HomeMy WebLinkAboutBOARD STANDING COMMITTEES - 10242022 - FHS Cte Agenda Pkt
FAMILY & HUMAN SERVICES
COMMITTEE
October 24, 2022
9:00 A.M.
To slow the spread of COVID-19, in lieu of a public gathering, the meeting will be accessible via
Zoom to all members of the public as permitted by Government Code section 54953(e).
https://cccounty-us.zoom.us/j/6976096783?pwd=M0RwNm1kTWF6SGlPbkE5T3E2RWRDUT09
Meeting ID 697 609 6783
Password 885522
To Join by Phone
Dial: 888-278-0254
Conference Code: 382517
Supervisor Diane Burgis, Chair
Supervisor Candace Andersen, Vice Chair
Agenda Items:Items may be taken out of order based on the business of the day and preference of the Committee
1.Introductions
2.Public comment on any item under the jurisdiction of the Committee and not on this agenda (speakers may be limited
to three minutes).
3. RECEIVE and APPROVE the Record of Action for the September 26, 2022 Family and Human Services
Committee (FHS) meeting. (Danielle Fokkema, Sr. Deputy County Administrator)
4. RECOMMEND to the Board of Supervisors the appointment of Toni Panetta to the Member at Large seat #7 and
Andrew Hayden to the Member at Large seat #8 on the Managed Care Commission, with a term expiring October
31, 2025, as recommended by the Commission. (Wendy Mascitto, Senior Program Manager )
5. ACCEPT the Needle Exchange Update report from the Public Health and Alcohol and Other Drugs (AOD)
divisions and DIRECT staff to forward the report to the Board of Supervisors for their information, as
recommended by the Health Services Director. (Jessica Osorio, Director of HIV/AIDS and STD Program; Fátima
Matal Sol, AOD Program Chief; and Obiel Leyva, Prevention Manager )
6. ACCEPT report on the Employment and Human Services Department’s (EHSD) Innovative Community
Partnerships and DIRECT staff to forward the report to the Board of Supervisors for their information, as
recommended by the EHSD Director. (Marla Stuart, EHSD Director and Tamina Alon, Interim Assistant Director
Policy & Planning)
7.The next meeting is currently scheduled for November 28, 2022.
8.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 1025 Escobar St., 4th Floor, Martinez, 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:
Danielle Fokkema, Committee Staff
Phone (925) 655-2047, Fax (925) 655-2066
danielle.fokkema@cao.cccounty.us
FAMILY AND HUMAN SERVICES COMMITTEE 3.
Meeting Date:10/24/2022
Subject:Record of Action
Submitted For: FAMILY & HUMAN SERVICES COMMITTEE,
Department:County Administrator
Referral No.: N/A
Referral Name: N/A
Presenter: Danielle Fokkema, Sr. Deputy County Administrator Contact: Danielle Fokkema, (925) 655-2047
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 record of action for the September 26, 2022 Family and Human Services Committee meeting.
Recommendation(s)/Next Step(s):
RECEIVE and APPROVE the Record of Action for the September 26, 2022 Family and Human Services Committee meeting.
Fiscal Impact (if any):
There is no fiscal impact for this action.
Attachments
DRAFT Record of Action FHS 9-26-22
D R A F T
FAMILY AND HUMAN SERVICES
COMMITTEE
RECORD OF ACTION FOR
September 26, 2022
Supervisor Diane Burgis, Chair
Supervisor Candace Andersen, Vice Chair
Present: Diane Burgis, Chair
Candace Andersen, Vice Chair
1.Introductions
Chair Burgis called the meeting to order at 9:00 a.m.
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 general public comment period.
3.RECEIVE and APPROVE the Record of Action for the July 25, 2022 Family and Human Services
Committee meeting.
The Committee approved the record of action for the July 25, 2022 meeting as presented.
AYE: Chair Diane Burgis
Vice Chair Candace Andersen
4.RECOMMEND to the Board of Supervisors the appointment of Adey Teshager to the At-Large 6 Seat on
the Contra Costa Commission for Women and Girls for a term expiring February 28, 2026, as
recommended by the Commission.
The Committee approved the appointment for Board of Supervisors approval as recommended.
AYE: Chair Diane Burgis
Vice Chair Candace Andersen
5.RECOMMEND to the Board of Supervisors the reappointment of the following individuals to At-Large seats
on the Contra Costa Advisory Council on Aging (ACOA) with terms expiring on September 30, 2024:
At-Large Seat #1: Penny Reed;
At-Large Seat #2: Shirley Krohn;
At-Large Seat #4: Sara Shafiabady;
At-Large Seat #5: Deborah Card;
At-Large Seat #6: Steve Lipson;
At-Large Seat #10: Terri Tobey;
At-Large Seat #12: Nuru Neemwuchalla;
At-Large Seat #15: Mary Bruns;
At-Large Seat #17: Kevin Donovan;
At-Large Seat #18: Michael Wener;
At-Large Seat #20: Sharon “Sam” Sakai-Miller
The Committee approved the reappointments for Board of Supervisors approval as recommended.
AYE: Chair Diane Burgis
Vice Chair Candace Andersen
6.ACCEPT the Homeless Continuum of Care 2022 Quarter 2 report from the Health Services Department,
Health, Housing and Homeless Services division and the Council on Homelessness, and forward to the
Board of Supervisors for their information.
Jaime Jenett and Jo Bruno presented the report to the Committee. The Committee advised staff
to follow up with Eric Angstadt, regarding the capital facilities master plan, particularly relating to
the Youth Centers planned for East and West County to support their recommendation for service
delivery partnerships with other County agencies. Chair Burgis recommended department staff
continue discussions, including with Board members, on continuing community and Countywide
collaborations for homeless services.
Public comment was received by one caller.
AYE: Chair Diane Burgis
Vice Chair Candace Andersen
7.ACCEPT the report from the Employment and Human Services Department that provides an update on the
oversight and activities of the Community Services Bureau’s Head Start Programs, and FORWARD it to
the Board of Supervisors for discussion.
Nic Bryant, newly appointed Employment and Human Services Department (EHSD) Community
Services Bureau (CSB) Director, introduced himself to the Committee and participants. Dr. Marla
Stuart, presented the report to the Committee.
The recomendations to 1) identify the EHSD Director as the Head Start Executive Director, 2)
delegate the EHSD Director to hire the Head Start Management Team, and 3) accept monthly
updates at the Family and Human Services Committee were presented. The Committe requested
clarification on the recommended delegation to hire Head Start management staff, and whether
any future changes would be needed to the staff classifications. Dr. Stuart clarified, that no
further changes would be required. Dr. Stuart also clarified that the year of '2024' as stated on
slide 23 of the presentation, should read '2023'. The minutes will reflect the correct date.
The Committee accepted the report and recommendations as presented, including forwarding the
report for discussion at the October 11, 2022 Board of Supervisors meeting.
Public comment was received by one caller.
AYE: Chair Diane Burgis
Vice Chair Candace Andersen
8.The next meeting is currently scheduled for October 24, 2022.
9.Adjourn
Chair Burgis adjourned the meeting at 9:52 a.m.
For Additional Information Contact:
Danielle Fokkema, Committee Staff
Phone (925) 655-2047, Fax (925) 655-2066
Danielle.Fokkema@cao.cccounty.us
FAMILY AND HUMAN SERVICES COMMITTEE 4.
Meeting Date:10/24/2022
Subject:Appointments to the Managed Care Commission
Submitted For: FAMILY & HUMAN SERVICES COMMITTEE,
Department:County Administrator
Referral No.: N/A
Referral Name: Appointment to Advisory Bodies
Presenter: Wendy Mascitto, (925) 608-7848 Contact: Danielle Fokkema, (925) 655-2047
Referral History:
On January 7, 2020, the Board of Supervisors adopted Resolution No. 2020/1 adopting policy amendments 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 Managed Care Commission (MCC) is the principal advisory board to the Contra Costa Health Plan (CCHP), a health
maintenance organization. The role of the MCC is to assure the attainment of CCHP’s goals, including to be responsive to the
health insurance needs of the people of Contra Costa County and to encourage the promotion and awareness of CCHP to the
general public, particularly those most medically vulnerable. The Managed Care Commission has 15 regular voting members.
Persons who are involved as contractors with Contra Costa Health Plan (CCHP) cannot be members of the Managed Care
Commission (MCC), nor can Health Department employees.
The Commission is made up of the following membership:
• No less than one (1) Medi-Cal Subscriber, and
• One (1) Medicare Subscriber
• One (1) Commercial Subscriber
• One (1) person sensitive to medically indigent health care need
• One (1) physician, non-contracting
• One (1) other provider, non-contracting
• No less than nine (9) at-large members, non-contracting
• The Director of Health Services is an ex-officio, non-voting member
• The Chief Executive Officer of CCHP is an ex-officio, non-voting member
• The Board of Supervisors function as ex-officio, non-voting members.
Currently the MCC has seven vacancies, which are in the Member At-Large 7, Member At-Large 8, Member At-Large 9,
Medi-Cal Subscriber Medicare Subscriber, person sensitive to medically indigent health care need, and Physician
non-contracting seats.
Referral Update:
On June 15, 2022, the MCC reviewed applications and voted to approve the recommendations of Toni Panetta's appointment to
the At-Large 7 seat and Andrew Hayden to the At-Large 8 seat on the Commission, with a term expiring October 31, 2025.
Approval of this action will support decreasing Commission vacancies, resulting in 5 remaining vacancies.
Recommendation(s)/Next Step(s):
RECOMMEND to the Board of Supervisors the following appointments to the Managed Care Commission:
Toni Panetta – Member at Large seat #7, with a term expiring October 31, 2025
Andrew Hayden – Member at Large seat #8, with a term expiring October 31, 2025
Fiscal Impact (if any):
There is no fiscal impact.
Attachments
Haydon, Andrew Application Redacted
Panetta, Toni Application Redacted
MCC Roster Oct 2022
Submit Date: Jul 11, 2022
First Name Middle Initial Last Name
Home Address Suite or Apt
City State Postal Code
Primary Phone
Email Address
Employer Job Title
Contra Costa County Boards & Commissions
Application Form
Profile
District Locator Tool
Resident of Supervisorial District:
District 5
Length of Employment
2 years
Do you work in Contra Costa County?
Yes No
If Yes, in which District do you work?
How long have you lived or worked in Contra Costa County?
I have lived in Contra Costa County for 8+ years
Are you a veteran of the U.S. Armed Forces?
Yes No
Board and Interest
Which Boards would you like to apply for?
Managed Care Commission: Submitted
Andrew L Haydon
Pacheco CA 94553
University of the Pacific, Thomas
J. Long School of Pharmacy
Associate Professor, and
Director of Professional
Programs
Andrew L Haydon
Seat Name
Any
Have you ever attended a meeting of the advisory board for which you are applying?
Yes No
If Yes, how many meetings have you attended?
10
Education
Select the option that applies to your high school education *
High School Diploma
College/ University A
Name of College Attended
University of the Pacific
Degree Type / Course of Study / Major
Pharm.D.
Degree Awarded?
Yes No
College/ University B
Name of College Attended
California State University, Chico
Degree Type / Course of Study / Major
B.S. Biological Sciences
Degree Awarded?
Yes No
College/ University C
Name of College Attended
Degree Type / Course of Study / Major
Andrew L Haydon
Upload a Resume
Degree Awarded?
