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HomeMy WebLinkAboutBOARD STANDING COMMITTEES - 02272023 - FHS Cte Agenda PktFAMILY & HUMAN SERVICES COMMITTEE February 27, 2023 10:30 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). To participate virtually via Zoom: https://cccounty-us.zoom.us/j/89781442970?pwd=T3JqbUlNT1QvR0xKYWVLRnFyQ3Q3dz09 To participate by telephone: USA 214 765 0478 USA 888 278 0254 (US Toll Free) Conference code: 382517 To indicate you wish to speak on an agenda item via Zoom, please “raise your hand” in the Zoom application. If you are joining the meeting via a telephone, you may dial *2 using your phone’s dial pad Supervisor Candace Andersen, Chair Supervisor Ken Carlson, 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 November 28, 2022 Family and Human Services Committee (FHS) Meeting. (Danielle Fokkema, FHS Staff) 4.CONSIDER recommending to the Board of Supervisors the appointment of Liliana Gonzalez to the First 5 seat on the Family & Children’s Trust Committee (FACT) with a term expiring September 30, 2024 and the appointment of Erin Cabezas to the Mental Health seat on the FACT with a term expiring September 30, 2023, as recommended by the Employment and Human Services Department. (Laura Malone, FACT Staff) 5.CONSIDER recommending to the Board of Supervisors the appointment of Cate Burkhart to the City of Richmond Local seat on the Contra Costa Advisory Council on Aging (ACOA) with a term expiring September 30, 2024 and the appointment of Thomas Lang to the At-Large Alternate #4 seat on the ACOA with a term expiring September 30, 2023, as recommended by the Employment and Human Services Department. (Ana Bagtas, ACOA Staff) 6.CONSIDER recommending to the Board of Supervisors the appointment of Sean Laurant to the Governmental and Economic and Community Development Seat #1 of the Workforce Development Board for a term expiring June 30, 2027, as recommended by the Workforce Development Board and the Employment Human Services Department. (Tamia Brown, WDB Executive Director) 7.CONSIDER accepting the annual reports on the Policy Options for Protecting Youth from Tobacco Influences in FHS Feb 23 2023 Packet Page 1 of 174 7.CONSIDER accepting the annual reports on the Policy Options for Protecting Youth from Tobacco Influences in the Retail Environment and the Secondhand Smoke Protections ordinances, including program and funding recommendations for cannabis education; and directing staff to forward the reports to the Board of Supervisors for their information, as recommeded by the Health Services Department and Public Health Officer. (Sefanit Mekuria, MD, MPH, Deputy Health Officer; and Mayra Lopez, Tobacco Prevention Program Manager) 8.DISCUSS the issues presented and the policy option recommendations from the Health Services Department Public Health Division staff on the topic of Healthy Options at Point of Sale and DIRECT staff on the appropriate next steps for further discussion and considerations on the topics presented. (Ali Wohlgemuth, Ingrid De Santiago, Denise Milosevich, Mayra Lopez, and HOPS Youth Advocates) 9.CONSIDER accepting the Council on Homelessness (COH) Quarter 4 report, directing staff to forward the report to the Board of Supervisors for their information, and consider recommending that the Board of Supervisors direct County departments to build on partnerships created through Measure X, Homekey, and CalAIM to maximize funding and resources to people experiencing homelessness in the County. (Jaime Jenett, Staff to the COH) 10.CONSIDER approving the 2023 Family and Human Services Committee meeting schedule, meeting format and work plan. (Danielle Fokkema, FHS Staff) 11.The March 27th meeting is canceled. The next meeting is tentatively scheduled for March 23, 2023. 12.Adjourn The Family & Human Services Committee will provide reasonable accommodations for persons with disabilities planning to attend Family & Human Services Committee meetings. Contact the staff person listed below at least 72 hours before the meeting. Any disclosable public records related to an open session item on a regular meeting agenda and distributed by the County to a majority of members of the Family & Human Services Committee less than 96 hours prior to that meeting are available for public inspection at 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 FHS Feb 23 2023 Packet Page 2 of 174 FAMILY AND HUMAN SERVICES COMMITTEE 3. Meeting Date:02/27/2023 Subject:Record of Action for the November 28, 2022 Meeting 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 November 28, 2022 Family and Human Services Committee meeting. Recommendation(s)/Next Step(s): RECEIVE and APPROVE the Record of Action for the November 28, 2022 Family and Human Services Committee meeting, including the Assisted Outpatient Treatment Program presentation slides that were revised after the meeting agenda publication and as presented at the meeting. Fiscal Impact (if any): There is no fiscal impact. Attachments 11-28-22 Record of Action Updated AOT Presentation FHS Feb 23 2023 Packet Page 3 of 174 D R A F T FAMILY AND HUMAN SERVICES COMMITTEE RECORD OF ACTION FOR November 28, 2022 Supervisor Candace Andersen, Chair Supervisor Ken Carlson, Vice Chair Present: Diane Burgis, Chair    Candace Andersen, Vice Chair    1.Introductions Chair Burgis called the meeting to order at 9:01 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 October 24, 2022 Family and Human Services Committee meeting. The Committee approved the Record of Action for the October 24, 2022 meeting as presented. AYE: Chair Diane Burgis  Vice Chair Candace Andersen  4.RECOMMEND to the Board of Supervisors the appointment of Steven A. France to the Education & Training Seat #1 of the Workforce Development Board with a term expiring June 30, 2026. The Committee approved the appointments for Board of Supervisor approval as recommended. AYE: Chair Diane Burgis  Vice Chair Candace Andersen  5.CONSIDER recommending to the Board of Supervisors the reappointment of Audra Carrion to the At-Large 1 seat, the appointment of Shelley Clark to the At-Large 2 seat, and the appointment of Alejandra Chamberlain to the School Representative Seat on the Family & Children’s Trust Committee (FACT) with terms expiring September 30, 2024, and the appointment of Kirsten Rigsby to the At-Large 3 seat and the appointment of Yvonne Wadleigh to the At-Large 4 seat on the FACT with terms expiring on September 30, 2023, as recommended by the Employment and Human Services Department. The Committe approved the appointments for Board of Supervisor approval as recommended. FHS Feb 23 2023 Packet Page 4 of 174 AYE: Chair Diane Burgis  Vice Chair Candace Andersen  6.1. RECEIVE and ACCEPT the recommended changes to the Council on Homelessness bylaws; and 2. RECOMMEND to the Board of Supervisors the reappointment of the following candidates for seats on the Council on Homelessness for two-year terms through December 31, 2024: 1) Affordable Housing Developer, Iman Novin, Novin Development; 2) Behavioral Health, Margaret Schlitz, The Hume Center; 3) City Government, Teri House, City of Antioch; 4) Educational/Vocational, Alejandra Chamberlain, CC Office of Education; 5) Emergency Solutions Grant, Gabriel Lemus, Dept. of Conservation and Development; 6) Healthcare, Maria Fairbanks, Healthcare for the Homeless; 7) Homeless Service Provider, Deanne Pearn, Hope Solutions; 8) Lived Experience Seat #1, Juno (Renee) Hedrick; and 9)Lived Experience Seat #2 [pending approval by BOS of creation of the second Lived Experience Seat through pending Bylaws revisions], Jo Bruno; 3. RECOMMEND to the Board of Supervisors the appointment of the following candidates for seats on the Council on Homelessness for 2-year terms: 1) Veteran, Jai De Lotto, Department of Veteran Affairs; 2) Workforce Development; Janae Thomas, Swords to Plowshares; and 3) Youth, Anastasia Padilla. 4. ACCEPT the Council on Homelessness Q3 report; and 5. DIRECT staff to forward the Q3 report to the Board of Supervisors for their information, and the bylaws revisions and seat appointments to the Board of Supervisors for their approval. The Committee approved the recommended changes to the bylaws and directed staff to forward to the Board of Supervisors for their approval. The Committee approved the appointments and reappointments and directed staff to forward to the Board of Supervisors for their approval. The Committee accepted the Council on Homelessness Q3 report and directed staff to forward the Q3 report to the Board of Supervisors for their information. The Committee discussed reducing the Law Enforcement seats from two to one and adding a seat for lived experience. Committee members also requested that attendance records be examined for reappointments. During Public Comment there was a suggestion that a seat be created for the voice of landlords. Committee members requested that the Council of Homeless prepare a report in the first quarter of 2023. The report should address the issues surrounding the Governors funding, where resources are going for Care Courts and how landlords can partner with the County to reduce homelessness. AYE: Chair Diane Burgis  Vice Chair Candace Andersen  7.ACCEPT the report from the Employment and Human Services Department on Aging and Adult Services, FHS Feb 23 2023 Packet Page 5 of 174 7.ACCEPT the report from the Employment and Human Services Department on Aging and Adult Services, including the Master Plan on Aging. The Committee accepted the report and Supervisor Anderson requested that this be brought as a Discussion Item to the full Board of Supervisors sometime in the first quarter of 2023. AYE: Chair Diane Burgis  Vice Chair Candace Andersen  8.ACCEPT the cumulative evaluation survey summary from the Health Services Department on the implementation of Laura’s Law – Assisted Outpatient Treatment (AOT) program during the period July 2020 through June 2021, DIRECT staff to forward the report to the Board of Supervisors for their information, and DIRECT the Department to forward future survey summaries annually and directly to the Board of Supervisors for their information. The Health Services Department's consultant RDA Consulting presented a PowerPoint presentation that was slightly different from the one included in the agenda packet. The Committee accepted this but requested that the updated PowerPoint be included with the meeting minutes. The Committee accepted the report and approved staff forwarding it to the Board of Supervisors for their information. The Committee approved the department to forward survey summaries annually and directly to the Board of Supervisors for their information. AYE: Chair Diane Burgis  Vice Chair Candace Andersen  9.The next meeting is currently scheduled for January or February 2023 on a date to be determined. 10.Adjourn Chair Burgis adjourned the meeting at 10:59 a.m. For Additional Information Contact:  Danielle Fokkema, Committee Staff Phone (925) 655-2047, Fax (925) 655-2066 Danielle.Fokkema@cao.cccounty.us FHS Feb 23 2023 Packet Page 6 of 174 Contra Costa County Assisted Outpatient Treatment Program FY 2020-2021 DHCS AOT Outcome Evaluation November 2022 FHS Feb 23 2023 Packet Page 7 of 174 2 FY 2020-2021 DHCS AOT Outcome Evaluation Purpose of the Evaluation • Meet state-mandated reporting requirements for AOT programs: • CQI process to support the AOT program to meet its intended goals. Evaluation Activities & Details •Secondary data analysis on Pre-AOT and AOT Enrollment between July 1, 2020 - June 30, 2021. •BHS & MHS Data Sources: □Referrals, investigations, & petitions □Service utilization, jail bookings, & assessments Enrollment & Engagement Skills & Functioning Treatment & Services Legal & Safety FHS Feb 23 2023 Packet Page 8 of 174 3 DHCS Changes & Other Considerations Changes to DCHS AOT Reporting Tool • Updated format, distribution, & submission • Expanded & reformatted questions •DHCS reporting is focused on court-involved consumer sample Other Evaluation Considerations •Staff turnover had implications for evaluation timing, data, & approach •COVID-19 impacted agency data collection processes • Housing and employment data are self-reported FHS Feb 23 2023 Packet Page 9 of 174 Pre-AOT Enrollment SECTION TWO 4 FHS Feb 23 2023 Packet Page 10 of 174 5 Referrals to AOT Total number of people referred to Contra Costa’s AOT Program during FY20-21 108 Total number of people found statutorily ineligible for the AOT program during FY20-21 31 Average number of investigation days for prospective AOT consumers during FY20-21 83 (FY19-20 Total: 117) Fiscal Year 20-21 FY20-21 Range: 2-248(FY19-20 Total: 21) FHS Feb 23 2023 Packet Page 11 of 174 6 FMH Investigation & MHS Outreach Investigation Outcome Referred Consumers Referred to MHS 19% (n=21) Engaged or Re-Engaged with other Provider or Program 26% (n=28) Investigated and Closed 55% (n=59) On average, the initial outreach period was one month (34 days) for all consumers. At minimum, initial outreach took two days and at maximum, over three months (101 days). Fiscal Year 20-21 FHS Feb 23 2023 Packet Page 12 of 174 AOT Enrollment SECTION THREE 7 FHS Feb 23 2023 Packet Page 13 of 174 8 Enrollment Status Total number of consumers who received voluntary services during FY20-21 106 Total number of court-involved consumers served during FY20-21 15 Total number of court-involved consumers petitioned in FY19-20 that continued receiving services in FY20-21 2 (FY19-20 Total: 77) Fiscal Year 20-21 (FY19-20 Total: 9)(FY19-20 Total: 11) FHS Feb 23 2023 Packet Page 14 of 174 9 Hospitalizations (N=15) Fewer court-involved consumers experienced hospitalizations during AOT enrollment compared to pre-AOT enrollment for FY20-21. Total number of hospitalization days reduced between pre-AOT enrollment to during AOT enrollment for FY20-21 6.4Consumer Hospitalizations Hospitalizations include: Detox, Crisis Residential, Crisis Stabilization, Hospital, Inpatient, IMD, and Skilled Nursing Facility Pre-AOT Enrollment During AOT Enrollment Proportion of Consumers 87% (n=13)20% (n=3) Fiscal Year 20-21 FHS Feb 23 2023 Packet Page 15 of 174 10 Jail Incarcerations (N=15) Fewer court-involved consumers experienced jail incarcerations during AOT enrollment compared to pre-AOT enrollment for FY20-21. Total number of jail incarceration days reduced between pre-AOT enrollment to during AOT enrollment for FY20-21 6.4Consumer Jail Incarcerations Pre-AOT Enrollment During AOT Enrollment Proportion of Consumers 53% (n=8) 7% (n=1) Fiscal Year 20-21 FHS Feb 23 2023 Packet Page 16 of 174 11 Employment & Housing (N=15) Consumer Employment Pre-AOT Enrollment During AOT Enrollment Proportion of Consumers 7% (n=1) 33% (n=5) Consumer Homelessness Pre-AOT Enrollment During AOT Enrollment Proportion of Consumers 40% (n=6) 27% (n=4) More court-involved consumers were employed during AOT enrollment compared to pre-AOT enrollment for FY20-21. Fewer court-involved consumers experienced homelessness during AOT enrollment compared to pre-AOT enrollment for FY20-21. 73% (n=11) of court-involved consumers were housed at some point during their AOT enrollment in FY20-21. Fiscal Year 20-21 FHS Feb 23 2023 Packet Page 17 of 174 12 Discussion •The AOT Care Team collaborated to connectreferred individuals to the appropriate mental health services. •Outreach and engagement efforts resulted inconsumers being enrolled into MHS relatively quickly. •Fewer court-involved consumers experiencedjail stays, hospitalizations, and homelessness during AOT enrollment compared to pre-enrollment. FHS Feb 23 2023 Packet Page 18 of 174 Thank you! FHS Feb 23 2023 Packet Page 19 of 174 FAMILY AND HUMAN SERVICES COMMITTEE 4. Meeting Date:02/27/2023 Subject: Submitted For: FAMILY & HUMAN SERVICES COMMITTEE,  Department:County Administrator Referral No.: N/A Referral Name: Appointments to Advisory Bodies  Presenter: N/A Contact: Laura Malone, 925-608-4943 Referral History: On January 7, 2020 the Board of Supervisors adopted Resolution No. 2020/1 adopting policy governing appointments to boards, committees, and commissions that are advisory to the Board of Supervisors. Included in this resolution was the requirement that applications for at large/countywide seats be reviewed by a Board of Supervisors committee. The Family and Children’s Trust Committee (FACT), was established in 1982 by the Contra Costa County Board of Supervisors to make funding recommendations on the allocation of a variety of funds for prevention and intervention services to reduce child abuse and neglect, provide supportive services to families and children, and promote a more coordinated, seamless system of services for families. Funding for FACT supported projects derived from federal and state program legislation, and donations to the County’s Family and Children’s Trust Fund. Every two years, the members of the FACT establish a series of County priorities for the use of these funds through review of existing data and reports and by holding Public Hearings in various areas of the county. The Committee then develops a competitive bidding process to select non-profit, community-based agencies that can best provide the services determined to be most important. Program recommendations are made to the Board of Supervisors which makes the final funding decisions. The Committee continues to evaluate these funded programs to ensure continued provision of quality service and achievement of stated goals. Programs currently being supported include countywide parenting classes, therapeutic day care for emotionally disturbed children, treatment for families, young children and teens with both substance abuse and child abuse issues, services for homeless families, and projects to support children whose mothers have been victims of domestic violence and sexual assault. The FACT has up to fifteen members who are appointed by the Board and include citizens with expertise in children’s issues, education, law, non-profit agency management, public health, and program research/evaluation. In addition, the Director of the Child Abuse Prevention Council sits as ex-officio member of the Committee and participates in all matters except actually voting on funding recommendations. Terms for all Commission seats are two years. At Large and non-District appointed seat vacancies on the FACT have been assigned for Family and Human Services Committee review since 2003. Referral Update: 1. The purpose of this committee is to establish priorities and make funding recommendations to the Board of FHS Feb 23 2023 Packet Page 20 of 174 1. The purpose of this committee is to establish priorities and make funding recommendations to the Board of Supervisors on the allocation of specific funds for the prevention/amelioration of child abuse and neglect, and the promotion of positive family functioning. These funds include: Child Abuse Prevention, Intervention, and Treatment funds (CAPIT) funds, (AB 1733), Birth Certificate revenue to the County Children’s Trust (AB2994), the Ann Adler Children’s Trust funds, Community-Based Child Abuse Prevention funds (CBCAP) and other funds as may be subsequently directed by the Board of Supervisors. 2. The FACT Committee, in conjunction with the County Administrator’s Office, performs extensive efforts to fill its vacant seats. The recent recruitment efforts resulted in the receipt of six (6) applications, of which five (5) were received in the last 90 days. The recruitment efforts include releasing public notices on the Employment and Human Services (EHSD) social media sites, outreach to educational partners, outreach to CFS Community Partnership distribution, outreach to each district Supervisor’s office and releasing public notice, inviting interested parties to consider membership and soliciting the support of current members to outreach to potential candidates for consideration for membership. 3. Since April 2022, the FACT Committee has been unable to meet due to lack of quorum, membership and vacancies. As of current there are nine (9) of fifteen (15) seats vacant. Given the severity of the situation and resulting impact to critical child abuse prevention funding and services, EHSD sought guidance from the County Administrator’s Office (CAO) to pursue alternate committee recruitment and appointment options. CAO provided direction to have the EHSD Director request recommendation of FACT Committee appointments/reappointments based on review and recommendation by FACT Chair and FACT Co-Chair. 