad that the carpet will be
replaced given its poor condition and the indeterminate lump underneath it. There were
initial concerns that the carpet was installed over asbestos and therefore could not be
replaced.
Recommended Follow Up:
Visit the clinic in two months to review progress.
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Mental Health Commission Response to Behavioral Health Services Update, 10/30/17 2
Acquiring a New Location for First Hope
The Commission recognizes the strong effort that is being made to relocate First Hope and
its First-Episode Psychosis Program to a financially sustainable and appropriately designed
facility.
Addressing the Shortage of Psychiatrists
The Commission believes that true prevention and early intervention start with hiring top-
notch psychiatrists. Maintaining effective staffing levels and a building a team-like
environment are also critical.
Behavioral Health has made significant progress in:
clarifying the number of approved FTE positions and the number of filled positions and
unfilled positions;
and improving recruiting efforts by contracting with four staffing agencies for the hiring
of contract psychiatrists, including Traditions, the agency that it has most recently
contracted with.
Behavioral Health has long recognized that a key factor in its challenge in hiring is its
inability to offer competitive compensation packages. Since most of the psychiatric staff is
contracted, focusing attention on the rates and benefits of contract employees is
particularly important. The Commission hopes that the more competitive compensation
offered by the staffing agency Traditions will help attract candidates. The use of MHSA
funds for student loan reimbursement should also be attractive.
Behavioral Health recognizes the importance of contracting with psychiatrists who are
willing to work at least three days a week to maintain treatment continuity, simplify
staffing planning, and support a team-oriented approach to care. Behavioral Health reports
that it has discussed this need with its staffing agencies but, like other counties, is
hampered by the regional- and nation-wide lack of child psychiatrists.
Questions:
Behavioral Health states that it will consider whether an assessment will be made once
current vacancies are filled. How will this determination be made? What kind of
staffing assessment would potentially be made?
Are MHSA student loan payment funds being fully utilized?
Is there the possibility of incenting contracting psychiatrists to work a minimum of
three days per week or more by a) offering a bonus for working 24 hours plus; or
increasing their hourly fee for every hour worked over 24 hours?
Follow-up/Suggestions:
Revisit the status of hiring in four months to see how hiring is progressing for unfilled
psychiatry positions;
Regularly review a Behavioral Health report on the status of all psychiatry and mental
health clinician positions, including newly or soon to-be-vacated positions;
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Mental Health Commission Response to Behavioral Health Services Update, 10/30/17 3
Explore ways to incentivize contracting physicians to work a minimum of 24 hours per
week;
Annually review a report on the MHSA school loan payment program for psychiatrists
to see how this program is being utilized.
Filling the Vacant Position of Medical Director
The Commission recognizes the challenges in filling the all-important Medical Director
position. However, this process has been underway for two years now. Although a
candidate was recently interviewed, the next interview is not scheduled until December,
2017. The Commission hopes that Behavioral Health can re-double its efforts to recruit and
make timely, strong offers to qualified candidates over the next two months.
Follow-up/Suggestions:
Review recruiting and hiring strategies to ensure they are as effective as possible.
Revisit the hiring status of the Medical Director in two months.
Legacy Planning for High Level Positions
The issue of legacy planning within Behavioral Health has been raised by EQRO. In
discussing the challenges around hiring a Medical Director position, the Commission
learned that county hiring practices do not permit a Department to interview and fill a
position until the incumbent has actually vacated the position. This is the case even if the
retirement or departure is planned. The Commission is very concerned that this practice
eliminates the ability to mentor and pass on institutional knowledge is lost. This in turn
disrupts administration and services and, ultimately, continuity and quality of care. This
practice will impact the management of the Children’s Division when the Director of the
Division, Vern Wallace, retires this coming year after decades of holding the position. The
Commission urges the Board of Supervisors to find a solution to the legacy problem.
Relief to Impacted Psyche Emergency Services (PES):
PES Internal Adjustments
The Commission recognizes how fortunate the county is to have a PES co-located with
medical facilities where a true medical evaluation can happen. The Commission lauds the
ongoing efforts of PES to find ways to manage an impacted environment with an increasing
number of 5150 clients and a decrease in the number of voluntary clients.
Since the White Paper was published, it seems that PES’s main strategies for managing the
new norm of an average 900 patients per month – still considerably higher than originally
intended – has been to hire additional staff for the morning shift to expedite re-evaluation
of overnight clients and to slightly reduce the average length of stay. This solution, plus a
more stable daily census has resulted in a situation that is “mostly manageable ”, with the
current staffing pattern seen as “minimally acceptable.”
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Mental Health Commission Response to Behavioral Health Services Update, 10/30/17 4
The Commission reads this situation either as 1) an increase in efficiency or 2) as a
somewhat tenuous situation that is consistently stressful for staff, often leading to burn-out
and turn-over, and that may decrease the amount of time that a consumer receives care.
Lastly, is there the time and staff to follow up on whether the consumer is following the
prescribed treatment? The Commission cannot be certain from the Update.
Questions:
Is the current strategy viable long-term or do we need to commit to increasing staffing
levels, potentially including psychiatrists, to reduce stress on staff and consumers and
to enhance quality of care? How would the need for additional staff be evaluated?
How has a decrease in the average length of stay has been achieved? Is it an increase in
the number of staff in the morning or are we relying on quick turnarounds?
Does this mean reduced time for a proper evaluation, adequate treatment and/or
disposition?
Has the experience of being a client at PES improved and have outcomes improved?
Will the new electronic health record system provide the ability to follow the
disposition of where PES patients receive their follow up and treatment?
Follow-up/Suggestions:
Revisit staffing needs in six months
Request clarifications on the amount of time for evaluation, stabilization, dispensation
and opinions on how these metrics are impacting the consumer experience and quality
of care.
Request information on the capabilities of the Electronic Health Records to support the
PES function of tracking patient post-PES treatment.
Relief to Impacted Psyche Emergency Services (PES):
Addressing Children’s Needs for the Facility
The Commission fully agrees with the facility design changes that are required to separate
children from adult clients and to improve the waiting, family consultation and treatment
spaces for children. The Commission urges the Superintendents to support changes
recommended by the Hospital and Clinics Unit for these high priority improvements.
Follow-up/Suggestions:
Request proposals from the Hospital and Clinics Unit for redesigning the children’s area
of PES.
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Mental Health Commission Response to Behavioral Health Services Update, 10/30/17 5
Relief to Impacted Psyche Emergency Services (PES):
Expanded Mobile Relief Services
The expansion in mobile relief services is intended to decrease pressure on PES. The
Commission is glad to see the increase in the hours of coverage of the Children’s Mobile
Crisis Response and the planned introduction of this service for the Adult System of Care.
Also significant is the Adult program’s coordination with the Forensic Mental Health
Evaluation Team (MHET) and the three county police departments where MHET is located.
Questions:
How will the impact of the Children and Adult Mobile Crisis Response on PES
congestion be evaluated?
What are the numbers related to the Children’s Mobile Crisis Response, e.g. number of
visits per month, number of diversions from PES? What are the projected numbers for
the Adult service?
How aware are all 23 law enforcement agencies of the three MHET teams?
How will the 20 county law enforcement agencies outside the three that host MHETs
activate a request for the adult mobile response team? How else will they interface?
Forensics is open 8:00 AM to 5:00 PM. How will it interact with MHET when the teams
will be used most frequently between 3:00 PM and 11:00 PM?
Unclear Staffing Needs of the Children’s Division
The Behavioral Health update notes that the Children’s Division staffing levels may not
fully meet the needs of its several mandates and programs. The Division lost 40 line staff
positions in 2008, and while several staff have been restored to respond to Katie A and
Continuum of Care, Behavioral Health states that staffing levels are still slightly below the
pre-2008 levels, despite the Affordable Care Act. Behavioral Health also reports that
additional clinical and Family Partner staff are needed in the regional clinics. The
Commission would like clarification to better understand what the Division’s needs are.
With the impending retirement of the Director of the Children’s Division, Vern Wallace, the
need for an adequate level of well-trained staff is essential.
Questions:
What is the estimated number of Children’s Division staff needed, by position?
Improvements to Family Support Services
Fully staffed Family Support services may have the impact of diverting consumers from
PES. Family Partner positions in the Children’s and Adult clinics that were empty, s ome for
multiple years, are now filled. This is a critical step forward.
With the new MHSA NAMI Program for Family Support through family volunteers, Family
Support Services is now comprised of three groups – the other two are 1) the Office of
Consumer Empowerment with its 20 peer staff Family and Community Support Workers
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Mental Health Commission Response to Behavioral Health Services Update, 10/30/17 6
and 2) the Family Coordinators. The key to success will be coordinating them to ensure
efficient and effective deployment of the appropriate services.
Lastly, there are important family support programs being driven by volunteers. Dave
Kahler, a Commissioner Emeritus, coordinates the CIT Training. He also has set up and
runs the NAMI Crash Course, which has been seen over 1,000 family members in the past
year. More direct involvement by Behavioral Health staff is needed in these crucial areas.
Questions:
Does each of the adult clinics have a family advocate?
How will the family advocates and coordinators interface with the new NAMI MHSA
program?
Follow-up/Suggestions:
Request a plan for coordinating and interfacing the three different family support
services from Behavioral Health.
Determination of Wait Times at Clinics
The Grand Jury expressed a deep concerned regarding wait times at the Children’s clinics,
as did the White Paper . The White Paper also expressed concerns regarding the Adult clinic
wait times. What the Commission hears from the community on wait times differs
significantly from Behavioral Health’s numbers. EQRO 2016 has also questioned the
Behavioral Health numbers and has stated that Behavioral Health’s technique for
calculating wait times is an estimate. It will be months until the impact of more
psychiatrists on wait times will be known as it will take time for them to fully ramp up at
the clinics.
The Commission and Behavioral Health do agree, however, that the new Behavioral Health
information system should provide accurate data on how long it takes a patient to be
initially assessed, receive non-medication treatment, and be assessed by a psychiatrist and
receive medication treatment if warranted.
Follow-up/Suggestions:
Revisit wait times as part of the 2017 External Quality Review process.
Confer with information systems to ensure that the ability to accurately track wait
times is being properly implemented.
Request wait times as tracked by the new information system once the system has been
up and running for four to six months.
Reduction of Wait Times for CBO and Private Therapist Appointments
The Grand Jury was very concerned about the availability of network providers for children
who need to access treatment for moderate to severe mental illness. The Commission
commends the new Access Line team for reducing abandoned calls from 15% to 2%.
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Mental Health Commission Response to Behavioral Health Services Update, 10/30/17 7
Access Line data, however, does support the Grand Jury’s concern, demonstrating that, in
fact, that the five providers in East County are not able to meet demand.
Questions:
How will the need for additional treatment providers for Children in East County be
determined? Can Access Line data help estimate the number of needed providers?
Follow-up/Suggestions:
Request a plan for determining the need for additional providers in East County and for
acquiring the necessary number of providers.
The Continued Need for a Children’s Residential Treatment Center
The Commission has advocated for a children’s residential treatment center for the past
two years on the behalf of the Children’s Division. While creating a unit at the Contra Costa
Regional Medical Center does not appear to be financially viable, the Commission continues
to strongly support the Children’s Division’s efforts to find a workable solution for a
treatment center. In particular, the Commission encourages more exploration into creating
a regional solution of multiple surrounding counties participating in a pool of beds, thereby
sharing costs and decreasing the risk of any one treatment center having to cover the cost
of an unfilled bed. The Commission urges the Board of Supervisors to explore a regional
solution to this critical problem.
Follow-up/Suggestions:
Brainstorm a high level concept for a multi-county program for a children’s residential
treatment center. Present this concept to likely partners
The Need for Housing for Those With a Serious Mental Illness
The critical issue of housing for the Homeless with a Serious Mental Illness was a key issue
raised by the White Paper. This concern was not addressed in the Behavioral Health
Services update.
Supportive Services such as keeping an apartment clean and eating properly ---these are
services that the Regional Center provides those with a Developmental Disability —but
these are not provided for those with a Serious Mental Illness. Non-Profit Housing
Corporations must be involved on a larger scale to help develop a housing plan for those
with a Serious Mental Illness.
Questions:
How many clients of our Specialty Mental Health Clinics live in Non-Profit Housing
Corporation developments such as Riverhouse? There were Behavioral Health ties
directly into these facilities —what is happening now?
What is done to assure that people with a mental illness are not just left on their own?
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Mental Health Commission Response to Behavioral Health Services Update, 10/30/17 8
How many Full Service Partnership clients are housed in unregulated Room and
Boards?
What are the plans to house the Homeless with a mental illness? Do we have a
measurable plan?
Follow-up/Suggestions:
Request a comprehensive plan for housing the Seriously Mentally Ill.
In closing, the Mental Health Commission hopes that its evaluations, questions and
recommended follow up are received as intended – in the spirit of partnership and to
stimulate ongoing dialog around the continuous improvement of our county’s System of
Care for those suffering from mental illness.
This report is respectively submitted by:
Duane Chapman
Chair, Mental Health Commission
Barbara Serwin,
Vice Chair, Mental Health Commission
Lauren Rettagliata
Past Chair, Mental Health Commission
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Contra Costa County 2016-2017 Grand Jury Report 1703 Page 1
Grand Jury Reports are posted at http://www.cc-courts.org/grandjury
Contact: Jim Mellander
Foreperson
925-608-2621
Contra Costa County Grand Jury Report 1703
Mental Health Services for At-Risk Children in Contra
Costa County
TO: County Board of Supervisors, Behavioral Health Services
SUMMARY
The Grand Jury conducted a detailed investigation concerning the County’s delivery of
mental health services to at-risk children (“At-Risk Children”), which is defined as foster
children or those in danger of becoming foster children, Commercial Sexually Exploited
Children victims (CSEC), youth detained in Juvenile Hall, and children in domestic
violence or sexual abuse situations. Over the course of a seven-month investigation, the
Grand Jury found that at-risk children are not receiving timely access to mental health
treatment. Several factors were preventing timely access, all of which are within the
control of Behavioral Health Services and its subdivision Children’s Mental Health
Services. The Board of Supervisors should consider identifying funds to provide timely
treatment for children.
METHODOLOGY
The Grand Jury researched the statutes, agreements and regulations on mental health
services for children that pertain to the County. It also researched official reports from
State and County agencies, and conducted numerous interviews with County personnel
who are involved in the delivery of mental health services.
BACKGROUND
This Grand Jury conducted a detailed investigation of mental health services for at-risk
children in Contra Costa County. For purposes of this investigation, the Grand Jury
defined at-risk children as:
• Foster children or those in danger of becoming foster children
• Commercial Sexual Exploitation of Children (CSEC) victims
• Youth detained in Juvenile Hall
• Children who have experienced domestic violence and sexual abuse.
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Contra Costa County 2016-2017 Grand Jury Report 1703 Page 2
Grand Jury Reports are posted at http://www.cc-courts.org/grandjury
The Mental Health Commission White Paper
The Mental Health Commission (MHC), an advisory body appointed by the Board of
Supervisors to serve as the watchdog group in the County for mental health services,
issued a white paper in April 2016 “to encourage discussion around the current crisis in
the county public mental health care system and deficits in the county mental health
budget process that contribute to this crisis.”
While the white paper was issued by MHC, Behavioral Health Services (BHS) assisted
MHC with the data and the contents of the paper. The paper describes key points that
are pertinent to at-risk children:
“The wake-up call of the crisis at Psychiatric Emergency Services (PES) that points to
an impacted system that is unable to provide the right treatment at the right moment in
time and is therefore struggling to truly meet the needs of people with a serious mental
illness,”
“The compromised ability of… Child/Adolescent Clinics to meet the needs of patients
due to understaffing as evidenced by three to four months wait times and a migration of
patients to PES for intervention that is not meant to be a stand-in for treatment,”
“The underlying theme of inadequate staffing levels due to the inability of treatment
facilities to attract and keep high quality psychiatrists and nurses because of
uncompetitive compensation and such practices as closing of lists,”
“The underlying theme of dedicated, quality staff struggling to offer excellent care but
undercut by budgets that are generated by a formulaic, top down process rather than a
process that builds up a budget from program needs.”