Yes No
Other Trainings & Occupational Licenses
Other Training A
Certificate Awarded for Training?
Yes No
Other Training B
Certificate Awarded for Training?
Yes No
Occupational Licenses Completed:
Licensed CA Pharmacist - expires 2024
Qualifications and Volunteer Experience
Please explain why you would like to serve on this particular board, commitee, or
commission.
As a resident of Contra Costa County, it's vitally important to me that the county health plan provide high-
quality services to our residents, especially the most vulnerable ones. Having served as Pharmacy
Director for CCHP for 5+ years, the mission of the health plan is still close to my heart despite the fact
that I no longer have the privilege of working in my previous position. Joining the commission will allow
me to give back to my community and will also assist the county in reaching the goals of the MCC.
Describe your qualifications for this appointment. (NOTE: you may also include a copy of
your resume with this application)
Please see attached resume. My experience as Pharmacy Director for CCHP gives me a unique
understanding of the Managed Care landscape in California. In addition, my experiences in the military
and other areas of medicine and education make me qualified to provide an opinion on the quality of care
being provided to the citizens of Contra Costa County. I have a strong understanding of Managed Care
policy, I have a desire to ensure health care equity in the community in which I live, and I think I would
bring a skill set to the commission that may not have been present otherwise.
Would you like to be considered for appointment to other advisory bodies for which you
may be qualified?
Yes No
Andrew L Haydon
Do you have any obligations that might affect your attendance at scheduled meetings?
Yes No
If Yes, please explain:
Are you currently or have you ever been appointed to a Contra Costa County advisory
board?
Yes No
If Yes, please list the Contra Costa County advisory board(s) on which you are currently
serving:
If Yes, please also list the Contra Costa County advisory board(s) on which you have
previously served:
List any volunteer or community experience, including any advisory boards on which you
have served.
Conflict of Interest and Certification
Do you have a familial or financial relationship with a member of the Board of Supervisors?
(Please refer to the relationships listed under the "Important Information" section below or
Resolution No. 2021/234)
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 relationships?
Yes No
If Yes, please identify the nature of the relationship:
Andrew L Haydon
Please Agree with the Following Statement
I CERTIFY that the statements made by me in this application are true, complete, and correct
to the best of my knowledge and belief, and are made in good faith. I acknowledge and
undersand that all information in this application is publicly accessible. I understand that
misstatements and/or omissions of material fact may cause forfeiture of my rights to serve
on a board, committee, or commission in Contra Costa County.
I Agree
Important Information
1. This application and any attachments you provide to it is a public document and is subject to
the California Public Records Act (CA Government Code §6250-6270).
2. All members of appointed bodies are required to take the advisory body training provided by
Contra Costa County.
3. Members of certain boards, commissions, and committees may be required to: (1) file a
Statement of Economic Interest Form also known as a Form 700, and (2) complete the State
Ethics Training Course as required by AB 1234.
4. Meetings may be held in various locations and some locations may not be accessible by
public transportation.
5. Meeting dates and times are subject to change and may occur up to two (2) days per month.
6. Some boards, committees, or commissions may assign members to subcommittees or work
groups which may require an additional commitment of time.
7. As indicated in Board Resolution 2021/234, a person will not be eligible for appointment if
he/she is related to a Board of Supervisors' member in any of the following relationships:
(1) Mother, father, son, and daughter;
(2) Brother, sister, grandmother, grandfather, grandson, and granddaughter;
(3) Husband, wife, father-in-law, mother-in-law, son-in-law, daughter-in-law, stepson, and
stepdaughter;
(4) Registered domestic partner, pursuant to California Family Code section 297;
(5) The relatives, as defined in 1 and 2 above, for a registered domestic partner;
(6) Any person with whom a Board Member shares a financial interest as defined in the
Political Reform Act (Gov't Code §87103, Financial Interest), such as a business partner or
business associate.
Andrew L Haydon
Andrew Haydon
_______________________________________________________________________________________________________________________________
‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾
OBJECTIVE
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Licensed pharmacist with outstanding interpersonal skills and leadership experience in the field of
managed care pharmacy seeks a rewarding position that will allow me to contribute towards
improving the overall health of the served population.
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
EDUCATION
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
University of the Pacific,
Thomas J. Long School of Pharmacy and Health Sciences Stockton, CA
Doctor of Pharmacy, May 2012.
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
California State University Chico Chico, CA
Bachelors of Science degree, Biology. Minor in Chemistry. May 2002.
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
EXPERIENCE
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
2020 – present University of the Pacific, Thomas J. Long School of Pharmacy – Stockton CA
Associate Clinical Professor & Director of Professional Programs
Responsibilities: In collaboration with the Associate Dean of Professional Programs, oversees the
overall coordination of the experiential curriculum within the Doctor of Pharmacy program and
supervises the administrative staff in the Office of Professional Programs. In addition to teaching
responsibilities, carries administrative duties to support the Advanced Pharmacy Practice Experience
(APPE) Regional Coordinators and the Introductory Pharmacy Practice Experience (IPPE)
Experiential Coordinators, including clinical site development, administration of student placement in
regions, assuring student eligibility to start IPPEs/APPEs, and oversees the overall coordination of
IPPE and APPE activities.
Courses taught: PRAC 131 (Managed Care Elective), PHAR 332 (Case-based Practice 3), PHAR 551
(Community II IPPE), PHAR 321 (Health Care Delivery Systems & Pharmacoeconomics), PRAC 142
(Introduction to the Medicare Benefit & MTM), PRAC 131 (Managed Care P&T Competition
elective), and PHAR 631 (APPE Preparedness).
Key committee involvement: Curriculum Committee and Top Drugs List Committee.
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
2015 – 2020 Contra Costa Health Plan – Martinez CA
Pharmacy Director
Responsibilities: Managed all aspects of pharmacy operations for Contra Costa Health Plan, covering
over 200,000 lives in managed Medicaid and commercial product lines, with an annual operational
outpatient drug budget of $85 million, managed and oversaw $30 million annual 340B drug discount
program on behalf of Contra Costa County's public hospital and community clinics, maintained and
published Medicaid and commercial formularies across multiple delivery channels, reviewed
pharmacy prior authorization requests, created prior authorization criteria, provided pharmacy subject
matter expertise on a variety of health plan committees and workgroups, provided oversight and
management of PBM, managed contracts, performance, and relationships with vendors, participated in
vendor contract negotiations, performed detailed analysis of pharmaceutical utilization trends and
forecast budget, modeled financial impact of current pharmacy issues on health plan's business
performance, synthesized data into actionable insights and presented findings to health plan
leadership, lead pharmacy department continuous quality improvement initiatives, co-chaired the
health plan pharmacy & therapeutics committee, developed and improved upon pharmacy benefit
performance reporting tools (such as PMPM spend, PA statistics, specialty drug utilization, detailed
opiate analytics, etc.), maintained operational compliance with NCQA, DHCS, and DMHC standards,
and served as the primary point of contact for provider education related to health plan initiatives and
formulary improvement.
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
2014 – 2015 CA Dept. of Corrections & Dept. of Veterans Affairs – Vacaville/Oakland CA
Clinical Pharmacist
Responsibilities: Authorized and processed inpatient and outpatient orders within major state and
federal medical treatment facilities, managed pharmacotherapy including oral medications, injectable
drugs, IV admixtures and TPN, monitored clozapine/REMS therapy under the direction of overseeing
physician.
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
2012 – 2015 Myers Medical Pharmacy – Ukiah, CA
Staff/Compounding Pharmacist
Responsibilities: verified prescriptions, supervised technicians and ancillary staff, managed pharmacy
workflow including retail, compounded and hospice medication orders, monitored clozapine therapy,
and provided travel medication and immunizations under the direction of an overseeing physician.
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
2010 – 2012 Safeway Pharmacy – Stockton and Lafayette, CA
Intern Pharmacist
Responsibilities: processed prescriptions, consulted patients on prescription and over the counter
medications, and assisted in management/supervision of technicians and clerks.
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
2008 – 2010 CVS Pharmacy – Petaluma/Stockton, CA
Pharmacy Technician/Intern Pharmacist
Responsibilities: processed prescriptions, maintained pharmacy stock levels, billed and reconciled
third party insurance, and communicated with physicians and office staff regarding therapy.
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
2005 – 2008 Merck & Co. Inc. Pharmaceuticals – Northern CA
Professional Representative
Responsibilities: managed over 250 physician accounts, supplied pharmaceutical samples for patient
use, updated providers regarding product development, managed adverse drug event reporting, and
sponsored clinician education programs.
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
2004 – 2005 MTI College - Sacramento, CA
Medical Assisting Program Instructor
Responsibilities: created and implemented medical curriculum for medical assistant candidates, and
taught courses in medical terminology, anatomy/physiology, and laboratory and clinical assisting.
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
CERTIFICATIONS/LICENSURE
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
CA Pharmacist, expires 2024
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
APhA Immunizations Certificate, obtained 2009
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
APhA Advanced Preceptor Training Certificate, obtained 2016.
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
APhA Pharmacy-Based Travel Health Services Certificate, obtained 2021.
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Professional Compounding Centers of America (PCCA) Core compounding Course, completed 2012.
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
AHA Basic Life Support (BLS) for Providers, expires 2023.
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
MILITARY DUTY
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
2002 – 2016 United States Air Force Reserve - Travis AFB, CA
Medic
Responsibilities: Patient care in all aspects of military medicine including wound care, phlebotomy,
electrocardiography, medication administration, airway management, intravenous fluid therapy, emergency
medical treatment, intensive care, and immunizations. Assignments have included tours in: Iraq, Afghanistan,
and various locations within the United States.
---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
-
PROFESSIONAL REFERENCES
---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
-
Available upon request
Submit Date: Mar 06, 2022
First Name Middle Initial Last Name
Home Address Suite or Apt
City State Postal Code
Primary Phone
Email Address
Employer Job Title
Contra Costa County Boards & Commissions
Application Form
Profile
District Locator Tool
Resident of Supervisorial District:
District 2
Length of Employment
4.25
Do you work in Contra Costa County?
Yes No
If Yes, in which District do you work?
2
How long have you lived or worked in Contra Costa County?
4 years
Are you a veteran of the U.S. Armed Forces?
Yes No
Board and Interest
Which Boards would you like to apply for?
Managed Care Commission: Submitted
Toni Panetta
CA
Mobile:
National Service Office of Nurse-
Family Partnership & Child First Government Affairs Manager
Toni Panetta
Seat Name
At-large vacancy
Have you ever attended a meeting of the advisory board for which you are applying?
Yes No
If Yes, how many meetings have you attended?
N/A
Education
Select the option that applies to your high school education *
High School Diploma
College/ University A
Name of College Attended
Whitter College
Degree Type / Course of Study / Major
Degree Awarded?
Yes No
College/ University B
Name of College Attended
University of Denver Korbel School for International Studies
Degree Type / Course of Study / Major
Degree Awarded?
Yes No
College/ University C
Name of College Attended
Degree Type / Course of Study / Major
Toni Panetta
Degree Awarded?
Yes No
Other Trainings & Occupational Licenses
Other Training A
Certificate Awarded for Training?
Yes No
Other Training B
Certificate Awarded for Training?