4. To ensure involvement from a voice in the community with the Committee appointments, each new applicant was reviewed and vetted by the FACT Chair and FACT Co-Chair via an interview and evaluation process. The FACT Chair and FACT Co-Chair provided interview and evaluation results with recommendation for applicant appointments. The FACT Committee met on February 6, 2023 and vetted the applicants. Each candidate has the background and experience to support the discipline specific seat designation. After a thorough review, the Committee voted to appoint Liliana Gonzalez to the First 5 seat and Erin Cabezas to the Mental Health seat. Recommendation(s)/Next Step(s): RECOMMEND to the Board of Supervisors the appointment of Liliana Gonzalez to the First 5 seat on the Family & Children’s Trust Committee (FACT) with a term expiring September 30, 2024 and the appointment of Erin Cabezas to the Mental Health seat on the FACT with a term expiring September 30, 2023, as recommended by the Employment and Human Services Department. Fiscal Impact (if any): There is no fiscal impact. Attachments FHS Appointment Request Memo Application E. Cabezas Application L. Gonzalez FACT Roster FHS Feb 23 2023 Packet Page 21 of 174 FHS Feb 23 2023 Packet Page 22 of 174 FHS Feb 23 2023 Packet Page 23 of 174 FHS Feb 23 2023 Packet Page 24 of 174 FHS Feb 23 2023 Packet Page 25 of 174 FHS Feb 23 2023 Packet Page 26 of 174 FHS Feb 23 2023 Packet Page 27 of 174 FHS Feb 23 2023 Packet Page 28 of 174 FHS Feb 23 2023 Packet Page 29 of 174 FHS Feb 23 2023 Packet Page 30 of 174 FHS Feb 23 2023 Packet Page 31 of 174 FHS Feb 23 2023 Packet Page 32 of 174 FHS Feb 23 2023 Packet Page 33 of 174 FHS Feb 23 2023 Packet Page 34 of 174 FHS Feb 23 2023 Packet Page 35 of 174 FHS Feb 23 2023 Packet Page 36 of 174 FHS Feb 23 2023 Packet Page 37 of 174 FHS Feb 23 2023 Packet Page 38 of 174 FHS Feb 23 2023 Packet Page 39 of 174 FACT ROSTER February 2023 Committee Seats (5) At-Large Members (5) District Seats (5) 1.First 5 Commission Exp. 09/30/2024 Liliana Gonzalez Concord, CA 94520 lgonzalez@gmail.com 2. School Representative Exp. 09/30/2024 Alejandra Chamberlain Pleasant Hill, CA 94523 achamberlain@cccoe.k12.ca.us 3.Child Development Early Childhood Education/Local Planning Council Exp. 09/30/2022 Vacant 4.Child Abuse Prevention Council Exp. 09/30/2023 Carol Carrillo, MSW Concord, CA 94520 ccarrillo@capc-coco.org 5.Mental Health Exp. 09/30/2023 Erin Cabezas Concord, CA 94521 erin.emily.carter@gmail.com 1.Audra Carrion Exp. 09/30/2024 San Ramon, CA 94583 audracarrion@gmail.com 2.Shelley Clark Exp. 09/30/2024 Danville, CA 94526 sclark@westcaltech.com 3.Kirsten Rigsby Exp. 09/30/2023 Oakley, CA 94561 P: (925) 584-9051 kirsten@vcrcbrentwoodca.org 4.Yvonne Wadleigh Exp. 09/30/2023 San Ramon, CA 94583 yrwadleigh@gmail.com 5.Vacant Exp. 09/30/2022 District I Exp. 09/30/2023 Supervisor John Gioia Demnlus Johnson Richmond, CA 94805 johnsondemnlus@yahoo.com District II Exp. 09/30/2023 Supervisor Candace Andersen Mary Flott Alamo, CA 94507 flottmary@gmail.com District III Exp. 09/30/2024 Supervisor Diane Burgis Pa’tanisha Davis Brentwood, CA 94513 pat@keycounselpc.com District IV Exp. 09/30/2023 Supervisor Ken Carlson David Leimsieder* Walnut Creek, CA 94596 djliemer05@gmail.com District V Exp. 09/30/2023 Supervisor Federal Glover Ani Pereira-Sekhon** Lafayette, CA 94549 bernadettepereira@gmail.com *Chair **Co-Chair Staff to FACT Laura Malone 40 Douglas Drive Martinez, CA 94553 O: (925) 608-4943 malonl@ehsd.cccounty.us Jan Nelson 40 Douglas Drive Martinez, CA 94553 O: (925) 608-4941 nelsojb@ehsd.cccounty.us Reception: (925) 608-5000 DRAFT - Updated January 15, 2023 Blue Highlights represent Appointments Pending Final Approvals FHS Feb 23 2023 Packet Page 40 of 174 FAMILY AND HUMAN SERVICES COMMITTEE 5. Meeting Date:02/27/2023   Subject:Appointments to the Advisory Council on Aging Submitted For: FAMILY & HUMAN SERVICES COMMITTEE,  Department:County Administrator Referral No.: N/A   Referral Name: Appointments to Advisory Bodies  Presenter: N/A Contact: Anthony Macias, 925-602-4175 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 Advisory Council on Aging (ACOA) provides a means for county-wide planning, cooperation and coordination for individuals and groups interested in improving and developing services and opportunities for the older residents of this County. The Council provides leadership and advocacy on behalf of older persons and serves as a channel of communication and information on aging. The Advisory Council on Aging consists of 40 members serving 2 year staggered terms, each ending on September 30. The Council consists of representatives of the target population and the general public, including older low-income and military persons; at least one-half of the membership must be made up of actual consumers of services under the Area Plan. The Council includes: 19 representatives recommended from each Local Committee on Aging, 1 representative from the Nutrition Project Council, 1 Retired Senior Volunteer Program, and 19 Members at-Large. Pursuant to the ACOA Bylaws, the ACOA may recommend for appointment up to four (4) alternate Member-at-Large (MAL) members, who shall serve and vote in place of members (City or MAL) who are absent from, or who are disqualifying themselves from participating in a meeting of the ACOA. The Area Agency on Aging, the ACOA and the Clerk of the Board, using Contra Costa TV (CCTV), assisted with recruitment. Area Agency on Aging staff has encouraged interested individuals including minorities to apply through announcements provided at the Senior Coalition meetings and at the regular monthly meetings of the ACOA. The Contra Costa County Employment and Human Services Department (EHSD) website contains dedicated web content where interested members of the public are encouraged to apply. The website provides access to the Board of Supervisors' official application with instructions on whom to contact for ACOA related inquiries, including application procedures. Referral Update: The Contra Costa Area Agency on Aging (AAA) recommends the following individual for appointment to the City of Richmond Local seat assigned to the Contra Costa Advisory Council on Aging (ACOA) with a term expiring on September 30, 2024:  City of Richmond Local Seat: Cate Burkhart Ms. Burkhart submitted an application for ACOA membership dated 10/20/22 that is provided as a separate attachment. The Richmond City Council interviewed Ms. Burkhart on 11/15/22 and they recommended that she serve as the City of Richmond representative on the Contra Costa Advisory Council on Aging (ACOA). The Contra Costa Area Agency on Aging (AAA) recommends the following individual for appointment to the At-Larrge Alternate #4 Seat assigned to the Contra Costa Advisory Council on Aging (ACOA) with a term expiring on September 30, 2023: FHS Feb 23 2023 Packet Page 41 of 174 2023:  Alternate #4 Member At-Large Seat: Thomas Lang Mr. Lang submitted an application for ACOA membership dated 11/28/22 that is provided as a separate attachment. The ACOA Membership Committee interviewed Mr. Lang on12/21/22. The Membership Committee recommended Mr. Lang to the ACOA Executive Committee to fill the Alternate #4 Member At-Large Seat. The ACOA Executive Committee approved Mr. Lang to fill the Alternate #4 Member At-Large Seat at their meeting on 1/19/23. Members of the ACOA voted unanimously to approve Mr. Lang’s appointment to the Alternate #4 Member At-Large Seat. Recommendation(s)/Next Step(s): RECOMMEND to the Board of Supervisors the appointment of the following individual to the Contra Costa Advisory Council on Aging (ACOA) with a term expiring on September 30, 2024:  City of Richmond Local Seat: Cate Burkhart RECOMMEND to the Board of Supervisors the appointment of the following individual to the Contra Costa Advisory Council on Aging (ACOA) with a term expiring on September 30, 2023:  Alternate #4 Member At-Large Seat: Thomas Lang Fiscal Impact (if any): There is no fiscal impact for this action. Attachments ACOA Roster Application C. Burkhart Application T. Lang FHS Feb 23 2023 Packet Page 42 of 174 Advisory Board Seat Title Term Expiratio Current Incumbent Incumbent Supervisor District Advisory Council on Aging Nutrition Project Council Vacant Advisory Council on Aging At-Large 1 9/30/2024 Reed, Penny I Advisory Council on Aging At-Large 2 9/30/2024 Krohn, Shirley IV Advisory Council on Aging At-Large 3 Vacant Advisory Council on Aging At-Large 4 9/30/2024 Shafiabady, Sara V Advisory Council on Aging At-Large 5 9/30/2024 Card, Deborah V Advisory Council on Aging At-Large 6 9/30/2024 Lipson, Steve I Advisory Council on Aging At-Large 7 Vacant Advisory Council on Aging At-Large 8 Vacant Advisory Council on Aging At-Large 9 9/30/2023 Richards, Gerald V Advisory Council on Aging At-Large 10 9/30/2024 Tobey, Terri II Advisory Council on Aging At-Large 11 9/30/2023 Bhambra, Jagjit V Advisory Council on Aging At-Large 12 9/30/2024 Neemuchwalla, Nuru IV Advisory Council on Aging At-Large 13 Vacant Advisory Council on Aging At-Large 14 9/30/2023 Yee, Dennis IV Advisory Council on Aging At-Large 15 9/30/2024 Bruns, Mary IV Advisory Council on Aging At-Large 16 9/30/2023 O'Toole, Brian IV Advisory Council on Aging At-Large 17 9/30/2024 Donovan, Kevin D.II Advisory Council on Aging At-Large 18 9/30/2024 Wener, Michael II Advisory Council on Aging At-Large 19 9/30/2023 Kleiner, Jill II Advisory Council on Aging At-Large 20 9/30/2024 Sakai-Miller, Sharon II Advisory Council on Aging Local Committee Antioch 9/30/2024 Fernandez, Rudy III Advisory Council on Aging Local Committee Brentwood 9/30/2023 Kee, Arthur III Advisory Council on Aging Local Committee Clayton 9/30/2023 Berman, Michelle IV Advisory Council on Aging Local Committee Concord 9/30/2023 John Haberkorn IV Advisory Council on Aging Local Committee Danville 9/30/2023 Donnelly, James II Advisory Council on Aging Local Committee El Cerrito 9/30/2024 Kehoe, Carol I Advisory Council on Aging Local Committee Hercules 9/30/2024 Doran, Jennifer V Advisory Council on Aging Local Committee Lafayette 9/30/2023 Partridge, Erin II FHS Feb 23 2023 Packet Page 43 of 174 Advisory Council on Aging Local Committee Martinez 9/30/2023 Iorns, Jody Advisory Council on Aging Local Committee Moraga 9/30/2023 Aufhauser, Martin II Advisory Council on Aging Local Committee Oakley 9/30/2023 Rigsby, Michael III Advisory Council on Aging Local Committee Orinda 9/30/2023 Evans, Candace II Advisory Council on Aging Local Committee Pinole Vacant Advisory Council on Aging Local Committee Pittsburg 9/30/2023 Carterelliott, Kacey V Advisory Council on Aging Local Committee Pleasant Hill 9/30/2023 Van Ackeren, Lorna IV Advisory Council on Aging Local Committee Richmond Pending Burkhart, Cate Advisory Council on Aging Local Committee San Pablo Vacant Advisory Council on Aging Local Committee San Ramon 9/30/2023 Bajpai, Swamini II Advisory Council on Aging Local Committee Walnut Creek 9/30/2023 Freitag, Eric IV Advisory Council on Aging Alternate Member 1 9/30/2023 Awadalla, Mike II Advisory Council on Aging Alternate Member 2 9/30/2023 Lee, George V Advisory Council on Aging Alternate Member 3 9/30/2023 Raju, Ramapriya III Advisory Council on Aging Alternate Member 4 Pending Lang, Thomas Term length: 24 months Pending BOS Approval Vacant FHS Feb 23 2023 Packet Page 44 of 174 FHS Feb 23 2023 Packet Page 45 of 174 FHS Feb 23 2023 Packet Page 46 of 174 FHS Feb 23 2023 Packet Page 47 of 174 FHS Feb 23 2023 Packet Page 48 of 174 FAMILY AND HUMAN SERVICES COMMITTEE 6. Meeting Date:02/27/2023   Subject:Appointment to the Workforce Development Board Submitted For: FAMILY & HUMAN SERVICES COMMITTEE,  Department:County Administrator Referral No.: N/A   Referral Name: Appointments to Advisory Bodies  Presenter: N/A Contact: Tamia Brown, 925-671-4560 Referral History: On January 7, 2020, the Board of Supervisors (BOS) adopted Resolution No. 2020/1 adopting policy governing appointments to boards, committees, and commissions that are advisory to the BOS. Section III.A. of this resolution states that when an advisory body conducts interviews for at-large/countywide seats, the body's recommendation will be provided to a Board committee for further review, along with all applications received for the applicable seat(s). In all cases, the Board Committee decides which applicants to nominate for full Board action. The Workforce Development Board implements federal requirements for programs to address the education, skills, and employment needs for a skilled workforce, and that lead to an increase in the skills and earnings of Contra Costa residents. On March 14, 2016, the Family and Human Services Committee (FHS) accepted the Employment and Human Services Department's recommendation to decertify the then-current Workforce Investment Act local Board and re-certify a new board structure in compliance with the new Workforce Innovation and Opportunity Act (WIOA). FHS approved these recommendations, and the Board did the same at its March 29, 2016 meeting. Under new standards in WIOA (2016) and as adopted by the Board on March 29, 2016, the new Workforce Development Board structure is: a total of 23 required seats and 2 "optional seats", consisting of: 13 Business representatives, 5 Workforce representatives, and 5 Education and Training representatives as follows: (1) Adult Education/Literacy; (2) Higher Education; (3) Economic & Community Development; (4) Wagner Peyser representative; (5) Vocational Rehabilitation. Also two additional/"optional" seats that may be filled from any of the 3 categories above. Referral Update: Local board structure and size: Compared to predecessor legislation, the Workforce Innovation and Opportunity Act (WIOA) substantially changes Local Board composition by reducing local workforce development board size while maintaining a business and industry majority and ensuring representation from labor and employment and training organizations.  Category – Representatives of Business (WIOA Section 107(b)(2)(A))  Thirteen (13) representatives (52%) Category – Representatives of Workforce (WIOA Section 107(b)(2)(A))  Five (5) representatives (20%) Category – Representatives of Education and Training (WIOA Section 107(b)(2)(C))  One (1) Adult Education/Literacy Representative (WIOA title II) One (1) Higher Education Representative One (1) Economic and Community Development Representative One (1) Wagner Peyser Representative One (1) Vocational Rehabilitation Representative Two (2) additional seats from the above categories, including constituencies referenced in Attachment III of Training Employment & Guidance Letter (TEGL) 27-14. FHS Feb 23 2023 Packet Page 49 of 174 The Workforce Development Board Executive Committee, approved on February 7, 2023 the recommended appointment of Sean Laurant to the Governmental and Economic and Community Development Seat #1. No other candidates competed for the seat. Please see the attached memo and application for additional information. Recommendation(s)/Next Step(s): RECOMMEND to the Board of Supervisors the appointment of Sean Laurant to the Governmental and Economic and Community Development Seat #1 of the Workforce Development Board with a term expiring June 30, 2027. Fiscal Impact (if any): There is no fiscal impact. Attachments WDB Appointment Recommendation Memo Application S. Laurant WDB Roster FHS Feb 23 2023 Packet Page 50 of 174 WORKFORCE DEVELOPMENT BOARD OF CONTRA COSTA COUNTY 4071 Port Chicago Highway • Suite 250 • Concord, CA 94520 Tel. (925) 671-4560 • Fax (925) 228-0238 Website: www.wdbcc.com MEMORANDUM DATE: February 14, 2023 TO: Family and Human Services Committee CC: Danielle Fokkema, CAO Sr. Deputy County Administrator FROM: Tamia Brown, Executive Director SUBJECT: Appointment to Workforce Development Board This memorandum requests the Family and Human Services Committee recommend to the Contra Costa County Board of Supervisors the appointment of the following candidates to the new WIOA compliant Workforce Development Board of Contra Costa County. Background: Local board structure and size: Compared to predecessor legislation, the Workforce Innovation and Opportunity Act (WIOA) substantially changes Local Board composition by reducing local workforce development board size while maintaining a business and industry majority and ensuring representation from labor and employment and training organizations. To meet the categorical membership percentages, the WDB recommended a board of twenty-five (25) members. This option represents the minimum required local board size under WIOA plus an additional six (6) optional representatives in the following enumerated categories: 1) business; 2) workforce; 3) education and training. Category – Representatives of Business (WIOA Section 107(b)(2)(A)) •Thirteen (13) representatives (52%) Category – Representatives of Workforce (WIOA Section 107(b)(2)(A)) •Five (5) representatives (20%) Category – Representatives of Education and Training (WIOA Section 107(b)(2)(C)) •One (1) Adult Education/Literacy Representative (WIOA title II) •One (1) Higher Education Representative •One (1) Economic and Community Development Representative •One (1) Wagner Peyser Representative •One (1) Vocational Rehabilitation Representative Two (2) additional seats from the above categories, including constituencies referenced in Attachment III of Training Employment & Guidance Letter (TEGL) 27-14. Recommendation: a)Recommend approval of local board candidate for the vacant board seat. (Attached application and board roster) - Approved on February 7, 2023 at the Full Board Meeting •Sean Laurant – Governmental and Economic and Community Development Seat #1 TAMIA BROWN EXECUTIVE DIRECTOR FHS Feb 23 2023 Packet Page 51 of 174 **No other candidate competed for the Governmental and Economic and Community Development Seat #1 NEW APPOINTMENT Seat Last Name First Name Address & District # Term Start Date Term of Expiration District (Resident) Governmental & Economic & Community Development Seat # 1 Laurant Sean R. Pittsburg, CA District # 5 3/1/2023 6/30/2027 Suisun, CA Thank you /rms attachment FHS Feb 23 2023 Packet Page 52 of 174 I Print Form I Please return completed applications to: Contra Costa County Clerk of the Board of Supervisors 1025 Escobar Street, 1st Floor Martinez, CA 94553 or email to: ClerkofTheBoard@cob.cccounty.us BOARDS, COMMITTEES, AND COMMISSIONS APPLICATION First Name lsean Home Address -Street Middle Initial IR I City lsuisun Email Address Last Name ILaurant Resident of Supervisorial District (if out of County, please enter N/ A): IN/A ---- State ICA I Postal Code 194585 Do you work in Contra Costa County? [Z] Yes D No If Yes, in which District do you work? lconcord Current Employer Job Title I District Administator I District Administator How long have you lived or worked in Contra Costa County? IN/A ___ ___, Board, Committee, or Commission !Youth Committee Seat Name Length of Employment 120 years Have you ever attended a meeting of the advisory board for which you are applying? Pease check one: OYes 0 No If Yes, how many? EDUCATION Check appropriate box if you possess one of the following: [Z] High School Diploma D CA High School Proficiency Certificate Colleges or Universities Attended Degree Type/ Course of Study/Major University of North Carolina BAS San Diego State University MA Occupational Licenses Completed: ,--------------, ...._ __________ __, D G.E.D. Certificate Degree Awarded l✓I Yes f7l Yes□Yes I I No ONo □No .-------------------, Certificate Awarded for Training? 