The Katie A. Requirements
In delivering mental health services, the County must comply with the terms of the Katie
A. requirements. Katie A. was the lead plaintiff in a multiple-plaintiff lawsuit filed against
Los Angeles County and the State of California in 2002. The lawsuit alleged that
significant gaps existed in mental health services provided to children in the foster care
system. By the age of 14, Katie A. had been shuffled through 37 foster homes and had
endured 19 confinements in psychiatric hospitals.
Los Angeles County settled with the plaintiffs in 2003. The State of California agreed to
the following Katie A. child definition and mental health service requirements in 2011:
Children who are in or at risk of entering foster care will be identified as the “Katie A.
subclass.” A child will be part of the subclass if wraparound or specialized services are
being considered for the child, or the child has been hospitalized three times in the past
24 months for behavioral reasons or is currently hospitalized for a behavioral issue.
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Contra Costa County 2016-2017 Grand Jury Report 1703 Page 3
Grand Jury Reports are posted at http://www.cc-courts.org/grandjury
Pursuant to this agreement, California counties must adhere to a protocol, called a “core
practice model,” for screening and treating foster children. In accordance with this
protocol, children may be eligible for the following services:
• Intensive Care Coordination (ICC)
• Intensive Home-Based Services (IHBS)
• Therapeutic Foster Care in specially-trained foster homes.
The County hired several coordinators and appointed a Katie A. specialist manager to
handle the new protocol.
DISCUSSION
The Grand Jury used the new Katie A. requirements and the MHC white paper as
starting points to investigate Contra Costa County’s delivery of mental health services to
at-risk children.
Youth confined in Juvenile Hall receive a consistent and well-regulated package of
children’s mental health services from the County since these children are in a
controlled confinement. Of the 110 youth currently at the Hall (some of whom are CSEC
victims), 30% have been identified as having mental health problems. BHS has
assigned three County clinicians and a program manager to work exclusively at the Hall
to provide treatment, which involves medication and therapy. All three therapists are
grant-funded, and the grants require regular data reports on the outcome of the
treatments.
CSEC victims and children in domestic violence and sexual abuse situations are
sometimes discovered by police responding to a complaint. The police refer the children
to the Victim Advocates in the District Attorney’s Office. After securing the child in a safe
environment, the advocate arranges for the child to receive therapy so that the child can
better assist in the legal prosecution of their abusers. BHS is not usually involved in this
process. Rather, the Victim Advocate arranges for the victim to receive treatment from a
private therapist or psychiatrist. This treatment is funded by the State Victim
Compensation Fund and continues for the months or years that the victim needs to
recover. Despite receiving mental-health treatment, some CSEC victims are reluctant to
testify against their pimp abusers.
An estimated 85-90% of foster children need some form of mental health services.
Given this statistic, it is not surprising that a significant component of the estimated
7,000-plus children in the County who are serviced for mental health annually are foster
children, estimated at over 1,700, or those who are in danger of becoming foster
children. Only 300 of these children currently belong to the “Katie A. subclass.” The
County’s compliance in the Katie A. requirements is a work in progress. Satisfactory
120
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compliance depends upon skilled coordination between the social workers in Children
and Family Services (CFS) and the clinicians at BHS.
Children who may need mental health services are generally assessed and evaluated
within 7-10 days. However, children wait much longer, weeks or months, to receive
treatment.
After assessment and evaluation, the social workers at CFS arrange for treatment for
the child client through the BHS liaisons. The liaisons provide the social workers and
child guardians with three referrals of available psychiatrists or therapists from their
database. The social workers or guardians call these mental health professionals to
schedule treatment. Oftentimes, the social workers or guardians find that the three
referrals they have been given by the BHS liaisons are not available. Then they must
go back to the liaisons to arrange for another set of three referrals. This is the cause of
many delays. The CFS social workers state that the child has an average waiting time
for treatment of three months and the BHS liaisons state that the average is only 4 to 6
weeks. These two sets of County workers are working from different perspectives and
from different calendar counts. The BHS liaisons also state that they do not have an
updated list of unavailable psychiatrists or therapists.
After the screening and evaluation phase, each of the 7,000-plus children are classified
into two groups:
1. Medium to severe
2. Mild to medium
The mild to medium cases are scheduled for appointments with psychiatrists and
therapists in non-profit community-based organizations (CBOs) and private therapists
contracted by BHS. The medium to severe cases are scheduled for appointments with
the psychiatrists and therapists in the County’s three regional mental health clinics.
There are several factors that prevent children from accessing mental health services in
a timely manner. These factors differ depending on whether the child is classified as
medium to severe, or mild to medium.
Medium to Severe Cases
The three mental health clinics are understaffed in terms of psychiatrists, the doctors
who diagnose the children and prescribe medication for them when appropriate.
Children’s Mental Health Services estimates it needs to hire six more psychiatrists to
handle the workload and resolve the inequitable distribution among the regional clinics.
The County pays $30-50,000 less than what psychiatrists can earn in private practice.
Table 1 shows the distribution of the medium to severe cases assigned to the three
clinics and the corresponding distribution of psychiatrists in those three clinics.
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TABLE 1
Antioch Concord West County TOTAL
Children 630 740 800 2170
Psychiatrists* 2.2 3.5 1.3 7
Ratio 286.4 211.4 615.4 310
Note: * Full time equivalent
As shown on Table 2, the distribution of 85 County therapists across the three clinics is
inequitable relative to the distribution of medium to severe mental cases.
TABLE 2
Antioch Concord West County TOTAL
Children 630 740 800 2170
Therapists 22 47 16 85
Ratio 28.6 15.7 50 25.5
The normal management response to such uneven distribution is to reallocate some
therapists from Concord, to Antioch and to West County. The Grand Jury found no
evidence that any such plan is being considered.
Mild to Medium Cases
BHS contracts with 34 non-profit Community Based Organizations (CBOs) to treat the
estimated 5,000 children considered mild to medium cases. Twenty percent of these 34
CBOs were at capacity as of February 2017, meaning that seven of the CBOs had no
appointment availability. The BHS liaisons, who provide the appointment referrals for
the guardians/patients, do not have current data on the clinicians’ availability. Thus,
social workers or guardians call to CBOs that have no availability, causing delays in the
children’s treatment.
In addition to providing mental health treatment through CBOs, BHS can assign the
5,000 children who are diagnosed as mild to medium cases to the over 200 individual
private therapists that it contracts with. Like CBOs, these private therapists have limited
availability. Table 3 shows the availability of those private therapists in February 2017
and their distribution in the three regions.
TABLE 3
East County Central West County TOTAL
Private Therapist 60 100 47 207
Available 13 33 21 67
Not available 47 (78%) 67 (67%) 26 (55%) 140 (68%)
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Overall, 68% of the private therapists were not available for appointments. Thus,
children must wait longer for mental health services.
While no-shows for appointments also contribute to longer wait times, this factor is not
under the control of BHS. The tables show what is within the control of BHS and its
subdivision that manages treatment delays for at-risk children.
FINDINGS
F1. The County provides timely and consistent mental health services to detained
youth in Juvenile Hall, CSEC victims, and children in domestic violence and sexual
abuse situations.
F2. Under the terms of the Katie A. requirements, upper and middle management
levels of CFS and BHS have started to coordinate their efforts.
F3. Many at-risk children are not receiving mental health treatment for several weeks
to several months after the County assesses their mental-health needs.
F4. Children’s Mental Health Services estimates that the County needs an additional
six psychiatrists for its three clinics.
F5. County salaries for psychiatrists are not competitive with private practice.
F6. The shortage of psychiatrists causes delays in the diagnosis and treatment of
medium to severe mentally ill children.
F7. West County clinic, which has the most medium to severe patients, also has the
highest patient to therapist ratio.
F8. The 85 County therapists, who treat medium to severely mentally ill children, are
not equitably distributed among the three clinics based on workload.
F9. Twenty percent of the CBOs and 68% of the individual private therapists are not
available for appointments.
F10. BHS liaisons are not provided with current information about the availability of
CBOs and private therapists for appointments.
RECOMMENDATIONS
R1. The Board of Supervisors should consider identifying funds to add six psychiatrists
at the three regional mental health clinics.
R2. The Board of Supervisors should consider directing Human Resources to review
the compensation packages for County psychiatrists to ensure their compensation
packages are competitive compared with the private market.
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R3. The Board of Supervisors should consider directing BHS to redeploy therapists
with a view to a more equitable ratio of children per therapist among the County’s
three mental health clinics.
R4. The Board of Supervisors should consider identifying funds to enable BHS to
review and improve systems related to the real time availability of CBOs and
individual private therapists for mental health service appointments.
R5. The Board of Supervisors should consider directing BHS to monitor and report on
the wait times for mental health treatment for at-risk children.
REQUIRED RESPONSES
Findings Recommendations
Contra Costa County Board of Supervisors F1 to F10 R1 to R5
These responses must be provided in the format and by the date set forth in the cover
letter that accompanies this report. An electronic copy of these responses in the form of
a Word document should be sent by e-mail to ctadmin@contracosta.courts.ca.gov and
a hard (paper) copy should be sent to:
Civil Grand Jury – Foreperson
725 Court Street
P.O. Box 431
Martinez, CA 94553-0091
124
CONTRA COSTA COUNTY CIVIL GRAND JURY REPORT NO. 1703
"Mental Health Services for At-Risk Children in Contra Costa County”
BOARD OF SUPERVISORS’ RESPONSE
FINDINGS – California Penal Code Section 933.05(a) requires a response to the designated findings
of the Grand Jury.
F1. The County provides timely and consistent mental health services to detained youth
in Juvenile Hall, CSEC victims, and children in domestic violence and sexual abuse
situations.
Response: The respondent agrees with the finding. The County’s Probation and Health
Services departments work collaboratively to provide a high level of Mental Health services to
the youth in the Juvenile Justice system including Juvenile Hall and the Orin Allen Youth
Facility.
F2. Under the terms of the Katie A. requirements, upper and middle management levels
of CFS and BHS have started to coordinate their efforts.
Response: The respondent disagrees wholly with the finding. Since about 1996, the
Behavioral Health Division and Child and Family Services Bureau have collaborated on
children’s mental health services in a comprehensive way. Katie A. and the implementation of
Continuum of Care Reform have contributed to a more coordinated relationship since Health
Services and Employment and Human Services department staff meet on a weekly basis and
often meet more than once a week.
F3. Many at-risk children are not receiving mental health treatment for several weeks
to several months after the County assesses their mental-health needs.
Response: The respondent disagrees partially with the finding. Children presenting at the
Regional Clinics are seen on average within eleven to sixteen days for their first appointment
with a Mental Health Clinical Specialist that provides comprehensive assessment and treatment.
The County recognizes challenges with the availability of child psychiatrists and delays may
occur with the medical treatment and medication support of the child.
F4. Children’s Mental Health Services estimates that the County needs an additional six
psychiatrists for its three clinics.
125
Response: The respondent disagrees partially with the finding. The County recognizes a need
for additional psychiatrists to eliminate long waits for Psychiatry and to adequately staff our
clinics. While the County is working to fill vacant psychiatrist positions, psychiatrist contractors
are working at the clinics to support psychiatry services. The County will be looking at
psychiatrist staffing to determine the number of additional psychiatrists needed for its three
clinics.
F5. County salaries for psychiatrists are not competitive with private practice.
Response: The respondent agrees with the finding. In general, private sector practices offer
more competitive salaries than public agencies.
F6. The shortage of psychiatrists causes delays in the diagnosis and treatment of
medium to severely mentally ill children.
Response: The respondent disagrees partially with the finding. Shortage of psychiatrists may
delay the medical treatment and medication support of the child. However, children are
assessed and diagnosed to be seen for outpatient therapy by a Mental Health Clinical Specialist
within eleven to sixteen days on average.
F7. West County clinic, which has the most medium to severe patients, also has the
highest patient to therapist ratio.
Response: The respondent disagrees wholly with the finding. The number of children and ratios
cited in table 1 of this grand jury report are inaccurate. The numbers stated by the grand jury
are the total number of clients that are provided Utilization Review Services by that County
Clinic in each region. The actual number of open children cases (County staff serviced) are 430
in Antioch, 435 in Concord, and 305 in West County for a total of 1,095.
Table A below provides more accurate figures of patient to therapist ratios, which shows
caseloads are balanced across the clinics.
TABLE A:
Antioch Concord West County Total
Children 430 435 305 1095
Therapists* 15 16 12 43
Ratio 28.6:1 27.2:1 25.4:1 25.5:1
*Therapists include both psychiatrists and mental health clinical specialists.
F8. The 85 County Clinical Staff, who treat medium to severely mentally ill children,
are not equitably distributed among the three clinics based on workload.
Response: The respondent disagrees wholly with the finding. Assignment of therapists across
the County’s regions is balanced as demonstrated in Table A of response F7. In addition to the
therapist staff assigned to the clinics as stated in Table A of response F7, each clinic has an
equitable distribution of Family Partners, Family Support Workers, etc. that also work as a team
126
to provide therapeutic intervention and stability to the families. In total, the County staffs
approximately 95 clinical treatment staff, which includes psychiatrists, Mental Health Clinical
Specialists, Mental Health Community Support Workers, and Mental Health Specialist IIs.
F9. Twenty percent of the CBOs and 68% of the individual private therapists are not
available for appointments.
Response: The respondent disagrees wholly with the finding. Only CBOs and Network
Providers that are available for appointments are referred. In order for individual private
therapists and CBO’s to maintain availability for referrals, they must have appointments
available within ten (10) days.
The Access Unit is staffed by licensed clinicians who screen callers to determine clinical acuity
in order to make a referral. The Access Unit uses an acuity screening tool to determine a
patient’s functional impairment. The screening tool also indicates level of care options for
referrals. Patients with mild-moderate impairments are either referred back to their primary care
providers referred to a mental health clinician who works at a primary care health center, or to
the contracted network of providers. Those who have mild-moderate functional impairments with
private insurance such as Kaiser or Blue Cross are referred back to their managed care health
plans. Patients who have moderate-severe impairments are referred to Community Based
Organizations or the County Regional Mental Health Clinics.
F10. BHS liaisons are not provided with current information about the availability of
CBOs and private therapists for appointments.
Response: The respondent disagrees wholly with the finding. Liaisons operate with the most
recent information available, as provided by surveys to private therapists and the expectation
that CBOs notify liaisons of any availability changes. Behavioral Health liaisons follow the same
protocol as Mental Health Access by providing three potential clinician referrals to each
beneficiary. The County is not aware of issues with CBO’s and private therapist’s lack of
availability and this is a process that is reviewed annually by the state.
RECOMMENDATIONS - California Penal Code Section 933.05(b) requires a response to the
designated recommendations of the Grand Jury.
R1. The Board of Supervisors should consider identifying funds to add six
psychiatrists at the three regional mental health clinics.
Response: The recommendation requires further analysis. There are currently three funded
psychiatrist positions that are vacant and the County is working to fill. Once those positions are
filled, the County will continue assessing staffing needs and determine the number of additional
positions needed. Furthermore, the County is currently in negotiations with Physicians’ and
Dentists’ Organization of Contra Costa, which includes a review of benefits and wages for all
represented classifications, including psychiatrists. Once an agreement is reached, more
accurate salary and benefits figures will be available to identify the amount of funding needed
for any additional positions.
127
R2. The Board of Supervisors should consider directing Human Resources to review
the compensation packages for County psychiatrists to ensure their compensation
packages are competitive compared to the private market.
Response: The recommendation will not be implemented because it is not reasonable. The
County is currently in negotiations with Physicians’ and Dentists’ Organization of Contra Costa;
therefore, a review of benefits and wages for all represented classifications, including
psychiatrists, is underway. The County cannot compete with the private market; therefore,
comparing County compensation packages with other counties establishes more reasonable
benchmarks. The issue of the County’s psychiatrist compensation packages is being
addressed and will be known after negotiations are complete.