Yes No
Occupational Licenses Completed:
Qualifications and Volunteer Experience
Please explain why you would like to serve on this particular board, commitee, or
commission.
I’m excited to apply for an at-large position on the County’s Managed Care Commission at a critical time
in Contra Costa Health Plan’s delivery of services to Plan members. When I relocated to Contra Costa
County in 2018 from Colorado, I stepped away from community engagement in both formal roles (a
mayoral appointee of the Denver Women’s Commission) and advisory capacities to advance health
equity. Since settling into Contra Costa, first as a resident of Walnut Creek and now Moraga, I’ve learned
the critical role that county agencies, including county-operated health plans, play as providers of care
coordination and comprehensive safety-net health services. With the implementation of CalAIM and the
County receipt of State approval to transition from a two-plan county to a single-plan county, CCHP has
substantial responsibility for ensuring high-quality, accessible, and comprehensive care is available to all
eligible Medi-Cal members. This presents CCHP with a critical opportunity to build on the successful
implementation of Whole Person Care pilot by providing Enhanced Care Management to eligible CCHP
members who are among the most vulnerable in our communities. In partnership with Contra Costa
Health Services, CCHP can be a leader in advancing robust, prevention-oriented population health
management strategies to mitigate social determinants of health that disproportionately affect CCHP
members.
Toni Panetta
Upload a Resume
Describe your qualifications for this appointment. (NOTE: you may also include a copy of
your resume with this application)
As detailed in the submitted resume, I would bring more than 15 years in health care policy and health
care financing strategies to serve marginalized communities, with the goal of mitigating disparities in
health outcomes. Most recently, my role as Government Affairs Manager with the National Service Office
for Nurse-Family Partnership and Child First has allowed me to learn about multiple states’ approaches to
improving maternal and child health outcomes for Medicaid-enrolled and Medicaid-eligible populations.
Specific to California, I am familiar with expectations DHCS has laid out for managed care plans through
CalAIM, as well as comprehensive transformation for children’s behavioral health care that is underway. I
currently also serve on a Medicaid maternal mental health advisory commission for Arizona, through
which we explore strategies to increase access to and use of comprehensive behavioral health services
to address perinatal or postpartum mood and anxiety disorders and substance misuse among pregnant
and postpartum women.
Would you like to be considered for appointment to other advisory bodies for which you
may be qualified?
Yes No
Do you have any obligations that might affect your attendance at scheduled meetings?
Yes No
If Yes, please explain:
I work standard business hours, but have ability to flex schedule around Managed Care Commission
meeting times
Are you currently or have you ever been appointed to a Contra Costa County advisory
board?
Yes No
If Yes, please list the Contra Costa County advisory board(s) on which you are currently
serving:
If Yes, please also list the Contra Costa County advisory board(s) on which you have
previously served:
List any volunteer or community experience, including any advisory boards on which you
have served.
-- Non-Profit Organization Representative, Arizona Health Care Cost Containment System (AHCCCS)
Maternal Mental Health Advisory Committee -- Commissioner, Denver Women’s Commission (mayoral
appointment) -- Board Member, Women’s Lobby of Colorado -- Young Professional Board, Project
C.U.R.E. -- American mentor to Filipino young professionals, Young Southeast Asia Leaders Initiative --
International leadership programs in Azerbaijan, El Salvador, Guatemala, Morocco, Jordan, the
Philippines and Saudi Arabia
Toni Panetta
Conflict of Interest and Certification
Do you have a familial or financial relationship with a member of the Board of Supervisors?
(Please refer to the relationships listed under the "Important Information" section below or
Resolution No. 2021/234)
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 relationships?
Yes No
If Yes, please identify the nature of the relationship:
I do not. However, Contra Costa Health holds a licensing & affiliation contract with my employer to deliver
the evidence-based Nurse-Family Partnership (NFP) early childhood home visiting program to first-time
low-income expectant mothers and their infants. Contra Costa Health pays an annual affiliation/licensing
fee. I am not involved in decision-making about continuation of the contract or fees. I have a working
relationship with Contra Costa Health employees who administer the County's NFP program. As
Government Affairs Manager for the National Service Office of Nurse-Family Partnership and Child First, I
educate staff about federal and state funding streams authorized to sustain and expand delivery of NFP
services. This includes as a subject matter expert for the 1) California Home Visiting Program whose
federal and state funding as administered through the CA Dept of Public Health; 2) CalWORKs Home
Visiting Program whose funding is administered through the CA Dept of Social Services; 3) Family First
Prevention Services Act Prevention funds administered through the CA Dept of Social Services.
Please Agree with the Following Statement
I CERTIFY that the statements made by me in this application are true, complete, and correct
to the best of my knowledge and belief, and are made in good faith. I acknowledge and
undersand that all information in this application is publicly accessible. I understand that
misstatements and/or omissions of material fact may cause forfeiture of my rights to serve
on a board, committee, or commission in Contra Costa County.
I Agree
Important Information
Toni Panetta
1. This application and any attachments you provide to it is a public document and is subject to
the California Public Records Act (CA Government Code §6250-6270).
2. All members of appointed bodies are required to take the advisory body training provided by
Contra Costa County.
3. Members of certain boards, commissions, and committees may be required to: (1) file a
Statement of Economic Interest Form also known as a Form 700, and (2) complete the State
Ethics Training Course as required by AB 1234.
4. Meetings may be held in various locations and some locations may not be accessible by
public transportation.
5. Meeting dates and times are subject to change and may occur up to two (2) days per month.
6. Some boards, committees, or commissions may assign members to subcommittees or work
groups which may require an additional commitment of time.
7. As indicated in Board Resolution 2021/234, a person will not be eligible for appointment if
he/she is related to a Board of Supervisors' member in any of the following relationships:
(1) Mother, father, son, and daughter;
(2) Brother, sister, grandmother, grandfather, grandson, and granddaughter;
(3) Husband, wife, father-in-law, mother-in-law, son-in-law, daughter-in-law, stepson, and
stepdaughter;
(4) Registered domestic partner, pursuant to California Family Code section 297;
(5) The relatives, as defined in 1 and 2 above, for a registered domestic partner;
(6) Any person with whom a Board Member shares a financial interest as defined in the
Political Reform Act (Gov't Code §87103, Financial Interest), such as a business partner or
business associate.
Toni Panetta
Toni Panetta, M.A.
Moraga, CA
SENIOR POLICY ADVOCATE - HEALTH
Accomplished and passionate professional with deep background in health policy, safety-net delivery and
financing systems, program management, and collaborative workstyle to engage internal and community
partners. Demonstrated achievements in health policy; legislative, regulatory, and fiscal authorizations;
government affairs; community relations; and staff development. Adept in organizational leadership, executive
stakeholder relations, and driving impact programming.
AREAS OF EXPERTISE
Health Policy Analysis | Fostering Collaboration Among Diverse Stakeholders | Program Management
Legislative Relations | Coalition Building | Public Speaking | Budget Management
Non-Profit Operations | Connecting People and Resources to Drive Change
PROFESSIONAL HISTORY
Government Affairs Manager January 2018 – present
National Service Office of Nurse-Family Partnership (NFP) and Child First
● Co-Chair, NFP Maternal Mortality and Maternal Morbidity Taskforce
● Member, NFP Research & Publications Committee
● Non-Profit Organization Representative, Arizona Health Care Cost Containment System (AHCCCS)
Maternal Mental Health Advisory Committee
Develop & implement multi-state, multi-county government affairs strategies to: secure $70.4M in public
funding to serve 7,400 at-risk families in Arizona, California, Nevada & Tennessee; drive growth by
diversifying public funding authorized to support program delivery; & position organization as a thought
leader to reduce disparities in maternal & infant health, reduce child abuse, & improve families’ economic stability
● Increased public funding by $12.9M annually for NFP programs, and a combined $111.5M for
the field of evidence-based maternal, infant and early childhood home visiting
● Prevented loss of $7M annually in Medicaid reimbursement during state’s 1115 Medicaid waiver
renewal process by coordinating advocacy efforts with county health executive officers and county
maternal & child adolescent health directors
● Sustained $14.7M annually in federal Maternal, Infant and Early Childhood Home Visiting Program
(MIECHV) grants for NFP by strengthening relationships with state agency administrators in Arizona,
California & Nevada
● Engaged state agency directors and state agency program staff who administer Medicaid, TANF,
Family First Prevention Services Act Part 1, and Title V programs; state legislators; county health
officials; and other executive stakeholders; to integrate evidence-based home visiting services into states’
strategies to improve maternal & infant health, prevent child abuse, & reduce poverty
● Supervised contract lobbyists, coached grassroots advocates, cultivated networks of local community
leaders, maintained relationships with Congressional district offices, arranged site visits, and represented
NFP on various coalitions to influence legislative and administrative decisionmakers
● Directed cross-departmental coordination to achieve organization growth goals
Director of Mission Programs August 2013 – December 2017
Susan G. Komen Colorado
Managed foundation’s grant-making, public policy, regional coalition, and community needs assessment efforts
● Developed and implemented state and federal public policy plans, including direct lobbying;
managing volunteer advocacy program; staffing public policy advisory committee; and legislative analysis
of Medicaid expansion, payment reform, coordinated care models, essential health benefits in commercial
insurance plans, and other health reform policies
● Facilitated 8 regional coalitions across 22 counties to increase collaboration between health care
systems, mitigate barriers to care for at-risk populations, and reduce likelihood of patients falling out of
the continuum of care
Toni Panetta page 2 of 2
● Developed and managed process to solicit, evaluate, and award $1M-$2M in annual grants to
disproportionate-share hospitals, federally qualified health centers, and community-based organizations
to reduce disparities in breast cancer outcomes
Consultant May – September 2013
Coordinated event logistics; implemented multi-model fundraising plan that raised 250% of revenue goal; and
developed and directed implementation of online communications and fundraising strategy for new organization
GIVE DENVER Director December 2012-March 2013
Denver Human Services
Created the first budget, multi-modal fund-raising plan, and comprehensive strategic communication plan to
increase monetary and in-kind donations, public awareness, and volunteer engagement for $250,000+ program
Political Director August 2006-November 2012
NARAL Pro-Choice Colorado/NARAL Pro-Choice Colorado Foundation
Coordinated public policy, political and communications activities for state-level non-profit organizations
● Developed and implemented organization’s public policy program, including serving as organization’s
lobbyist on state reproductive health laws and regulations, establishing and staffing the organization’s
first policy advisory committee, and creating analytical matrix to recommend allocation of resources on
legislation of interest to the organization
● Used SWOT analysis to develop short-, intermediate-, and long-term strategic plans for public policy,
community organizing, public education/research, and political action programs for 501(c)(3) and
501(c)(4) non-profit organizations
● Informed strategic direction and implementation of organization’s multi-year, grant-funded $1.5+ million
program to provide health education services and change state laws regarding contraceptive access and
insurance coverage for maternal health care
● Secured more than $200,000 through grants from private foundations, managed general- and restricted-
fund-allocated grants, wrote grant reports, and maintained relationships with program officers
Managing Editor June 1998-July 2004
California Association of Realtors® Los Angeles, CA
Managed editorial production of trade association’s award-winning monthly, semi-annual, and annual publications,
which had combined annual operating budgets of more than $2 million
● Managed vendor contracts and developed and managed annual budget
● Doubled circulation size and frequency of semi-annual publication, resulting in increased advertising
revenue, national recognition, and awards for excellence in business-to-business publishing
● Developed and managed production of comprehensive, company-wide marketing kit
EDUCATION & PROFESSIONAL DEVELOPMENT
M.A., International Studies, Josef Korbel School of International Studies at the University of Denver
B.A., English Language & Literature (Magna cum Laude), Whittier College
Fellow, United Nations Alliance of Civilizations
Progressive Leadership & Advocacy Network Institute
National Women’s Law Center
Alumna, International Exchange Program, American Council of Young Political Leaders
Colorado Institute for Leadership Training
COMMUNITY INVOLVEMENT
● American mentor to Filipino young professionals, Young Southeast Asia Leaders Initiative
● International leadership programs in Azerbaijan, El Salvador, Guatemala, Morocco, Jordan, the Philippines and
Saudi Arabia
● Commissioner, Denver Women’s Commission
● Women’s Lobby of Colorado Board
● Project C.U.R.E. Young Professional Board
MCC ROSTER
Member at Large #1
Bruce Gorman
8/31/2024
Member at Large #7
VACANT
Rep Medically Indigent
Health Care Needs
VACANT
Member at Large #2
Rebecca Brossa
8/31/2024
Member at Large #8
VACANT
Physician, non-contracting
VACANT
Member at Large #3
Wendy Mailer
8/31/2024
Member at Large #9
VACANT
Other Provider, non-
contracting
Clifton Louie
8/31/2024
Member at Large #4
Barbara Hockett
8/31/2024
Medi-Cal Subscriber
VACANT
Director of Health Services
Anna Roth
Ex-Officio
Member at Large #5
Marshall Riddle
8/31/2024
Medicare Subscriber
VACANT
CEO of CCHP
Sharon Mackey
Ex-Officio
Member at Large #6
Pier Angeli Linsangan
8/31/24
Commercial Subscriber
Susan Frederick
8/31/2024
Board of Supervisors
Gayle Israel
Ex-Officio
FAMILY AND HUMAN SERVICES COMMITTEE 5.