1-----------------11 D Yes 0 NoOther Trainings Completed: _ D Yes 0 No Do you have any obligations that might affect your attendance at scheduled meetings? D Yes [Z] No If Yes, please explain: Would you like to be considered for appointment to other advisory bodies for which you may be qualified? [Z]YesONo Are you a veteran of the U.S. Armed Forces? OYes [Z] No PAGE 1 of 3 THIS FORM IS A PUBLIC DOCUMENT FHS Feb 23 2023 Packet Page 53 of 174 FHS Feb 23 2023 Packet Page 54 of 174 FHS Feb 23 2023 Packet Page 55 of 174 FHS Feb 23 2023 Packet Page 56 of 174 FHS Feb 23 2023 Packet Page 57 of 174 BOARD MEMBERS Public Roster MICHAEL MCGILL JERRY L. ARANAS YOLANDA VEGA (CHAIR) MMS Design Associates, Inc.Lam Research Peak Performance Corporate Training President/Principal Engineer Business Manager Principal Committee: Executive & Youth Committee Committee: Youth Committee Committee: Executive & Business & Economic Dev. Business Seat #1 Business Seat #2 Business Seat #3 Appointment Date: 7/1/2020 Appointment Date: 7/26/2022 Appointment Date: 7/1/2020 Term End Date: 6/30/2024 Term End Date: 6/30/2026 Term End Date: 6/30/2024 TERRY CURLEY (VICE CHAIR)DOUGLAS R. LEZAMETA SARAH A. CHODAKEWITZ Executive Vice President Founder Director, Government and Community Affairs United Business Bank Fusion Latina Network John Muir Health Committee: Executive & Business & Economic Dev. Committee: Business & Economic Development Committee Committee: Business & Economic Development Committee Business Seat #4 Business Seat #5 Business Seat #6 Appointment Date: 7/26/2022 Appointment Date: 08/01/2021 Appointment Date: 6/7/2022 Term End Date: 6/30/2026 Term End Date: 06/30/2025 Term End Date: 6/30/2026 NICHOL CARRANZA VACANT ROBERT MULLER Sr. Rep. Corporate Social Responsibility & Public Affairs Martinez Refining Company Marathon Petroleum Corporation Learning Manager Committee: Business & Economic Development Committee Committee: Committee: Executive & Youth Committee Business Seat #7 Business Seat #8 Business Seat #9 Appointment Date: 6/7/2022 Appointment Date: Appointment Date: 7/11/2017 Term End Date: 06/30/2026 Term End Date: 6/30/20XX Term End Date: 6/30/2023 LAURA TREVINO - FERNANDEZ STEPHANIE RIVERA (VICE CHAIR)MONICA MAGEE Hargrove Engineer & Contractors Lazarex Cancer Foundation Bishop Ranch Senior Recruiter Specialist Chief Executive Officer Director of Marketing Committee: Business & Economic Development Committee Committee: Executive & Business & Economic Dev. Committee Committee: Business & Economic Development Committee Business Seat # 10 Business Seat # 11 Business Seat #12 Appointment Date: 7/1/2020 Appointment Date: 7/1/2020 Appointment Date: 7/1/2020 Term End Date: 06/30/2024 Term End Date: 06/30/2024 Term End Date: 06/30/2024 CORRY KENNEDY Chevron Human Resource Manager Committee: Business & Economic Development Committee Business Seat # 13 Appointment Date: 7/1/2020 Term End Date: 06/30/2024 BUSINESS SEATS Tamia Brown Executive Director FHS Feb 23 2023 Packet Page 58 of 174 BOARD MEMBERS Public Roster THOMAS HANSEN JOSHUA ANIJAR TIMOTHY JEFFRIES IBEW Local 302 Central Labor Council Contra Costa County BM Local 549 Business Manager Executive Director Committee: Executive & Youth Committee Committee: Executive Committee: Workforce & Labor Seat #1 Workforce and Labor Seat # 2 Workforce and Labor Seat #3 Appointment Date: 07/01/2021 Appointment Date: 12/10/2019 Appointment Date: 07/1/2021 Term End Date: 6/30/2025 Term End Date: 6/30/2023 Term End Date: 6/30/2025 STEVE OLDER TRACI YOUNG Machinists Union Local 1173 Central Labor Council Contra Costa County Area Director/Business Representative Community Services Director, Labor Liaison to UWBA Committee: Committee: Business & Economic Development Committee Workforce and Labor Seat #4 Workforce and Labor Seat #5 Appointment Date: 08/01/2021 Appointment Date: 08/01/2021 Term End Date: 6/30/2025 Term End Date: 6/30/2025 STEVEN A. FRANCE KELLY SCHELIN Del Valle Education Center Contra Costa College Director Associate Vice Chancellor, Educational Services Committee: Committee: Business & Economic Development Committee Education & Training Seat #1 Seat No: Business #2 Appointment Date: 12/1/2022 Appointment Date: 7/1/2020 Term End Date: 06/30/2026 Term End Date: 6/30/2024 SEAN A. LAURANT (PENDING)RICHARD JOHNSON KWAME REED Department of Rehabilitation California Employment Development Department City of Antioch District Administrator Employment Service/Program Manager II Economic & Community Development Committee: Committee: Business & Economic Development Committee Committee: Executive & Business & Economic Dev. Governmental & Eco. & Community Dev. Seat #1 Governmental & Eco. & Community Dev. Seat #2 Governmental & Eco. & Community Dev. Seat #3 Appointment Date: Appointment Date: 7/1/2020 Appointment Date: 7/1/2020 Term End Date: 6/30/20XX Term End Date: 6/30/2024 Term End Date: 6/30/2024 WORKFORCE AND LABOR SEATS EDUCATION AND TRAINING SEATS GOVERNMENTAL AND ECONOMIC AND COMMUNITY DEVELOPMENT SEATS Tamia BrownExecutive Director FHS Feb 23 2023 Packet Page 59 of 174 BOARD MEMBERS Public Roster LESLAY CHOY DEVONN POWERS San Pablo Economic Development Humanity Way, Inc. Executive Director Founder/Chief Executive Director Committee: Business & Economic Development Committee Committee: Flex Seat #1 Flex Seat #2 Appointment Date: 7/1/2020 Appointment Date: 12/1/2020 Term End Date: 6/30/2024 Term End Date: 6/30/2024 FLEX SEATS Tamia Brown Executive Director FHS Feb 23 2023 Packet Page 60 of 174 FAMILY AND HUMAN SERVICES COMMITTEE 7. Meeting Date:02/27/2023   Subject:Annual Updates on the Tobacco Retail License and Secondhand Smoke Ordinances Submitted For: Anna Roth, Health Services Director  Department:Health Services Referral No.: 112 & 82   Referral Name: Policy Options for Protecting Youth from Tobacco Influences in the Retail Environment & Secondhand Smoke Ordinance  Presenter: Dr. Sefanit Mekuria, MD, MPH; and Mayra Lopez Contact: Enid Mendoza, (925) 655-2051 Referral History: FHS Referral No. 112 - Policy Options for Protecting Youth from Tobacco Influences in the Retail Environment The Board of Supervisors approved two tobacco control ordinances in July 2017 to protect youth from tobacco influences in the retail environment: a zoning ordinance and a tobacco retailer licensing ordinance. Of particular concern were the marketing and availability of youth-friendly flavored tobacco products, small pack sizes of cigars and cigarillos, and density and location of tobacco retailers, since these contribute largely to youth exposure to tobacco influences and tobacco use. The tobacco retailer licensing ordinance required extensive preparation for implementation, and tobacco retailers were required to be compliant with the new provisions by January 1, 2018. Health Services Department Public Health staff provided a report to the Board of Supervisors in March 2018 on preliminary implementation efforts. In November 2019, the Board of Supervisors adopted Ordinance 2019-34 (Sale of Electronic Smoking Devices and E-Liquids Prohibited) which increased the protections for youth from tobacco influences in the retail environment. Ordinance 2019-34 was a necessary response to an epidemic rise in youth vaping where young people were vulnerable to tobacco addiction as well as concerns related to E-cigarette/Vaping Associated Lung Injury (EVALI). The ordinance also expanded the restrictions on the sale of flavored tobacco in all areas of the unincorporated areas of the County, rather than just within 1,000 feet of youth-sensitive areas. At the October 29, 2020 Family and Human Services Committee (FHS) meeting, Public Health staff reported on the implementation of the newly adopted Ordinance 2019-34, including information on strategies to continue tobacco retailer licensing and businesses zoning ordinance implementation activities despite the challenges presented by the COVID-19 pandemic. At the February 28, 2022, FHS Committee meeting, Public Health staff were directed to include in the next report, an update on SB793/Prop 31, which is the statewide flavored tobacco ban and to provide updates on enforcement of the tobacco control laws. At the December 3, 2022, the Board of Supervisors meeting, Public Health staff were directed to provide recommendations on cannabis youth education campaigns and/or programs. FHS Referral No. 82 - Secondhand Smoke Ordinance At the November 13, 2017 Family and Human Services Committee meeting, Public Health presented its annual report on the implementation of the County’s Secondhand Smoke Ordinance with a recommendation that the Committee consider a proposed ordinance to strengthen the current smoking protections to prohibit smoking inside dwelling units of multi-unit housing, including condos and townhomes. The Committee accepted the report and recommendations, requested that language be added to extend smoking restrictions to guest rooms of hotels and motels, and directed staff to forward those recommendations to the Board of Supervisors for discussion and approval. FHS Feb 23 2023 Packet Page 61 of 174 The ordinance, titled Smoke-free Multi Unit Residences, was adopted by the Board of Supervisors on March 13, 2018 with implementation to begin for new and renewing leases on July 1, 2018, and for continuing leases and owner-occupied units on July 1, 2019. At the request of the Board of Supervisors, Contra Costa Public Health staff provided reports in March 2018 on preliminary implementation of the ordinances. A follow up report was later presented to the FHS in October of 2018, at which the FHS asked Public Health staff to send a letter to each City Manager inviting them to model their own city ordinances after the County's ordinance. At the October 29, 2020 FHS meeting, Public Health staff reported on the implementation of the Secondhand Smoke Protections Ordinance. The report included updates on the implementation of the Multi-Unit Housing Ordinance, compliance challenges and the technical assistance provided to cities within Contra Costa County. At the February 28, 2022, FHS meeting, Public Health staff reported on the implementation of the Secondhand Smoke Protections Ordinance. The report included updates on the implementation of the Multi-Unit Housing Ordinance, compliance challenges and the technical assistance provided to cities within Contra Costa County. Referral Update: Please see the attached reports and presentation materials for updates on the implementation of Tobacco Retail Licensing Ordinance No. 2019-34 and Secondhand Smote Protections Ordinance No. 2018-07. Recommendation(s)/Next Step(s): ACCEPT the annual reports from the Health Services Department's Public Health Division with updates on the implementation of the Tobacco Retail Licensing and Secondhand Smoke Protections ordinances, and DIRECT staff to forward the reports to the Board of Supervisors for their information. ACCEPT the following four cannabis education, outreach, and support recommendations, totaling approximately $634,225, from the Health Services Department's Tobacco Prevention Program staff in response to the directive given by the Board of Supervisors at their January 10, 2023 meeting, and DIRECT staff to forward the recommendations for Board of Supervisors consideration:  Provide additional funding of $300,000 to existing intervention efforts at the school-based level;1. Provide funding of up to $200,000 for local schools to hire restorative practice specialists;2. Provide funding of approximately $34,225 to pilot a youth-led cannabis social media program; and3. Provide approximately $100,000 to fund a youth town hall campaign geared towards sharing information about the harms of youth use of cannabis with a unique view of working with ethnic media sources. 4. Fiscal Impact (if any): There is no fiscal impact. Attachments Report on the Tobacco Retailer License Ordinance Updates Report on the Secondhand Smoke Protections Ordinance Updates Tobacco Prevention Program Presentation Slides FHS Feb 23 2023 Packet Page 62 of 174 To: Family and Human Services Committee, Contra Costa Board of Supervisors From: Ori Tzvieli, MD Health Officer, Contra Costa County Public Health Director, Contra Costa Health Services Re: Annual Report on the Implementation of Tobacco Retail Licensing Ordinance 2019-34 and Recommendations for Cannabis Youth Education and Outreach Campaigns Date: 02/27/2023 I.Summary This report provides details of tobacco enforcement of the Ordinance 2019-34, specifically activities conducted since the last report made to this committee in February 2022. The report includes the support provided to the surrounding cities within Contra Costa during the pas t year. Lastly, it presents the program and media campaign options as directed by the Board of Supervisors when they discussed and passed the resolution to repeal the Cannabis Vaping Prohibitions on December 3, 2022, and January 10, 2023. II.Background and Emerging Issues on Tobacco Policy National, State, and Local level In 2009, the Family Smoking Prevention and Tobacco Control Act prohibited the sale of all flavored cigarettes except for Menthol. In 2017 and 2019, Contra Costa’s Board of Supervisors strengthened protections for youth against tobacco influences in the retail environment by restricting the sale of all flavored tobacco products and vaping devices not approved by the FDA1. In 2022, the FDA began the rulemaking process to prohibit on a national level the sale and manufacture of menthol cigarettes and flavored cigars (See Table 1. Background on Flavored 1 Tobacco Retailer License Ordinance Background: On September 12, 2019, the Board of Supervisors directed Public Health staff to prepare policy options that would address mounting concerns related to the rapid increase of use with electronic cigarettes by minors as wel l as the co-occurring epidemic of serious lung disease that has been linked to the use of vaping devices. On November 18, 2019, Public Health staff provided the policy recommendations listed below: 1.Revise Division 445-6.006 (Secondhand Smoke and Tobacco Product Control) of the County Ordinance Code to prohibit the sale of any electronic smoking device or e-liquid that is required to obtain, but has not yet obtained, a premarket review order from the U.S. Food and Drug Administration pursuant to the federal Family Smoking Prevention and Tobacco Control Act. 2.Revise Section 445-6.006 of the County Ordinance Code to prohibit the sale of flavored tobacco products and menthol cigarettes expanding this prohibition to the entirety of the unincorporated county. Previously, the sale of these products was only prohibited within 1,000 feet of a public or private school, playground, park, or library. 3.Amend Section 413-4.608 (Commercial Cannabis Health Permits) of the County Ordinance Code to prohibit the sale or delivery of any e- liquid that contains tetrahydrocannabinol or any other cannabinoid, and to prohibit the sale or delivery of any electronic smoking device that can be used to deliver tetrahydrocannabinol or any other cannabinoid in aerosolized or vaporized form. FHS Feb 23 2023 Packet Page 63 of 174 Tobacco Policy). Most recently, in November 2022, California voters upheld the State law prohibiting tobacco retailers from selling most flavored tobacco products (See Table 2. California Prohibited Flavored Tobacco Products). The FDA has reviewed close to 1 million ‘new tobacco product’ applications (application per product rather than per company) to assess risk and benefits to population health. As of November 2022, the FDA issued 44 authorizations and thousands of denial marketing orders. Additionally, the FDA is also reviewing public comments that were submitted in August 2022 in response to the federal ban on menthol cigarettes and flavored cigars. Lastly, due to product safety concerns and youth consumption, the FDA issued a moratorium on the sale of all synthetic nicotine products (including Puff Bars, disposable vapes, etc.) until further notice. In response to the Statewide flavor tobacco ban in California, since, December 2022, there has been an increase in the retailing of “nonmenthol products.” Year Level Prohibited Tobacco Products 2009 Federal Flavored cigarettes, except for menthol 2017 County All flavored tobacco products, including menthol, within 1,000 ft of any school, playground, park or library; small pack cigar sales (no packs less than 10, unless cigar is over $5) 2019 County All flavored tobacco regardless of location; all e-cigs or e-liquids pending FDA approval 2020 Federal Flavored cartridge-based e-cigarettes (menthol flavor exempt) 2021 Federal FDA proposes to prohibit menthol cigarettes and flavored cigars 2022 State Most flavored tobacco products (flavored hookah/shisha, pipe tobacco, and premium cigars are exempt). *In November 2022, The Department of Cannabis Control (DCC) issued a ban on all vaping additives including flavors that are not natural of the cannabis flower. III.Implementation of Ordinance 2019-34 Since February 2022 Report The Tobacco Prevention Program (TPP) facilitates the implementation of the unincorporated County’s tobacco retail license ordinance and collaborates with the Contra Costa Sheriff’s Department for the enforcement of commercial tobacco sales. Additionally, TPP supports all Contra Costa jurisdictions with education to support decisionmakers with information about the public health framework and understanding of best practices in tobacco control. This support is by provided through tailored technical assistance, tobacco educational packets and materials, public health law resources. TPP partners with the Contra Costa County Business License Office and Tax Collectors Office to educate all retailers on how to renew their tobacco business license and update them annually on any policy changes that affect them. In May 2022, the Business License Office mailed the annual business renewal reminder letters to 85 tobacco retailers in unincorporated Contra Costa. FHS Feb 23 2023 Packet Page 64 of 174 In order to sell tobacco in unincorporated Contra Costa, a retailer must apply for a local tobacco retailer license (in addition to state tobacco license). TPP oversees the tobacco retailer license application process. TPP monitors all existing and new tobacco stores and provides education to retailers about the everchanging tobacco policy landscape. The Sheriff's Department distributes retailer education flyers developed by TPP during inspections to store clerks and owners. IV.Enforcement of Ordinance 2019-34 Since February 2022 Report In May 2022, TPP hired one staff member to focus on retailer engagement and enforcement efforts. The Sheriff's Department is the primary enforcer of Ordinance 2019-34, though it is a collaborative effort between the Tobacco Prevention Program staff and the Sheriff’s Tobacco Enforcement Unit. However, during the pandemic, the Sheriff's Department priorities shifted, and tobacco enforcement was based on complaints from the community. During that time, several businesses were identified as non-compliant and were found selling or intending to sell unlawful tobacco products (including, the sale of flavored tobacco, vapes, small packs of 5 cigarillos, and single cigarillos). In 2022 as recovery from the pandemic continued, compliance checks were allowed to begin again. There were five inspection visits conducted in collaboration with the Sheriff’s Department. Two compliance visits led by the Sheriff’s Department led to a retail license suspension hearing and another compliance visit at a separate location led to an administrative fine. TPP staff identified a need to educate enforcers on the characterization of flavored tobacco and the County's tobacco ordinance. A need was also identified to assist the detectives in providing appropriate resources and education to retailers during inspections visits. TPP plans to address this matter with the development and implementation of a new inspection process to include at minimum annual inspections which will incorporate youth decoy operations as stated in the County's ordinance. TPP applied for and was awarded funding in November 2022 from the California Department of Justice, in the amount of $443,000 over three years. Programmatic deliverables include conducting bimonthly trainings on tobacco control laws and facilitating monthly workshops with law enforcement agencies and city staff on implementation and enforcement of tobacco control laws, including education on characterizing flavors and distinguishing what constitutes a flavored tobacco product. For example, there has been a rise in ‘concept’ flavors in the retail market which has posed challenges to agencies enforcing flavored tobacco laws. V.Technical Assistance to Contra Costa Cities TPP Staff continue to offer comprehensive technical assistance to Contra Costa cities interested in considering tobacco control policies that prohibit the sale of flavored tobacco products and vaping devices. Over the past year, the following cities have either adopted or are considered expanding their tobacco retail control policies: FHS Feb 23 2023 Packet Page 65 of 174 City Policy Description Date adopted/ Date effective Brentwood Moratorium on New Tobacco Smoke Shops, June 2022-August 2022 Effective: through August 2023 Moraga Flavor ban (NO EXEMPTIONS) Adopted: October 12, 2022 Effective: January 1, 2023 Orinda Flavor ban (NO EXEMPTIONS) Adopted: May 3, 2022 Effective: January1, 2023 Antioch Adopt comprehensive tobacco retailer license with a flavors restriction and a minimum pack size requirement Antioch’s City Council directed staff to develop draft ordinance (like County’s policy) in May 2021/ 1st reading of TRL ordinance pending On March 8, 2022, Antioch City Council adopted Ordinance NO. 2206- C-S, a On June 14, 2022, Antioch City Council adopted Ordinance 2215-C-S, officially granting tobacco retailers until December 2022before the enforcement began. Effective date: December 2022 Pittsburg Adopt a comprehensive tobacco retailer license ordinance inclusive of flavored tobacco restrictions and a minimum pack size requirement On December 12, 2022, the Ad-Hoc Committee met and directed the Public Health Policy Consultant to create a draft ordinance and complete a community survey to get resident input on this issue. Council will discuss prioritizing TRL in March. Danville Prohibits the sale of vaping devices and electronic smoking devices February 18, 2020/ March 18, 2020 FHS Feb 23 2023 Packet Page 66 of 174 Concord Adopt comprehensive tobacco retailer restrictions that are inclusive of flavored tobacco restrictions and a minimum price Staff directed to draft ordinance. Draft expected to be presented March 2023. San Ramon Comprehensive tobacco retail license with vaping sales restrictions, minimum pack size, minimum price, tobacco free pharmacies, no exemptions TPP staff provided overview of best practices to San Ramon Teen Council in November 2022. Walnut Creek Adopt tobacco retail license with same exemptions as SB 793 (hookah, pipe tobacco, and roll your own tobacco leaves exempt from flavors restrictions) Adopted November 9, 2021 Implemented April 9, 2022 Pleasant Hill Adopt flavored tobacco sales restriction and vaping device sales ban with same exemptions as SB 793 (hookah, pipe tobacco, and roll your own tobacco leaves exempt from flavors restrictions) Adopted February 7, 2022/ Implemented January 2023 Finally, the passing of Prop 31, the statewide flavored tobacco ban, requires all jurisdictions to enforce this new law with or without a local tobacco retail license policy. Given this monumental change in tobacco policy, providing education and support to all agencies through regular workgroup meetings will be crucial to ensure all 19 jurisdictions in the County are well equipped with the understanding needed to carry out enforcement of the state (and local) policies. VI.Technical Assistance on Vaping Policies On June 26, 2018, the Board of Supervisors adopted cannabis land use Ordinance Nos.2018- 18 and 2018-19 to regulate commercial cannabis activities and personal cannabis cultivation in unincorporated county, including requiring land use permits to engage in commercial cannabis activities. Considering the newness of regulating the commercial cannabis industry and the evolving landscape of cannabis regulation, Contra Costa Health Services recommended a cautionary approach to local regulation that emphasizes protections for consumers, the public, and at-risk groups such