R3. The Board of Supervisors should consider directing BHS to redeploy therapists with
a view to a more equitable ratio of children per therapist among the County’s three
mental health clinics.
Response: The recommendation has been implemented. Clinical staff are fairly and evenly
distributed across the regional clinics with equitable ratios of children per therapist. Table A,
included in the response to F7 shows the equitable distribution of psychiatrists across the
County clinics. Our goal is to continue to deploy therapists with consideration to equity and the
number of consumers presenting at the clinics for services.
R4. The Board of Supervisors should consider identifying funds to enable BHS to review
and improve systems related to the real time availability of CBOs and individual private
therapists for mental health service appointments.
Response: The recommendation will not be implemented because it is not reasonable. The
County is not aware of the existence of a real time tool to support the recommended effort.
However, the County has processes in place to maintain current information on the availability
of CBOs and individual private therapists. The Access Line regularly conducts test calls to
CBOs and private therapists to ensure appointments are available. No referral is made to a
CBO or private therapist unless they have an appointment available in the next ten (10) days.
R5. The Board of Supervisors should consider directing BHS to monitor and report on
the wait times for mental health treatment for at-risk children.
Response: The recommendation has been implemented. The Behavioral Health Division is
required by regulation to monitor and report on the timeliness of mental health treatment for at-
risk youth. During the last annual review, which was conducted in February of this year, the
following data was presented to the External Quality Review Organization (State audit team):
128
Timeline from initial request to clinical assessment appointment:
County
Wide
West
Region
Central
Region
East
Region
Average length of time from first request
for service to first clinical assessment 14.1 days 11.6 days 11.5 days 16.5 days
MHP standard or goal 15 days 15 days 15 days 15 days
Percent of appointments that meet this
standard 63.8% 80.6% 81.0% 46.9%
Range 1-48 days 1-47 days 1-43 days 5-48 days
Timeline from initial request to first psychiatry appointment:
County
Wide
West
Region
Central
Region
East
Region
Average length of time from first
request for service to first psychiatry
appointment
12.0 days 11.2 days 3.1 days 20.5 days
MHP standard or goal 30 days 30 days 30 days 30 days
Percent of appointments that meet this
standard 100% 100% 100% 100%
Range 1-30 days 1–26 days 1-9 days 12–30 days
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Region # of Clients % of Total Region # of MC
children
% of Total
Central 358 32.9%Central 25,284 22.8%
East 418 38.4%East 49,741 44.8%
West 312 28.7%West 36,024 32.4%
Grand Total 1,088 100.0%Grand Total 111,049 100.0%
MH Children's Outpatient Clinics - Demographics by Age and Ethnicity
Served vs Medi-Cal eligiblle population in FY 2016-2017
Basic demographic indicators for the Medi-Cal eligible population, served by the CCHSD MH vs county wide
Children, open at MH Clinics for svcs CCC Medi-Cal Eligible Children
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Region # of Clients % of Region
Total
Region Age Group % of Region
Total
1 0.3%Age Group #1: 0-5 28.2%
127 35.5%Age Group #2: 6-12 33.1%
179 50.0%Age Group #3: 13-17 21.8%
51 14.2%Age Group #4: 18-21 17.0%
358 100.0%Total for Central 100.0%
136 32.5%Age Group #1: 0-5 28.4%
228 54.5%Age Group #2: 6-12 33.6%
54 12.9%Age Group #3: 13-17 21.7%
418 100.0%Age Group #4: 18-21 16.3%
1 0.3%Total for East 100.0%
112 35.9%Age Group #1: 0-5 29.8%
158 50.6%Age Group #2: 6-12 33.7%
41 13.1%Age Group #3: 13-17 20.8%
312 100.0%Age Group #4: 18-21 15.7%
1,088 N/A Total for West 100.0%
Grand Total 100.0%
MH Children's Outpatient Clinics - Demographics by Age and Ethnicity
Served vs Medi-Cal eligiblle population in FY 2016-2017
Basic demographic indicators for the Medi-Cal eligible population, served by the CCHSD MH vs county wide
Children, open at MH Clinics for svcs CCC Medi-Cal Eligible Children
Age Group # of MC
children
Central Age Group #1: 0-5 Central 7,124
Age Group #2: 6-12 8,361
Age Group #3: 13-17 5,511
Age Group #4: 18-21 4,288
Total for Central 7,124
East Age Group #2: 6-12 East 14,110
Age Group #3: 13-17 16,727
Age Group #4: 18-21 10,812
Total for East 8,092
West Age Group #1: 0-5 14,110
Age Group #2: 6-12 West 10,731
Grand Total 10,731
111,049
Age Group #3: 13-17 12,125
Age Group #4: 18-21 7,502
Total for West 5,666
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Region # of Clients Region Ethnicity % of Region
Total
47 African American 4.1%
13 Asian/Pacific Islander 14.9%
164 Caucasian 23.1%
120 Hispanic 35.7%
3 Native American 0.3%
10 Other Non White 18.8%
1 Unknown 3.0%
358 Total for Central 100.0%
113 African American 18.1%
10 Asian/Pacific Islander 10.1%
119 Caucasian 14.2%
139 Hispanic 41.4%
4 Native American 0.2%
7 Other Non White 12.8%
26 Unknown 3.0%
418 Total for East 100.0%
93 African American 16.9%
12 Asian/Pacific Islander 14.0%
60 Caucasian 5.3%
127 Hispanic 48.5%
4 Native American 0.1%
1 Other Non White 12.3%
15 Unknown 2.9%
312 Total for West 100.0%
1,088 Grand Total N/A
MH Children's Outpatient Clinics - Demographics by Age and Ethnicity
Served vs Medi-Cal eligiblle population in FY 2016-2017
Basic demographic indicators for the Medi-Cal eligible population, served by the CCHSD MH vs county wide
Children, open at MH Clinics for svcs CCC Medi-Cal Eligible Children
Ethnicity % of Region
Total
# of MC
children
Central African-American 13.1%Central 1,040
Asian/Pacific Islander 3.6%3,771
Caucasian 45.8%5,840
Hispanic 33.5%9,029
Native American 0.8%69
Other Non White 2.8%4,764
Unknown 0.3%771
Total for Central 100.0%1,040
East African-American 27.0%East 9,024
Asian/Pacific Islander 2.4%5,030
Caucasian 28.5%7,069
Hispanic 33.3%20,617
Native American 1.0%116
Other Non White 1.7%6,382
Unknown 6.2%1,503
Total for East 100.0%9,024
West African-American 29.8%West 6,099
Asian/Pacific Islander 3.8%5,035
Caucasian 19.2%1,925
Hispanic 40.7%17,456
Native American 1.3%50
Other Non White 0.3%4,414
Unknown 4.8%1,045
Total for West 100.0%6,099
Grand Total N/A 111,049
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Region # of Svcs
in FY16-17
% of Svcs Total Cost % of Cost
Central 13,266 39.6%$3,154,828 35.7%
East 11,955 35.7%$3,300,070 37.3%
West 8,264 24.7%$2,389,185 27.0%
Grand Total 33,485 100.0%$8,844,083 100.0%
MH Children's Outpatient Clinics - Demographics by Age and Ethnicity
Served vs Medi-Cal eligiblle population in FY 2016-2017
Basic demographic indicators for the Medi-Cal eligible population, served by the CCHSD MH vs county wide
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Region # of Clients % of Total Region # of MC
children
%
Central 763 25.0%Central 25,284 22.8%
East 983 32.2%East 49,741 44.8%
West 1,305 42.8%West 36,024 32.4%
Grand Total 3,051 100.0%Grand Total 111,049 100.0%
MH Children's Outpatient Clinics - Demographics by Age and Ethnicity
Served vs Medi-Cal eligiblle population in FY 2016-2017
Basic demographic indicators for the Medi-Cal eligible population, served by the CCHSD MH vs county wide
Children, open at MH Clinics - all cases CCC Medi-Cal Eligible Children
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Region # of Clients % of Region
Total
Region Age Group % of Region
Total
51 6.7%Age Group #1: 0-5 28.2%
288 37.7%Age Group #2: 6-12 33.1%
321 42.1%Age Group #3: 13-17 21.8%
103 13.5%Age Group #4: 18-21 17.0%
763 100.0%Total for Central 100.0%
70 7.1%Age Group #1: 0-5 28.4%
409 41.6%Age Group #2: 6-12 33.6%
417 42.4%Age Group #3: 13-17 21.7%
87 8.9%Age Group #4: 18-21 16.3%
983 100.0%Total for East 100.0%
151 11.6%Age Group #1: 0-5 29.8%
598 45.8%Age Group #2: 6-12 33.7%
438 33.6%Age Group #3: 13-17 20.8%
118 9.0%Age Group #4: 18-21 15.7%
1,305 100.0%Total for West 100.0%
3,051 N/A Grand Total 100.0%
MH Children's Outpatient Clinics - Demographics by Age and Ethnicity
Served vs Medi-Cal eligiblle population in FY 2016-2017
Basic demographic indicators for the Medi-Cal eligible population, served by the CCHSD MH vs county wide
Children, open at MH Clinics - all cases CCC Medi-Cal Eligible Children
Age Group # of MC
children
Central Age Group #1: 0-5 Central 7,124
Age Group #2: 6-12 8,361
Age Group #3: 13-17 5,511
Age Group #4: 18-21 4,288
Total for Central 7,124
East Age Group #1: 0-5 East 14,110
Age Group #2: 6-12 16,727
Age Group #3: 13-17 10,812
Age Group #4: 18-21 8,092
Total for East 14,110
Grand Total 111,049
West Age Group #1: 0-5 West 10,731
Age Group #2: 6-12 12,125
Age Group #3: 13-17 7,502
Age Group #4: 18-21 5,666
Total for West 10,731
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Region # of Clients Region Ethnicity % of Region
Total
105 African American 4.1%
20 Asian/Pacific Islander 14.9%
304 Caucasian 23.1%
302 Hispanic 35.7%
8 Native American 0.3%
18 Other Non White 18.8%
6 Unknown 3.0%
763 Total for Central 100.0%
240 African American 18.1%
27 Asian/Pacific Islander 10.1%
268 Caucasian 14.2%
391 Hispanic 41.4%
8 Native American 0.2%
10 Other Non White 12.8%
39 Unknown 3.0%
983 Total for East 100.0%
372 African American 16.9%
35 Asian/Pacific Islander 14.0%
169 Caucasian 5.3%
666 Hispanic 48.5%
10 Native American 0.1%
22 Other Non White 12.3%
31 Unknown 2.9%
1,305 Total for West 100.0%
3,051 Grand Total N/A
MH Children's Outpatient Clinics - Demographics by Age and Ethnicity
Served vs Medi-Cal eligiblle population in FY 2016-2017
Basic demographic indicators for the Medi-Cal eligible population, served by the CCHSD MH vs county wide
Children, open at MH Clinics - all cases CCC Medi-Cal Eligible Children
Ethnicity % of Region
Total
# of MC
children
Central African-American 13.8%Central 1,040
Asian/Pacific Islander 2.6%3,771
Caucasian 39.8%5,840
Hispanic 39.6%9,029
Native American 1.0%69
Other Non White 2.4%4,764
Unknown 0.8%771
Total for Central 100.0%1,040
East African-American 24.4%East 9,024
Asian/Pacific Islander 2.7%5,030
Caucasian 27.3%7,069
Hispanic 39.8%20,617
Native American 0.8%116
Other Non White 1.0%6,382
Unknown 4.0%1,503
Total for East 100.0%9,024
West African-American 28.5%West 6,099
Asian/Pacific Islander 2.7%5,035
Caucasian 13.0%1,925
Hispanic 51.0%17,456
Native American 0.8%50
Other Non White 1.7%4,414
Unknown 2.4%1,045
Total for West 100.0%6,099
Grand Total N/A 111,049
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Region # of Clients % of Total Region # of MC
children
% of Total
Central 358 32.9%Central 25,284 22.8%
East 418 38.4%East 49,741 44.8%
West 312 28.7%West 36,024 32.4%
Grand Total 1,088 100.0%Grand Total 111,049 100.0%
MH Children's Outpatient Clinics - Demographics by Age and Ethnicity
Served vs Medi-Cal eligiblle population in FY 2016-2017
Basic demographic indicators for the Medi-Cal eligible population, served by the CCHSD MH vs county wide
Children, open at MH Clinics for svcs CCC Medi-Cal Eligible Children
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Region # of Clients % of Region
Total
Region Age Group % of Region
Total
1 0.3%Age Group #1: 0-5 28.2%
127 35.5%Age Group #2: 6-12 33.1%
179 50.0%Age Group #3: 13-17 21.8%
51 14.2%Age Group #4: 18-21 17.0%
358 100.0%Total for Central 100.0%
136 32.5%Age Group #1: 0-5 28.4%
228 54.5%Age Group #2: 6-12 33.6%
54 12.9%Age Group #3: 13-17 21.7%
418 100.0%Age Group #4: 18-21 16.3%
1 0.3%Total for East 100.0%
112 35.9%Age Group #1: 0-5 29.8%
158 50.6%Age Group #2: 6-12 33.7%
41 13.1%Age Group #3: 13-17 20.8%
312 100.0%Age Group #4: 18-21 15.7%
1,088 N/A Total for West 100.0%
Grand Total 100.0%
MH Children's Outpatient Clinics - Demographics by Age and Ethnicity
Served vs Medi-Cal eligiblle population in FY 2016-2017
Basic demographic indicators for the Medi-Cal eligible population, served by the CCHSD MH vs county wide
Children, open at MH Clinics for svcs CCC Medi-Cal Eligible Children
Age Group # of MC
children
Central Age Group #1: 0-5 Central 7,124
Age Group #2: 6-12 8,361
Age Group #3: 13-17 5,511
Age Group #4: 18-21 4,288
Total for Central 7,124
East Age Group #2: 6-12 East 14,110
Age Group #3: 13-17 16,727
Age Group #4: 18-21 10,812
Total for East 8,092
West Age Group #1: 0-5 14,110
Age Group #2: 6-12 West 10,731
Grand Total 10,731
111,049
Age Group #3: 13-17 12,125
Age Group #4: 18-21 7,502
Total for West 5,666
138
Date Published : 8/3/2017 19:34;
3 of 4
Region # of Clients Region Ethnicity % of Region
Total
47 African American 4.1%
13 Asian/Pacific Islander 14.9%
164 Caucasian 23.1%
120 Hispanic 35.7%
3 Native American 0.3%
10 Other Non White 18.8%
1 Unknown 3.0%
358 Total for Central 100.0%
113 African American 18.1%
10 Asian/Pacific Islander 10.1%
119 Caucasian 14.2%
139 Hispanic 41.4%
4 Native American 0.2%
7 Other Non White 12.8%
26 Unknown 3.0%
418 Total for East 100.0%
93 African American 16.9%
12 Asian/Pacific Islander 14.0%
60 Caucasian 5.3%
127 Hispanic 48.5%
4 Native American 0.1%
1 Other Non White 12.3%
15 Unknown 2.9%
312 Total for West 100.0%
1,088 Grand Total N/A
MH Children's Outpatient Clinics - Demographics by Age and Ethnicity
Served vs Medi-Cal eligiblle population in FY 2016-2017
Basic demographic indicators for the Medi-Cal eligible population, served by the CCHSD MH vs county wide
Children, open at MH Clinics for svcs CCC Medi-Cal Eligible Children
Ethnicity % of Region
Total
# of MC
children
Central African-American 13.1%Central 1,040
Asian/Pacific Islander 3.6%3,771
Caucasian 45.8%5,840
Hispanic 33.5%9,029
Native American 0.8%69
Other Non White 2.8%4,764
Unknown 0.3%771
Total for Central 100.0%1,040
East African-American 27.0%East 9,024
Asian/Pacific Islander 2.4%5,030
Caucasian 28.5%7,069
Hispanic 33.3%20,617
Native American 1.0%116
Other Non White 1.7%6,382
Unknown 6.2%1,503
Total for East 100.0%9,024
West African-American 29.8%West 6,099
Asian/Pacific Islander 3.8%5,035
Caucasian 19.2%1,925
Hispanic 40.7%17,456
Native American 1.3%50
Other Non White 0.3%4,414
Unknown 4.8%1,045
Total for West 100.0%6,099
Grand Total N/A 111,049
139
Date Published : 8/3/2017 19:34;
4 of 4
Region # of Svcs
in FY16-17
% of Svcs Total Cost % of Cost
Central 13,266 39.6%$3,154,828 35.7%
East 11,955 35.7%$3,300,070 37.3%
West 8,264 24.7%$2,389,185 27.0%
Grand Total 33,485 100.0%$8,844,083 100.0%
MH Children's Outpatient Clinics - Demographics by Age and Ethnicity
Served vs Medi-Cal eligiblle population in FY 2016-2017
Basic demographic indicators for the Medi-Cal eligible population, served by the CCHSD MH vs county wide
140
141
Contra Costa County 2016-2017 Grand Jury Report 1703 Page 1
Grand Jury Reports are posted at http://www.cc-courts.org/grandjury
Contact: Jim Mellander
Foreperson
925-608-2621
Contra Costa County Grand Jury Report 1703
Mental Health Services for At-Risk Children in Contra
Costa County
TO: County Board of Supervisors, Behavioral Health Services
SUMMARY
The Grand Jury conducted a detailed investigation concerning the County’s delivery of
mental health services to at-risk children (“At-Risk Children”), which is defined as foster
children or those in danger of becoming foster children, Commercial Sexually Exploited
Children victims (CSEC), youth detained in Juvenile Hall, and children in domestic
violence or sexual abuse situations. Over the course of a seven-month investigation, the
Grand Jury found that at-risk children are not receiving timely access to mental health
treatment. Several factors were preventing timely access, all of which are within the
control of Behavioral Health Services and its subdivision Children’s Mental Health
Services. The Board of Supervisors should consider identifying funds to provide timely
treatment for children.