Meeting Date:10/24/2022
Subject:HIV Prevention Needle Exchange Program Update
Submitted For: Anna Roth, Health Services Director
Department:Health Services
Referral No.: 61
Referral Name: HIV Prevention Needle Exchange Program
Presenter: Jessica Osorio, Fátima Matal Sol, and Obiel Leyva Contact: Enid Mendoza, (925) 655-2051
Referral History:
The HIV Prevention/Needle Exchange program was referred to the Family and Human Services Committee (FHS) in October
2002. The issue was discussed four times during 2003 and was subsequently closed. The referral was then re-opened on
January 4, 2005 for annual reports to FHS.
During the December 18, 2014 FHS meeting, Health Services Department staff were directed to begin reporting to FHS
biennially regarding Referral #61 - HIV Prevention/Needle Exchange Program and to submit a report directly to the Board of
Supervisor in the intervening years. Additionally, in December 14, 2015, FHS received a report on the program and recognized
the incidents of HIV and AIDS had significantly decreased. Therefore, FHS felt that a biennial report to the Committee was
sufficient. The Committee also advised staff to return to them at any time should the exposure data significantly change.
The Family and Human Services Committee last received the 2021 annual report on this program at their February 28, 2022
meeting. The report as presented to FHS was forwarded to the Board of Supervisors for their information and approved at their
September 13, 2022 meeting.
Referral Update:
Please see the attached staff report for an update on needle exchange services provided in Contra Costa County during the
period of January 1, 2021 and June 30, 2022.
Recommendation(s)/Next Step(s):
ACCEPT the Needle Exchange Update report from the Public Health Division of the Health Services Department and DIRECT
staff to forward the report to the Board of Supervisors for their information.
Fiscal Impact (if any):
There is no fiscal impact.
Attachments
Needle Exchange Program Update
Contra Costa Health Services
Needle Exchange Update Report to Family & Human Services Committee
October 2022
Page 1 of 24
RECOMMENDATIONS
1) Accept this report on needle exchange as part of the comprehensive prevention program to
reduce transmission of HIV in Contra Costa County.
2) Direct the Health Services Department to continue supporting and monitoring sterile needle
exchange services utilizing a modified “needs-based” distribution exchange model with built-in
incentives to return used needles.
GLOSSARY
Terms currently used to discuss needle exchange services include:
◻ Sterile needle/syringe instead of clean needle/syringe.
◻ Used needle/syringe instead of dirty needle/syringe.
◻ People who inject drugs (PWID) instead of Injection Drug Users (IDUs).
◻ One-for-one exchange model involves exchanging one sterile needle/syringe for a used one;
the individual cannot get any additional needles/syringes.
◻ Needs-based exchange model is less restrictive and allows individuals to receive as many
needles/syringes as they self-report using in each day, without regard to the number of
needles and syringes returned. This model increases opportunity for PWID to always have a
sterile needle on hand.
SUMMARY
In 2006, the Contra Costa Board of Supervisors:
• Terminated the local State of Emergency first declared on December 14, 1999.
• Authorized the Health Services Department to administer a clean needle and syringe
exchange project pursuant to Health and Safety Code section 121349 et seq; and
• Directed the Health Services Director to annually report to the Board on the status of the
clean needle and syringe exchange project.
This report satisfies State regulatory requirements to maintain needle exchange services
in Contra Costa and covers the period of January 1, 2021, to June 30, 2022.
As of June 2022, 2,869 individuals are living wit h HIV or AIDS in Contra Costa. Between 2020
and 2022, the percentage of people living with HIV and identifying injection drug use (IDU) as the
mode of transmission has dropped from 6.7% of all those living with HIV to 6.4%. In addition, the
percentage of those newly infected with HIV in 2021/2022 identifying IDU as the mode of
transmission was 1.3%, a decrease from 2018 (2.7%) and 2019 (2.1%). This speaks in large part
to the importance of the County’s accessible, weekly needle exchange services.
Contra Costa Health Services
Needle Exchange Update Report to Family & Human Services Committee
October 2022
Page 2 of 24
In Contra Costa County, needle exchange services are provided through a contract with the HIV
Education and Prevention Project of Alameda County (HEPPAC). The Health Department
provides an annual amount of $97,000 from County General Funds to support the weekly
operation of needle exchange services in West and East County. In addition, harm red uction
services including needle exchange are offered in Martinez at Waterfront Park by the Martinez
Harm Reduction Collective (MHRC), a volunteer group that acts as a secondary exchanger with
HEPPAC. Please note, the funds from Contra Costa’s contract with HEPPAC do not support
MHRC; HEPPAC utilizes funds from other sources to provide them with technical assistance and
harm reduction supplies.
The availability of needle exchange as part of a comprehensive continuum of services for PWID
continues to be a necessary public health measure to reduce transmission of blood borne
diseases in Contra Costa.
BACKGROUND ON ACCESS TO STERILE NEEDLES TO REDUCE TRANSMISSION
The California Department of Public Health (CDPH) reports that of the 139,703 people who were
living with HIV/AIDS in California in 2020, 5.5% identified their risk for HIV as solely as IDU.1
Further, the CDPH Office of Viral Hepatitis reports that transmission of hepatitis C is primarily
through sharing needles, syringes, or other drug inject ion equipment. Lack of access to new,
sterile injection equipment is one of the primary risk factors that may lead to sharing hypodermic
needles and syringes, which puts PWID at elevated risk for HIV, HCV, and Hepatitis B
infections.2
Needle exchange has been an essential component of Contra Costa’s strategy to reduce the
transmission of HIV attributed to IDU since 1999, when the program operated under the Board’s
declaration of a State of Emergency to authorize needle exchange services. Health and Safety
Code Section 121349.3 removed the requirement for a Declaration of Emergency and current
regulations now require only that needle exchange information be provided at an open meeting of
the authorizing body every two years.
From 2005-2010, Contra Costa participated in a statewide Disease Prevention Demonstration
Project (DPDP) to assess the potential to reduce transmission of HIV by increasing access to
sterile needles and syringes. The project evaluation showed lower injection -related risks among
people who inject drugs in counties with syringe exchange programs. Additionally, evaluators of
the pilot project found lower levels of unsafe discard of used syringes, no increase in the rate of
accidental needle-stick injuries to law enforcement, and no increase in rates of drug use or drug-
related crime.3
1 https://www.cdph.ca.gov/
https://www.cdph.ca.gov/Programs/CID/DOA/CDPH%20Document%20Library/California_HIV_Surveillance_Report2020_ADA.pdf
2 https://www.cdph.ca.gov/Programs/CID/DCDC/CDPH%20Document%20Library/2018-Chronic-HCV-Surveillance-Report-Exec- Summary.pdf
3 The full report of the evaluation can be accessed on the California Department of Public Health, Office of AIDS website
http://www.cdph.ca.gov/programs/Documents/SB1159StateReportFinal.pdf -
Contra Costa Health Services
Needle Exchange Update Report to Family & Human Services Committee
October 2022
Page 3 of 24
As a result of the success of the DPDP, 2011 legislation expanded syringe access through
pharmacies throughout the state. Assembly Bill (AB) 1743 (Ting, Chapter 331, Statutes of 2014)
further expanded access in January 2015 by allowing customers to purchase and possess an
unlimited number of syringes. Participating pharmacies must provide counseling and offer
information on safe disposal.
REDUCING TRANSMISSION OF DISEASE
As of June 30, 2022, there were 2,869 individuals reported living with HIV (PLHIV) in Contra
Costa. Roughly 33.7% reside in Central County, 33.5% in West County, and 32.8% in East
County.4 Of all PLHIV in Contra Costa, 323 individuals (11.3%) identify injection drug use or
injection drug use among men who have sex with other men as their mode of HIV transmission.5
Among new HIV infections in Contra Costa County, most new cases are still attributed to male-to-
male sexual contact (MMSC). Of the total newly diagnosed HIV cases (153) between January 1,
2021, and June 30, 2022, 94 (61.4%) were attributed to MMSC. Since 2018 the total number of
new diagnoses attributable to injection drug alone use has decreased from 2.7% to 1.3%.
Chart 1: Distribution of all PLWH by Region in Contra Costa as of 6/30/2022
West, 33.5% East, 32.8%
Central, 33.7%
MATERNAL TRANSMISSION
It often takes two or three months for an accurate diagnosis of HIV or AIDS in a newborn since a
positive test at birth may reflect maternal antibodies and not HIV infection. Children with HIV have
usual childhood infections more often and more severely than uninfected children and can also
be susceptible to the same opportunistic infections as adults with HIV.
Of the 2,869 individuals living with HIV or AIDS in Contra Costa County in 2022, 26 are pediatric
cases: the majority are now adults and 3 are children 12 years of age or younger. Identification
and treatment of HIV-positive women in prenatal care is nearly universal, but we continue to
encounter women who do not seek prenatal care prior to delivery. As an example, in February
2022, Contra Costa had one new case of
4 Data Use Agreement (DUA) Q2 2022
5 Data from 2022 Data Use Agreement (DUA) Data, Q2 2022.
Contra Costa Health Services
Needle Exchange Update Report to Family & Human Services Committee
October 2022
Page 4 of 24
Chart 2: Reported (Non Medical) Needle Stick
Exposures to First Responders
Over Time
30
20
10
0
19/20 20/21 21/22
Needlestick All Exposures
maternally transmitted HIV. A comprehensive case review completed by our HIV Surveillance
Coordinator and the Outbreak and Investigation Unit of the Office of AIDS found that the prenatal
care was accessed late (24 weeks) in pregnancy, through multiple providers, and two outside
LHJs. Seroconversion occurred shortly before delivery, which was one month after the initial
prenatal visit and initial negative HIV test. System changes were proposed, including increased
collaboration between LHJs and increased testing of high-risk pregnant individuals, and there
have been no new subsequent maternal transmission cases reported. Mother and baby are both
virally suppressed at this time.