as youth and individuals challenged with substance use disorders. In November 2019, Ordinance 2019-34 was introduced and subsequently adopted amending three sections of County code to bring alignment between County Tobacco Control Policy and Cannabis regulation. In particular, the provision prohibiting the sale of flavored cannabis products and any electronic smoking device that contains tetrahydrocannabinol or any other cannabinoid. At the request of the Board of Supervisors, in May 2021 and July 2021 TPP Staff provided reports on the Triangulum between tobacco, cannabis and electronic smoking or vape devices, current FHS Feb 23 2023 Packet Page 67 of 174 trends in use among youth, and the negative health impacts associated with the use of vape devices, in particularly among vulnerable populations such as underage youth. In 2022, TPP had the opportunity to hire an intern temporarily to research cannabis ordinances locally and nationally to determine best practices. As a result of this research the intern developed a document entitled “Protecting Communities from Adverse Health Effects of Cannabis Products” where the following recommendations based on the research was made. The main finding was that legalization should not imply normalization. This can be achieved by implementing policies that prevent aggressive marketing practices, ensuring health warning are predominantly displayed at checkout, and not allowing consumption of cannabis at public places, including on premises of a cannabis retailer. With the support of the Board of Supervisors, the Contra Costa Tobacco Prevention Program continues to advance tobacco prevention policies and responds to various requests to provide technical assistance and work collaboratively with other public health departments on both tobacco and the other aerosolized substances, throughout the State, including San Francisco, Alameda, Sonoma, Santa Barbara, Los Angeles, and San Diego Counties. Technical assistance includes sharing best practices on the adoption, implementation, and enforcement of local tobacco prevention ordinances. Youth, who are most vulnerable to nicotine addiction and the harmful effects of tobacco, use tobacco at alarming rates. Contra Costa Health Services’ Tobacco Prevention Program is focused on addressing both ongoing and emerging issues that affect youth access to and use of tobacco products. Some of these emerging issues include the increasing co-use of tobacco with aerosolized substances such as hemp and cannabis, the potential increased use among youth of non-menthol cigarettes, and the lack of pro-active enforcement of tobacco policies across the county. Another concern TPP is focused on is countering the tobacco industry’s messaging that inaccurately promotes inhalable harm reduction/modified risk tobacco products as cessation aids. These issues are interconnected and have direct consequences on youth tobacco use and prevention, as well as TPP’s work. VII.Recommendations a.Tobacco retailers in Contra Costa must follow all state and local laws relating to the sale of tobacco, tobacco paraphernalia, drug paraphernalia, and controlled substances. Contra Costa has strong tobacco control policies which incorporates many components of a model Tobacco Retail Licensing Policy. Best practices for tobacco retail license policies also include a minimum price of $10 (per pack of cigarettes, little cigars, or cigars) and minimum pack size of 20 little cigars/cigarillos; and prohibition of tobacco coupons and discounting and the County’s tobacco policy currently does not include that The availability of inexpensive tobacco products leads to increased tobacco use as evidenced by more than 100 academic studies that conclusively show that when tobacco products are made more expensive, fewer people use tobacco, fewer initiate tobacco use, and more people quit tobacco use (citations 1-9, PHLC 2023). TPP asks that they be directed to further explore the benefits of considering these provisions in Contra Costa. FHS Feb 23 2023 Packet Page 68 of 174 b.TPP ask that staff be directed to continue to inform the FHS Committee and Board of Supervisors of the FDA’s final decision on menthol cigarettes and flavored cigars, and to provide updates on emerging trends in tobacco retail environment that have an impact on youth use of vaping. c.As has been previously mentioned in this report, TPP Staff was directed by the Board of Supervisors when they discussed and passed the resolution to repeal the Cannabis Vaping Prohibitions on December 3, 2022, and January 10, 2023. The following recommendations are in response to this directive and offer four options that TPP Staff would like to offer for consideration that support outreach and education efforts to increase the knowledge of youth about the harmful health impacts of youth use of cannabis products. 1.) Fund Existing Intervention Efforts at School Based Level: TPP Staff proposes providing $300,000 in additional funds for student services to existing programs such as TUPE to continue implementing and expanding their 1-1 brief interventions and YVAPE, an after- school education program that serves as an alternative to suspension, when youth are caught smoking or vaping on school campus. As highlighted through an analysis of California Healthy Kids Survey Data, it has become cri tical to specifically address the disparities that exist at the intersection of tobacco, cannabis, and youth mental health. This additional funding would ensure all youth’s needs are met by making these services available to all students on campus, along with two student demographics, LGBTQ+ students and Non-traditional students, who have been disproportionately affected by tobacco and cannabis use and are in need these services more. 2.) Fund a Restorative Justice After School Program TPP Staff proposes (1) providing funding up to $200,000 to schools to hire (3) Restorative Practice Specialists to implement Restorative Justice Programs that focus on building a sense of school community and resolve conflict by repairing harm and restoring positive relationships through the use of regular coaching and “restorative circles” where students and educators work together to set academic goals, develop core values for the classroom community, and resolve conflicts; and (2) providing additional funding to community- based organizations that focus on providing resources and assistance to schools to implement alternatives to school suspensions for those students caught using or holding vaping products. Decades of research has shown that suspension is not an effective tool to reduce youth use of substances like tobacco. Students who are suspended are far more likely to drop out and get involved with the juvenile justice system. In 2011, Richmond High School in West Contra Costa Unified School District implemented a Restorative School Discipline Program that resulted in decreasing the school’s nearly 500 suspensions (Jan 2011) in half FHS Feb 23 2023 Packet Page 69 of 174 by January 2012. Implementing this Restorative Justice Program would ensure the areas of the County with the highest need for additional support are met. 3.) Fund a Countywide Cannabis Youth Social Media Program: TPP Staff propose piloting a youth-led cannabis social media program. The program would have 25 youth and young adult participants that meet every month virtually and in-person to create personalized social media posts that showcase their daily lives and how they are staying safe from the harmful effects of cannabis. The goal of the program would be to increase knowledge, change attitudes, and increase positive behaviors among young people aged 14 to 24 through peer-to-peer education and leading by example via social media prevention and education messaging. Social media has become the main source of information for many young people. TPP Staff plan to tailor education and prevention efforts to meet the needs of youth in the community by using and meeting youth where they are on social media. Youth participants would be responsible for (1) attending one Creative Focus Group per month to brainstorm themes, draft social media posts, and create monthly campaigns, (2) attending one monthly meetup per month where they will have the opportunity to connect with their fellow program participants, receive presentations and trainings from experts in the cannabis prevention field, and engage in discussion regarding emerging topics related to cannabis, (3) creating a minimum of 3 social media posts per month, and (4) planning and hosting one workshop for the public on a topic related to cannabis prevention (e.g. cannabis and mental health). The pilot program would run for one year and each participant would complete a minimum of 35 hours and up to 70 hours and receive a stipend at $15 per hour rate. A total budget of $34,225 would be needed to run this program successfully. The budget justification is as follows: •Youth Stipends (70 hours x $15.50/hour x 25 YYA): $27,125 •Social Media Analytics Platform (1 year subscription): $3,600 •Workshop Venue: ~$1,000 •Honorariums for Guest Speakers and Trainers: $1,000 •Food and supplies for workshop: $500 •Youth Incentives: $1,000 TPP Staff will utilize (1) Instagram analytics, (2) Creative Focus Group discussions, and (3) monthly feedback sessions with program participants during the Monthly Meet Up to evaluate the effectiveness of the program on a quarterly basis to ensure program goals are being met and changes are being implemented as needed throughout the duration of the program. FHS Feb 23 2023 Packet Page 70 of 174 4.) Fund Youth Town Hall –"What's Up with Cannabis Vaping?" TPP staff propose hosting one town hall in collaboration with local partners to share insight into what cannabis vaping looks like and its effects through the eyes of a doctor, a local community-based organization that works with youth and 2 – 3 young people from throughout Contra Costa County. Local media will be engaged in this effort in order to widen the messaging about the impacts of cannabis vaping. Youth cannabis vaping continues to be a widespread issue as the 2022 Monitoring the Future report shared that 20.6% of 12th graders reported vaping cannabis within the past year compared to 27.3% of 12th graders who reported vaping nicotine. Given the high rate of cannabis vape use among youth TPP finds it to be an important time to dispel myths around cannabis vaping and youth and propose doing so in a widely publicized town hall. A similar town hall was conducted with the Tobacco Prevention Project in collaboration with Full Court Press and Global Media X for $20,000 focused on elevating the social injustices of the tobacco industry and their marketing of flavored tobacco products in two communities. A significantly larger style campaign of $100,000 geared towards sharing information about the harms of youth use of cannabis is being proposed with the unique view of working with ethnic media sources. d.Finally, TPP Staff recommends that the Family and Human Services Committee accept the report and direct staff to continue to provide updates on implementation of the ordinance as part of staff’s annual report on the County’s Tobacco Retail Licensing Ordinance. FHS Feb 23 2023 Packet Page 71 of 174 Citations: Institute of Medicine. Ending the Tobacco Problem: A Blueprint for the Nation. Washington, DC. 2007. Available at: https://www.nap.edu/catalog/11795/ending-the-tobacco-problem-a- blueprint-for-the-nation. Community Preventive Services Task Force. Reducing Tobacco Use and Secondhand Smoke Exposure: Interventions to Increase the Unit Price for Tobacco Products. 2012. Available at: https://www.thecommunityguide.org/findings/tobacco-use-interventions-increase-unit-price- tobacco. Centers for Disease Control and Prevention. State Cigarette Minimum Price Laws — United States, 2009. MMWR Morb Mortal Wkly Rep. 2010;59(13):389-392. Chaloupka FJ, Cummings KM, Morley C, Horan J. Tax, price and cigarette smoking: evidence from the tobacco documents and implications for tobacco company marketing strategies. Tob Control. 2002;11(Supplement 1):i62-i72. doi: 10.1136/tc.11.suppl_1.i8 Jawad M, Lee JT, Glantz S, Millett C. Price elasticity of demand of non -cigarette tobacco products: a systematic review and meta-analysis. Tob Control. 2018. doi: 10.1136/tobaccocontrol-2017-054056. Centers for Disease Control and Prevention. STATE System Excise Tax Fact Sheet. https://www.cdc.gov/statesystem/ factsheets/excisetax/ExciseTax.html. Accessed May 27, 2020. 60 Cal. Rev. & Tax. Code § 30111. Schleicher NC, Johnson T, Ahmad I, Henriksen L. Tobacco Marketing in California’s Retail Environment (2011–2014). Palo Alto, CA: Stanford Prevention Research Center, Stanford University School of Medicine. 2015. Federal Trade Commission. Cigarette Report for 2018. 2019. Available at: https://www.ftc.gov/reports/federal-trade-commission-cigarette-report-2018-smokeless- tobacco-report-2018. Wang TW, Falvey K, Gammon DG, et al. Sales Trends in Price-Discounted Cigarettes, Large Cigars, Little Cigars, and Cigarillos-United States, 2011-2016. Nicotine Tob Res. 2018;20(11):1401-1406. doi: 10.1093/ntr/ntx249 https://www.nytimes.com/2023/01/11/health/cigarettes-flavor-ban-california.html FHS Feb 23 2023 Packet Page 72 of 174 To: Family and Human Services Committee, Contra Costa Board of Supervisors From: Ori Tzvieli, MD Health Officer, Contra Costa County Public Health Director, Contra Costa Health Services Re: Annual Report on Implementation of Secondhand Smoke Protections Ordinance 2018-07 Date: 2/27/2023 I.Summary The Contra Costa Board of Supervisors adopted Smoke-free Multi-Unit Residences Ordinance 2018-07 on March 13, 2018, which increased secondhand smoke protections for persons and families living within multiunit housing. Implementation of Ordinance 2018-07 for new and renewing leases began on July 1, 2018, whereas for continuing leases and owner-occupied units, implementation would start on July 1, 2019. This brief report is specific to the continued implementation of the broader Smoke-free Secondhand Protections (Division 445-4) and the modified strategies utilized to continue activities as the project continues to be impacted by the COVID-19 pandemic. II.Secondhand Smoke Ordinance Background Across the State of California, and nationally, Contra Costa County continues to be recognized as a leader in developing and implementing local tobacco control policies. The County’s secondhand smoke protections have been updated and strengthened by the Contra Costa Board of Supervisors for more than a decade, with additional policies being adopted in October 2009, October 2010, April 2013, June 2014, July 2017, and March 2018. Amendments to the County’s Secondhand Smoke policy (Division 445-4) have expanded secondhand smoke protections and include the following: requiring all County-owned properties be 100% smoke-free; the inclusion of electronic smoking devices and cannabis in defining “secondhand smoke”; and the expansion of 100% smoke-free multiunit housing to include condos, townhomes, and the guest rooms of hotels and motels. III.Implementation of Ordinance 2018-07 Since February 2022 Report The Smoke-free Multi-Unit Residence Ordinance 2018-07 is implemented through the activities of the Tobacco Prevention Program (TPP) for the Public Health Division of Contra Costa Health Services. TPP operates a secondhand smoke complaint line and provides resources and education to community members about smoke-free multiunit housing tobacco control policies through email and phone calls. TPP Staff last reported to the Family and Human Services Committee in February 2022. The following is a summary of activities conducted March 2022 through December 2022. FHS Feb 23 2023 Packet Page 73 of 174 From March through December 2022, TPP received 53 secondhand smoke complaints from residents and landlords within the unincorporated areas and incorporated cities throughout the County. TPP Staff tracks secondhand smoke complaints in a spreadsheet and conducts follow-up by phone or email within 48 hours. TPP Staff provides residents with appropriate resources such as how to address the issue with the smoker and/or landlord, how to document smoking occurrences, and legal options for tenants affected by secondhand smoke. For complaints within unincorporated Contra Costa, TPP communicates with property managers, HOA, and owner- occupied units to ensure that compliance with signage and lease addendums is being followed. On- site compliance visits are conducted to address questions about where smoking is allowed and for unresolved complaints. Between March and December 2022, three on-site visits were conducted. Most complaints can be addressed with additional information provided to property managers. However, some cases have led to tenants moving towards legal action or moving out of current multiunit housing residence. When complaints are from incorporated cities in Contra Costa, after GIS address verification and secondhand smoke policy review, TPP Staff provide information about the relevant community’s policy and refer complainants to appropriate resources such as city staff, law and or code enforcement. As illustrated in Graph 1, of the 53 secondhand smoke complaints received between March and December 2022, over one third came from unincorporated Contra Costa. The next highest number of complaints came from the cities of Concord, Martinez and Richmond residents (Graph 1). Among the complaints from unincorporated communities, almost half were from unincorporated Walnut Creek, with smaller percentages from the unincorporated areas of El Sobrante, Danville, Bay Point and Crocket (See Graph 2). FHS Feb 23 2023 Packet Page 74 of 174 In terms of types of SHS complaints received March through December 2022, 57% of complaints were for combustible cigarette smoke, while 34% were for cannabis smoke; 9% were complaints for both cannabis and tobacco (Graph 3). IV.Technical Assistance to Contra Costa Cities TPP Staff provided technical assistance to local jurisdictions to incorporate components of the model ordinance and seeks to inform and educate those local jurisdictions that do not have tobacco control policy so that they consider protective smoke-free multiunit dwelling policies. Resources and downloadable smoke-free signs in four languages continue to be available on the CCHS TPP website. The smoke-free signs highlight that cannabis, vaping, and cigarette smoke is prohibited. Smoke free signage and decals can be provided upon request to all. The secondhand smoke webpage had 697 page views and 539 visitors between January 1, 2022, and June 30, 2022. TPP Staff plans to update the webpage to include additional information on other smoke-free MUH policies throughout the county in the future. Smoke-free messages that focus on reaching residents in unincorporated Contra Costa are posted regularly on the Tobacco Prevention Coalition ’s Facebook and Instagram social media platforms in collaboration with TPP Staff regularly. TPP Staff will continue to respond to requests for resources, assistance and information from residents, property managers and owners by phone and by email. TPP Staff plans to resume auditing and inspecting properties at random to confirm compliance with the smoke-free multiunit housing tobacco control policies early 2022 if funding is secured for these activities. TPP Staff provided education and resources to community members who filed complaints and forward the complaint to the appropriate contact in those cities when possible. Of the 19 jurisdictions, TPP Staff provided technical assistance to the cities of Pinole, Richmond, Hercules, Concord, and Pittsburg to either adopt, implement, or enforce secondhand smoke protection laws in their community. V.Next Steps for Technical Assistance to Contra Costa Cities TPP Staff will continue smoke-free efforts in 2023-2025 to help expand smoke-free protections to residents in Antioch and Pittsburg. TPP Staff has made moderate progress to date in these communities by informing and educating policymakers and community members on the importance of secondhand smoke model policy and best practices. FHS Feb 23 2023 Packet Page 75 of 174 VI.Recommendations TPP Staff requests that the Family and Human Services Committee accept the report and direct staff to continue to provide updates on implementation of the ordinance as part of staff’s annual report on Contra Costa’s Secondhand Smoke Protections Ordinance. FHS Feb 23 2023 Packet Page 76 of 174 Tobacco Prevention Program Annual Report Board of Supervisors Family & Human Services Committee 2/27/2023 FHS Feb 23 2023 Packet Page 77 of 174 Mission and Vision To educate and empower Contra Costa County residents through community research, capacity building, and laws to protect public health for all. Mission Tobacco Prevention Program Vision A Contra Costa free of harmful effects of tobacco and secondhand smoke FHS Feb 23 2023 Packet Page 78 of 174 Tobacco Prevention Program Goals Adopt secondhand smoke protections throughout Contra Costa County Adopt comprehensive Tobacco Retail Licensing Policies throughout Contra Costa County 11/19 jurisdictions 14/19 jurisdictions Utilize a community engagement approach with a special emphasis on youth and multi-unit housing residents FHS Feb 23 2023 Packet Page 79 of 174 Smoke Free Multi-Unit Housing Policy Picture Courtesy: CDPH FHS Feb 23 2023 Packet Page 80 of 174 Smoke Free Multi-Unit Housing in Unincorporated County