METHODOLOGY
The Grand Jury researched the statutes, agreements and regulations on mental health
services for children that pertain to the County. It also researched official reports from
State and County agencies, and conducted numerous interviews with County personnel
who are involved in the delivery of mental health services.
BACKGROUND
This Grand Jury conducted a detailed investigation of mental health services for at-risk
children in Contra Costa County. For purposes of this investigation, the Grand Jury
defined at-risk children as:
• Foster children or those in danger of becoming foster children
• Commercial Sexual Exploitation of Children (CSEC) victims
• Youth detained in Juvenile Hall
• Children who have experienced domestic violence and sexual abuse.
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The Mental Health Commission White Paper
The Mental Health Commission (MHC), an advisory body appointed by the Board of
Supervisors to serve as the watchdog group in the County for mental health services,
issued a white paper in April 2016 “to encourage discussion around the current crisis in
the county public mental health care system and deficits in the county mental health
budget process that contribute to this crisis.”
While the white paper was issued by MHC, Behavioral Health Services (BHS) assisted
MHC with the data and the contents of the paper. The paper describes key points that
are pertinent to at-risk children:
“The wake-up call of the crisis at Psychiatric Emergency Services (PES) that points to
an impacted system that is unable to provide the right treatment at the right moment in
time and is therefore struggling to truly meet the needs of people with a serious mental
illness,”
“The compromised ability of Child/Adolescent Clinics to meet the needs of patients
due to understaffing as evidenced by three to four months wait times and a migration of
patients to PES for intervention that is not meant to be a stand-in for treatment,”
“The underlying theme of inadequate staffing levels due to the inability of treatment
facilities to attract and keep high quality psychiatrists and nurses because of
uncompetitive compensation and such practices as closing of lists,”
“The underlying theme of dedicated, quality staff struggling to offer excellent care but
undercut by budgets that are generated by a formulaic, top down process rather than a
process that builds up a budget from program needs.”
The Katie A. Requirements
In delivering mental health services, the County must comply with the terms of the Katie
A. requirements. Katie A. was the lead plaintiff in a multiple-plaintiff lawsuit filed against
Los Angeles County and the State of California in 2002. The lawsuit alleged that
significant gaps existed in mental health services provided to children in the foster care
system. By the age of 14, Katie A. had been shuffled through 37 foster homes and had
endured 19 confinements in psychiatric hospitals.
Los Angeles County settled with the plaintiffs in 2003. The State of California agreed to
the following Katie A. child definition and mental health service requirements in 2011:
Children who are in or at risk of entering foster care will be identified as the “Katie A.
subclass.” A child will be part of the subclass if wraparound or specialized services are
being considered for the child, or the child has been hospitalized three times in the past
24 months for behavioral reasons or is currently hospitalized for a behavioral issue.
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Pursuant to this agreement, California counties must adhere to a protocol, called a “core
practice model,” for screening and treating foster children. In accordance with this
protocol, children may be eligible for the following services:
• Intensive Care Coordination (ICC)
• Intensive Home-Based Services (IHBS)
• Therapeutic Foster Care in specially-trained foster homes.
The County hired several coordinators and appointed a Katie A. specialist manager to
handle the new protocol.
DISCUSSION
The Grand Jury used the new Katie A. requirements and the MHC white paper as
starting points to investigate Contra Costa County’s delivery of mental health services to
at-risk children.
Youth confined in Juvenile Hall receive a consistent and well-regulated package of
children’s mental health services from the County since these children are in a
controlled confinement. Of the 110 youth currently at the Hall (some of whom are CSEC
victims), 30% have been identified as having mental health problems. BHS has
assigned three County clinicians and a program manager to work exclusively at the Hall
to provide treatment, which involves medication and therapy. All three therapists are
grant-funded, and the grants require regular data reports on the outcome of the
treatments.
CSEC victims and children in domestic violence and sexual abuse situations are
sometimes discovered by police responding to a complaint. The police refer the children
to the Victim Advocates in the District Attorney’s Office. After securing the child in a safe
environment, the advocate arranges for the child to receive therapy so that the child can
better assist in the legal prosecution of their abusers. BHS is not usually involved in this
process. Rather, the Victim Advocate arranges for the victim to receive treatment from a
private therapist or psychiatrist. This treatment is funded by the State Victim
Compensation Fund and continues for the months or years that the victim needs to
recover. Despite receiving mental-health treatment, some CSEC victims are reluctant to
testify against their pimp abusers.
An estimated 85-90% of foster children need some form of mental health services.
Given this statistic, it is not surprising that a significant component of the estimated
7,000-plus children in the County who are serviced for mental health annually are foster
children, estimated at over 1,700, or those who are in danger of becoming foster
children. Only 300 of these children currently belong to the “Katie A. subclass.” The
County’s compliance in the Katie A. requirements is a work in progress. Satisfactory
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compliance depends upon skilled coordination between the social workers in Children
and Family Services (CFS) and the clinicians at BHS.
Children who may need mental health services are generally assessed and evaluated
within 7-10 days. However, children wait much longer, weeks or months, to receive
treatment.
After assessment and evaluation, the social workers at CFS arrange for treatment for
the child client through the BHS liaisons. The liaisons provide the social workers and
child guardians with three referrals of available psychiatrists or therapists from their
database. The social workers or guardians call these mental health professionals to
schedule treatment. Oftentimes, the social workers or guardians find that the three
referrals they have been given by the BHS liaisons are not available. Then they must
go back to the liaisons to arrange for another set of three referrals. This is the cause of
many delays. The CFS social workers state that the child has an average waiting time
for treatment of three months and the BHS liaisons state that the average is only 4 to 6
weeks. These two sets of County workers are working from different perspectives and
from different calendar counts. The BHS liaisons also state that they do not have an
updated list of unavailable psychiatrists or therapists.
After the screening and evaluation phase, each of the 7,000-plus children are classified
into two groups:
1. Medium to severe
2. Mild to medium
The mild to medium cases are scheduled for appointments with psychiatrists and
therapists in non-profit community-based organizations (CBOs) and private therapists
contracted by BHS. The medium to severe cases are scheduled for appointments with
the psychiatrists and therapists in the County’s three regional mental health clinics.
There are several factors that prevent children from accessing mental health services in
a timely manner. These factors differ depending on whether the child is classified as
medium to severe, or mild to medium.
Medium to Severe Cases
The three mental health clinics are understaffed in terms of psychiatrists, the doctors
who diagnose the children and prescribe medication for them when appropriate.
Children’s Mental Health Services estimates it needs to hire six more psychiatrists to
handle the workload and resolve the inequitable distribution among the regional clinics.
The County pays $30-50,000 less than what psychiatrists can earn in private practice.
Table 1 shows the distribution of the medium to severe cases assigned to the three
clinics and the corresponding distribution of psychiatrists in those three clinics.
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TABLE 1
Antioch Concord West County TOTAL
Children 630 740 800 2170
Psychiatrists* 2.2 3.5 1.3 7
Ratio 286.4 211.4 615.4 310
Note: * Full time equivalent
As shown on Table 2, the distribution of 85 County therapists across the three clinics is
inequitable relative to the distribution of medium to severe mental cases.
TABLE 2
Antioch Concord West County TOTAL
Children 630 740 800 2170
Therapists 22 47 16 85
Ratio 28.6 15.7 50 25.5
The normal management response to such uneven distribution is to reallocate some
therapists from Concord, to Antioch and to West County. The Grand Jury found no
evidence that any such plan is being considered.
Mild to Medium Cases
BHS contracts with 34 non-profit Community Based Organizations (CBOs) to treat the
estimated 5,000 children considered mild to medium cases. Twenty percent of these 34
CBOs were at capacity as of February 2017, meaning that seven of the CBOs had no
appointment availability. The BHS liaisons, who provide the appointment referrals for
the guardians/patients, do not have current data on the clinicians’ availability. Thus,
social workers or guardians call to CBOs that have no availability, causing delays in the
children’s treatment.
In addition to providing mental health treatment through CBOs, BHS can assign the
5,000 children who are diagnosed as mild to medium cases to the over 200 individual
private therapists that it contracts with. Like CBOs, these private therapists have limited
availability. Table 3 shows the availability of those private therapists in February 2017
and their distribution in the three regions.
TABLE 3
East County Central West County TOTAL
Private Therapist 60 100 47 207
Available 13 33 21 67
Not available 47 (78%) 67 (67%) 26 (55%) 140 (68%)
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Contra Costa County 2016-2017 Grand Jury Report 1703 Page 6
Grand Jury Reports are posted at http://www.cc-courts.org/grandjury
Overall, 68% of the private therapists were not available for appointments. Thus,
children must wait longer for mental health services.
While no-shows for appointments also contribute to longer wait times, this factor is not
under the control of BHS. The tables show what is within the control of BHS and its
subdivision that manages treatment delays for at-risk children.
FINDINGS
F1. The County provides timely and consistent mental health services to detained
youth in Juvenile Hall, CSEC victims, and children in domestic violence and sexual
abuse situations.
F2. Under the terms of the Katie A. requirements, upper and middle management
levels of CFS and BHS have started to coordinate their efforts.
F3. Many at-risk children are not receiving mental health treatment for several weeks
to several months after the County assesses their mental-health needs.
F4. Children’s Mental Health Services estimates that the County needs an additional
six psychiatrists for its three clinics.
F5. County salaries for psychiatrists are not competitive with private practice.
F6. The shortage of psychiatrists causes delays in the diagnosis and treatment of
medium to severe mentally ill children.
F7. West County clinic, which has the most medium to severe patients, also has the
highest patient to therapist ratio.
F8. The 85 County therapists, who treat medium to severely mentally ill children, are
not equitably distributed among the three clinics based on workload.
F9. Twenty percent of the CBOs and 68% of the individual private therapists are not
available for appointments.
F10. BHS liaisons are not provided with current information about the availability of
CBOs and private therapists for appointments.
RECOMMENDATIONS
R1. The Board of Supervisors should consider identifying funds to add six psychiatrists
at the three regional mental health clinics.
R2. The Board of Supervisors should consider directing Human Resources to review
the compensation packages for County psychiatrists to ensure their compensation
packages are competitive compared with the private market.
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Contra Costa County 2016-2017 Grand Jury Report 1703 Page 7
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R3. The Board of Supervisors should consider directing BHS to redeploy therapists
with a view to a more equitable ratio of children per therapist among the County’s
three mental health clinics.
R4. The Board of Supervisors should consider identifying funds to enable BHS to
review and improve systems related to the real time availability of CBOs and
individual private therapists for mental health service appointments.
R5. The Board of Supervisors should consider directing BHS to monitor and report on
the wait times for mental health treatment for at-risk children.
REQUIRED RESPONSES
Findings Recommendations
Contra Costa County Board of Supervisors F1 to F10 R1 to R5
These responses must be provided in the format and by the date set forth in the cover
letter that accompanies this report. An electronic copy of these responses in the form of
a Word document should be sent by e-mail to ctadmin@contracosta.courts.ca.gov and
a hard (paper) copy should be sent to:
Civil Grand Jury – Foreperson
725 Court Street
P.O. Box 431
Martinez, CA 94553-0091
148
FAMILY AND HUMAN SERVICES COMMITTEE 8.
Meeting Date:09/24/2018
Subject:Continuum of Care Plan for the Homeless/Health Care for the Homeless
Submitted For: Anna Roth, Health Services Director
Department:Health Services
Referral No.: FHS #5
Referral Name: Continuum of Care Plan for the Homeless/Healthcare for the Homeless
Presenter: Jaime Jenett, Continuum of Care Planning
and Policy Manager; Joseph Mega, MPH,
MD, Medical Director-Health Care for the
Homeless
Contact: Lavonna Martin (925)
608-6700; Rachael
Birch (925) 608-5123
Referral History:
Since 1990, the Health Care for the Homeless (HCH) Program has provided health care services
to the homeless population in Contra Costa County through mobile clinics, stationary health
centers, the Concord Medical Respite facility, street medical outreach clinics and the
medication-assisted treatment program. Health care services provided by the HCH team include
routine physical assessments, basic treatment of primary health problems such as minor wounds
and skin conditions, respiratory problems, TB screening, acute communicable disease screening,
coordination and referrals for follow up treatment of identified health care needs, dental services,
health education, behavioral health services, medication assisted treatment for opioid addiction,
and outreach and enrollment services. A significant portion of the homeless patients seen by the
HCH team have chronic diseases, including asthma, hypertension, diabetes, and mental
health/substance abuse issues. They also have disproportionately more dental, substance abuse
and mental health needs than the general population.
In November 2014, the Board approved “Forging Ahead Towards Preventing and Ending
Homelessness: An Update to Contra Costa’s 2004 Strategic Plan”, that renewed our 2004 plan
with the latest data, best practices, and community feedback and reaffirmed our commitment to
the Housing First approach. As such, “Forging Ahead” establishes this guiding principle:
“Homelessness is first a housing issue, and necessary supports and services are critical to help
people remain housed. Our system must be nimble and flexible enough to respond through shared
responsibility, accountability, and transparency of the community.” The Strategic Plan Update
identifies two goals: 1) Decrease the length of time people experience homelessness by focusing
on providing Permanent Housing and Services and; 2) Decrease the percentage of people who
become homeless by providing Prevention activities. To achieve these goals, three strategies
emerged:
Implement a coordinated entry/assessment system to streamline access to housing and
services while addressing barriers, getting the right resources to the right people at the right
1.
149
services while addressing barriers, getting the right resources to the right people at the right
time;
Use best, promising , and most effective practices to give the consumer the best possible
experience through the strategic use of resources; and
2.
Develop the most effective platforms to provide access, support advocacy, and connect to
the community about homelessness and available resources.
3.