HEPATITIS C
Hepatitis C infection (HCV) is largely attributed to the use of con taminated needles. Chronic HCV
can lead to scarring of the liver, cirrhosis, liver failure and/or liver cancer. Across California the
number of chronic Hepatitis C carriers continues to be unreliable due to variation in reporting
capacities, changes in patient residences, and the high volume of duplicated positive lab tests.
Consequently, Contra Costa’s Acute Communicable Disease (ACD) program reviews only a
fraction of the reports and only follows extremely acute infections and those with a higher
likelihood of yielding opportunities for contact intervention and transmission interruption.
EXPOSURE IMPACT ON LAW ENFORCEMENT AND FIRST RESPONDERS
Occupational exposure to needle stick injuries (Chart 2) for first responders remains low. The
Communicable Disease Control Program is responsible for communicating the source person’s
results with Occupational Health, but they do not advise on treatment or follow up.
Communicable Disease Control remains available for consult as requested and printed materials
are also available on the Syringe Exchange website: https://cchealth.org/hiv/syringe-
exchange.php
There were ten reported exposures in FY 20/21 and twenty in FY 21/22 among law enforcement
and first responders, but none were from needle sticks:
Contra Costa Health Services
Needle Exchange Update Report to Family & Human Services Committee
October 2022
Page 5 of 24
NEEDLE EXCHANGE SERVICES: JANUARY 1, 2021- JUNE 30, 2022
All data below is supplied by Contra Costa’s needle exchange contractor, HIV Education
Prevention Project of Alameda County (HEPPAC). HEPPAC has provided services in Contra
Costa since 2013.
Needle exchange services in the region rely on a combination of county general funds and other
funding secured by the contractor through foundations and other organizations. HEPPAC’s
budget funds portions of several staff salaries, including Community Heal th Promoters, a clerk,
and the Harm Reduction Services Manager. The budget also funds supplies. HEPPAC’s service
delivery and reporting continue to improve.
Impact of COVID-19 Pandemic: Needle exchange is an essential service, so HEPPAC stayed
open during COVID-19 related lockdowns. Fewer individuals came to the syringe exchange sites
but the drop in the number of individuals served and total number of syringes distributed was
minimal. In the January 2021—June 2022 reporting period, two COVID-19 variants (Delta and
Omicron) affected the number of weekly clients accessing harm reduction services at HEPPAC
needle exchange sites in West and East Contra Costa County. However, with the increase in
vaccination rates across the county, HEPPAC was able to serve more individuals in FYs 20/21
and 21/22 as compared to the beginning of the COVID-19 pandemic. Table 1 shows an increase
of 10% in this reporting period from FY 19/20. At the beginning of the COVID-19 pandemic,
HEPPAC had to reconfigure their service delivery process. Before the pandemic, clients would
line up to receive services; clients are now served using a “taco truck” method with one window
to collect used syringes and take the client’s order and another window to give the client their
syringes and other requested paraphernalia.
Clients are asked to wear a mask and maintain social distancing. In FY 19/20, HEPPAC
submitted a Social Distancing Protocol which was reviewed and approved by county staff and
continues to be followed.
Table 1: Race/Ethnicity Totals Over Time (Needle Exchange Program)
Race/Ethnicity Totals Over Time
FY 19/20 FY 20/21 FY 21/22
African American 376 734 689
White 1,720 1,668 1,709
Latino/Hispanic 342 319 299
Native American 9 3 6
Asian/Pacific Islander 11 4 8
Other 25 15 5
Total 2,483 2,743 2,716
Contra Costa Health Services
Needle Exchange Update Report to Family & Human Services Committee
October 2022
Page 6 of 24
In this reporting period, West County residents exchanged a total of 20,884 used needles, which
is higher than the previous two fiscal years. In East County, a similar increase was observed –
East County residents exchanged a total of 152,990 used needles, which was also higher than
the previous two fiscal years. These increases may be due to the easing up of COVID-19
restrictions. The upward trend is also evident when looking at needle exchange rates base d on
race and ethnicity for African Americans. In this reporting period, an average of 711 African
American individuals per fiscal year were served at needle exchange sites as compared to 376 in
FY 19/20.
However, for White clients, the opposite is true. A total of 1,720 White clients were served in FY
19/20 as compared to an average of 1,675 White clients in the two fiscal years included in this
report (see Table 1).
However, for reasons outlined here and later in this report, the number of used needles
exchanged by African American clients (n=18,617) remained much lower than the amount by
White clients (n=208,620). There is a notable difference in exchange behaviors: White clients
report exchanging needles for secondary users at a much higher rate than do African American
clients. In addition, the volume of White clients continues to grow in East County. Overall, the
data reported by HEPPAC shows a continued shift toward increased utilization at the East Contra
Costa site
West County Harm Reduction Services:
In FYs 20/21 and 21/22, HEPPAC reported an increase in the number of clients using harm
reduction services in West Contra Costa County. This increase is due in large part to HEPPAC’s
increased outreach efforts in the region, which included the work of the HEPPAC Community
Health Promoters (CHPs) who scouted new areas throughout Richmond (roving sites) to
increase visibility and identify areas requesting harm reduction services. Despite these efforts,
most of these individuals are still primarily accessing harm reduction supplies other than syringes
(safer smoking supplies, condoms, Narcan, etc.). This is evident in the huge increase in the
number of African American clients, specifically in West County, from FY 19/20 to FYs 20/21 and
21/22 and the low number of needles exchanged by this population. One reported observation
from HEPPAC is that African Americans tend to take other harm reduction supplies (i.e.,
condoms, hygiene/wound care, safer smoking supplies, etc.) instead of sterile needles . Another
reason reported is that the physical site where services were being offered needs to be
reevaluated to serve a higher percentage of African Americans who inject drugs. HEPPAC
reports an increase in smoking as the modality of drug use rather than injecting, and this is
another reason for the increase in African American clientele at harm reduction services. In this
reporting period, HEPPAC also increased its efforts to create more access to Medically Assisted
Treatment (MAT) during Syringe Services Program (SSP) sites in East and West County with
specific focus on increasing visibility in Richmond. The agency received a grant from the Sierra
Health Foundation to increase PWID access to MAT at SSPs. With this funding, HEPPAC can
hire Substance Use Navigators (SUNs) to assist in this effort by setting up Harm Reduction SSPs
at sites that the County does not have the capacity to support.
Contra Costa Health Services
Needle Exchange Update Report to Family & Human Services Committee
October 2022
Page 7 of 24
East County Harm Reduction Services:
In East County the situation is different: Bay Point sites yield the highest volume of syringe
exchanges in Contra Costa County. The average client utilizing harm reduction services in East
County continues to be a White male between the ages of 40 -49. As demonstrated in Table 1,
the percentage of clients who identify as White has remained stable over the past three fiscal
years, and that population continues to be most needle exchange clients in the current fiscal year
as well.
New Trends Reported Among PWID:
HEPPAC staff continue to report an increase in the number of countywide participants reporting
use of prescription opioid pills that are crushed and modified for injection. This trend is reflective
of national trends and may be a contributing factor in accidental overdose deaths.
Another reported trend in drug using behavior during this reporting period is that many former
PWID are turning more to smoking as opposed to injecting their new drug of choice: fentanyl. A
study conducted by researchers from California and Washington state, published in 2021 in the
journal Drug and Alcohol Dependence, found that many people who use drugs in San Francisco
have been reducing their injection of heroin and other drugs and smoking more fentanyl instead.6
Study participants reported that smoking fentanyl, compared to injecting tar heroin and other
opioids, helped them experience better highs, better health, reduced stigma, and improved
quality of life.
This trend speaks to the importance of continuing to offer safer smoking supplies at syringe
exchange sites to reduce the risk of reuse/sharing and thus transmission of blood borne diseases
such as HIV and Hepatitis C.
Chart 3: Reported Number of Syringes Distributed by Fiscal Year
6 Transition from injecting opioids to smoking fentanyl in San Francisco, California Drug and Alcohol Dependence Volume 227, 1 October 2021,
109003.
Reported Number of Syringes Distributed by Fiscal
Year
200000
195000
190000
185000
180000
FY 19/20 FY 20/21
Fiscal Year (July-June)
FY 21/22 Number of Syringes
Contra Costa Health Services
Needle Exchange Update Report to Family & Human Services Committee
October 2022
Page 8 of 24
In FYs 20/21 and 21/22, HEPPAC continued to provide effective harm reduction services
including syringe exchange and overdose prevention services for East and West C ontra Costa
County residents. These services include collection and disposal of used syringes, distribution of
biohazard containers for disposal and future collection, one-on-one education, and intervention
with clients to promote the use of clean syringes, provide clean syringes and other tools for safer
use focused on PWIDs. In addition, the agency provides overdose prevention kits with Narcan to
those that are at risk of overdose and their peers/family members that may need to administer
the Narcan. Due to the increase in fentanyl in almost all the illicit street drugs, all drug users are
at risk. HEPPAC continues to distribute fentanyl test strips at all sites to prevent overdose deaths
among PWIDs. The permanent sites in East and West Contra Costa Count y are in the middle of
overdose “hot spots” where harm reduction services are most needed.
Referrals to Health and Social Services
Another sign of rebounding from the COVID-19 pandemic was seen in the number of referrals
made in FY 20/21 and FY 21/22 as compared to the previous year. HEPPAC reported a marked
increase in health and social services referrals from 2,889 in FY 19/20 to an average of 3,153 per
year in this reporting period. HEPPAC maintains strong linkages to health care providers,
substance use treatment services, collaborative partnerships with other community agencies, and
other resources.
HEPPAC has an established relationship with the Contra Costa Health Care for the Homeless
(HCH) program and provides them with harm reduction materials to distribute to clients,
particularly at the Antioch Fulton Shipyard site.
Syringe Disposal
One important and often overlooked aspect of syringe exchange services programs is the actual
disposal of used (formerly known as “dirty”) needles. HEPPAC’s modified needs-based model
assures that disposal of used needles occurs every week. Agency staff measure the number of
used needles they dispose of after every exchange by the size of the biohazard container they
bring back to incinerate. HEPPAC uses containers that hold increments of 10, 50, 100, 250, 300,
1,200 and 5,000 used syringes. They also provide these containers to clients to take home and
bring back full to exchange. If clients bring used needles in other containers, HEPPAC staff
estimates based on the size compared to the biohazard containers. The collection and disposal
of used needles occurs on a weekly basis and helps ensure that shared community spaces (i.e.,
playgrounds, parks, etc.) are free of used needles that may create a public health risk for county
residents.
Contra Costa Health Services
Needle Exchange Update Report to Family & Human Services Committee
October 2022
Page 9 of 24
Secondary Exchangers
In Contra Costa County, there are individuals who access harm reduction services for
themselves as well as on behalf of others. These individuals are called “secondary exchangers”.