Adopted March 2018 Update since 2022 FHS Report Technical Assistance FHS Feb 23 2023 Packet Page 81 of 174 FHS Feb 23 2023 Packet Page 82 of 174 Contra Costa Smoke-Free Multi Unit Housing Policies FHS Feb 23 2023 Packet Page 83 of 174 Second-Hand Smoke (SHS) Data- 2022 FHS Feb 23 2023 Packet Page 84 of 174 Tobacco Retailer Licensing Policy Photo: Public Health Law Center PHLC TRL Enforcement Guide FHS Feb 23 2023 Packet Page 85 of 174 Tobacco Retail Licensing Overview Compliance Checks SB793 Prop 31 Technical Assistance Tobacco Education FHS Feb 23 2023 Packet Page 86 of 174 The Board of Supervisors Adopted Ordinance 2019-34 in November 2019. No sale of flavored tobacco (including menthol) No sale of e-cigarette/vaping devices Little cigars must be sold in packs of at least 10 No new tobacco retailers within 1,000 ft of youth sensitive areas or 500 ft of another retailer Cap on tobacco retailers (90) Prohibits coupons Ordinance 2019-34 Contra Costa County Tobacco Retail Licensing Ordinance No new significant tobacco retailers including smoke shops and hookah lounges FHS Feb 23 2023 Packet Page 87 of 174 Compliance Inspection Visits: 5 1 visit led to Retail License Suspension Hearing that resulted in 21 day suspension 1 visit led to a Notice of Fine for operating without a license 3 visits led to warnings The Board of Supervisors Adopted Ordinance 2019-34 in November 2019. Sale of flavored tobacco Sale of e-cigarette/vaping devices Sale of little cigars in packs less than 10 Ordinance 2019-34 Tobacco Compliance Inspections Sales to Minors FHS Feb 23 2023 Packet Page 88 of 174 Flavored Tobacco Policy Background 2017 & 2019 2022 20222009 The Family Smoking Prevention Act Adopted Ordinance 2019-34 Board of Supervisors strengthened ordinance - prohibiting sale of all flavored tobacco products and restricting sales of vaping devices FDA began rule-making process to prohibit the sale and manufacturing of vaping devices without FDA approval CA voters upheld state law prohibiting tobacco retailers from selling most flavored tobacco products 2020 FDA prohibits flavored cartridge based e- cigarettes (menthol exempt) FHS Feb 23 2023 Packet Page 89 of 174 Retailers and their employees who sell, offer for sale, or possess with intent to sell or offer for sale, prohibited flavored tobacco products will be found guilty of an infraction and fined $250 for violation of Prop 31. **Local Enforcement Agencies determine if they will fine $250 per product, per package/carton, or per visit** Proposition 31 SB 793: Flavored Tobacco Products FHS Feb 23 2023 Packet Page 90 of 174 "Characterizing flavor" means a distinguishable taste or aroma imparted by a tobacco product or any byproduct produced by the tobacco product that is perceivable by an ordinary consumer by either the sense of taste or smell, other than the taste or aroma of tobacco. A "characterizing flavor" includes, but is not limited to, a taste or aroma relating to a fruit, chocolate, vanilla, honey, candy, cocoa, dessert, alcoholic beverage, menthol, mint, wintergreen, herb, or spice. Concept & Characterizing Flavors FHS Feb 23 2023 Packet Page 91 of 174 FHS Feb 23 2023 Packet Page 92 of 174 Tobacco Retail Policy Landscape per City FHS Feb 23 2023 Packet Page 93 of 174 Health Impact of Cannabis on Adolescents Cannabis affects the developing brain leading to potential changes on how we feel, think, and how stress affects us Standford Medicine-Cannabis Prevention and Awareness Toolkit, 2023 Youth "training" the brain to get pleasure from cannabis use & then myelinating that, and training the brain to also think it's important Use cheats brain from improving or perfecting a cool, new skill that fires off dopamine naturally for youth Finding what naturally releases dopamine for each individual is key for youth development FHS Feb 23 2023 Packet Page 94 of 174 Recommendations for Cannabis Education and Prevention Programs for Youth Youth Town Hall Youth Education/ Social Media Program School-Based Interventions FHS Feb 23 2023 Packet Page 95 of 174 THANK YOU FHS Feb 23 2023 Packet Page 96 of 174 FAMILY AND HUMAN SERVICES COMMITTEE 8. Meeting Date:02/27/2023 Subject:Consideration for a Healthy Retail Ordinance Submitted For: Anna Roth, Health Services Director  Department:Health Services Referral No.: 122 - New 2023 Referral Name: Policy Options for Healthy Options at the Point of Sale (HOPS)  Presenter: Ali Wohlgemuth, Ingrid De Santiago, Denise Milosevich, Mayra Lopez, HOPS Youth Advocates Contact: Enid Mendoza, (925) 655-2051 Referral History: At the May 24, 2022 Board of Supervisors meeting, Healthy Options at Point of Sale (HOPS) youth advocates presented information and recommendations for healthy food options and condom accessibility in the retail environment of unincorporated Contra Costa County. The presentation concluded with a unanimous Board vote to refer to the Family and Human Services Committee the topic of Healthy Options at Point of Sale so that the Health Services Department's Public Health Division, in collaboration with the HOPS youth advocates, could look further into the issues presented and prepare policy or ordinance recommendations for the full Board's consideration. Referral Update: The policy being considered is the Healthy Retail Ordinance, which would set minimum nutrition standards for foods and drinks at checkout, and require condoms to be available to customers without staff assistance, in food retail stores over 2000 square feet throughout unincorporated Contra Costa County. The purpose of this policy is to address inequitable marketing and placement of unhealthy foods and drinks in the retail environment and ultimately decrease the prevalence of diet related chronic diseases in Contra Costa County. The secondary purpose is to address the gap in condom availability through the retail environment to mitigate the disproportionate rates of Sexually Transmitted Infections (STIs). Recommendation(s)/Next Step(s): DISCUSS the issues presented and the policy option recommendations from the Health Services Department Public Health Division staff on the topic of Healthy Options at Point of Sale; AND ACCEPT the reports and workplan as presented by the Health Services Department Public Health Division staff regarding its findings and recommendations on the topic of Healthy Options at Point of Sale and DIRECT staff to forward the reports and recommendations to the Board of Supervisors for further consideration; OR DIRECT staff regarding further follow up information needed for continuing the discussion at this Committee. Fiscal Impact (if any): There is no fiscal impact. Attachments Healthy Retail Staff Report Retailer Implementation Packet FHS Feb 23 2023 Packet Page 97 of 174 Proposal for Healthy Checkout Model Ordinance Healthy Retail Presentation Slides FHS Feb 23 2023 Packet Page 98 of 174 To: Family and Human Services Committee, Contra Costa Board of Supervisors From: Ori Tzvieli, MD, Director Public Health Re: Healthy Options at Point of Sale Date: 2/27/23 I.Background On May 24, 2022, Contra Costa Health Services (CCHS) and a local community organization named Bay Area Community Resources (BACR) presented along with their youth led advocacy team known as Healthy Options at Point of Sale (HOPS) with the prospective health benefits of a Healthy Retail policy to the Board of Supervisors. The recommended policy would require the placement of healthy food options in checkout queues or point of sale and make condoms accessible without retailer assistance with the overarching goal of reducing the negative health impacts associated with poor nutrition and sexually transmitted infections (STIs) resulting from unprotected sexual activity. At the conclusion of the presentation the Board of Supervisors requested that Contra Costa Health Services staff work with BACR to further explore Healthy Retail policy options and the matter was referred to the Family and Human Services Committee for continued discussion. This report seeks to provide supplementary information regarding Healthy Retail health benefits and offer considerations for action to be reviewed by this committee and the full Board of Supervisors. II.Contra Costa Health Services Nutrition and Physical Promotion Program The overall goal of the CCHS Nutrition and Physical Activity Promotion Program (NPAP) is to use evidence-based approaches to reduce rates of obesity and chronic diseases associated with poor nutrition and physical inactivity. This is accomplished through a comprehensive nutrition education and physical activity promotion program that seeks to increase access to and the consumption of healthy foods and water; reduce sugar-sweetened beverage accessibility; increase opportunities for safe, physical activity; and increase food security among the most vulnerable Contra Costa County residents. As a U.S. Department of Agriculture (USDA) Supplemental Nutrition Assistance Program Education (SNAP-Ed) funded program, NPAP prioritizes partnering with communities that are living <185% below the federal poverty line to support and enhance the probability that persons eligible for SNAP will make healthier food choices and choose physically active lifestyles as an outcome of the program’s strategies and interventions that focus on education and training; social marketing and retailer engagement; as well as policy, systems, and environmental changes (PSE) that make the healthy choice the easy choice. The work developed by NPAP is guided by several public health best practices and model frameworks that influence a person’s health within a community. FHS Feb 23 2023 Packet Page 99 of 174 III.Model Frameworks of Public Health Public Health Social-Ecological Model for Food & Physical Activity Decisions The Social Ecological Model is a guiding principle for SNAP-Ed program that demonstrates how various influences ranging from individual factors to social and cultural norms can shape decisions regarding physical activity patterns, food and beverage consumption, and, eventually, health outcomes. The social-ecological model used by the USDA places individual factors such as knowledge and taste within environmental settings (the food environment). For example, a participant’s behavioral changes resulting from nutrition education and physical activity class and/or workshop. Individual behaviors are then influenced within the sectors, systems, organizations, businesses, and industries. This includes agriculture, marketing, retail, and government influence on the food environment, which are set within social and cultural norms and values. Within these sectors are the settings where individuals eat, learn, live, play, shop, and work. The settings influence those individuals’ behaviors through the PSE changes. Similar conceptual upstream frameworks, such as Bay Area Regional Health Inequities Initiative, illustrates the connection between social inequities and health, and focuses attention on measures which have not characteristically been within the scope of public health department epidemiology. This framework has been used widely as a guide to health departments undertaking work to address health inequities. Changes to public policies to improve health equity remains an important tenet of NPAP’s work in Contra Costa County. FHS Feb 23 2023 Packet Page 100 of 174 IV.National and Local Health Outcomes National and Local Rates of Adult Obesity Over 4 out of every 10 American adults are obese, according to a study by the CDC. 1 out of every 10, the study says, is severely obese. This chart shows the percentage of Americans who are obese based on a height and weight survey. The findings come from the Centers for Disease Control and Prevention annual health survey from 2017-2018, where over 5,000 U.S. adults measured their height and weight. For 2017- 2018, the survey recorded a record 42 percent of people within the obesity threshold, with over 9 percent within the severely obese threshold (NHANES, 2021). These numbers are up 2 percent and 8 percent, respectively, from the health survey of 2015-2016. According to the CDC, obesity rates in the country have been steadily climbing for the past two decades. In 1999-2000, the same health survey found an obesity rate around 30 percent – much lower than the 42 percent recorded in 2017-2018 (NHANES, 2021). Other national data from the 2017-2020 National Health and Nutrition Examination Survey also show nationally, 41.9 percent of adults have obesity, with African Americans adults having the highest level of adult obesity at 49.9%, followed by Hispanic adults with a rate of 45.6%, White adults at a rate of 41.4%, and Asian adults with the lowest obesity rate of 16.1% (NHANES, 2021). In Contra Costa County the obesity rate continues to rise, with over 25% of the adult population with obesity. National and Local Rates of Childhood Obesity The CDC states that childhood and adolescent (ages 2-19 years) obesity rates have reached epidemic levels in the United States. Currently, about 17% (14.7 million) of US children and adolescents are obese. Yet not all communities experience the same level of negative impacts by this health condition, making it also an issue of health equity. Childhood obesity is also more common among certain populations. FHS Feb 23 2023 Packet Page 101 of 174 According to the CDC, the obesity prevalence was the highest among Hispanic children at 26.2%, compared to 24.8% among non-Hispanic Black children, 16.6% among non-Hispanic White children, and 9.0% among non-Hispanic Asian children (Stierman, 2021). In addition, the CDC revealed that obesity prevalence was correlated with socioeconomic status. Its study found higher obesity rates of 18.9% among children and adolescents aged 2-19 years in the lowest income group, compared to 10.9% among those in the highest income group. Local data, such as the FitnessGram Report, is a reference that allows tracking of the physical fitness assessment scores and healthy zone achievement among students in 5th, 7th, and 9th grade. In Contra Costa County, the FitnessGram Report revealed that 36.5% of 5th and 7th grade students are obese, with its highest obesity rates among children of color. Rates are highest among communities of color with over 40% for African Americans, close to 50% for Hispanic and Latinos, and 60% for Native Hawaiian/ Pacific Islanders. National and Local Leading Causes of Death The CDC further states that obesity has individual and societal consequences for both children and adults as it has the potential to increase the risk of numerous health conditions that lead to illness and death, decrease quality of life, increase risks for mental health challenges, and medical costs. According to the CDC, these conditions themselves can lead to other chronic illnesses and health maladies that impact quality of life such as heart disease and stroke, certain cancers (including colorectal cancer and breast cancer), Type 2 diabetes, and tooth decay; these conditions can also be disruptive to one’s work life and contribute to a loss of income for an individual. Psychological problems such as anxiety and depression, low self-esteem and lower self- reported quality of life, social problems such as bullying and stigma result in impacting children and adolescents overall physical health. In fact, heart disease remains the leading cause of death in the United States, at 165 deaths per 100,000 individuals in 2017 (Morrison, 2015). Other diseases related to cardiometabolic health saw increases. CDC’s National Center for Health Statistics (NCHS) revealed that strokes and diabetes each caused a small but significant increase in deaths in 2017, which saw a 1-year increase to 37.6 from 37.3 stroke deaths per 100,000 people. Diabetes deaths increased to 21.5 from 21 per 100,000 the previous year (NHANES, 2021). Stroke was the fifth and diabetes the seventh most common cause of death, according to the data brief published by the CDC’s National Center for Health Statistics. FHS Feb 23 2023 Packet Page 102 of 174 The Behavioral Risk Factor Surveillance System (BRFSS), which collects county health data through telephone surveys, along with research from the California Department of Public Health (CDPH), revealed that among adults in Contra Costa, 9.06% have been diagnosed with heart disease within the last 5 years. Moreover, the 2017-2019 Centers for Disease Control’s Interactive Atlas of Heart Disease and Stroke estimated the average hypertension hospitalization rate for Contra Costa County adults over 65 years old was 14.4%, with rates for African Americans being the highest. In fact, according to the CDPH Contra Costa County Health Status Profile for 2018, the leading cause of death is attributed to heart disease. The report also stated in 2019-2020, adults diagnosed with high blood pressure was 27.15%, with 9.87% being diagnosed with diabetes. Rates were higher overall for adults living 185% below the Federal Poverty Level (FPL) illustrating the health disparities that continue to exist for those underserved communities within the county (CDPH, 2020). Health Impact and Access within the Retail Environment Increasing attention has been given to the role of retail food environments in shaping dietary behavior and obesity risk. Studies show an association between living in a neighborhood near healthy food options and better dietary quality, higher fruit/vegetable intake, and a lower risk of having a higher body weight, even after controlling for individual level characteristics (Pem, 2015). Promoting healthier foods and beverages in retail environments near underserved communities of color who frequently lack full-service grocery stores is one solution to promote health and prevent chronic disease. Individual circumstances, such as mobility, financial resources, travel time, and transportation availability, greatly influence food access. The United States Department of Agriculture’s (USDA) Economic Research Service defines food deserts as “areas with limited access to affordable and nutritious food.” There are various measures of access, including distance to the store, income, and availability of transportation (personal vehicle or public transit). The USDA Economic Research Service estimates that 2% to 5% of the United States population lives outside of walking distance from a supermarket and has no vehicle access. In 20% of rural counties, residents must travel more than ten miles to the closest supermarket or superstore (USDA, 2023). While urban community members may have access to supermarkets via public transportation, they face other challenges, such as the cost of using public transit and significant travel time to and from food retailers. In the absence of conveniently accessible supermarkets or conventional grocery stores, small stores may serve as the primary retail food source for many community residents. In some communities, FHS Feb 23 2023 Packet Page 103 of 174 small stores are the only place for SNAP recipients to use their benefits. While corner stores stock a range of options (hot and cold prepared foods, packaged items, beverages), their inventories tend to feature high-calorie, low-nutrient items, such as fried foods, snacks, and packaged baked goods. Consequently, the USDA Economic Research Services research states that individuals who rely on these establishments have difficulty obtaining the quality and quantity of healthy food they need to meet dietary guidelines. The items stocked by corner stores often reflect the goods available to them. Independently owned businesses constitute 63 percent of the nearly 153,000 small stores that operate in the United States. Supply chain and distribution channels can make it difficult for these stores to stock healthy items because they may not, given their size, meet distributors’ minimum order requirements and may face cost issues, namely that healthy items must be purchased in smaller quantities due to shorter shelf lives and are often more expensive to stock. Additional barriers to stocking fresh food include: a lack of equipment for proper storage, staff knowledge regarding handling and food safety, and understanding of what constitutes healthy food. Research suggests that communities without access to grocery stores are at higher risk of being overweight or obese (Morland et al. 2006). Instead of grocery stores, these areas are often high in stores that sell less nutritious foods, including fast food restaurants and convenience stores. This combination is especially prevalent in low-income urban areas, and the high density of non- nutritive food options has led some researchers to term these areas “food swamps.” Food swamps are abundant throughout Black, Indigenous, People of Color (BIPOC) communities where fast foods and junk foods are more abundant than healthy foods (Hager et al, 2017). The USDA’s Food Access Research Atlas provides data to showcase food access indicators for low-income communities, which map the accessibility to sources of healthy food as measured by distance to a store or by the number of stores in an area. Below is the 2019 food access map for Contra Costa County. The green highlighted areas depict the communities that are low-income and have a lack of access to food, otherwise known as the county’s food deserts. From examining the map, low-income communities of East and West Contra Costa County have more than a 1- mile distance to the nearest supermarket with vehicle availability within the county. Retail environments can make the difference to