Referral Update:
Health Care for the Homeless
The HCH Program’s Medication Assisted Treatment (MAT) team, which provides Nurse and
Behaviorist Care Management services to patients seeking recovery from opiate addiction, has
expanded to five CCHS Health Centers with between 500-600 patients served annually. This
program works in collaboration with the CCHS primary care and the CCHS Behavioral Health
divisions. MAT patients are prescribed Buprenorphine, a drug used to treat opioid addiction,
enrolled in regular group classes to support their recovery, and assigned a nurse care manager to
support this process and ensure medication and appointment compliance. The MAT program has
seen significant growth in the last year through referrals for patients needing these services.
The HCH Program recently added a mobile dental clinic to our fleet and is now providing dental
services to homeless patients at the Bay Area Rescue Mission, Brookside Shelter and Calli House
Youth Shelter. Expanded dental services are planned in East County in the near future.
CCHS and the HCH team received a Health Center Quality Leader award in August 2018. This
award recognizes the highest performing health centers nationwide. As a Health Center Quality
Leader, CCHS achieved the best overall clinical performance among health centers, placing in the
top 30% of the adjusted quartile rankings for clinical quality measures. This award was based on
the quality of care that CCHS provides to our homeless patients.
The attached report highlights the increasing needs of the rapidly growing senior homeless
population, as well as the disproportionate burden of medical and behavioral issues faced by those
living without homes in Contra Cost County. Along with an aging population comes patients with
more complex chronic health conditions and mental illness. With little housing choices, the HCH
team struggles to address patients’ illnesses on the street and in encampments, or as they shuffle
between shelters. We cannot care for this population in a safe and humane manner without
additional resources addressing the central issue of lack of stable housing. This population faces a
crisis that needs to be addressed by the county with additional supportive long-term care facilities
that are accessible for our patients.
Continuum of Care Plan for the Homeless
The Homeless Program of the Health, Housing and Homeless Services Division partners with the
150
Homeless Advisory Board and Continuum of Care to develop and carry out an annual action plan
that identifies the objectives and benchmarks related to each of the goals and strategies of Forging
Ahead. Further, the Homeless Program incorporates the strategic plan goals into its own delivery
system of comprehensive services, interim housing and permanent supportive housing as well as
contracting with community agencies to provide additional homeless services and housing with
the goal of ending homelessness in our community.
Attached is a summary infographic of the 2018 Point in Time Count.
Recommendation(s)/Next Step(s):
1. Accept this report from the Health Services Department; and
2. Forward this report to the Board of Supervisors for acceptance; and,
3. Direct Staff to continue to report on an annual basis to the FHS Committee regarding progress
of the effort to end homelessness and the activities of Contra Costa Council on Homelessness; and
the health status of the homeless population in Contra Costa County by the Health Care for the
Homeless Program.
Attachments
Annual Update on Homeless Continuum of Care
Health Care for the Homeless
151
Annual Update on the
Homeless Continuum of Care
1
Presented to the Family and Human Service Committee
Contra Costa County Board of Supervisors
September 24, 2018 152
Contra Costa Housing Crisis
On any given night, there are
2,234 people experiencing
homelessness in Contra Costa
County.
Shelter capacity met only 30% of
the need for those in housing crisis
in 2018.
88% increase in seniors (age
62+) experiencing homelessness
from 2017 to 2018.
Contra Costa County needs
31,193 more affordable rental
homes to meet current demand.
Sources: Contra Costa Housing Need Report 2018, California Housing Partnership Corporation and Contra Costa Point In Time Count data, 2018, Contra Costa Health Services.
Renters in Contra Costa County
need to earn $43.27/hr -nearly 4
times the state minimum wage -to
afford the median monthly asking
rent of $2,250.
Contra Costa County’s lowest
income renters spend 58% of
income on rent.
153
CoC Activities
3
Point in Time Count and Youth and Family Count
Built for Zero Campaign
Coordinated Entry Evaluation –Phase 1
Coordinated Entry-Phase 2
Council on Homelessness
One-time funding to enhance crisis response system
154
Point In Time Count
4
155
5 156
Youth and Family Count
6
First time in Contra Costa
Online option
Approximately 400 responses
Strengthened partnerships with:
Community colleges
EHSD
Libraries
Probation
School Districts
Youth Action Council
Youth Serving Agencies
157
Built For Zero
7
VETERANS
CHRONICALLY
HOMLELESS
158
Coordinated Entry-Phase 1
8
•Establishing CARE and
CARE-Capable Centers
•Piloting Warming Center
•Housing Navigation
•Expanding CORE Outreach
Teams
159
9 160
Coordinated Entry –Next Phase
10
Shelter Diversion Centralized Shelter
Placement
161
CoC Impact 17-18
Homeless Court
•464 clients
served last year
•1,791 cases
dismissed
•78,100 total
community
service hours
granted
Supportive Housing
Retention Rate: 96%
Staff
satisfaction
“I love helping
people and
rewarding to
know that I
made a
difference in
people's lives.”
“I have the
upmost respect
for clients.”
CORE
•Served 3,662
people
experiencing
homelessness
in 2017-2018
Decrease in Veterans
•In the 2018 PIT,
108 Veterans
were surveyed,
only 8% of the
total population
CoC Served/Provided:
•Housing assessments
completed:1,822
•People housed since CES
kick-off:716
•211 calls related to
housing crisis or
assistance:5,287
•People served at CARE
Centers:1,797
162
163
Council on Homelessness
13
Community conversation on Equity
Youth Action Council
New Committees
Subpopulations
Ad Hoc Funding
164
Future State Funding
14
Funding Source Anticipated
Amount for CC
Target Population
California Emergency Solutions
and Housing (CESH)
$855,496 in two
phases
Homeless
Homeless Emergency Aid
Program (HEAP)
$7.1 M/one-time Unsheltered Homeless
Homeless Mentally Ill Outreach
and Treatment (HMIOT)
$745,000/one-
time
Individuals with serious mental
illness and who are homeless or at
risk of becoming homeless
NPLH non-competitive $2.14 M SMI
165
Jaime Jenett, MPH
CoC Planning and Policy Manager
Health, Housing and Homeless Services
Jaime.jenett@hsd.cccounty.us
925-608-6716
15
166
PRESENTATION TO THE
FAMILY & HUMAN SERVICES COMMITTEE
CONTRA COSTA COUNTY BOARD OF
SUPERVISORS
Contra Costa Health Services
Health Care for the Homeless (HCH)
JOSEPH MEGA, MD, MPH
MEDICAL DIRECTOR
HEALTH CARE FOR THE HOMELESS
MONDAY, SEPTEMBER 24, 2018
167
2017-2018 HCH PROGRAM UPDATES
1.Health Center Quality Leader
2.Medical Outreach Expansion
3.Dental Mobile Van
4.Global Health Fellowship Physician on staff
5.Weekly Yoga & Mindfulness Groups in Shelters
168
CHOOSING CHANGE PROGRAM
Medication Assisted Treatment (MAT)
for Opioid Addiction
FY 2017-2018, we had 539 patients enrolled in
the program, 46% of them were homeless
We currently have Choosing Change clinics in
5 CCHS Health Centers.
HCH Street Outreach MAT
169
HCH PRODUCTIVITY
7/1/2013 - 6/30/2014 7/1/2014 - 6/30/2015 7/1/2015 - 6/30/2016 7/1/2016 - 6/30/2017 7/1/2017 - 6/30/2018
Encounters 4,437 4,538 5,678 6,081 7,103
Clients 2,157 1,892 2,134 2,010 2,285
0
1,000
2,000
3,000
4,000
5,000
6,000
7,000
8,000
Total HCH Encounters and Clients
170
CHRONIC CONDITIONS
4.33
1.70
0.00
0.50
1.00
1.50
2.00
2.50
3.00
3.50
4.00
4.50
5.00
HCH Medi-Cal Patients All Medi-Cal Patients
FY 2017/2018
Average Number of Chronic Conditions-HCH vs CCC Medi-Cal Patients
171
AVERAGE NUMBER OF VISITS
2.66
0.23
0.35
1.03
0.54
0.03 0.07 0.07
0.00
0.50
1.00
1.50
2.00
2.50
3.00
Average Number of
ED Visits
Average Number of
PES Visits
Average Number of
Inpatient Visits
Average Number of
Ambulance Rides
FY 2017/2018
Average Number of Visits -HCH vs CCC Medi-Cal Patients
HCH Medi-Cal
Patients
Medi-Cal
Patients
172
CRIMINAL JUSTICE INVOLVEMENT
Disproportionate involvement with
Criminal Justice system
36.11% of HCH Medi-Cal patients
5.8% of Medi-Cal patients
173
OLDER , SICKER HOMELESS PATIENTS
Case Study
174
HCH STAFF TESTIMONIALS
“In my 40 years of nursing, I have worked in many high
intensity settings, such as intensive care, trauma, and
oncology. Though the patients I served in these settings had a
magnitude of needs, none compare to those of our homeless
patients we serve at the respite center and shelters.
Their medical histories are complex; they present often with
end stage disease, and are all dealing with issues such as
trauma, loss, addiction, and mental illness. Their care
demands intense dedication, support, and advocacy. My past
experiences prepared me for high acuity care, but the
challenges of this population are ever expanding and continue
to encourage us to do more and think differently about what
care means.”
-Sue Dickerson, RN
HCH Respite Nurse
Three-time honorable mention for Ruth Pease Award
175
CALL TO ACTION
1.County-run Board and Care
2.County-run Skilled Nursing Facilities
176
FAMILY AND HUMAN SERVICES COMMITTEE 9.
Meeting Date:09/24/2018
Subject:Workforce Innovation and Opportunity Act (Follow Up Report)
Submitted For: Kathy Gallagher, Employment & Human Services Director
Department:Employment & Human Services
Referral No.: FHS #109
Referral Name: Workforce Innovation and Opportunity Act (Follow Up Report)
Presenter: Donna Van Wert, Workforce Development
Board- Executive Director
Contact: Tish Gallegos (925)
608-4808
Referral History:
On January 6, 2015 the Board of Supervisors referred oversight and receipt of updates on the
Workforce Innovation and Opportunity Act (WIOA) to the Family and Human Services
Committee (FHS).
WIOA was signed into law on July 22, 2014. WIOA is designed to help job seekers access
employment, education, training, and support services to succeed in the labor market and to match
employers with the skilled workers they need to compete in the global economy. Congress passed
the Act by a wide bipartisan majority; it is the first legislative reform in 15 years of the public
workforce system. WIOA was expected to significantly impact the Employment and Human
Services Department (EHSD) and the way the Workforce Development Board does its work.
Therefore, updates on the impacts and changes was referred to FHS.
Referral Update:
Please see the attached report for an update on the Workforce Development Board and Workforce
Innovation and Opportunity Act. The last report on this topic to FHS was on April 23, 2018.
Recommendation(s)/Next Step(s):
ACCEPT the report from the Employment and Human Services Department on the Workforce
Development Board and Workforce Innovation and Opportunity Act updates and DIRECT staff
to forward it to the Board of Supervisors for their information.
Fiscal Impact (if any):
None. This is an informational report.
Attachments
Workforce Development Board Status Report on Implementation of Local and Regional Plans
177
Workforce Development Board Presentation
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The WDB is now located at 4071 Port Chicago Hwy. Suite 250, Concord CA 94520
Workforce Innovation & Opportunity Act (WIOA) Implementation Update
The WDB has successfully completed most of the WIOA implementation criteria inclusive of new local
and regional plans, MOU Phase I & Phase II, One-Stop Operator requirement and the AJCC Certification
process. The one area that remains constant and fluid is the regional work under the new State
designated Re gional Planning Units (RPU) of which Contra Costa is the lead for the East Bay RPU
(updates below).
Adult & Dislocated Worker Career Services/AJCC Transition
Transition
Due to significant reductions in the WDB budget, the WDB, along with the Board of Supervisors,
approved the procurement for WIOA Adult & Dislocated Worker Career Services in October of 2017. An
RFP was released in November of 2017, and a recommendation and subsequent award was made in
March of 2018 to Rubicon Programs on behalf of the Contra Costa Workforce Collaborative.
As of May 24th, 2018, 3 of the 4 EASTBAY Works America’s Job Centers of California (AJCC) were closed:
Liberty, Antioch, and San Pablo. Eighteen staff were affected by these closures: 15 were successfully
transitioned to equitable positions within the County; 2 retired; 1 accepted a positon in San Francisco;
and 1 is still eligible for the TET program and seeking employment.
The comprehensive AJCC located in Concord remained open with limited staff, and with the assistance
of partner organizations continued to offer services throughout the county until the contract with
Rubicon was in place.
Rubicon/Contra Costa Workforce Collaborative
The contract with Rubicon Programs to operate the Comprehensive America’s Job Center of California
and the delivery of Adult & Dislocated Worker Career Services throughout Contra Costa County was
approved at the August 14th Board of Supervisors meeting with an August 1st start date. Rubicon staff
have started working at the Concord AJCC as of August 1st and we continue to work with them and the
Contra Costa Workforce Collaborative to fully implement Adult & Dislocated Worker Career Services
throughout Contra Costa County.
The Collaborative is an innovative public-nonprofit partnership of Contra Costa County workforce
development organizations that currently operate within the County and was created specifically in
response to this RFP. The Collaborative consists of our Community Colleges, our Adult Education
partners, Opportunity Junction, Lao Family Community Development, New Horizons, San Pablo EDC, and
Rubicon as the lead.
WIOA Youth Programs
Program year 2018-19 youth contractors include: Contra Costa County Office of Education and Mt.
Diablo Unified School District . Bay Area Community Resources will no longer be a provider; Contra Costa
County Office of Education will pick up the service delivery in East Contra Costa County . Contracts are in
place and the funding for these contracts will remain level.
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CCWORKS
Under the direction of the WDBCCC the CCWORKS subsidized employment program continues to have a
high success rate of finding work experience opportunities for CalWORKS recipients. The WDBCCC
continues to work on deepening its collaboration with the CalWORKS program and is currently strategizing
a process for co-enrollment.
CCWORKS is experiencing a lower than usual placement rate due to the new County onboarding process
that requires all CCWORKS participants being placed in a county work assignment to be finger printed via
live scan. This process is delaying placement of participants up to 6 weeks and many are timing or
dropping out due to this long delay.
Highlights:
CCWORKS placements for 2018-2019 July 1st through August 31st: 12
CCWORKS placements for 2017-2018: 110
Business Services
The WBD business services team continues to work closely with our local chambers, our city offices and
economic development entities throughout the county, our identified regional sector partnerships and
other programs and partnerships.
Highlights include:
The WDB hosted 2 Fair Chance Employer Summits in program year 2017-18: 1 on
October 18th at the El Cerrito Community Center and 1 on May 16th at the Antioch
Community Center. Both events were extremely successful with over 250 attendees and
35 Fair Chance Business Pledges secured for both events combined.
The WDB business services recently entered into a partnership with the Contra Costa
County Employer Advisory Council and will be hosting employer forums jointly. Along
with the City of Concord we will host a forum on “Finding the Untapped Workforce
Market” on November 7th.
The WDB business team is establishing a county wide business task force that will
include EDD and other public and community based organizations to streamline services
for all Contra Costa businesses: Integrated Business and Employment Service Team =
IBest
Through the Disability Accelerator Employment Grant, WDB business services will be
hosting an employer educational forum on hiring people with disabilities in February of
2019.
Rapid Response & Layoff Aversion Summary
We received 4 WARN Notices: (Archer Norris Law Firm-97 Impacted Workers),
(AT&T-59 Impacted Workers), (Orchard Supply Hardware (OSH)-50 Impacted Workers),
and (Kmart-68 Impacted Workers)
In-Person Outreach to five OSH Stores in the county (San Ramon, Moraga, Pinole, Pleasant Hill,
and Concord)
8/29 - Completed a RR Orientation with Archer Norris Law Firm in Walnut Creek.
There were 19 employees in attendance.