Secondary exchangers report the estimated number of individuals for whom they exchange
syringes, summarized in Chart 4. The overall volume of secondary exchange has decreased over
the past three fiscal years, which could be the result of the COVID-19 pandemic. The number of
secondary exchangers by race and region continues to be the same with White clients in East
County accounting for most secondary exchangers reported. Because secondary exchangers
attend needle exchange more than once in a year their numbers are dupli cated. The number of
clients they exchange for is self-reported.
Chart 4: Secondary Exchanges at Needle Exchange Services
One key group of secondary exchangers with HEPPAC are the volunteers that make up the
Martinez Harm Reduction Collective (MHRC). This is a group made up of Martinez residents that
came together in 2019 to start harm reduction services in Martinez. In this reporting period,
HEPPAC continued to provide technical assistance to MHRC in the form of training and supplies,
including Narcan kits. In return, MHRC submits quarterly client service data to HEPPAC. MHRC
provided weekly harm reduction services to an average of 35 residents per week at the
Waterfront Park in the Martinez marina area.
Challenges and Response
In early May 2022, Health Services Alcohol and Other Drugs Program (AODS) received a formal
complaint from a Martinez resident regarding used syringes/needles on the ground in Waterfront
Park. The AODS Director reached out to the Health Services Public Health HIV Program who has
a contract with HEPPAC for syringe exchange. The HIV Program contacted HEPPAC to clarify
the syringe collection process being utilized by MHRC. HEPPAC confirmed that MHRC
volunteers collect used syringes from clients at their weekly exchange site in Waterfront Park as
well as provide clients with large sharps containers to keep the used needles and transport them
back to the exchange site. In addition, MHRC volunteers reported that they educate every client
to not discard used syringes on the ground and instead direct clients to the closest community
site for disposal, either the sharps containers in the Waterfront Park’s bathrooms or the
Mountainview Sanitation District in Martinez. The HIV Program Manager also spoke with a
Supervisor at Martinez Public Works who confirmed that his staff has been finding and cleaning
FY21/22 FY 20/21 FY 19/20
1497 1668
Secondary Exchanges at Needle Exchange
Services Sites
3543 Total Clients
Contra Costa Health Services
Needle Exchange Update Report to Family & Human Services Committee
October 2022
Page 10 of 24
up used syringes/needles in the Waterfront Park since he has been working there, almost twenty
years. However, he did report that there has been a higher volume of used syringes in the last
four years and that the sharps containers in the park bathrooms get full and need to be emptied
every two weeks by Public Works as part of their regular maintenance of the park facilities.
While the investigation into the complaint about used needles was ongoing, the Interim Chief of
Police for Martinez asked to meet with Health Services Public Health representatives to discuss
concerns over used syringes/needles on the ground in Waterfront Park. Representatives from
both AODS and Public Health met with the Interim Chief and provided him with data about the
harm reduction services in Waterfront Park. The Interim Chief also inquired about how the
services initially began and raised some questions about legal authority which were referred to
County Counsel.
Dr. Ori Tzvieli, Public Health Director, requested that HEPPAC pause syringe excha nge services
in Martinez Waterfront Park while the Health Department and County Counsel review the legal
questions as well as the contract with HEPPAC. MHRC was told that they can continue providing
referrals, safer sex materials, and Narcan to their clients, but the group decided to pause all
activities until advised otherwise. Clients in need of harm reduction services in Martinez are being
referred to the Richmond or Bay Point sites, where HEPPAC staff can provide them with harm
reduction services. The full impact of this pause on harm reduction activities in Martinez is
unknown at the time of this report.
Future Endeavors
In response to the service disruption in Martinez, Health Services may decide to amend the
contract with HEPPAC to include Central County as a service area for harm reduction services to
be able to identify additional or alternate locations. If this is the case, the Public Health HIV
Program will bring a resolution to a future FHS Committee meeting to describe any financial,
legal, or logistical issues to increase HEPPAC’s capacity to serve Central County clients.
Contra Costa Health Services
Needle Exchange Update Report to Family & Human Services Committee
October 2022
Page 11 of 24
Distribution Model Change
During this reporting period, the model used in Contra Costa for syringe exchange was changed
from a one-to-one model to a modified needs-based model per approval of the Board of
Supervisors. To increase the return rate (the rate of returned used needles compared to new,
sterile needles given out), HEPPAC proposed incentives for clients to bring back used needles.
As a modified version of this model, HEPPAC offers various incentives for clients to bring back
their used needles (i.e., giving them verbal praise, additional bio buckets, and when available, a
$5 voucher for a Subway sandwich). HEPPAC staff report that verbal praise is the most useful
strategy, since they let clients know how important their efforts are in keeping used syringes from
littering shared, public spaces. HEPPAC staff also place a cap on the number of sterile needles
and syringes to be received by each client based on their historical use. For example, if a client
states that they need 25 needles per day and is given 350 needles for a two -week period, but at
their next exchange encounter they report needing two or three times more needles, they will
only receive their usual allotment of 350 needles. This example only applies to individuals
exchanging for themselves and does not apply to secondary exchangers. HEPPAC staff have
demonstrated their ability to get to know their clients and their use habits, as well as documenting
previous exchanges. This information also helps HEPPAC determine the cap for each client.
Given HEPPAC’s rapport with clients and in-depth knowledge of their use, creating and enforcing
a cap has not been problematic for their staff.
In the third quarter of the first fiscal year of this report, HEPPAC began to report the total number
of new, sterile syringes given out and the total number of used syringes collected. According to
the California State Office of AIDS, the average return rate for used syringes statewide is 60%.
Contra Costa County’s HIV Prevention Program negotiated a return rate of 70% for HEPPAC in
Contra Costa. The 70% return rate has been difficult for HEPPAC to achieve in the reporting
period, and HEPPAC reported a return rate of 56%. HEPPAC has shifted focus on utilizing the
incentives described above to get more clients to bring in their used needles. In addition,
HEPPAC has increased the distribution and size of biohazard containers so that clients can bring
back larger amounts of used needles. This is additionally important for clients that come monthly
to the exchange sites since larger sharps containers can keep more used needles from being
discarded in shared community settings.
HEPPAC continues to distribute overdose prevention kits (naloxone) to individuals most likely to
experience or witness opioid overdoses. Before a kit is given, the client receives education on
how to use the kit. In FYs 20/21and 21/22, HEPPAC provided overdose education and
prevention kits to a total of 1,217 clients (equivalent to 2,542 doses of Narcan). This represents a
61% increase from FY 19/20. Late in FY 21/22 there was a national shortage of nasal Narcan
which affected HEPPAC’s ability to distribute Narcan at a high capacity as com pared to previous
quarters. HEPPAC does provide intramuscular Narcan, however, clients prefer to have the nasal
Narcan in the event of an overdose because it is easier and faster to use.
Overall, HEPPAC is performing well and will continue to provide services in both East and West
Contra Costa on a weekly basis. The Public Health program will continue to monitor and respond
to the situation in Waterfront Park and is working diligently to restore harm reduction services in
Martinez.
Contra Costa Health Services
Needle Exchange Update Report to Family & Human Services Committee
October 2022
Page 12 of 24
6000
5000
4000
3000
2000
1000
0
FY 16/17 FY 18/19 FY 19/20 FY 21/22
All Admissions Opioid Admissions
ALCOHOL AND OTHER DRUG SERVICES (AODS)
Admissions to AODS services (Chart 5) in this reporting period were up by 22.6% from FY 18/19.
The increased enrollment is attributed to several factors, including an expansion of methadone
treatment services due to increased admissions for opioid abuse treatment and increased access
due to the Affordable Care Act. Admissions are not necessarily unduplicated individuals – one
person may enter treatment multiple times during the year depending on the availability of
treatment slots.
Chart 5: All AODS Admissions and Opioid-Related Admissions*
*Note: FYs vary slightly due to differences in reporting periods prior to COVID-19. FY 16/17 refers to July
2016-June 2017; 17/18 data was not able to be pulled because it was in another system; 19/20 refers to
July 2019-December 2020; 21/22 refers to January 2021—June 2022. In the next reporting period, we will
resume reporting on single year FYs from July-June.
Contra Costa Health Services
Needle Exchange Update Report to Family & Human Services Committee
October 2022
Page 13 of 24
Total Clients Served IDU Served
FY 21/22 FY 19/20 FY 18/19 FY 16/17
6000
5000
4000
3000
2000
1000
0
Of the 5,337 admissions this reporting period (Jan 2021—June 2022), roughly 15.1% identified
injection drug use behavior (Chart 6). The proportion of injection drug users to the overall
population in AODS services has noticeably decreased compared to previous years: FY 16/17
(28%), FY 18/19 (24%), FY 19/20 (16%), FY 21/22 (10.4%).
This trend may be attributed to the changing behaviors and the prevalence of fentanyl as detailed
above.
Chart 6: Total Clients Served and IDUs as a Proportion of all AOD Services*
*Note: FYs vary slightly due to differences in reporting periods prior to COVID-19. FY 16/17 refers to July
2016-June 2017; 17/18 data was not able to be pulled because it was in another system; 19/20 refers to
July 2019-December 2020; 21/22 refers to January 2021—June 2022. In the next reporting period, we will
resume reporting on single year FYs from July-June.
Contra Costa Health Services
Needle Exchange Update Report to Family & Human Services Committee
October 2022
Page 14 of 24
African American White Hispanic
FY 20/21 FY 19/20 FY 18/19 FY 16/17
3000
2500
2000
1500
1000
500
0
As seen in Chart 7, the overall percentage of African Americans enrolled in services has
remained similar to previous years, representing 22% of those served in 2018/19, 19% in FY
19/20, and 21% in 2021/22. The percentage of Hispanics enrolled in services has decreased
slightly, going from roughly 27% of those served in past years to 21% in 2021/22. Normally over
half of service enrollees, White participants also decreased to 45% in 2021/22.
Chart 7: Enrollment in AODS Sites over Time by Primary Race/Ethnicity*
*Note: FYs vary slightly due to differences in reporting periods prior to COVID-19. FY 16/17 refers to July
2016-June 2017; 17/18 data was not able to be pulled because it was in another system; 19/20 refers to
July 2019-December 2020; 21/22 refers to January 2021—June 2022. In the next reporting period, we will
resume reporting on single year FYs from July-June.
Contra Costa Health Services
Needle Exchange Update Report to Family & Human Services Committee
October 2022
Page 15 of 24
6000
5000
4000
3000
2000
1000
0
FY 16/17 FY 18/19 FY 19/20 FY 20/21
Total Clients Served New (No Prior Enrollment)
Nearly 44% of those served in FY 21/22 (Chart 8) are new enrollees, a slight decrease from
19/20, which was 47%.
Chart 8: New Enrollees in AODS Services*
*Note: FYs vary slightly due to differences in reporting periods prior to COVID-19. FY 16/17 refers to July
2016-June 2017; 17/18 data was not able to be pulled because it was in another system; 19/20 refers to
July 2019-December 2020; 21/22 refers to January 2021—June 2022. In the next reporting period, we will
resume reporting on single year FYs from July-June
Contra Costa Health Services
Needle Exchange Update Report to Family & Human Services Committee
October 2022
Page 16 of 24
Chart 9 shows a decrease in enrollees who reported being homeless at the time -of- service
initiation. In FY 2018/19, 32% of total clients enrolled reported being homeless, in 19/20 it was
29%, and in 21/22 it was 23%.