reduce the obesity rates among all populations by offering foods or snacks that are healthier and can be prepared at home. Moreover, studies have FHS Feb 23 2023 Packet Page 104 of 174 found that retail outlets can be readily available and accessible for those last minute purchases that are important, such as condoms, for preventing the spread of STIs. Local Rates of Sexually Transmitted Infections Contra Costa Health Services HIV/AIDS and STI Program is dedicated to fostering the development, implementation, and coordination of programs to reduce the transmission of HIV and STIs; provide education, prevention and testing services including free condoms and lube, HIV and Hepatitis C testing services, PrEP Navigation, and trainings for community and providers. STIs are steadily increasing in Contra Costa. The numbers are very high in sexually active youth under the age of 25 years. The program encourages all persons who are sexually active to practice safer sex. By using a barrier such as an intact condom, the risk of spreading an infection is decreased. In Contra Costa County 275 of every 100,000 residents (age 13 and above) are living with human immunodeficiency virus, or HIV. Chlamydia cases have also risen at 521.7 new cases diagnosed per 100,000 people, based on 2019 data. The chart below indicates county, state, and national trends for STIs from 2007 to 2019. Retail Setting and Condom Accessibility One of the instrumental programs of the HIV/AIDS and STI program has been educating and assisting youth with access to condoms. The Essential Access Health's Condom Access Project is expanding its free home mailer condom distribution program for teens to Contra Costa County in partnership with CCHS. The program is being launched locally to address high STI rates among youth in the region. In addition, to combat the rising STI rates, the Condom Access Project allows teens and young adults in Contra Costa to sign up for free, confidential delivery of condoms to their homes as often as once a month. The service, already offered in eight other counties, including Alameda and San Francisco, has delivered more than 753,000 free condoms to date. However, more work still needs to be done to increase access in retail outlets. FHS Feb 23 2023 Packet Page 105 of 174 Locking up condoms or keeping them behind a counter creates barriers that make it more difficult for individuals at the time of purchase. Requiring customers to ask a store clerk to unlock a shelf or select a condom from behind the counter discourages youth and adults from purchasing condoms because of feelings of shame and stigma. It is important that retailers be supported and encouraged to sell condoms and keep them unlocked on shelves that are always accessible to foster safe sexual behaviors. Condoms are considered a high-risk theft item by retailers. However, according to a report conducted by The Pharmacy Practice, a 2010 pilot study was done with eight Midwestern pharmacies, in which all condoms were unlocked and on the shelf for three months. The study showed that after removing condoms from locked displays, more condoms were purchased and less were stolen from the pilot study pharmacies. It was revealed that sales outweighed theft in all pharmacies. It is believed that Contra Costa could experience the same over time, if retailers practice increasing condoms accessibility in high need areas, and that this could potentially result in a decrease in STIs. V.Inequities of Access to Healthy Food within the Social-Ecological Model Marketing and Advertising in Low Income Communities of Color According to Rudd Center for Food Policy & Obesity; Council on Black Health, U.S. food companies disproportionately target Black and Hispanic consumers with marketing for high- calorie, low-nutrient products including candy, sugary drinks, snacks, and fast food (Durfee, 2021). The more than one billion spent on this targeted marketing exacerbates inequities in poor diet and diet-related diseases in communities of color, including heart disease, obesity, and diabetes. The marketing of unhealthy foods and beverages to youth may contribute to obesity by influencing their food choices, taking advantage of their developmental vulnerabilities. The food and beverage industry spends approximately $2 billion per year marketing to youth (Kovacic, W. e. 2008). Low-income and BIPOC people in the United States are targeted by the food and beverage industries with disproportionate in-store and media-based advertising. In 2017, food companies spent $1.1 billion targeting Black, and Hispanic television viewers, and Black teens saw twice as many advertisements for unhealthy foods as their white counterparts (Harris, 2018). A meta-analysis of 22 studies showed that food advertising is linked to increased food consumption in children, particularly after kids have viewed ads for highly processed foods (Boyland et al, 2016). Furthermore, the food industry pays to place products at checkout. Product promotion, like that referenced above, occurs not just on television and online but also in retail stores. The industry pays slotting fees to get highly processed, often sugar-sweetened products in front of consumers throughout the grocery store (Rivlin, 2016). Research shows that this strategic placement can prompt children’s requests for foods (Horsley, 2014) and adult purchases (Kerr, 2012). Products at checkout are currently unavoidable and contribute to impulse buys that harm health (Cohen, 2012). Data from the Journal of American Diabetics stated that empty calories from added sugars and solid fats contribute to 40% of daily calories for children and adolescents age 2–18 years— affecting the overall quality of their diets (Reedy, J, Krebs-Smith SM, 2010). Approximately half of these empty calories come from six sources: soda, fruit drinks, dairy desserts, grain desserts, FHS Feb 23 2023 Packet Page 106 of 174 pizza, and whole milk (Reedy J, Krebs-Smith SM, 2010). Most youth do not consume the recommended amount of total water (Drewnowski A, Rehm CD, Constant F., 2013.) Experts and researchers agree that high levels of consumption of unhealthy foods is a huge contributor to the steep rise in rates of diabetes, high blood pressure, and even strokes. Healthy Stores Healthy Communities (HSHC) Survey – Contra Costa County In 2019 NPAP, the HIV/AIDS and STI, Tobacco Prevention and Alcohol and Other Drugs Program and their partners, including BACR, participated in the CDPH Healthy Stores Healthy Communities (HSHC) campaign whose goal is to improve the health of residents and reduce health inequities by supporting healthy changes in the retail store (including convenience stores and gas stations) environment. Below are the findings from the survey. Findings: Access to Healthy Foods in Contra Costa County Of the 183 Tobacco retail stores surveyed by the HSHC Taskforce, 54% of those stores carried a selection of fresh fruits and vegetables for purchase and 33.9% stocked low-or non-fat milk. In comparison, over 50% of unhealthy sugary drink storefront ads and access to sugary drinks were advertised at the point of checkout. The dearth of availability of fresh, quality, nutritious foods and drinks in the retail store environment is apparent in the data. Findings: Condom Accessibility in Contra Costa County While the abundance of unhealthy foods and beverages are a concern due to their profound impact on consumer health, the HSHC campaign also revealed barriers regarding the accessibility of condoms in the same communities that face a high burden of sexually transmitted infection. The data collected by HSHC on condom inaccessibility in unincorporated communities was alarming with 86% of county retailers selling condoms; of those, 57% kept condoms locked on shelves or behind the checkout counter. VI.Community Collaboration for Change Historically NPAP has engaged local retailers in education and social marketing strategies to improve their store environment and encourage patrons to purchase healthy foods. For example, NPAP has conducted store tours, provided recipes for retailers to provide to their customers, and conducted food demonstrations in the stores themselves. In addition, NPAP has intentionally developed strong ties and relationships with youth-serving agencies as empowering young people to make healthy choices to improve their quality of life has been a priority for the project. Bay Area Community Resources is one of several youth-serving agencies that NPAP has also awarded subcontracts to engage young people in developing healthy eating habits and physically active lifestyles in the early stages of life. BACR and the HOPS Youth Advocacy Team BACR’s program uses a Youth Participatory Action Research (YPAR) model which engages young people to conduct community-based research, analyze data, and use this data to develop policy, systems or other environmental change proposals. In engaging youth as co-researchers, youth participants gain transferable, real-world skills in project planning, communication, and complex problem-solving. FHS Feb 23 2023 Packet Page 107 of 174 In 2019, BACR began a project working with high school aged youth in the West Contra Costa Unified School District. The youth wanted to assess the prevalence of sugar-sweetened foods and beverages in the retail environment. The project later became known as the Healthy Options at Point of Sale youth advocacy team. Community-based Research and Findings Incorporating the tenets of the YPAR framework, the HOPS youth gathered information and conducted in-store retail observations throughout Richmond and unincorporated areas of Contra Costa County. The youth also conducted surveys, resident focus groups, and expert interviews in Richmond, North Richmond, East Richmond Heights, and El Sobrante neighborhoods. This two- year effort and assessment resulted in data being collected from 40 grocery and corner stores, 5 focus groups, 8 key interviews (local health providers, educators), and 3 retailer interviews (local grocery and convenience stores in Richmond) and 562 Richmond voters being surveyed. Their findings revealed that in the unincorporated communities of Contra Costa, 69% of beverages at the local stores’ checkout area were unhealthy compared to only 24% healthy options that were available. Similarly, 55.5% of foods sold were unhealthy with chips, candy, and high sugar snacks available at the checkout, while only 4.5% of foods present were healthy with bananas, mixed nuts, and dried fruit available at the point of sale. The remaining 40% of food options was made up exclusively of gum and mints. Overall, the HOPS advocacy team findings revealed that candy made up 35% of all foods sold at checkout. Focus group and key informant findings had unanimous support for healthy checkout. The main motivators for this support included the acknowledgement that unhealthy items appeared to be targeting children; a concern for long term health effects on youth who consume unhealthy foods and beverages; a lack of access to quality foods in low-income neighborhoods; inaccessibility to healthier groceries stores; and the desire to support local farmers in their produce purchases. Of the 562 Richmond voters surveyed, 77% supported a policy or ordinance of healthier options at the point of checkout. Of the 3 retailers interviewed, all were in full support for a healthy checkout, with their main concerns centered around a perceived lack of demand, short life of produce, but they agreed that consumers should have the choice to eat healthier foods. Community and Partner Collaboration In July of 2021, the HOPS youth advocates presented their findings and proposal for a healthy checkout policy to the countywide Families CAN coalition, hosted by the NPAP team. Subsequently, NPAP invited HOPS to present at an HSHC Taskforce meeting. From this collaboration came the addition of condom access to HOPS’ proposal. Upon considering both healthy retail efforts, there was an apparent opportunity for HOPS to amplify the impact of healthy retail and to pursue wider health outcomes in unincorporated areas by including condom access. Many of the 32 stores under healthy checkout are stores which sell condoms but restrict access and are situated in areas experiencing higher STI rates. With the guidance of the HSHC Taskforce and the HIV/AIDS and STI program, HOPS integrated education around this issue into their ongoing campaign. Countless other community partners from across the county, several of whom were fellow subgrantees of NPAP, hosted the youth advocates’ presentations and provided FHS Feb 23 2023 Packet Page 108 of 174 feedback and letters of support. These included organizations such as Healthy and Active Before 5, 18 Reasons, Fresh Approach, and the UC Cooperative Extension. Youth Advocacy The HOPS youth advocacy team has presented the findings above to the Richmond City Council and the Contra Costa Board of Supervisors requesting that strong consideration in both jurisdictions be given to a policy that would require that items stocked at checkout consist of 5 or less grams of added sugar per serving, 200mg or less of sodium per serving, and that beverages exclude added sugar and sweeteners. This policy recommendation puts healthier snack options in front of waiting customers. This makes it easier for customers to make healthy choices, while still allowing them to purchase their favorite treats in other store aisles. VII.Research Best Practices in Healthy Retail International Research To address obesity and corresponding metabolic disease, the United Kingdom (UK) now implements restrictions on less healthy food items, which are no longer permitted within two meters of designated queuing area or point of sale (Department of Health and Social Care, 2021). It also disallows the placement of less healthy foods in prime locations such as aisle end caps. The regulations come following years of research throughout Europe supporting strong, consistent policy for healthy foods at checkout. Before the UK implemented national policy, many supermarkets across the UK piloted voluntary healthy checkout initiatives, reducing the less healthy options stocked at checkout. Studies conducted on these stores found that those with clear, consistent policies were the most effective at implementation (Lam et al., 2018). In the year following the implementation of these healthy checkout policies, there was a 15% decrease in the purchase of less healthy items like chocolate, candy, and chips that were previously stocked at checkout (UKCRC Centre for Diet and Activity Research, 2020). A corresponding study by Dutch researchers found that when implementing healthy checkout, the complete substitution of less healthy snacks with healthier alternatives is most effective at reducing less healthy purchases (Huitink et al., 2020). Local Research In a national study, one in three adults reported purchasing foods from the checkout aisle during their last shopping trip, with lower-income shoppers more likely to purchase from checkout than higher-income shoppers (Falbe et al., 2021). Falbe’s research indicates that healthy checkout policies have the potential to impact both nutrition and health equity. A meta-analysis of sugar-sweetened beverage tax policies, like those enacted in Berkeley, Albany, Oakland, and San Francisco also work to reduce the purchase of sugary drinks through higher prices (Andreyeva et al., 2022). VIII.Bay Area Healthy Retail Initiatives Healthy retail is a priority for many leading health organizations and local health departments. In Contra Costa County, NPAP has been a long-standing grantee of the California Department of Public Health’s Nutrition, Education, Obesity Program (CDPH-NEOP) Branch to deliver nutrition and physical activity programming to low-income families within the county. The program’s FHS Feb 23 2023 Packet Page 109 of 174 funding with CDPH-NEOP grant is aimed to assist families who are enrolled and/or are eligible for SNAP for themselves and their families. Its programming offers SNAP participants with nutrition education classes, social marketing campaigns, and efforts to improve policies, systems, and the environment of communities. It also encourages efforts to promote retail-based PSE change strategies to encourage storeowners to increase access to and availability of healthy food choices. The SHOP Healthy Here (SHH)- Healthy Retail Recognition Program facilitates partnerships between qualifying small neighborhood grocery stores and local health departments to increase the purchase and consumption of healthy foods and beverages among SNAP-eligible Californians. By providing retailers with a variety of tools, resources, and outreach activities, SHH builds the capacity of retailers to inspire healthy changes among consumers. Funds granted to CCHS-NPAP include the Healthy Refrigeration Grant Program from the California Department of Food and Agriculture to support additional retail environment interventions. The funds support energy efficient refrigeration units in corner stores, small businesses in low-income or low-access areas throughout the state to stock California-grown healthy, minimally processed, and culturally appropriate foods. CCHS is partnering with local retail stores to provide technical assistance to retailers to apply for energy-efficient refrigeration for quality produce, connect retail stores to local farms for better quality produce, stimulate the local economy and minimize transportation needs, and marketing strategies, including in-store cooking demonstrations and healthy advertising. Other local partners, such as BACR and the Berkeley HOPS youth advocacy team, have been awarded by the Healthy Berkeley Community Grants Program to lead efforts to pass the Healthy Checkout Ordinance for the City of Berkeley, the first of its kind in the United States. This ordinance applies to stores larger than 2,500 square feet and prohibits stores from selling food items that contain more than five grams (5g) of added sugars or 200 milligrams (200mg) of sodium per serving or beverages with any added sugar or sweeteners, within three feet of a cash register. The City of Berkeley’s ordinance went into effect on March 1, 2021, and enforcement began on January 1, 2022. Youth-led HOPS teams are currently working in the cities of Richmond and Oakland to introduce similar healthy retail policies. Finally, other Bay Area counties that have passed similar policies include the County of San Francisco that in 2013, adopted The Healthy Food Retailer Ordinance to improve health outcomes by increasing access to healthy food and reducing unhealthy influences such as tobacco, alcohol, and processed foods in underserved parts of the city. Technical assistance and store redesign to support a healthy retail environment are key components of the program. IX.Policy Considerations for a Healthy Retail Ordinance in the unincorporated communities of Contra Costa County Contra Costa County’s retail environment plays a critical role in the overall health of the county. The retail food environment impacts the local economy and affects the physical health of the neighborhood. Other essential items that contribute to an individual’s health, include access to condoms. Retail outlets are ideal convenience hubs to purchase condoms for adolescents and adults alike. FHS Feb 23 2023 Packet Page 110 of 174 It is with this understanding, coupled with findings from data gathered through extensive research from local and national studies, the HOPS youth advocacy assessments and HSHC retail findings, that Contra Costa Health Services recommends the following actions designed to help protect youth and other sensitive populations from the potential negative health impacts associated with poor nutrition, physical inactivity, and inaccessibility to condoms in the unincorporated communities of Contra Costa County. Policy Recommendation Contra Costa Health Service’s NPAP staff and BACR recommend adopting a two-phase approach to healthy retail policy for stores greater than 2000 square feet in unincorporated Contra Costa County. Phase 1: Adopt a policy to advance healthy checkout which would require, in designated checkout aisles and within 3 feet of a register: ●Foods with ≤ 5 grams added sugar and ≤ 200 mg sodium per serving ●Gum and mints with no added sugar ●Beverages with no added sugar and no low- and no-calorie sweeteners Timeframe for Phase 1 Phase 2: Adopt a policy that would make one or more external condoms available in retail stores without clerk assistance. Timeframe for Phase 2 FHS Feb 23 2023 Packet Page 111 of 174 Implementation Contra Costa Health Services staff and BACR’s HOPS youth will provide Healthy Retail education and technical assistance to 32 retail stores. This assistance will include: 1) distributing retailer education packets, information cards, list of healthy options, and health promotion posters; 2)providing one-on-one technical assistance for all stores by phone, email and in-person visits; and 3) conducting no penalty store evaluations and evaluation feedback for store managers. Enforcement It is recommended that the Health Services Department staff will be responsible for the enforcement of the sale of healthy food and beverage options at checkout, which will begin nine months after the passing of the ordinance to allow time for retailer education and engagement. The Health Services Department staff will make at least one visit to each retailer each year to ensure stores are compliant in stocking healthier foods and beverages at checkout. Retailers in violation will be rechecked within three months. ●Step 1: Conduct annual spot checks of 10 or more products stocked at checkout and, when phased in, condom accessibility; ● Step 2: Send letter with feedback to stores, with opportunities for correction as needed; ● Step 3: Revisit stores that need to make corrections; if corrections are made at time of revisit, no fee will be assessed, if stores continue to stock ineligible products at checkout a nominal fee would be assessed. Violation-Penalty It is recommended that those retailers in violation of the proposed Healthy Retail Ordinance would be subject to administrative citations in accordance to the following: ●1st Violation: Store owner will be served with a written notice to comply with the Healthy Retail Ordinance and re-inspection. ●2nd Violation: Impose a $100 violation fee* ●3rd Violation: $200 violation fee* ●4th Violation: $500 violation fee* *Fee Violation is based on Chapter 445-6 Tobacco Sales Ordinance X.Additional Considerations Direct Health Services staff to request guidance and legal support from County Counsel to develop a DRAFT Healthy Retail Ordinance for review to the Board of Supervisors for a formal vote of action. FHS Feb 23 2023 Packet Page 112 of 174 References Andreyeva T, Marple K, Marinello S, Moore TE, Powell LM. Outcomes following taxation of sugar-sweetened beverages. JAMA Network Open. 2022;5(6). Boyland EJ, Nolan S, Kelly B, Tudur-Smith C, Jones A, Halford JC, et al. Advertising as a cue to consume: A systematic review and meta-analysis of the effects of acute exposure to unhealthy food and nonalcoholic beverage advertising on intake in children and adults. American Journal of Clinical Nutrition [Internet]. 