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Small Business Development Center
Partially funded by the Small Business Administration (SBA), this program, hosted by the WDBCCC, delivers
individualized advising and group training to current and aspiring business owners in English and Spanish
throughout the County. The SBDC actively partners with myriad public, nonprofit, and private sector
organizations to attract “high-impact” employers as well as community-based agencies to reach and serve
low-to-moderate income (LMI) residents.
The SBDC braids and leverages federal Small Business Administration (SBA) funding with state and local
support from the Governor’s Office of Business and Economic Development (GO -Biz), Community
Development Block Grant (CDBG) and Keller Canyon Mitigation funds. Approximately 75% of our clients
self-identify as 80% below the area median income.
FY 17-18 Performance:
• 996 individuals (535 in business) advised, 730 trained
• 197 jobs created, 48 jobs retained
• 33 new business starts
• $7,385,419.00 in debt/equity invested in small businesses
• $ 13,168,696.03 in annualized sales increases
Noteworthy developments
Was approved as an affiliate partner of the SparkPoint collaborative
Successes
Was awarded $62,500 in GO-Biz support for the Capital Infusion Program (CIP) an
ongoing project
Was awarded $20,000 by the Keller Canyon Mitigation Fund (an ongoing partnership)
Was awarded $12,500 by the City of Brentwood (an increase of ongoing support)
Regional Initiatives, Organizing and Training
East Bay Regional Planning Unit (RPU)
There is a lot going on in workforce around regionalism. Contra Costa County is still the lead for the
approximately 1 million dollars in regional funds that the East Bay RPU has been awarded toward this
effort.
Regional trainings we are in the process of scheduling:
Understanding Context of Criminal Justice Supervision
Creating Talent for Change
Facilitating Career Development
East Bay Slingshot
While initial funding for this initiative has expired, Contra Costa and the East Bay Region continues to be
recognized for our SlingShot model and successes. The East Bay RPU funds will support all 5 of the sector
partnerships to build capacity and sustain these efforts regionally. Some of the regional funds will be
used to support a regional administrative support staff person to organize these efforts. Some of this
funding has been allocated for specific regional industries (Advanced Manufacturing and Healthcare) to
181
Family & Human Services Committee Presentation
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support sustainability models they are working on and some of these funds have been allocated to
training cohorts with earn & learn components in the healthcare industry ; specifically a dental assisting
training targeted to start late 2018 or early 2019.
Earn & Learn East Bay (ELEB)
Earn & Learn East Bay is an employer engagement campaign that supports employers in providing
quality work-based learning experiences for youth and provides them with a local talent pipeline. To
support this work, Earn & Learn works with school districts, community colleges, workforce
development boards, youth development providers and business associations in Alameda and Contra
Costa counties in creating a coordinated system that increases and enhances transformative
experiences for youth. ELEB is currently hosted and coordinated by the WDBCCC and the Contra Costa
Economic Partnership (CCEP).
The Problem: Business as usual wasn’t working for business anymore, employers were being inundated
with work based learning requests, and were ready for a change.
The Solution: Earn & Learn East Bay organiz es work-based learning experiences that are
transformational for youth and easy and meaningful for employers. We are a single point of contact for
employers to work with the region's schools, colleges and community organizations
Our Impact: 11,329 Total Youth Served with WBL Activities; 30 Connectors
Our Reach: Over 1,500 Organizations; Over 2,500 Employees located in Contra Costa and Alameda
Counties
Our Community:
Contra Costa County Office of Education
Alameda County Office of Education
Contra Costa County Workforce Development Board
Alameda County Workforce Development Board
Oakland Unified School District
Mt. Diablo Unified School District
UC Berkeley Boost
Contra Costa County Community College District; Los Medanos College & Diablo Valley College
Antioch Unified School District
San Ramon Unified School District
Pittsburg Unified School District
West Contra Costa Unified School District
Martinez Unified School District
John Swett Unified School District
Oakland Workforce Development Board
Earn & Learn Highlights
Co-Coordinating Manufacturing Day 10/5 including marketing, employer outreach.
Manufacturing companies participating include: Benchmark, Bishop-Wisecarver, DOW,
Fresenius, Granberg, Lennar, Quick Mount PV. Participating schools include: LMC, DVC, Mt.
Diablo, Pittsburg, San Ramon, John Swett, and Antioch.
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Family & Human Services Committee Presentation
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E&L selected to present at the Dreamforce Salesforce Conference in September
E&L will pitch for round #3 Strong Workforce funding at CCCAOE in October
Prison 2 Employment Initiative (P2E)
As part of Governor Brown's efforts to improve California’s criminal and juvenile justice systems and
reduce recidivism through increased rehabilitation, the California Workforce Development Board (State
Board), California Department of Corrections and Rehabilitation (CDCR), California Prison Industry
Authority, and California Workforce Association have finalized a partnership agreement that is included
in amendments to the California WIOA Unified Strategic Workforce Development Plan 2016-2020.
The partnership agreement is intended to strengthen linkages between the workforce and corrections
systems in order to improve the process by which formerly incarcerated and justice-involved1
individuals reenter society and the labor force. The partnership agreement will inform policies specific to
Local Workforce Development Boards (Local Board) and how they serve the state's formerly
incarcerated and justice-involved population
This initiative proposes $37 million over three budget years to fund the states 14 regional planning units.
The money will be released in 3 phases: Planning, Implementation, and Evaluation.
We are in the planning phase now and have convened the mandatory partners with the specific
intention of creating and submitting a request for $100,000 for our proposed plan. This proposal was
submitted Monday, August 27th. The planning funds should be available by October and all regions will
be required to submit their plan and request for implementation funds as part of our revised RPU plans
due March 15, 2019.
Regional and Local Plan Update
Under WIOA, a biennial update of regional and local plans is required in order to ensure plans remain
current and account for “changes in labor market and economic conditions or in other factors affecting
the implementation of the local plan” (29 U.S. Code § 3123). The California Workforce Development
Board (State Board) has also made changes to the State Plan which require that Local Boards update
their plans to keep them consistent with the policy direction of the State Plan. Pursuant to the State Plan
modifications submitted to the U.S. Department of Labor in the spring of 2018 and approved on June 11,
2018, the State Board is providing guidance to Local Boards on the requirements associated with local
and regional planning modifications. This Directive provides specific guidance and instructions on both
required and elective modifications to local and regional plans. Revised plans are due March 15, 2019.
New elements that must be included in the revised plans:
Workforce-Corrections Partnerships: A New Element of Regional Plans
New Partnership Agreement with CalFresh and Strengthened Partnerships with Human Service
Agencies
Required Plan Content Pertaining to the DCSS and Workforce System Partnership
Revised Partnership Agreement Pertaining to Competitive Integrated Employment
Provision of Services to English Language Learners, the Foreign Born, and Refugees
Required compliance with State Plan guidance and State Law regarding Multi-Craft Core
Curriculum pre-apprenticeship partnerships
Economic Development, EC2 and the Northern Waterfront Initiative
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The WDB remains actively involved with local economic development efforts including EC2 and the
Northern Waterfront Initiative. The WDB participates in monthly meetings as well as attends the 5th
Tuesday EC2 partner update meeting most recently on July 31st at the Pittsburg City Hall. WDB Staff
recently attended a presentation on the planning that has been done around developing human capital
for the Northern Waterfront and is working with another contractor providing input for the new Norther
Waterfront strategic plan.
The WDB is working closely with the new Economic Manager, Amalia Cunningham, and has been jointly
organizing get-togethers with all city economic managers and chambers.
Budget/Grants/Funding Opportunities
The WDB budget is stable for the current FY 2018-2019 however are still experiencing difficulty getting
expenditure reports and up-to-date budget information to validate this.
The WDB has prioritized pursing additional funding opportunities to support the important work we are
tasked with. The WDB has or is considering pursing the following opportunities:
AB 109: The WDBCCC will continue to receive $208,000 annually from AB 109 funding for PY
2018-2019. These funds have primarily been used for two purposes: 1) to deepen connections
between the re-entry community and businesses/employers; 2) to strengthen partnerships
between the WDBCCC and other public agencies, as well as the contracted nonprofit service
providers that are helping AB 109 participants reenter the community.
EDD Disability Employment Accelerator: The WDB was awarded $250,000 on behalf of the East
Bay Region to support training, work experience and employment for people with disabilities.
The East Bay RPU will be working with Futures Explored, East Bay Innovations, EDD and our
Adult Education partners on this project.
The WDB is collaborating with the Contra Costa Transportation Authority (CCTA) on an Electric
Vehicle Ready Communities grant the CCTA was awarded from the Clean Energy Commission.
The WDB is pursuing a YouthBuild grant that is due September 18th.
The WDB is actively research the possibility of creating a 501c3
WDB Board
With 25 seats, The WDB is almost fully seated and with several applications coming in we anticipate
being fully seated very soon.
The current Chair, Bhupen Amin, was asked to participate on a board panel at the upcoming California
Workforce Association (CWA) conference Meeting of the Minds in Monterey, CA September 4 th through
the 6th.
The ED and Chair Amin will be meeting with all the Board of Supervisors individually during the months
of September and October.
184
Year in review and a
snapshot looking forward
Presentation to Family & Human Services Committee
September 24, 2018 185
2186
Adult & Dislocated Worker Career
Services/AJCC Transition
3
November of 2017 WDB released an RFP for A/DW Career Services/AJCC
March of 2018 award was made to Rubicon Programs on behalf of the Contra Costa
Workforce Collaborative (CCWC)
May 2018 -3 of the existing brick & mortar AJCCs closed with the Comprehensive
site in Concord remaining open
August 2018 Rubicon began delivering services at the Concord AJCC and working
with the CCWC for all access points to become operational
CCWC Partners:
Rubicon, Mt Diablo Adult Education, Martinez Adult Education, Pittsburg Adult Education,
Liberty Adult Education, New Horizons, Opportunity Junction, Lao Family Community
Development, San Pablo EDC, and the Contra Costa Community College District.
187
4
Earn & Learn East Bay (ELEB)
ELEB is an employer engagement campaign that supports employers in
providing quality work-based learning (WBL) experiences for youth and
provides them with a local talent pipeline
ELEB works with school districts, community colleges, workforce boards, youth
providers and businesses in Contra Costa and Alameda Counties
ELEB has impacted 11,329 youth to date through WBL activities
ELEB has 30 connectors, 1,500 organizations, and over 2,500 employers using
the platform: Earn & Learn Employer Network Activated (ELENA)
188
5
CCWORKS
110 Placements
Coordinated EASTBAY WORKS Tech Fair in Concord
distributing computers to over 100 low income
families
Coordinated Volunteer Income Tax Assistance (VITA)
program training CalWORKs participants in
preparing tax returns
189
6
GO-Biz Technical Assistance Expansion Program increased support for no-cost
advising, workshops, outreach to disadvantaged areas and populations
Approved as a SparkPoint Affiliate Partner in Richmond and Bay Point
FY 17-18 Performance:
996 individuals (535 in business) advised; 730 trained
197 jobs created; 48 retained
33 new business starts
$7,385,419.00 in debt/equity invested in small businesses
$13,168,696.01 in annualized sales increases
190
Business Services
•Economic Development: In contact with MCE< Supporting Northern
Water Front Initiative, Supported Tri-Valley Mayors Summit,
Support East Bay EDA Innovations Award and WCC Economic
Development Summit
•Business Forums: Fair Chance Employer Summits, Untapped Talent
Forums, Disability Awareness Forum
•Collaborations: Leveraging resources by coordinating Integrated
Business and Employment Services Team (iBEST) to support
businesses and job seekers in Contra Costa. Partners include EDD,
Rubicon & CCCEAC
•Rapid Response: Outreach to 5 OSH locations in Contra Costa
affected by the closure per WARN notice
191
8
What’s New?
Regional Planning Units: State of California has designated 14 planning
units of which Contra Costa is the lead for the East Bay Region consisting
of Alameda, Oakland, Richmond and Contra Costa
WDBCCC has received over 1 million dollars from the State to support
the regional work
Prison to Employment Initiative
Regional and Local plan revisions are due March of 2019
WDBCCC is the lead on a regional Disability Employment Accelerator
grant in the amount of $250,000
192
9
Thank You and Questions?
193
FAMILY AND HUMAN SERVICES COMMITTEE 10.
Meeting Date:09/24/2018
Subject:SNAP/CalFresh (Food Stamp) Program
Submitted For: Kathy Gallagher, Employment & Human Services Director
Department:Employment & Human Services
Referral No.: FHS #103
Referral Name: SNAP/CalFresh (Food Stamp) Program
Presenter: Wendy Therrian, Workforce Services
Director
Contact: Tish Gallegos (925)
608-4808
Referral History:
The SNAP Program was originally referred to the Family and Human Services Committee by the
Board or Supervisors on February 15, 2011.
This program was formerly known as Food Stamps and is currently known as the Federal
Supplemental Nutrition Assistance Program (SNAP). In California, the name of the program is
CalFresh.
Referral Update:
Please see attached CalFresh Program Update report.
Recommendation(s)/Next Step(s):
ACCEPT the report from the Employment and Human Services Department on the CalFresh
program, formerly known as Food Stamps and federally known as the Supplemental Nutritional
Assistance Program (SNAP), and DIRECT staff to forward the report to the Board of Supervisors
for their information.
Attachments
CalFresh Program Update
CalFresh Presentation
194
CalFresh Report to FHS for 09.24.18 - Page 1
40 Douglas Drive, Martinez, CA 94553 • (925) 608 5000 • Fax (925) 608-9748 • www.ehsd.org
To: Family and Human Services Committee
Contra Costa County Board of Supervisors
Date: September 2 4, 2 018
From: • Kathy Gallagher, Department Director
• Wendy Therrian, Workforce Services Director
• Rebecca Da rnell, Workforce Services Deputy Director
• Kathi Kelly, CalFresh Policy Manager
Subject: CALFRESH PROGRAM UPDATE
I. Overview
The CalFresh program, formerly known as Food Stamps and federally known as the
Supplemental Nutrition Assistance Program (SNAP) was designed to help provide
assistance to hungry people, regardless of their age, gender, marital or family status. The
program issues monthly electronic benefits that can be used to buy most foods at many
markets and food stores.
The CalFresh program helps to improve the health and well-being of qualified households
and individuals by providing them a means to meet their nutritional needs. At the federal
level, the United States Department of Agriculture’s (USDA) Food and Nutrition Service
(FNS) administers the program. In California, the CalFresh program falls under the
California Department of Social Services (CDSS) and is administered at the local level by
the Employment and Human Services Department (EHSD).
Since the Great Recession, we have experienced an unprecedented increase in the number
of individuals applying for CalFresh benefits. In 2006, we had approximately 12,554
families applying for aid as compared to 27,684 in 2017. This represents a 121% increase
in the number of CalFresh applications received during this period.
Technology advancements available allow applicants the ability to file an application “on
line” eliminating the need to walk into a district office. Our community partners are also
able to utilize this technology reaching more potentially eligible households. Residents of
Contra Costa County were able to file applications using a new portal (getcalfresh.org)
effective July 2017. The average number of on line applications for 2018 is 1,036, which is
an increase of 55% from 2017.
M E M O R A N D U M
Kathy Gallagher, Director
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CalFresh Report to FHS for 09.24.18 - Page 2
Source: CDSS Report DFA 296
Source: CDSS Report DFA 296
Over the last 12 years, the CalFresh only cases have increased a total of 375% going from
roughly 5,846 average cases a month in 2006 to 27,743 average monthly cases in 2017.
Beyond the CalFresh only average caseload of 27,743 in 2017, we also had an additional
average of 4,250 Public Assistance cases, which represents those households that receive
both cash aid (CalWORKs) and CalFresh. This represents a total average of 31,521
CalFresh cases in 2017.