Chart 9: Homeless Proportion of Enrollment in AOD Services*
*Note: FYs vary slightly due to differences in reporting periods prior to COVID-19. FY 16/17 refers to July
2016-June 2017; 17/18 data was not able to be pulled because it was in another system; 19/20 refers to
July 2019-December 2020; 21/22 refers to January 2021—June 2022. In the next reporting period, we will
resume reporting on single year FYs from July-June.
AODS Program Highlights
During this reporting period, AODS expanded its services network by adding two new Narcotic
Treatment Programs (NTP) to provide Medication Assisted Treatment (MAT) for Opioid Use
Disorders: BAART Clinic in Concord and Harmonic Solutions in Walnut Creek. The BAART
Concord Clinic and Antioch Clinic also provide HIV/HCV screening for clients as needed, and
clients in need of treatment and other services receive on -site care and warm handoffs to the
HIV/AIDS and STD Program.
Beginning in April 2022, AODS fully integrated substance abuse counselors with the Medical
Team in Detention Facilities to provide SUD treatment in the jail and linkages to SUD treatment
post release. This effort also focuses on continuity of care post release to facilitate re -entry
through recovery support services.
AODS currently has two Nuevos Comienzos (New Beginnings) groups for Spanish speaking
clients in need of lower-level SUD treatment. Nuevos Comienzos is an effort to address health
inequities and the low utilization rate of SUD treatment in the Spanish speak ing population.
AODS is also part of the larger community of harm reduction services in Contra Costa. They
coordinate with the East Bay Harm Reduction coalition by distributing Narcan at needle exchange
sites and engage clients into SUD treatment. AODS provides training and distribution of
Naloxone across all Recovery Residences, also known as Sober Living Environments (SLE).
Clients Reporting Homelessness Total Clients Served
FY 21/22 FY 19/20 FY 18/19 FY 16/17
6000
5000
4000
3000
2000
1000
0
Contra Costa Health Services
Needle Exchange Update Report to Family & Human Services Committee
October 2022
Page 17 of 24
OTHER PREVENTION ACTIVITIES FOR INJECTION DRUG USE
Opioid Agonist Therapy
As abuse of prescription opioids rises and as more individuals inject drugs like heroin, the risk of
increased blood borne illnesses such as HIV and Hepatitis C also increases. Their investigation
of HIV prevention programs for injection drug users revealed that opioid agonist therapy (OAT)
options, most commonly methadone and buprenorphine maintenance therapies, are the most
cost effective. OAT options can also be highly effective in helping people stop injecting drugs
over time and combining prevention efforts such as needle-syringe exchanges, OAT, Pre-
Exposure Prophylaxis (PrEP), and prevention and testing with high -risk negatives have higher
rates of success than standalone interventions.78
Contra Costa’s Choosing Change (CHOCH) initiative provides effective treatment for people
who want to stop using opioids such as heroin, prescription painkillers like oxycodone, and
similar drugs. The program provides buprenorphine medication combined with a group visit,
recovery-focused therapy. Highlights from CHOCH during this reporting period include:
• Currently offering 14 clinics associated with 6 health centers throughout Contra Costa County
(see CHOCH Table 2 below)
• Sublocade (long-acting) injectable form of buprenorphine now available weekly at the Miller
Wellness Center in Martinez
• Groups are currently being held via telehealth Zoom, with demonstrated success in engaging
patients through this model of care
• CHOCH referrals can be placed directly by CCHS system providers within ccLink or through the
AODS Access line
• For patients needing more intensive treatment, CHOCH can assist in connecting to inpatient and
outpatient services
• Substance Use Navigators stationed at CCRMC are associated with CHOCH and connect
patients seen in the ED to program services
8 https://med.stanford.edu/news/all-news/2017/05/study-identifies-cost-effective-ways-to-combat-hiv-risk.htm
Contra Costa Health Services
Needle Exchange Update Report to Family & Human Services Committee
October 2022
Page 18 of 24
Tables 2-4: Choosing Change Patient Demographics
Table 2: Patients Served by Primary Clinic
Table 3: Patients by Race
Table 4: Patients with HIV
Contra Costa Health Services
Needle Exchange Update Report to Family & Human Services Committee
October 2022
Page 19 of 24
Alameda & Contra Costa County Integrated HIV Prevention & Care Plan
Contra Costa County HIV/AIDS & STD program staff and Consortium members assisted in the
development of the regional 2017 - 2021 Alameda & Contra Costa County Integrated HIV
Prevention & Care Plan. Although the plan has not yet been
updated for the next five years, it is referenced to evaluate care and prevention efforts in both
counties. Key prevention components of the plan that focus on PWID include:
1. Through a collaboration involving the Oakland Transitional Grant Area (OTGA) Planning
Council, the Contra Costa HIV Consortium, and the two county health departments, develop
an End of AIDS Action Plan for the Oakland TGA that outlines steps to implement a
collaborative, multidisciplinary campaign to end HIV in the two-county region, including
ending new HIV infections, ending HIV-related deaths, and ending HIV related stigma.
2. Continually collect and report data on new HIV diagnoses in the OTGA, including
breakdowns by ethnicity, gender, transmission category, and age.
3. Conduct ongoing needs assessments to identify emerging issues related to HIV infection and
access to HIV education, testing, and other resources.
4. Deliver targeted, sustained, and evidence-based HIV prevention interventions that are
appropriate for high-risk populations.
5. Support the development of expanded, tailored, HIV-related stigma reduction campaigns in
English and Spanish that are aimed at specific, high-risk subpopulations and are developed
in collaboration with consumers; that address stigma related to HIV, homophobia, and HIV
risk behaviors; that incorporate cutting-edge social media approaches; and that contain sex-
positive messages.
6. Utilize targeted social marketing, media, mobilization and condom distribution programs in
English and Spanish to raise and sustain awareness of HIV risk.
7. Ensure widespread, accessible, and well-publicized syringe distribution and syringe
exchange services.
The Integrated HIV Prevention & Care Plan targets the highest risk populations including men
who have sex with other men and injection drug users, for HIV prevention and care services.
Needle exchange remains an integral component of the plan. In Contra Costa County, we
anticipate continuing the use of County General Funds for needle exchange services to support
the downward trend in HIV infections attributed to injection drug use. The current plan can be
found on the Public Health website at http://cchealth.org/aids.
Data-to-Care Programs
Data-to-Care is a public health strategy that aims to use HIV and STD surveillance data to
identify HIV-diagnosed individuals and those at highest risk for HIV not in care, link them to care.
In this reporting period, the HIV/AIDS & STD Program continued to offer two data-to-care
interventions that prioritize high-risk individuals: 1) targeted outreach to individuals who have
been recently diagnosed with an STD, including individuals who are co -infected with HIV and
STDs, and 2) a PrEP Navigation Program for county residents.
PrEP (pre-exposure prophylaxis) is the use of anti-retroviral medication to prevent acquisition of
HIV infection. It is used by HIV-negative persons who are at high risk of being exposed to HIV. At
Contra Costa Health Services
Needle Exchange Update Report to Family & Human Services Committee
October 2022
Page 20 of 24
present, there are currently three medications with US Food and Drug Administration (FDA)
approved indication for PrEP that are either taken as a daily pill or by an injection and are both
highly effective at protecting individuals from HIV. Both indications are approved for both adults
and adolescents ages 12 and over who weigh at least 35 kilograms (77 pounds).
Truvada® and Descovy® for PrEP
At present, there are two medications with an FDA-approved indication for daily use PrEP:
tenofovir disoproxil fumarate-emtricitabine, which is available as a fixed-dose combination in a
tablet called Truvada® and emtricitabine & tenofovir alafenamide tenofovir, which is available in a
fixed-dose combination in a tablet called Descovy®. When taken daily, studies have shown that
both Truvada® and Descovy® reduce the risk of getting HIV from sex by about 99% and by at
least 74% among people who inject drugs.9 Both medications are also commonly used in the
treatment of HIV. The main difference is that Descovy® for PrEP is recommended to prevent HIV
for people at risk through sex, excluding people at risk through receptive vaginal sex.
Descovy® has not yet been studied for HIV prevention for receptive vaginal sex, so it may not be
appropriate for some people.
Injectable PrEP
On December 20, 2021, the FDA approved one injectable pre-exposure prophylaxis (PrEP)
medication: cabotegravir (CAB) 600 mg (brand name Apretude®). CAB is a single antiretroviral
drug given as an intramuscular injection every 2 months to prevent HIV. CAB is approved for
cisgender men, transgender women, and cisgender women. CAB injections may be a good
option for PrEP for people who:
• Have problems taking oral PrEP as prescribed.
• Prefer getting a shot every 2 months instead of taking oral PrEP.
• Have serious kidney disease that prevents use of oral PrEP medications.
CAB is FDA approved as an intramuscular injection in the buttocks initiated as a first injection
followed by a second injection 1 month after the first and then continued with an injec tion every 2
months thereafter. A 4-week lead-in period of 30 mg daily oral CAB prior to the first injection is
optional for patients who are worried about side effects.
All forms of PrEP should be considered as part of a comprehensive prevention
plan that includes adherence, risk reduction counseling, HIV prevention education and provision
of condoms and requires follow-up with a provider to assess for HIV and STI testing at regular
intervals
The Line List targeted outreach intervention consists of generating lists that are pulled from State
and County surveillance systems. These line lists are focused on three high - risk populations:
MSMs recently diagnosed with one or more STD, women of color (African American and Latinas)
recently diagnosed with one or more STD, and individuals co-infected with HIV and STD(s).
Trained Disease Intervention Technicians (DITs) call the individuals on the line lists and offer risk
reduction services, partner services, and, in the case of people who do not have HIV, Pre -
Exposure Prophylaxis (PrEP) navigation services. In this reporting period, DITs provided risk
reduction services to a total of 624 individuals (594 HIV negative and 30 PLHIV).
9 https://www.cdc.gov/hiv/basics/prep.html
Contra Costa Health Services
Needle Exchange Update Report to Family & Human Services Committee
October 2022
Page 20 of 24
OPIOID OVERDOSE
Opioids are medications that relieve pain. They reduce the intensity of pain signals reaching the
brain, diminishing the effects of a painful stimulus. Medications that fall within this class include
hydrocodone (e.g., Vicodin), oxycodone (e.g., OxyContin, Percocet), morphine (e.g., Kadian,
Avinza), codeine, and related drugs. Hydrocodone products are the most prescribed for a variety
of painful conditions, including dental and injury-related pain. Morphine is often used before and
after surgical procedures to alleviate severe pain. Codeine is often prescribed for mild pain. In
addition to their pain-relieving properties, some of these drugs—codeine and diphenoxylate
(Lomotil) for example—can be used to relieve coughs or severe diarrhea.
Heroin is an opioid drug that is synthesized from morphine. In 2020, 902,000 Americans reported
using heroin in the past year, a number that has been on the rise since 2007. The greatest
increase in heroin use has been seen in young adults 18- 25.10
Chart 10: Past Heroin Use among People Aged 12 or Older (2017—2020)
10 https://www.drugabuse.gov/publications/research-reports/heroin/scope-heroin-use-in-united-states
Contra Costa Health Services
Needle Exchange Update Report to Family & Human Services Committee
October 2022
Page 22 of 24
Data from 2011 showed that nearly 80% of Americans using heroin report misusing prescription
opioids first, and it is estimated that about 23% of individuals who use heroin become dependent
on it.11 Prescription opioid pain medications such as Oxycontin and Vicodin can have effects
similar to heroin when taken in doses or in ways other than prescribed, and they are currently
among the most commonly abused drugs in the United States.