2016 [cited 2022Apr20];103(2):519–33. Available from: https://academic.oup.com/ajcn/article/103/2/519/4662876 California Department of Public Health. Nutrition, Education and Obesity Prevention (NEOP) Branch.https://www.cdph.ca.gov/Programs/CCDPHP/DCDIC/NEOPB/Pages/SNAPEdCountyPr ofileDashboard.aspx. February 2023. Cohen DA, Babey SH. Contextual influences on eating behaviours: Heuristic processing and dietary choices. Obesity Reviews. 2012;13(9):766–79. Department of Health and Social Care. Promotions of unhealthy foods restricted from October 2022 [Internet]. GOV.UK News. GOV.UK; 2021 [cited 2023Jan20]. Available from: https://www.gov.uk/government/news/promotions-of-unhealthy-foods-restricted-from-october- 2022 Drewnowski A, Rehm CD, Constant F. Water and beverage consumption among children age 4– 13 years in the United States: Analyses of 2005–2010 NHANES data. Nutr J. 2013;12(1):85. Durfee T, Myers Jr. S, Wolfson J, DeMarco M, Harnak L, Caspi C. The determinants of racial disparities in obesity: baseline evidence from a natural experiment. Agricultural and Resource Economics Review (2021) 1-26. https://www.doi.org/10.1017/age.2021.21. Falbe J, White JS, Sigala DM, Grummon AH, Solar SE, Powell LM. The potential for healthy checkout policies to advance nutrition equity. Nutrients. 2021;13(11):4181. Hager ER, Cockerham A, O’Reilly N, Harrington D, Harding J, Hurley KM, et al. Food swamps and food deserts in Baltimore City, MD, USA: Associations with dietary behaviours among urban adolescent girls. Public Health Nutrition [Internet]. 2017Oct20 [cited 2023Jan15];20(14):2598–607. Available from: https://pubmed.ncbi.nlm.nih.gov/27652511/ . Harris JL, Frazier W. Increasing disparities in unhealthy food advertising targeted to Hispanic and Black youth. Hartford, CT: UConn; 2018 p. 4–9. FHS Feb 23 2023 Packet Page 113 of 174 Horsley JA, Absalom KAR, Akiens EM, Dunk RJ, Ferguson AM. The proportion of unhealthy foodstuffs children are exposed to at the checkout of Convenience Supermarkets. Public Health Nutrition. 2014;17(11):2453–8. Huitink M, Poelman MP, Seidell JC, Kuijper LD, Hoekstsra T, Dijkstra C. Can healthy checkout counters improve food purchases? Two real-life experiments in Dutch supermarkets. International Journal of Environmental Research and Public Health. 2020;17(22):8611. Kerr J, Rosenberg D, Frank L. The role of the built environment in healthy aging. Journal of Planning Literature. 2012;27(1):43–60. Kovacic, W. e. (2008). Marketing food to children and adolescents: A review of industry expenditures, activities, and self-regulation: A Federal Trade Commission report to Congress. Federal Trade Commission. Lam CC, Ejlerskov KT, White M, Adams J. Voluntary policies on checkout foods and healthfulness of foods displayed at, or near, Supermarket Checkout Areas: A cross-sectional survey. Public Health Nutrition. 2018;21(18):3462–8. Morland K, Diez Roux AV, Wing S. Supermarkets, other food stores, and Obesity. American Journal of Preventive Medicine. 2006Apr;30(4):333–9. Morrison KM, Shin S, Tarnopolsky M, et al. Association of depression and health related quality of life with body composition in children and youth with obesity. Journal of Affective Disorders 2015;172:18–23. National Health and Nutrition Examination Survey(NHANES). CDC National Center for Health Statistics (NCHS) Data Brief, March 2017-2021 Pem D, Jeewon R. Fruit and Vegetable Intake: Benefits and Progress of Nutrition Education Interventions- Narrative Review Article. Iran J Public Health. 2015 Oct;44(10):1309-21. PMID: 26576343; PMCID: PMC4644575. Reedy J, Krebs-Smith SM. Dietary Sources of Energy, Solid fats, and added sugars among children and adolescents in the United States. Journal of the American Dietetic Association. 2010;110:1477–1484. Rivlin G. [Internet]. Rigged Supermarket Shelves for Sale. Center for Science in the Public Interest (CSPI); 2016 Sep [cited 2023Jan18]. Available from: https://www.cspinet.org/sites/default/files/media/documents/misc/CSPI_Rigged_4_small.pdf Stierman, Bryan;Afful, Joseph;Carroll, Margaret D.;Chen, Te-Ching;Davy, Orlando;Fink, Steven;Fryar, Cheryl D.;Gu, Qiuping;Hales, Craig M.;Hughes, Jeffery P.;Ostchega, FHS Feb 23 2023 Packet Page 114 of 174 UKCRC Centre for Diet and Activity Research (CEDAR), Evidence Brief 19 – Effects of UK supermarket policies on healthier food at the tills – February 2020. www.cedar.iph.cam.ac.uk/resources/evidence/eb-19-checking-out-checkout-food/ United States Department of Agriculture (USDA), Economic Research Service. https://www.ers.usda.gov/data-products/food-access-research-atlas/go-to-the-atlas/.,February, 2023. Yechiam;Storandt, Renee J.;Akinbami, Lara J.; National Health and Nutrition Examination Survey 2017–March 2020 Pre Pandemic Data Files Development of Files and Prevalence Estimates for Selected Health Outcomes, June 2021. FHS Feb 23 2023 Packet Page 115 of 174 DATE To Store Management: We are writing to inform you about a new policy known as the Healthy Retail Ordinance which was approved by the Contra Costa Board of Supervisors in December of 2022 and will take effect March 1, 2023. For stores in unincorporated areas of Contra Costa County that are 2,000 square feet or larger, any food or beverages sold in checkout lanes and within a three-foot radius of the point-of-sale will need to be a healthier item. A healthier food item is defined as a food that contains no more than 5 grams of added sugar per serving and no more than 200 milligrams of sodium per serving; a healthier beverage is one that contains no added sugar or artificial sweeteners. In addition, these stores will need to place at least one facing of condoms unlocked for customers to access without assistance. Healthy Options at Point of Sale (HOPS) is the advocacy group that has been working in Contra Costa to bring this initiative to the Board of Supervisors. Healthy Retail will not only positively impact the retail environment by setting minimum nutrition standards to help change people’s snacking habits, but also ensure lower rates of sexually transmitted infections, so that we may have an all around healthier county. Our team is committed to assisting retailers throughout unincorporated areas with the transition. To that end, you will find documents attached to help guide your process and information on how we can support you through implementation: ●HOPS Implementation Support Options ●Condom Accessibility Standards ●Checkout Food and Beverage Standards and Examples ●Retailer Factsheet ●Healthy Retail Ordinance Our team is very excited to partner with you in supporting community wellness. We are also mailing you a hard copy of this information and we will be reaching out over the next few months. If we can be of assistance to you as you move towards Healthy Retail, please let us know. Together, we can make a healthier Contra Costa. Sincerely, Elvira Martin-Bautista, Selena Din, Anjelika Khadka, Ingrid De Santiago Ingrid De Santiago & The HOPS Advocates FHS Feb 23 2023 Packet Page 116 of 174 HOPS Implementation Support Options Healthy Options at Point of Sale (HOPS) is a Richmond-based health advocacy team that has been working on Healthy Retail for the past three years. Our team is available to support your store's transition to meet the Healthy Retail Ordinance standards. ●Provide General Consultation We can schedule an in-person or Zoom consultation meeting to walk through the nutrition standards for checkout, condom guidelines, answer questions, and provide guidance. ●Evaluate items you sell throughout the store We can look at the items currently sold throughout your store to determine which products meet the nutrition standards and could be included in the checkout lanes. ●Check your suppliers to see which items meet criteria for Healthy Retail If you have slotting fees with specific companies, we can research which of their snacks and beverages meet the checkout requirements. ●Feedback on the food and beverages in checkout lanes and/or condom placement We can review and provide feedback on the store’s healthy checkout lane(s) and/or condoms selection and placement, at any stage of the transition. ●Promote your business We can create and publish posts featuring your business as a Healthy Retail participant on our Facebook, Instagram, and other social media platforms. Thank you for helping us create a healthier community! HOPS is happy to help your business in any way we can. Please feel free to contact us with any questions or concerns, at idesantiago@bacr.org. FHS Feb 23 2023 Packet Page 117 of 174 Healthy Retail Condoms Placement Standard ##.##. Condoms Accessibility Each Retail Store shall, at all hours during which the Retail Store is open to the public, ensure that: A. One or more facings of External Condoms be displayed and accessible to customers without staff assistance. Condoms Best Retail Practices Condoms Accessibility A best practice suggestion, though not required, is for each Retail Store, at all hours which the Retail Store is open to the public, to ensure that: A.At least one facing of latex External Condoms and at least one facing of non-latex External Condoms be displayed and accessible to customers without staff assistance. FHS Feb 23 2023 Packet Page 118 of 174 Healthy Retail Sample of Qualifying Food and Beverage Items #.##.###. Healthy Checkout Areas. Each Retail Store shall at all hours during which the Retail Store is open to the public, ensure that all foods and beverages displayed for sale in the Checkout Areas meet the following standards in Sec #.##.###.: A. Beverages with no added sugars and no artificial sweeteners. B. Beverages must be in the following categories: waters, milk and milk alternatives, 100% juice, coffee, and tea. C. Food items with no more than 5 grams of Added Sugars and 200 milligrams of sodium per labeled serving. The following pages showcase a small sampling of products that meet the above requirements and could be placed at checkout. Please feel welcome to reach out to the HOPS team if you have questions, idesantiago@bacr.org. FHS Feb 23 2023 Packet Page 119 of 174 Chewing Gum & Mints Trident Spearmint Gum Brand: Trident Parent Company: Mondelez Added Sugar: 0g Sodium: 0 mg Ice Breakers Duo Watermelon Brand: Ice Breakers Parent Company: Hershey Trust Company Added Sugar: 0g Sodium: 0 mg Extra Classic Bubble Brand: Extra Parent Company: Wrigley Jr. Company Added Sugar: 0g Sodium: 0mg Altoids Peppermint Brand: Altoids Parent Company: Wrigley Jr. Company Added Sugar: 0g Sodium: 35mg FHS Feb 23 2023 Packet Page 120 of 174 Fruit and Vegetables Dried Chili Mango Brand: Peeled Parent Company: Peel Snacks Added Sugar: 0g Sodium: Varies No Sugar Added Organic Applesauce Brand: Mott’s Parent Company: Keurig Dr. Pepper Added Sugar: 0g Sodium: 5mg Diced Yellow Cling Peaches in 100% Fruit Juice Brand: Dole Parent Company: Dole Food Company, Inc. Added Sugar: 0g Sodium: 5mg Terra Original Chips Parent Company: Hain Celestial Group Added Sugar: 0g Sodium: 110mg Brand: Terra Whole Fruits and Vegetables Brand: Varies Parent Company: Varies Added Sugar: 0g Sodium: 30mg FHS Feb 23 2023 Packet Page 121 of 174 Nuts, Seeds & Legumes Snak Club Yogurt Trail Mix Brand: Snak Club Parent Company: Insignia Capital Group Added Sugar: 3g Sodium: 0mg Dry Roasted Pistachios Brand: Planters Parent Company: Kraft-Heinz Added Sugar: 0g Sodium: 150mg Mesquite Barbeque Crunchy Broad Beans Brand: Bada Bean Bada Boom Parent Company: Enlightened Added Sugar: 1g Sodium: 150 mg Vegan White Cheddar Hippeas Brand: Hippeas Organic Chickpea Snacks Parent Company: Green Park Snacks Ltd. Added Sugar: 1g Sodium: 140mg Blue Diamond Whole Natural Almonds Brand: Blue Diamond Parent Company: Co-op Added Sugar: 0g Sodium: 0 mg FHS Feb 23 2023 Packet Page 122 of 174 Whole Grains Smart50 Sea Salt Popcorn Brand: Smartfood Parent Company: PepsiCo Added Sugar: 0g Sodium: 150mg Boom Chicka Pop Sea Salt Popcorn Brand: Angie’s Boom Chicka Pop Parent Company: Conagra Brands Added Sugar: 0g Sodium: 130mg Kids Organic Whole Grain Bites Brand: Quaker Parent Company: PepsiCo Added Sugar: 4g Sodium: 55 mg Apple Cinnamon Crunchy Rice Rollers Brand: Crunchy Rollers Parent Company: General Mills Sodium: 0 mg *Estimate (contains 3g total sugar) Added Sugar: 3g* Kracklin’ Kamu Brand Ancient Grain – Sea Salt Brand: Kracklin' Kamut Parent Company: Big Sandy Organics Added Sugar: 0g Sodium: 180mg FHS Feb 23 2023 Packet Page 123 of 174 Yogurt & Cheese Chobani Clingstone Peach Less Sugar Greek Yogurt Brand: Chobani Parent Company: Chobani Global Holdings, Inc. Added Sugar: 5g Sodium: 50mg Siggi’s Vanilla Skyr Brand: Siggi’s Parent Company: Lactalis Added Sugar: 5g Sodium: 55mg Tillamook Medium Cheddar Parent Company: Tillamook County Creamery Association (TCCA) Added Sugar: 0g Sodium: 125mg Sargento String Cheese Brand: Sargento Parent Company: Gentine family Added Sugar: 0g Sodium: 190mg Brand: Tillamook FHS Feb 23 2023 Packet Page 124 of 174 Multi-Category Foods Blueberry Vanilla Cashew Kind Bar Brand: Kind Parent Company: Mars Added Sugar: 4g Sodium: 20mg Toasted Coconut Almond Granola Brand: Bear Naked Parent Company: Kellogg’s Added Sugar: 5g Sodium: 10mg Kashi Peanut Peanut Butter Granola Bar Brand: Kashi Parent Company: Kellogg’s Added Sugar: 5g Sodium: 100mg Mint Chip Brownie Lärabar Brand: Lärabar Parent Company: General Mills Added Sugar: 4g Sodium: 0 mg Tart Cherry and Apple Superfood Bites Brand: Urban Foods Parent Company: Urban Foods Added Sugar: 3g Sodium: 0 mg FHS Feb 23 2023 Packet Page 125 of 174 Spindrift, Blackberry Brand: Spindrift Parent Company: VMG Partners Added Sugar: 0g Sodium: 0mg La Colombe Pure Black Cold-Pressed Coffee Brand: La Colombe Parent Company: La Colombe Added Sugar: 0g Sodium: 25mg Aquafina Brand: Aquafina Parent Company: PepsiCo Added Sugar: 0g Sodium: 0mg Minute Maid 100% Orange Juice Brand: Minute Maid Parent Company: Coca-Cola Added Sugar: 0g Sodium: 25 mg Bubly, Strawberry Brand: Bubly Parent Company: PepsiCo Added Sugar: 0g Sodium: 0 Beverages FHS Feb 23 2023 Packet Page 126 of 174 69% In unincorporated Contra Costa County, where there are few full service grocery stores, unhealthy food and beverages are promoted repeatedly throughout stores. Snacks high in sodium, saturated fat, and added sugars dominate checkout lanes and aisle endcaps, which are designed to prompt impulse purchases. Such curated food environments in largely low income rural and urban areas and communities of color have been shown to contribute to health issues such as dental cavities, heart disease, and type 2 diabetes. This especially impacts families; 1 in 2 children of color in the US will be diagnosed with type 2 diabetes in their lifetime. Additionally, sexual health and condom availability is another a challenge in our communities that retailers play a role in. of all beverages at checkout are sugar sweetened, Questions? Contact Ingrid De Santiago at idesantiago@bacr.org Healthy Options at Point of Sale (HOPS) Few stores stock fresh fruits and veggies Social responsibility to youth Desire to purchase from local farmers Exposure to greater healthy variety 100%100% support fromsupport from intervieweesinterviewees and gum and mints aside, snacking options are almost entirely unhealthy. Contra Costa County can be the first County in the nation to implement Healthy Retail. By doing so, we will increase access to healthy snacks and beverages, encourage healthy eating habits, create precedent for other community led public health initiatives, and support the health of all residents! Healthy Food 4.5% Gum and Mints 40% Unhealthy Food 55.5% FHS Feb 23 2023 Packet Page 127 of 174 of c o n doms sold a r e locked upof c o n doms sold a r e locked upIn a 2010 pilot study of 8 Midwestern pharmacies, condoms were unlocked and placed on the shelf for three months. While some condoms were stolen, sales outweighed theft across the board. Retailers can increase sales while making condoms more accessible. Areas of the County in which 88-95% of the stores restrict access to or do not carry condoms have the highest rates of chlamydia and gonorrhea. Subsequently, areas where few stores lock up condoms are areas with lower rates of these STIs. 57%57% Questions? Contact Ingrid De Santiago at idesantiago@bacr.org While food and drinks are the majority of products sold at checkout, they are not the only items present that impact consumers' health. Research shows that condom availability is integral to promoting sexual health and, thus, overall wellness. Retailers are in a perfect position to increase availability because they are open day and night and are often a go-to source for most resident needs, including condoms. However, in many communities, condoms are locked up or behind the counter. Unfortunately, the stigma around sex can prevent individuals from asking for them. In particular, youth and young adults are often too embarrassed to ask cashiers for condoms. Making condoms reachable will increase their accessibility in the community, help us keep youth safe, and prevent the spread of sexually transmitted infections.of stores in Co n t r a Costa sell c o ndoms of stores in Co n t r a Costa sell c o ndoms 86%86% H O W EVER,H O W EVER, One latex option One non-latex option FHS Feb 23 2023 Packet Page 128 of 174 FHS Feb 23 2023 Packet Page 129 of 174 FHS Feb 23 2023 Packet Page 130 of 174 FHS Feb 23 2023 Packet Page 131 of 174 FHS Feb 23 2023 Packet Page 132 of 174 DRAFTHealthy Retail Ordinance Chapter ##.## - Healthy Retail. ##.## - Findings. (a) Diets with an excess of added sugars and sodium are correlated with chronic health issues including hypertension, type 2 diabetes, tooth decay, and stroke.   (b) The safety of many low/reduced-calorie sweeteners is questionable, especially for children. Many have not been well tested, some appear to pose a risk of cancer, and some can cause gastrointestinal distress, especially when consumed in large amounts. (c) Grocery and convenience stores are Americans’ top source for foods and beverages. More than 65 percent of Americans’ caloric intake comes from food items purchased at large grocery retailers.    (d) The environments in which food choices are made affect those choices. The placement of unhealthy snack foods and beverages near the checkout registers and on aisle endcaps and freestanding displays throughout retail stores increases the likelihood that consumers will make unplanned purchases of unhealthy foods. The placement of unhealthy snack foods and sugar-sweetened beverages at checkout, therefore, undermines public health initiatives and consumers’ desire to make healthy choices.   (e) While over 80 percent of grocery, pharmacy, and corner stores across California and Contra Costa County sell condoms, only 43 percent of stores make them available for purchase without asking for assistance. This is a real barrier for the prevention of unwanted pregnancy and Sexually Transmitted Infections. (f) In Contra Costa County there are increased rates of chlamydia and gonorrhea in zipcodes where accessing condoms requires clerk assistance. (g) Providing customers with the choice to avoid undue pressure to purchase high-calorie, low-nutrient food when they shop as well as making condoms more accessible is in the interest of the health, safety, and welfare of all who live, work, and do business in Contra Costa County.  ##.## - Purpose.    (a) The purpose of the ordinance is to encourage healthy purchases and improve the health of Contra Costa residents by providing healthy food and beverage alternatives to consumers in checkout areas, limiting consumer exposure to sugar-sweetened beverages and unhealthy foods, and increasing accessibility of condoms in retail stores in unincorporated areas of Contra Costa County. ##.