0
5,000
10,000
15,000
20,000
25,000
30,000
35,000
40,000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017APPLICATIONS
Appplications increased by 121% in 2017
CalFresh Only Applications ~ 2017
0
5,000
10,000
15,000
20,000
25,000
30,000
35,000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017CASES
Cases have increased 375% between 2006-2017
CalFresh Only Cases ~ 2017
196
CalFresh Report to FHS for 09.24.18 - Page 3
In Contra Costa County, CalFresh puts almost $8.8 million into the local economy each
month. As indicated by the USDA, research shows that every $1 provided in CalFresh
benefits generates $1.79 in economic activity. Using the multiplier effect, CalFresh pumped
more than $17.9 million into the local economy in the past year. This economic stimulus is
almost exclusively Federal and State funded and provides an important local boost to our
economy. CalFresh benefits help families stretch their food dollars to buy healthier foods
for the whole family.
The average, total monthly CalFresh benefits issued in 2006 was $3,285,940 compared to
the 2017 issuance of $8,816,127. This accounts for an increase of 268% for our household s
and the local economy.
Source: CDSS Report DFA 296
Source: CDSS Report DFA 296
Source: EHSD Fiscal
34,176 37,089 32,851
36,120
27,684
0
10,000
20,000
30,000
40,000
2012 2013 2014 2015 2016 2017
CalFresh Applications 2013 -2017
23,991
29,805 30,560 29,789
27743
0
10,000
20,000
30,000
40,000
2013 2014 2015 2016 2017
CalFresh Caseload 2013-2017
$15,082,065
$15,751,052
$15,126,092 $14,926,461
$12,925,571
$10,000,000
$12,000,000
$14,000,000
$16,000,000
$18,000,000
2013/14 2014/15 2015/16 2016/17 2017/18
CalFresh Allocation 2013 -18
197
CalFresh Report to FHS for 09.24.18 - Page 4
1. Although the allocation has declined approximately 14% and the caseload and
applications have declined approximately 9% in the last two years, our operational
CalFresh specific staffing has reduced by approximately 26% in the same time frame.
This severe reduction has critically impacted our ability to deliver services timely.
2. We are interested in developing more partnerships and innovative services to better
serve the CalFresh applicants and recipients in our county. Our low staffing levels
impact our ability to explore these areas.
3. In addition, many counties have more than one Program Analyst dedicated to CalFresh
making it possible to expand beyond core services.
Alameda ~ 2.5 CF Program Analysts with one designated for outreach
Fresno ~ 2 CF Program Analysts
Ventura ~ 2 CF Program Analysts until 7/3/17. As of July 3, 2017, there are four
(4) CF Program Analysts. Two (2) are dedicated to writing policy and two (2)
operational analysts who visit district offices to ensure regulations are being
followed and provide Q and A.
There is an additional analyst dedicated to outreach for all programs.
II. Eligibility for CalFresh
Households that include single individuals, couples, or families are eligible for CalFresh
benefits if they meet certain income criteria and legally reside in California. For some
CalFresh beneficiaries (under the 200% FPL) eligibility is not asset-based or resource-based
which means their property is not counted such as vehicles, cash on hand or money
contained in bank accounts.
The amount of benefits a person receives depends on the number of people in the household
who purchase and prepare food together and how much monthly income is left after certain
expenses are deducted. Income consists of earned and unearned income. Expenses like rent,
utilities, dependent care and certain medical expenses are allowable deductions. For
example, a household of one (1) with no income would be eligible to receive $192.00 a
month in CalFresh benefits and a household of 10 with no income would receive $1,441.00
a month.
III. Program Accessibility
To make CalFresh benefits more readily accessible to County residents and families, over
the last several years the Department has increased its efforts in working with the Food Bank
of Contra Costa and Solano as well as other community agencies dedicated to the CalFresh-
eligible population.
As listed below, these efforts have contributed to the success of our expanding benefits to
those in need of food security.
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CalFresh Report to FHS for 09.24.18 - Page 5
The application process has been made easier by eliminating the requirement to apply
through a face-to -face interview process. A telephone interview is now acceptable at
both intake and recertification. A customer may still request a face-to -face interview if
they are more comfortable meeting directly with an Eligibility Worker.
Use of telephonic signature has begun at Department locations that have Automated Call
Distribution capability such as the Medi-Cal CalFresh Service Center (MCSC) and the
Health Care Access Center (HCAC). As we obtain and expand the necessary
technology, the use of telephonic signature will be used department-wide.
Applicants can now apply for CalFresh benefits on-line through My Benefits
CalWIN.org portal. Many of our community-based partners have received
orientations/trainings on assisting individuals through this on-line application process.
In addition, Community Based Organizations (CBOs) can register their organizations as
vendors in CalWIN. This will allow the CBOs to track the number of applications they
register and the number processed each month by the Department.
A customer can also access benefits through the use of a multi-program single paper
application. For example, a customer who applies for and is found ineligible for
CalWORKs benefits can use this same application (the SAWS 2 Plus) to automatically
apply for CalFresh benefits without completing another application.
In February 2014, the Department of Health Care Services (DHCS) initiated the Express
Lane Eligibility waiver program in which certain CalFresh beneficiaries were given
Medi-Cal benefits without having to complete and file an application. The waiver ended
June 30, 2017.
The statewide Work Incentive Nutritional Supplement (WINS) Program was
implemented in Contra Costa County on July 1, 2014. Under the WINS program,
CalFresh households who are not in receipt of CalWORKs, but who meet the work
participation hours of the Temporary Assistance for Needy Families (TANF) program
and have a child in the household under 18 receive an additional $10.00 food benefit
each month. From April 2017 through March 2018 there is a monthly average of 2,660
households in receipt of this additional benefit.
Horizontal Integration allows applicants who are applying for health coverage through
the California Healthcare Eligibility Enrollment and Retention System, (CalHEERS)
portal to complete their application for CalFresh and/or CalWORKs benefits at the same
time without having to respond to questions already asked through the Covered
California process.
It was expected that through Horizontal Integration there would be an increase in
program participation rates by expediting program enrollment and minimizing client
efforts. In 2017 there were an average of 30 CalFresh and 6 CalWORKS applications
submitted each month.
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Conversations are also taking place with the Health Services Department to expand
the existing clinic consortium Medi-Cal Express application processing to include
CalFresh.
Other efforts to increase CalFresh enrollments are outlined in the Outreach section of
this report.
IV. Current CalFresh Service Levels and Program Performance
A. Service Levels:
During Program Year 2016- 2017 the monthly average of individuals (families and
single) who were in receipt of CalFresh benefits was 64,666. This is a 9% decrease from
the previous program year which is the result of an improving economy. Forty-eight
percent (48%) of these individuals are children under the age of 18.
B. Program Performance:
1. Timeliness Processing Standards
FNS requires states and counties to maintain certain performance measures for the
timely processing of CalFresh applications. These measures require that 90% of all
applications received be processed within 30 days and requires a three (3) day
processing period for those CalFresh applicants determined to require Expedited
Services (ES).
We continue to meet the 30-day CalFresh application processing standard of 90%
for PY 2016-2017 with 97.5% of applications being processed within the 30-day
processing requirement. During this same period we achieved a 96.61% processing
of ES applications within three (3) days. With our existing efforts and commitment
to the ES process, we have met or exceeded the ES 90% standard for a fourth
consecutive year.
With the significant loss of staff, a two year hard hiring freeze in the Workforce
Services (WFS) Bureau and now more than 78 positions vacant; our staffing levels
have fallen below those needed to process the work. The wait times at the Medi-Cal
CalFresh Service Center (MCSC) are frequently exceeding two hours and we are at
risk of being out of compliance for the timely processing of CalFresh applications.
Through Program Year 2016-17 and 2017-18, the WFS Bureau lost over 300
positions/staff equating to a 28% reduction our workforce in the Bureau. In the
CalFresh program, a reduction of 55 staff was sustained.
The Department is looking into the details and reasons of denied applications. This
review will assist in identifying training needs, increase participation and approval
rating, and improve the Case and Procedural Error Rates. The top denial reasons are
failure to keep a scheduled intake interview, failure to provide verifications, over
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income limits, not a separate household, SSI/SSP recipient, ineligible student, and
application withdrawn.
Management Evaluation (ME)
As mandated by the FNS, the California State Department of Social Services
(C DSS) is required to conduct a Management Evaluation (ME) review of Contra
Costa County’s administration of the CalFresh Program. The federal priority areas
of the ME for FFY 2017 were Program Access, Customer Service, Timeliness of
Application Processing, Payment Accuracy, Quality Control and Training. The ME
review was conducted the week of October 9, 2017.
CDSS observed and interviewed staff and clients at the Medi-Cal CalFresh Service
Center (MCSC), Benefits CalWIN, Central Mailing Unit, and district offices in
Antioch and Hercules. CDSS indicated that they were very impressed with the
excellent customer service demonstrated by our staff. They noted that with this being
the first ME for FFY 2018 that CCC has set a high standard for other counties to
achieve. CDSS was also impressed that our department had conducted Case And
Procedural Error Rate training and stated staff had commented to them on the value
of this training.
During the exit interview CDSS noted a total of five findings in several easily
correctable administrative and procedural areas. In addition, they recommended that
supervisory staff periodically sit in on client interviews to provide feedback and
ensure appropriate forms are discussed.
The next ME review will take place the week of October 15, 2018.
2. CalFresh Error Rate
Every month in every county, FNS selects a random sampling of CalFresh cases that
are to be reviewed for case errors involving miscalculations of income or household
composition which result in benefit issuance errors. Our Quality Control (QC) Unit
reviews those cases that are selected and determines our CalFresh error rate. Based
on the number of cases reviewed and the number of errors cited an error rate
percentage is then derived.
FNS is currently evaluating all States QC procedures to ensure that there is no bias
applied to the final outcome of the error rate. As a result there will be no fiscal
penalties tied to the error rate for FFY 2015 and FFY 2016. Therefore there will be
no final error rate for FFY 2016. It resets with FFY 2017 with new QC rules and
procedures for case reviews.
The error rate for FFY 2017 (October 2016 through September 2017) is at 6.07%
compared to the State error rate of 7.93%. California’s error rate falls within the
tolerance level for QC related liability assessments for FFY 2017. CDSS does
anticipate a request from FNS for a corrective action plan, which they will do in
partnership with counties.
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The cumulative error rate for FFY 2018 (October 2017 through March 2018) is at
3.26% compared to the state error rate of 5.03%.
In recent prior years, our County has been one of the counties with a consistently
low error rate, which has contributed to the State error rate being below the federal
threshold.
3. Outside Consultant
In our attempt to improve customer service and performance levels, we hired an
outside consultant to assess our current business practices. While we have
incorporated several improvement recommendations there are still other
recommendations we will be instituting that will improve program access and
customer service. Due to allocation reductions, the contracted consultant will not
continue in Program Year 2018-19.
The QC consultant has worked with our IT staff in developing a Case Review
Management System tool. This tool allows the reviewer to go on-line to
complete the case review as well as produce real time data reports. This has been
instrumental in allowing our Unit Supervisors and the Program Integrity Unit to
quickly identify error trends so that corrective action can be taken. In addition,
the consultant has assisted our ability to fine tune the QC and Quality Assurance
(Q A) process with focus placed on the root cause of errors. This has allowed us
to identify error trends and develop corrective action strategies.
The Business Process consultant has evaluated our current CalFresh business
processes and analyzed data to identify areas for improvement. It was
determined that missed appointments are a large barrier for many applicants.
EHSD has incorporated and is evaluating options to reduce missed
appointments, including providing same day appointments, text appointment
reminders, and expanding alternatives to face-to-face interviews such as phone
and video conferencing.
EHSD is also working to identify and reduce “churn,” which is when clients
cycle on and off the program in a short amount of time; specifically, applicants
who reapply within three months of their semi-annual report or recertification
being due. If those clients were able to maintain continuous enrollment, it would
greatly reduce the workload of EHSD staff without an interruption in service for
clients. EHSD has begun work in this area, with a first step being the
implementation of text reminders to clients when their reports are due. In
addition, a “packet wrapper” was created for individuals walking into the district
office. This four step guide provides an overview of the enrollment process
including the interview, verification request, and EBT card issuance. Another
tool was developed for on-line applicants that places emphasis on how to
download and upload documents digitally, and how to create a
MyBenefitsCalWIN account so the applicant can track the application status.
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4. Staffing
As previously mentioned, 28% of the WFS Bureau’s staff/positions have been reduced
in the last two program years with 55 positons lost in CalFresh. Our inability to hire case
carrying or support staff is making it difficult to stay in compliance.
The loss of intake workers, eligibility workers, ongoing caseload workers, supervisory
and clerical positions in the Workforce Services Bureau will compromise the
improvements that have been achieved in the CalFresh program, specifically the reduced
error rate and Expedited Services delivery.
V. Outreach and Community
EHSD is proud of our efforts to increase CalFresh participation thereby ensuring that more
children, families and individuals are able to put nutritious food on their tables each day.
The Department has convened a CalFresh Partner Group with the goal of increasing
enrollment in the County. The partners include the Food Bank of Contra Costa and Solano,
the Multi-Faith ACTION Coalition, Ensuring Opportunity, and First 5. This group’s
strategies are to increase CalFresh enrollment and reach populations with historically lower
enrollment. What is already clearly a success is forging a path to partner with community
organizations on a shared goal; the ability to evaluate and modify processes and procedures ;
and a mindset that working together is always better.
The partner group is developing strategies for 2018 & 2019 that focus on outreach for
children, seniors, Latinos, reducing churn, and looking at dual enrollment by evaluating
existing Medi-Cal customers who could be potentially eligible to CalFresh. In addition,
work is being done to identify the potential population as it relates to 2019 regulation
changes that impact Able Bodied Adults Without Dependents (ABAWD) and SSI/SSP
population. These changes are discussed in the Policy Items of Interest section.
Successful efforts and key achievements of the group are illustrated as follows:
CalFresh Enrollment Process Improvements: We are developing new and strengthening
existing business processes for helping people enroll in CalFresh. EHSD currently
works with the Food Bank of Contra Costa and Solano to train nonprofit staff in
CalFresh so they have a better understanding of the program and enrollment process.
This enhanced training and knowledge as well as a more specifically identified EHSD
liaison for the Food Bank of Contra Costa and Solano will not only enhance the quality
of training and knowledge in the community, but will strengthen our community
partnerships.
Our partnering agencies have expressed a desire for the County to participate more
robustly in outreach efforts. Community activities, grants and funding opportunities
often request community based organizations to partner with the County or the County
needs to participate as a stakeholder. With the staffing issues that are currently being
faced, it is challenging for our staff to participate in expanded outreach efforts.
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We are currently exploring the possibility of providing additional funding support to our
partners to expand their outreach efforts. We will then measure the impact for the timely
processing of applications.
Walmart awarded a grant to the Food Bank for CalFresh Outreach. Partnering with
EHSD, the Food Bank mailed postcards to households currently receiving Medi-Cal but
not CalFresh. The Food Bank also partnered with local school districts to mail to
families with children on free/reduced lunch. Funds were also used to print posters
advertising the CalFresh program that are posted in health clinics, food pantries, and
other locations where low-income families are likely to visit.
When staffing levels increase, we will resume community based CalFresh events that
provide an opportunity to process applications and issue same day benefits while in the
community.
Technology partnership
o EHSD is working with the Food Bank and Code for America to utilize a mobile
application equipped with electronic signature. This allows the streamlining of
preliminary applications through an electronic portal via assistors in our partnering
agencies. The Food Bank and EHSD piloted a new application GetCalFresh
(formerly known as CLEAN), which is a simplified version of the on-line CalFresh
application that can be used on a tablet, smartphone or laptop. It was designed by
Code for America for use by community-based organizations. The application takes
only about 5-10 minutes to complete and is much simpler for outreach workers in
the field. Clients’ documents can also be uploaded for submission with the
application. The Food Bank continues to use GetCalFresh and is looking to this
platform as their sole application portal. It has greatly streamlined the application
process and makes filling out an online application while in line at a food distribution
event more feasible. This has increased the number of CalFresh applications.