The California Department of Health reported 5,502 opioid -related overdose deaths in 2020 and
6,843 in 2021, this marks a steady rise since 2018 when 2,428 were reported.12 In Contra Costa
County, there were 144 opioid deaths in 2020 and 180 in 2021,13 which is a marked increase
from the 84 opioid overdose deaths reported in 2018.14 All regions of the county have
experienced fatal overdoses, emergency department visits, and hospitalizations due to opioid
overdose.
Recognizing the life-saving effects of the opioid-overdose reversal drug naloxone, Senate Bill
(SB) 833 (Chapter 30, Statutes of 2016) established a new Naloxone Grant Program within the
California Department of Public Health (CDPH).15 The goal of the program was to reduce fatal
overdoses by increasing access to naloxone nasal spray called Narcan.
In 2017-2019, the HIV/AIDS and STD Program administered the Naloxone Grant Program by
distributing the county’s 1,642 State-allotted doses to local community agencies with existing
naloxone distribution systems and those working with individuals most likely to experience or
witness opioid overdoses.
After this successful pilot program, the California Department of Health Care Services began
providing free naloxone directly to organizations and entities.
DISPOSAL
Contra Costa Environmental Health (CCEH) administers the Medical Waste Management
Program for Contra Costa County and is the local enforcement and regulatory agency for Medical
Waste Generators. CCEH issues permits and registers generators of medical waste, responds to
complaints of abandoned medical waste on public property, and implements the Medical Waste
Management Act (Part 14, C. 1-11 of the California Health and Safety Code). The agency web
site maintains a list of frequently asked questions (FAQs) on syringe and needle disposal, a list of
disposal sites in Contra Costa, several pamphlets describing the proper disposal of syringes and
other medical waste, as well as links to state and other resources. Additional information can be
found at https://cchealth.org/eh/medical-waste/faq.php and
https://safeneedledisposal.org/search-results/ .
11 http://www.drugabuse.gov/publications/drugfacts/heroin
12 https://skylab.cdph.ca.gov/ODdash/?tab=Home
13 2021 data is preliminary and may increase slightly.
14 https://pdop.shinyapps.io/ODdash_v1/
15 https://www.cdph.ca.gov/Programs/CCDPHP/DCDIC/SACB/Pages/NaloxoneGrantProgram.aspx
Contra Costa Health Services
Needle Exchange Update Report to Family & Human Services Committee
October 2022
Page 23 of 24
The Public Health HIV/AIDS and STD program has received one complaint from a community
member regarding discarded syringes on the ground this year as reported earlier.
Contra Costa Regional
Medical Center Sheriff's
Substation - New
2500 Alhambra Ave.,
Martinez
Accepts all household
pharmaceutical waste
Open to all residents
Monday - Friday 8 a.m. – 5
p.m.
CCC Sheriff's Field Accepts all household Monday - Friday 8 a.m. –
Operations Building - New pharmaceutical waste 5 p.m.
1980 Muir Road, Open to all residents
Martinez
Walnut Creek City Hall - New
1666 North main
Street, Walnut Creek
West County Household
Hazardous Waste Facility
101 Pittsburg Ave.,
Richmond
Delta Household Hazardous
Waste Collection Facility
2500 Pittsburg -
Antioch Highway,
Pittsburg
Accepts all household
pharmaceutical waste
Open to all residents
Accepts non-controlled
household
pharmaceutical waste
Open to West County
residents only
Accepts non-controlled
household
pharmaceutical waste.
Open to East County
residents only
Monday - Friday 8 a.m. – 5
p.m.
Thursday, Friday, and First
Saturday of every month 9
a.m. - 4 p.m.
(Closed 12 - 12:30 p.m. for
lunch)
Thursday, Friday, and
Saturday 9 a.m. - 4 p.m.
Contra Costa Health Services
Needle Exchange Update Report to Family & Human Services Committee
October 2022
Page 24 of 24
CONCLUSIONS:
1. Access to new, sterile syringes/needles has made a difference in Contra Costa and
remains an important component of the overall strategy to reduce transmission of blood borne
diseases.
2. Law enforcement exposure to potential blood borne pathogens via needle stick injury has
not increased with the implementation of needle exchange and pharmacy sales. Materials for
Law Enforcement to document potential exposure and request assistance are available on the
website.
3. Needle exchange is a critical component and essential service of Contra Costa’s HIV
prevention strategy and should remain in effect until further notice. Needle exchange is also
the primary strategy that addresses Contra Costa’s opioid epidemic by increasing naloxone
access and linking people to substance use treatment programs.
FAMILY AND HUMAN SERVICES COMMITTEE 6.
Meeting Date:10/24/2022
Subject:Rapid Response and Innovative Partnerships
Submitted For: FAMILY & HUMAN SERVICES COMMITTEE,
Department:County Administrator
Referral No.: 110
Referral Name: Innovative Community Services
Presenter: Marla Stuart, EHSD Director, and Tamina Alon, Interim Assistant
Director Policy & Planning
Contact: Danielle Fokkema, (925)
655-2047
Referral History:
On January 6, 2015 the Board of Supervisors referred oversight and receipt of updates on the Employment and Human
Services Department's (EHSD) Innovative Community Partnerships to the Family and Human Services Committee (FHS). On
June 7, 2016, the Board approved expanding FHS Referral No. 110 "Innovative Community Partnerships" to include the
subject of Whole Family Services. This change was necessary to incorporate a major EHSD initiative, which refocuses
client-facing benefit eligibility to assess the status and needs of the “whole family” while they are also determining benefit
eligibility. Key to the new initiative is working with community partners to form a network of family resource centers in
current place-based centers such as SIT (Service Integration Team) and SparkPoint sites, Family Justice Centers, First 5
centers, et al.
On November 23, 2020, the Family and Human Services Committee received the most recent annual report on Innovative
Community Partnerships.
Referral Update:
Attached is a status report and presentation on EHSD's Innovative Community Partnerships program.
Recommendation(s)/Next Step(s):
ACCEPT the attached report on the Employment and Human Services Department’s Innovative Community Partnerships.
Fiscal Impact (if any):
There is no fiscal impact; the report is informational only.
Attachments
Rapid Response and Innovative Partnerships Presentation
Presentation to the Family and Human Services Committee –October 24, 2022
Marla Stuart, MSW, PhD
Director, Employment and Human Services Department
mstuart@ehsd.cccounty.us
COVID Rapid Response & Innovative Partnerships
1
Table of Contents
•Social Services Rapid Response
•New Innovative Partnerships
2
COVID Response Designed for Partnership
3
Social Service Rapid Response Team (SSRRT)
4
2,300 Number of families referred
to SSRRT
Highlights
The Social Services Rapid Response Team (SSRRT): 4 Our Families Navigators
responded to the need for service coordination between EHSD and community
partners during the COVID pandemic.
Active: March 2020 to March 2022.
Number of service connections
provided to families5,000
89%Percent of families receiving all services they
requested
94%Percent of families receiving at least one
service requested
Children’s Well Being Task Force
5
872 Number of requests for emergency
childcare made to CocoKids
Highlights
EHSD partnered with CocoKids, the Office of
Education, First 5 Contra Costa, the Local Planning
Council, and Contra Costa Health Services to
provide Emergency Child Care.
Active: March 17, 2020 to June 5, 2020.
Number of children of essential
workers that participated in the
program
565
405 Number of state-funded emergency
childcare subsidies issued to
essential worker families
Food and Nutrition Task Force
6
140,000 Number of restaurant-prepared meals
delivered to vulnerable older adults through
Great Plates Delivered
Highlights
EHSD collaborated with Contra Costa Health Services, Meals on
Wheels, Food Bank of Contra Costa/Solano and numerous other
community organizations to provide robust and consistent
support to Contra Costa residents dealing with food insecurity.
Active: May 2020 to March 2021
Number of meals delivered through Senior
Nutrition Program contracts36,000+
Equitable Economic Recovery Task Force
7
1,750
Number of engagements with
businesses and individuals through the
Workforce Development Board’s
#BounceBackContraCosta initiative
Highlights
EHSD’s Workforce Development Board partnered with Contra
Costa Economic Partnership (CCEP), 20+ local businesses,
community leaders, and displaced workers to support job
creation, identify and promote policies to retain local employers,
and expand training and employment connections for those
disproportionately impacted by pandemic-related layoffs.
Active: July 2020 and June 2021
Actionable
Recommendations were
made to the Contra Costa
Board of Supervisors
10
Family Violence Prevention Task
Force
8
Highlights
EHSD’s Alliance to End Abuse partnered with
Contra Costa Public Health, Child Abuse
Prevention Council, First 5 Contra Costa, and the
Family Justice Center to move forward
interpersonal violence prevention goals and
strategies outlined in Contra Costa County’s Call
to Action: Preventing Interpersonal Violence
Active: March 2020 to December 2020
30+Number of partnered agencies
that engaged in the Task Force
Measure X
9
Refugee Assistance
10
•Contract with Jewish Family Community Services
approved by the Board of Supervisors October 4, 2022
for $979,800, sent to contractor for signature October
10, 2022.
•Up to $5,000 will be provided per each participant
receiving services.
•Scope of work includes direct assistance, community-
based services, case management and legal services.
•Monthly progress reports will include the number of
refugees served and related expenses.
Children’s Services
11
•Three areas of need are being targeted to provide additional
support for young children and the professionals who serve
them.
•0-5 Children with Disabilities: Supports children with
disabilities as needed to be independent and included
in society.
•MOU in process
•0-5 Child Care: Reduces the shortage of childcare slots.
•RFI in development
•Child Care Retention and Incentive:Supports an
immediate retention strategy to help keep the
workforce afloat until a more permanent solution is
found.
•RFI in development.
Youth Centers
12
RFI for Youth Center Planning Management closed 9/20/22; 2
responses received.
Next steps:
•Reader Rater Evaluation Period week of 10/17/22
•Reader/Rater Evaluation Discussion 10/27/22
•Estimated Recommendation of Award/s 11/9/22
•Estimated Contract Negotiation/Development 12/22
•Estimated Date for BOS Contract Approval 1/25/23
•Estimated Process End Date 1/31/23
•Estimated Contract Start Date 2/1/23
•Estimated Report to BOS w/Program Plan 2/15/2023
•Estimated Release of RFP for Second Phase 1/1/2024
Master Plan on Aging
13
RFP issued and vendor selected.
•Working on finalizing the contract with Collaborative
Consulting, Inc.for $195,000 to include the following services:
•Gather data and conduct an ecosystem mapping of
agencies, services, coalitions, and efforts in Contra
Costa County to support older persons, adults with
disabilities, and family caregivers.
•Facilitate countywide planning meetings with
community stakeholders.
•Develop the Contra Costa Local Playbook, and
actionable plan for implementing Governor Newsom’s
Master Plan for Aging locally.
•Community event in support of local Master Plan on Aging
November 17, 2022 at Pleasant Hill Community Center.