Read Only Access
To further support the Food Bank’s efforts to assist clients more directly, EHSD has
provided CalWIN read only access to the Food Bank. This will allow designated Food
Bank staff to look up clients’ case status in real time, remind clients of their
appointments, let them know what paperwork they are missing, etc. This should
improve timely processing while also saving EHSD staff time. Before, the Food Bank
ha d to contact EHSD staff to get case updates, so this has significantly streamlined
access to data.
Marketing
o Volunteers from the Leadership Contra Costa alumni group have expressed interest
in helping advertise and market CalFresh to communities with many eligible people.
Developing a marketing plan for CalFresh will require studying the issue and
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applying smart advertising techniques to the challenge of CalFresh enrollment.
Leadership Contra Costa has marketing professionals who can help with this work.
o The month of May has been designated “CalFresh Awareness Month” by several
other California counties. Working with our community partners, the County Board
of Supervisors provided an official resolution and declared May as CalFresh
Awareness month in Contra Costa County.
o Community Produce Program is another successful example of the collaboration
between EHSD and the Food Bank. The Food Bank brings a food truck to the EHSD
Antioch District office parking lot at 4545 Delta Fair, every first and third Friday of
the month from 11:0 0 a.m. to 12:30 p.m. In 2017, the Food Bank served an average
of 106 households each month. In 2018, the average served is 120 households each
month thus far. The Food Bank and EHSD have been working together to find other
locations allowing the population to receive fresh produce.
o In addition, the Food Bank is working with EHSD in designing a note card to send
to existing CF households to remove confusion surrounding the ABAWD work
rules. These rules go into effect in three bay area counties September 1, 2018, but
not implementing in CCC.
Community Training on CalFresh:
o The EHSD CalFresh Program Analyst conducts “Just the Basics” training with the
Food Bank which takes place three to four times per year with 25 to 30 participants
from community organizations in each session. Provided in the training is a
CalFresh overview, hands-on outreach application exercise as well as an
introduction to the on-line application MyBenefitsCalWIN.
This training has been a foundation in developing new partners since 2006. Aides of
the Board of Supervisors, staff from Food and Nutrition Services (FNS) and regular
attendees have attended this training from WIC, the Monument Crisis Center, La
Clinica, Rubicon, Public Health, Head Start, One Stop Centers and the Family
Justice Centers.
o Over the last six (6) years, EHSD has attended an annual Food Bank Summit which
is held on a rotational basis between Contra Costa and Solano Counties. The
purpose of the Summit is to educate, inform and update those in attendance on topics
such as Nutrition Education, Food Safety, what the Food Bank does, and provide
instruction and mandates of USDA on the CalFresh Program. This is a daylong
event and is attended by various County Department representatives, agencies, and
CBOs who work closely with the Food Bank.
o Beginning this month, EHSD staff are providing client navigational services and
more direct access to benefits including CalFresh through our 4 Our Families
Strategic Initiative. This service model provides a holistic approach to helping first-
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time clients access the targeted supports and services they need, through EHSD and
our Community Partners.
Currently, the services are available at the Richmond Family Justice Center, Bay
Point SIT Site, EHSD Antioch District Office and the EHSD satellite office in
Brentwood.
o The CalFresh Program Analyst participated in the “Connecting Homeless Clients
with Mainstream Benefits ” training on August 14, 2018. This training was
sponsored by the CCC Health Services Department and featured several topics on
eligibility requirements for various programs including CalFresh. This training
allowed its participants to gain insight into the programs and or services that are
available and how the homeless population can connect with mainstream benefits.
Advocacy
As the CalFresh Partner Group worked at expanding access to increase participation; it
was clear that changes at the local, State, and National level would be helpful, or even
sometimes necessary, to improve CalFresh benefit access. Current CalFresh policies
limit accessibility, including an application process that can be arduous for residents
with young children, those who work traditional hours, those who are disabled, and the
elderly. Policy changes that allow residents to apply over the phone, through the mail,
or on-line are recent additions, but work is still needed to make CalFresh as accessible
as possible.
The CalFresh Partner Group is looking to CalFresh advocacy to increase participation.
Several partner organizations have legislative platforms that include CalFresh concerns,
including addressing college student food insecurity, providing supplemental benefits
in the summer to families with school-age children, and simplifying the application
process by using electronic employment databases to verify income .
VI. Legislation
Under the current Administration, we continue to be concerned about potential legislative
or allocation methodology changes, which may result in client eligibility and/or funding
reductions to SNAP. We continue to track this issue through several mechanisms including
County representative organizations and our Policy and Planning Division.
The impending cuts to CalFresh propo sed in some versions of this year’s Farm Bill have
the potential to be very harmful to program participants in our county, increasing hunger in
our community. Likewise, the more extreme time limits and stricter work requirements
proposed would likely remove many low-income individuals from the program.
Able Bodied without Dependents (ABAWD)
The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA)
limits the receipt of CalFresh benefits to three mo nths in a 36-month period for the Able
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Bodied without Dependents (ABAWD) CalFresh popula tion if they are not working:
participating at least 80 hours per month in a qualifying education or training activity;
participating in a workfare program or exempt due to age; caring for a child or incapacitate d
household me mber; or certified as medically unfit for emplo yment.
Previo usly, there was a waiver to this requirement, which is scheduled to end August 31,
2018. When this occurs, ABAWDs will be required to participate in work activities in order
to cont inue to receive benefits. The waiver has been extended through August 31, 2019 for
55 Counties including Contra Costa. Three counties; San Francisco, San Mateo and Santa
Clara will begin implementing ABAWD rules September 1, 2018. CCC is expected to be
implementing in the second waive which begins September 1, 2019.
With the impending end of this waiver, the State and Counties are current working on
various concepts to serve this population effective S eptember 1, 2018. This is a current
emphasis of the Department at this time.
In partnership with EHSD, the Food Bank has secured significant private funding from four
local foundations to tackle this issue. EHSD has engaged in the formation of a new
partnership, specifically focused on mitigating the negative effects of the ABAWD roll off
and ensuring adequate supports for work in the community. This project has involved
contracting with the Glen Price Group consulting firm to convene necessary stakeholders
and to leverage partnerships to create a community-wide response to this impending
challenge.
Supplemental Security Income and/or California State Supplementary Payment (SSI/SSP)
Cash Out Policy
Effective June 1, 2019 individuals receiving or authorized to receive SSI/SSP are eligible
for CalFresh, providing all other eligibility criteria are met. This policy changes California’s
“cash-out” policy that began in 1974 when it opted to increase the monthly SSP allotment
by $10 instead of administering benefits to SSI/SSP recipients. Two state funded programs
will also be created to provide benefits to continuing households that will have their monthly
benefits reduced or discontinued due to adding a previously excluded SSI/SSP individual.
VII. Policy Items of Interest
The following changes will have an impact to our CalFresh participation, and/or increase
the workload of our staff:
Telephonic signature
The telephonic signature is a type of electronic signature that uses an individual’s
recorded spoken signature or verbal consent in place of an actual written signature. The
use of the telephonic signature, as part of the application or recertification process, will
eliminate the need to mail documents in order to gather a client’s ink signature. In
addition, utilizing this process will also reduce the amount of cases being discontinued
for failure to complete the recertification process, which will assist with reducing churn.
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EHSD does not yet have the technology in place to roll out telephone signature
Department wide but it is used at our locations that operate under Automated Call
Distribution such as the Health Care Access Center and the Medi-Cal CalFresh Service
Center. We began using this process in May 2016.
SNAP to Skills or Employment and Training
Contra Costa County is currently participating in SNAP to Skills led by Seattle Jobs
Initiative (SJI). The Federal and State CalFresh agencies have contracted with SJI to
help select California counties develop Employment and Training (E&T) programs.
Contra Costa is one of 34 counties in the State to offer CalFresh participants training
and assistance towards job readiness, job security, work norms and access to higher
education. We are partnering with Opportunity Junction and Rubicon Programs, who
are overseen by the Foundation for California Community Colleges’ Fresh Success
program.
The E&T program launched in Contra Costa on April 17, 2017. To date, there are 74
voluntarily enrolled clients in the E&T program with a total of 225 referrals.
Supplemental Security Income (SSI) Suspense Status
Due to the outcome of the Hector Riojas vs. USDA case, individuals in California who
are in SSI suspense status are no longer ineligible for CalFresh benefits. It was argued
that SSI recipients whose benefits are in suspense status should be eligible for CalFresh.
Effective August 30, 2016, individuals in California who are in SSI suspense status are
not precluded from CalFresh eligibility. These individuals must apply and meet normal
CalFresh eligibility requirements in order to receive benefits. While this change does
increase the number of eligible household members, the benefits are reduced as the SSI
income that was previously excluded is now included in the budget.
Public Charge
Immigration discussions at the national level continue to cause concern for the CalFresh
recipient and potential applicant. There have been no regulatory changes to date and we
continue to communicate to the community that it is business as usual. Use of CalFresh
benefits does not affect ones immigration status and will not cause immigration officials
to consider these individuals as a public charge.
Public charge is a term used by the U.S. Citizenship and Immigration Services (CIS)
when referring to noncitizens that have or may become dependent on public cash
assistance such CalWORKs, General Assistance, or Supplemental Security Income
(SSI). This determination is made by CIS when a person is adjusting their citizenship
status to lawful permanent resident. CalFresh is considered a supplemental nutrition
program and not a cash benefit. As a result CalFresh recipients are not a public charge.
There has, however, been a leaked notice of proposed rulemaking to change these rules
and to make several public benefit programs, including CalFresh, public benefit
programs.
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Elderly and / or Disabled Household Demonstration Projects
Standard Medical Deduction
Effective October 1, 2017 through September 30, 2021 a standard medical deduction of
$120 will be issued for households in which an elderly or disabled member incurs
medical expenses in excess of $35 per month. Households with an elderly or disabled
member include those with at least one individual who is 60 years of age or older and/or
disabled and/or receives a disability based benefit. To be eligible, the household must
verify that they incur more than $35 a month in qualifying medical expenses.
Households with more than $155 a month may opt out to document and claim actual
expenses. Since the implementation of this new policy there are currently 1,876
households utilizing this deduction.
Elderly Simplified Application
Effective October 1, 2017 through September 30, 2021 a simplified application process
has been approved in an attempt at improving CalFresh access among the state ’s low
income elderly and disabled population. The project waives the recertification intervie w
requirement, uses existing data matches to reduce verification requests, and extends the
certification period to 36 months. The project applies to households where all members
are either elderly (age 60 or older) and/or disabled with no earned income. The project
does not apply to other CalFresh participants. Since the implementation of this new
policy, the 36-month certification has been approved for a total of 1,392 households.
VIII. Disaster CalFresh
As a result of the significant increase of disasters combined with record breaking
destruction, California created Assembly Bill AB 607, community Resiliency and Disaster
Preparedness Act of 2017. In accordance with AB 607, the Bay Area Social
Services Consortium (BASSC) is developing a social services mutual aid plan. The plan is
a work in progress and includes Alameda, Contra Costa, Marin, Monterey, Napa, San
Benito, San Francisco, San Mateo, Santa Clara, Solano and Sonoma County. It is
anticipated that the agreement will be officially incorporated into the Department and
CDSS disaster plan for FFY 2020.
An example of mutual aid agreement can be seen in the 2017 Northern California wildfires
as California was approved to operate Disaster CalFresh (D-CF) October 25 through
November 1, 2017 in seven counties: Butte, Lake, Mendocino, Napa, Nevada, Sonoma and
Yuba counties. D-CF provides individuals and families impacted by the wildfires and
displaced outside of the disaster area with access to D-CF. These benefits provide temporary
food assistance for one month to eligible disaster impacted households who do not already
receive CF. It also facilitates the issuance of supplemental CF benefits for ongoing CF
households up to the maximum monthly allotment for one month.
To be eligible for D-CF a household must have lived or worked in the identified disaster
area at the time of the disaster, plan to purchase food during the benefit period, experienced
adverse effects due to the disaster and meet D-CF income guidelines.
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Due to Sonoma County systems being down, the CalWIN counties leveraged the ACA Call
Center capabilities and established the D-CF Call Center. CCC, along with six (6) additional
counties, was provided access to the Sonoma County CalWIN region. CCC also provided
support by sending staff to Sonoma County to assist in interviewing and processing D-CF
applications.
Sonoma County has issued: 1) replacement benefits to 3,147 households using an automated
Mass Replacement Benefits process, 2) Issued mass supplemental D-CF to 5,111
households on 10/25/17, and 3) approved 1,207 households for D-CF and 5,227 households
for Supplemental D-CF.
X. Important Next Steps
The Department remains committed to providing timely and ready access to CalFresh
benefits for those with food insecurity, and in continuing to serve our CalFresh customers
in a timely and accurate manner. Although our staffing challenges will prevent us from
embarking on these improvements as robustly as we would like, we have a continual
improvement objective in the areas of outreach, access, enrollment, and services delivery.
Part of this objective is to continue our community outreach efforts and to work even more
closely with our community partners to expand access to CalFresh benefits. Expanding
access includes our continued rollout of electronic and other alternative means for applying
for benefits despite our staffing reductions. We will also continue our efforts to further
streamline our CalFresh application and benefits renewal process, and will continue to work
on increasing knowledge and awareness of the CalFresh program throughout and to targeted
areas within the County.
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Contra Costa County Employment & Human Services Department
Contra Costa County Family and Human Services Committee
September 24, 2018
CalFresh Program –Introduction & Facts:
Provides food for low-income families –one of the most important anti-
poverty programs in the country.
Serves an average of 65,000 individuals a month of which 68% are
children, seniors or disabled, with the majority of the remaining 32% of
recipients falling into the category of working poor.
An average of 2,815 applications are received monthly.
Average monthly benefit is $288.
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Contra Costa County Employment & Human Services Department
Contra Costa County Family and Human Services Committee
September 24, 2018
CalFresh Program –Introduction & Facts:
Economic Benefits:
The USDA has indicated that every $1 provided in CalFresh benefits
generates $1.79 in economic activity.
CalFresh puts almost $9 million into the local Contra Costa County
economy
As a result of the multiplier and the CalFresh dollars being primarily
Federal funded, Contra Costa County benefited from a $16.1 million
economic boost in program year 2017-18.
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Contra Costa County Employment & Human Services Department
Contra Costa County Family and Human Services Committee
September 24, 2018
CalFresh Program –Introduction & Facts:
CalFresh Allocations have dropped approximately 14% since PY 2014-2015.
The allocation reduction has contributed to a 28% reduction in staffing. The
reductions have been critically impactful to CalFresh program administration
in the following areas:
o Extended wait times at the Medi-Cal CalFresh Service Center
o Increasing error rates placing us at risk of fiscal sanction
o Ability to meet mandated application processing timelines resulting in
us being out of compliance
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Contra Costa County Employment & Human Services Department
Contra Costa County Family and Human Services Committee
September 24, 2018
CalFresh Partnership Group:
Group includes:
•Food Bank of Contra Costa and Solano -Larry Sly , Caitlin Sly, Carly
Finkle, Steven Courtney, and Vakil Kuner
•Ensuring Opportunity Campaign to End Poverty in Contra Costa -
Mariana Moore
•Family Economic Security Partnership (FESP)/First 5 -Fran Biderman
•Multi-Faith ACTION Coalition -Melody Howe-Weintraub
•Community Services Bureau –Sophia Talbot
•Community Clinic Consortium of Contra Costa and
Solano –Laura Sheckler
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Contra Costa County Employment & Human Services Department
Contra Costa County Family and Human Services Committee
September 24, 2018
CalFresh Partnership Group:
Collaborative efforts include Outreach Activities and Events as well as other
efforts to expand access to eligible families.
Medi-Cal Mailing
Able Bodied Adults Without Dependents (ABAWD) Convening
Glen Price Group
Current CalFresh Issues and Concerns
ABAWD
SSI/SSP Cash Out
Reauthorization of SNAP under the new Farm Bill
Outreach Impacts
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Contra Costa County Employment & Human Services Department
Contra Costa County Family and Human Services Committee
September 24, 2018
QUESTIONS?
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