## - Definitions. (a) “Added sugars” means sugars that are added during the processing of foods and beverages, or are packaged as such, and include sugars (free, mono and disaccharides), sugars from syrups and honey, and sugars from concentrated fruit or vegetable juices that are in excess of what would be expected from the same volume of 100 percent fruit or vegetable juice of the same type, as defined in Section 101.9 of Title 21 of the Code of Federal Regulations.   (b) “Category list” means the list of foods and beverages which meet the standards of XXX. (c) “Checkout area” means any area that is accessible to a customer of the Retail Store that is:   (i) Within 3 feet in any direction of any Register; or   FHS Feb 23 2023 Packet Page 133 of 174 DRAFT(ii) Designated primarily for or utilized primarily by customers to wait in line to make a purchase at a register; up to and including the Checkout Endcap.   (d) “Checkout endcap” means product displays placed at endpoints of areas designated primarily for or utilized primarily by customers to wait in line to make a purchase.  (e) “External condom” means a sheath which completely covers the penis with a closely fitting membrane, designed primarily for contraceptive and prophylactic purposes. (f) “Healthy Checkout Areas Standards” means the standards for foods and beverages set forth in [##.## (a)-(d)]. (g) “Low- and no-calorie sweeteners” means sweeteners with few to no calories that have a higher intensity of sweeteners per gram than sucrose. (h) “Register” means a device used for monetary transactions that calculates the sales of goods and displays the amount of sales for the customer. (i) “Retail store” means a commercial establishment, located within Contra Costa County, selling goods to the public with a total floor area of 2000 square feet or more and selling 25 linear feet or more of food and beverage products. ##.## - Healthy Checkout Areas. Each retail store shall at all hours during which the retail store is open to the public ensure that all foods and beverages displayed for sale in the checkout areas meet the following standards: (a) Beverages shall contain no added sugars and no low- and no-calorie sweeteners. (b) Beverages shall be from the following category list: water, milk and milk alternative, 100% juice, coffee, and tea. (c) Food items shall contain no more than 5 grams of Added Sugars and 200 milligrams of sodium per labeled serving. (d) Gum and mints shall contain no added sugars. Contra Costa County shall conduct an annual review of qualifying beverage categories in the Healthy Checkout Areas Standards. There shall be a 180-day phase-in period if changes to the Healthy Checkout Area Standards are made.  ##.## - Condom Accessibility. Each retail store offering external condoms for sale shall at all hours during which the retail store is open to the public ensure that: (a) One or more facings of external condoms be displayed and accessible to customers without staff assistance. ##.## - Enforcement. (a) Contra Costa County is authorized to issue all rules and regulations consistent with this ordinance.  (b) Contra Costa Health Services staff will implement enforcement of this chapter. (c) Contra Costa County may require retail stores to report information necessary to determine compliance with this chapter. ##.## - Violations – Penalties.   FHS Feb 23 2023 Packet Page 134 of 174 DRAFT(a) A retail store found to be in violation of this chapter may be subject to [PENALTY]   ##.## - Severability. (a) If any part or provision of this chapter or its application to a person is held invalid, the invalidity of that part, provision or application does not affect other parts, provisions, or applications of this chapter that can be given effect without the invalid part, provision, or application. ##.## - Effective Date.   This ordinance and the legal requirements set forth herein shall take effect and be in force for retail stores as of [DATE]. Enforcement pursuant to [##.##] shall commence no sooner than [DATE]. FHS Feb 23 2023 Packet Page 135 of 174 Healthy Retail in Contra Costa Family and Human Services Committee Presentation |February 27,2023 Dr.Sefanit Mekuria |CCHS Public Health Denise Milosevich |CCHS Community Wellness &Prevention Program Obiel Leyva,HIV/AIDS STD Program HOPS Youth Advocacy Team /Bay Area Community Resources FHS Feb 23 2023 Packet Page 136 of 174 Guiding Public Health Framework Social Determina n ts of Health FHS Feb 23 2023 Packet Page 137 of 174 ●Pre-diabetes prevalence is ~ 47% for adults in CCC ●In 94575 (Moraga) diabetes prevalence is 1.2%; in 94804 (Richmond) it’s 12.2% Health Inequities in Contra Costa ●Over 30% of children in 5th, 7th & 9th grades have overweight or obesity ●Inequities in obesity ○40% of African American children have overweight or obesity ○50% of Latino children have overweight or obesity C hildren Adults ●STI rates are 7-10 times higher in Antioch & Richmond than in Danville FHS Feb 23 2023 Packet Page 138 of 174 Public Health and the Retail Environment Poor nutrition is one of the leading causes of preventable deadly illness Lack of healthy food access affects low-income neighborhoods and communities of color the hardest African American and Latino youth are disproportionally targeted with unhealthy marketing by the food and beverage industry Condom availability varies drastically by income level FHS Feb 23 2023 Packet Page 139 of 174 Youth-led Healthy Retail Initiative C o m m u n i t y A s s e s s m e n t s : •Survey 40 Food Stores: 55.5% foods unhealthy, 4.5% healthy, 40%gum/mints •5 Focus Groups, 8 Community Interviews & 3 Retailer Interviews o Unanimous support •562 Richmond voters surveyed o 77% support for the policy; 73% low -income shoppers 'support FHS Feb 23 2023 Packet Page 140 of 174 Health Inequities Of Sexually Transmitted Infections In Contra Costa Chlamydia & Gonorrhea Annual Rate/100,000 790-1573 556-789 339-555 94-338 0-93 % Individuals Living Below 200% of Federal Poverty Level 28.8%-46.7%18.5%-28.7%12.3%-18.4%6.6%-12.2%0%-6.5% Source: CalREDIE DDP,12/15/2020FHS Feb 23 2023 Packet Page 141 of 174 790-1573 556-789 339-555 94-338 0-93 % Stores Selling Unrestricted Condoms 5%-12%24%-40%50%-69% Chlamydia & Gonorrhea Annual Rate/100,000 HSHC Survey –Condom Accessibility & STI Rates Source: CalREDIE DDP,12/15/2020 HSHC 2019 SurveyFHS Feb 23 2023 Packet Page 142 of 174 790-1573 556-789 339-555 94-338 0-93 % Stores Selling Unrestricted Condoms 5%-12%24%-40%50%-69% Chlamydia & Gonorrhea Annual Rate/100,000 32 Proposed Locations for Healthy Checkout Interventions Source: CalREDIE DDP,12/15/2020 HSHC 2019 Survey Stores Included in Proposed Ordinance FHS Feb 23 2023 Packet Page 143 of 174 VISION FOR HEALTHY RETAIL IN CONTRA COSTA A healthy retail environment is an environment where it is easier to make healthy choices than unhealthy ones. FHS Feb 23 2023 Packet Page 144 of 174 RECOMMENDATION: A HEALTHY RETAIL ORDINANCE FOR STORES >2000 SQ.FT Stock checkouts with more nutritious snacks in queues & within 3 ft of register: Foods •5 or less grams of added sugar per serving •200 mg or less of sodium per serving Gum and mints •No added sugar Beverages •No added sugar •No low-or no-calorie sweeteners For future consideration: 1 facing of external condoms accessible without clerk assistance FHS Feb 23 2023 Packet Page 145 of 174 TIMEFRAME: HEALTHY RETAIL ORDINANCE Step 1 Healthy Retail Ordinance Step 2 Implementation (months 1-8) Step 3 Enforcement @ 9 months Step 4 Condom Amendment @ 15 months 1.Engage Retailers: Continue work with retailers 2.Ordinance Adoption: Present DRAFT Ordinance to set nutrition standards for items stocked at checkout 3.Develop Enforcement Structure 4. Support Retailers: BACR & CCHS Staff will provide education and technical assistance to 32 unincorporated retailers including: •Materials •1-on-1 TA •No penalty inspections 5. Begin Enforcement: CCHS staff will conduct annual spot checks at checkout Stores in violation will be subject to an incremental system beginning with a warning and increasing from $100- $500 with subsequent violations 6. Conduct Research: additional research and outreach around condom access 7. Make Recommendations: to the BOS that the ordinance be amended to include condom access – making one type of condom available without staff assistance FHS Feb 23 2023 Packet Page 146 of 174 Thank you! FHS Feb 23 2023 Packet Page 147 of 174 FAMILY AND HUMAN SERVICES COMMITTEE 9. Meeting Date:02/27/2023   Subject:Council on Homelessness 2022 Quarter 4 Report Submitted For: Anna Roth, Health Services Director  Department:Health Services Referral No.: 5   Referral Name: Homeless Continuum of Care - Quarterly Report  Presenter: Jaime Jenett, Health Services Community Engagement Specialist Contact: Enid Mendoza, (925) 655-2051 Referral History: In November 2014, the Board approved “Forging Ahead Towards Preventing and Ending Homelessness: An Update to Contra Costa’s 2004 Strategic Plan”, that renewed the County's 2004 plan with the latest data, best practices, and community feedback and reaffirmed the County's commitment to the Housing First approach. As such, “Forging Ahead” establishes this guiding principle: “Homelessness is first a housing issue, and necessary supports and services are critical to help people remain housed. Our system must be nimble and flexible enough to respond through shared responsibility, accountability, and transparency of the community.” The Strategic Plan Update identifies two goals: 1) Decrease the length of time people experience homelessness by focusing on providing Permanent Housing and Services; and 2) Decrease the percentage of people who become homeless by providing Prevention activities. To achieve these goals, three strategies emerged:  Implement a coordinated entry/assessment system to streamline access to housing and services while addressing barriers, getting the right resources to the right people at the right time; and Use best, promising , and most effective practices to give the consumer the best possible experience through the strategic use of resources; and Develop the most effective platforms to provide access, support advocacy, and connect to the community about homelessness and available resources. The Contra Costa Council on Homelessness (COH), a Board of Supervisors appointed body, provides advice and input on the operations of homeless services, program operations, and program development efforts in the County. The COH establishes the local process for applying, reviewing and prioritizing project applications for funding in the HUD Homeless Assistance Grant Competitions, including the Continuum of Care (CoC) Program and the Emergency Solutions Grant Program. The County Health, Housing and Homeless Services Division (H3) of the Health Services Department partners with the COH to develop and carry out an annual action plan that identifies the objectives and benchmarks related to each of the goals and strategies of Forging Ahead. Further, H3 incorporates the strategic plan goals into its own delivery system of comprehensive services, interim housing and permanent supportive housing as well as contracting with community agencies to provide additional homeless services and housing with the goal of ending homelessness in our community. The Council submitted its last quarterly report (Q3) to the Family and Human Services Committee on November 28, 2022, which was later approved and accepted by the Board of Supervisors at their December 13, 2022 meeting. At the November FHS meeting, members requested updates on the Homeless Housing, Assistance Prevenetion (HHAP) Grant when available, as well as considerations for the inclusion of the landlord voice in the reports or advisory body membership. FHS Feb 23 2023 Packet Page 148 of 174 Referral Update: Please see the attached Council on Homelessness Quarter 4 report for updates. Recommendation(s)/Next Step(s): ACCEPT the Council on Homelessness Quarter 4 report, DIRECT staff to forward the report to the Board of Supervisors for their information, and RECOMMEND to the Board of Supervisors that they direct County departments to build on partnerships created through Measure X, Homekey, and CalAIM to maximize funding and resources to people experiencing homelessness in the County. Fiscal Impact (if any): There is no fiscal impact. Attachments Council on Homelessness 2022 Q4 Report COH Q4 Report Presentation Slides FHS Feb 23 2023 Packet Page 149 of 174 STAFF REPORT FROM THE CONTRA COSTA COUNCIL ON HOMELESSNESS Contra Costa County Homeless System of Care Quarterly Report for Quarter 4 of 2022 (October-December) LETTER FROM THE CHAIR AND VICE CHAIR Dear Contra Costa County Board of Supervisors, This quarter brought concrete work plans for a number of our committees, system changes to better amplify the voices of people with a lived experience of homelessness and many wonderful tools and events to mark Homelessness Awareness Month. Next quarter we look forward to kicking off a number of new and/or ad hoc committees to keep the work moving and seeing what wonderful programs and services come to fruition with the Measure X funding opportunities. Sincerely, Juno Hedrick, Chair of the Council on Homelessness and Jo Bruno, Vice Chair of the Council on Homelessness FHS Feb 23 2023 Packet Page 150 of 174 COH QUARTERLY REPORT 2 INTRODUCTION The Contra Costa Council on Homelessness (CoH) is the governing and oversight body for the County homeless Continuum of Care (CoC) and is appointed by the Board of Supervisors. The Council provides advice and input to the Board of Supervisors on the operations of homeless services, program operations, and program development efforts in Contra Costa County. The Contra Costa Council on Homelessness is the governing body for the Contra Costa County Continuum of Care (CoC). The Contra Costa CoC is comprised of multiple partners, including service providers, members of faith communities, local businesses, private and public funders, community members, education systems and law enforcement, and others who are working collaboratively to end homelessness. The COH and COC are supported by Contra Costa Health Services Health, Housing & Homeless Services (H3) Division. H3 functions as the CoC administrative entity and collaborative applicant, CoC Lead Agency and Homeless Management Information System (HMIS database) Lead Agency. The purpose of this report is to share information about the CoC and COH activities with the Contra Costa County Board of Supervisors and to provide recommendations from the COH to the County Board of Supervisors on long range planning and policy formulation that would support the county homeless CoC. This report includes information on system data, funding and policy activities, and CoC initiatives. All information will reflect activities and data for the prior quarter. This report was produced on behalf of the CoH by H3 in collaboration with the CoH and CoC partners. SYSTEM FUNDING This quarter the CoC continued to evaluate the system of care and pursued funding opportunities to address the gaps in Contra Costa’s homeless system, including our largest source of funding, the Housing and Urban Development (HUD) Continuum of Care (CoC) Notice of Funding Opportunity (NOFO). FEDERAL HUD Unsheltered NOFO: In late June, the U.S. Department of Housing and Urban Development (HUD) released a first-of-its-kind package of resources to address unsheltered homelessness and homeless encampments, including funds set aside specifically to address homelessness in rural communities. Contra Costa submitted an application and is waiting for more information about awards. FHS Feb 23 2023 Packet Page 151 of 174 COH QUARTERLY REPORT 3 Housing Stability Voucher Program: In October, Housing Authority of Contra Costa County, with support from the CoC, submitted a Letter of Intent to HUD to request Housing Stability Vouchers. These vouchers will be prioritized for Public Housing Agencies and CoCs who are awarded through the HUD Unsheltered NOFO. These vouchers are highly sought after and are competitively awarded. Contra Costa submitted an application and is waiting for more information about awards. STATE Bringing Families Home: The Bringing Families Home Program, funded by the State of California Department of Social Services (CDSS), will provide housing supports and services to referred families receiving Contra Costa County child welfare services who are experiencing, or at risk of, homelessness, thereby increasing family reunification and preventing foster care placement. The RFQ process took place in October and November 2022 and contract was awarded to Caminar. Services are slated to start in February 2023. Homeless, Housing and Assistance Program (HHAP): HHAP Round 3 is a $1 billion grant through the California Interagency Council on Homelessness (Cal-ICH) that provides local jurisdictions, including federally recognized tribal governments, with flexible funding to continue efforts to end and prevent homelessness in their communities. HHAP Round 4 was submitted in November and additional revisions were requested to HHAP 3 applications statewide, including Contra Costa County. Homekey 3: The RFP release date was pushed from September 2022 to March 2023. H3 will apply when the RFP is released. LOCAL Measure X: The Council heard updates from Health, Housing and Homeless Services about the RFP process for Measure X funding allocated for housing/homeless services. SYSTEM INITI ATIVES The CoC regularly engages in multiple activities, partnerships, evaluations, and improvement that are designed to improve services to clients and achieve various system goals. Equity: The Equity Committee finalized a Work Plan to achieve this 2023 goal: Create accessible information, outreach, and educational materials to engage hard to reach or previously unreached communities in Contra Costa County. Engagement of People with Lived Experience of Homelessness: FHS Feb 23 2023 Packet Page 152 of 174 COH QUARTERLY REPORT 4 • Recruitment: The Council actively recruited for applicants for the Lived Experience seat and Youth Representative on the Council and received 10 qualified applications (plus 3 more that did not complete the application process) for the Lived Experience Advisor seat and one for the Youth Representative seat. Staff added two “Office Hours” (one remote and one in person) to support people with the application process. The Council ultimately selected Jo Bruno and Juno Hedrick for Lived Experience Seats and Anastasia Padilla for the Youth Representative Seat. • Homelessness Awareness Month: A number of people with lived experience of homelessness were deeply involved in this quarter’s Homelessness Awareness Month activities, including helping develop the toolkit; conducting and being the subject of interviews for the short video; participating in the panel discussion; nominating and being nominated for candidates for the Thriving in the Face of Homelessness recognition category; and the Chair and Vice Chair, both who have a lived experience of homelessness, led the presentation to the Board of Supervisors. • Policies and Procedures: H3, as staff to the Council and other CoC activities made progress researching and developing policies and procedures, including a compensation policy, for engaging people with a lived experience of homelessness in system level work. HMIS Evaluation: H3 contracted with Focus Strategies to assess the configuration and use of the Homeless Management Information System (HMIS) to ensure that HMIS workflows, data and reporting enable providers to be successful with new program models and performance- based contracting. H3 and Focus Strategies worked on data collection through surveys, focus groups, and one-on-one interviews with partner providers, H3 staff, and people experiencing homelessness to get a robust understanding of challenges and opportunities in the HMIS. H3 and Focus Strategies share initial findings with the HMIS Policy Committee in November and discussed recommendations. In December 2022, Focus Strategies provided H3 with the final report based on feedback gathered through data collection activities. Homelessness Awareness Month: To mark Homelessness Awareness Month (November), the Council on Homelessness supported the following activities: • Development of a 100+ page toolkit (https://cchealth.org/h3/coc/pdf/Homeless- Awarenes-Toolkit-2022.pdf ) • Creation of a short video amplifying the voices of people with lived experience of homelessness (https://express.adobe.com/video/kP6MsvYeoN4te • Recognition of over 40 outstanding individuals and agencies impacting homelessness (https://cchealth.org/h3/coc/advocate.php) • Presentation about Homelessness Awareness Month and sought adoption of a Resolution Declaring November Homelessness Awareness Month to the Board of Supervisors on 11/8. • Hosting of a CoC Learning Hub on 11/14 called "R.O.O.T.S: Reflecting On Our Truth And Stories”, a panel discussion featuring people with lived experience in our community. A FHS Feb 23 2023 Packet Page 153 of 174 COH QUARTERLY REPORT 5 recording of the Learning Hub can be viewed here: https://www.youtube.com/watch?v=-CeQjhH7qgk . • Hosting of a Homeless Person’s Memorial Event on 12/21 with a number of community and faith leaders (https://youtu.be/7Cyv9pAbCkc) • Requested the Board of Supervisors adopt a resolution declaring 12/21 Homeless Person’s Memorial Day. Monitoring: Homebase is leading the 2022 monitoring process for 19 Continuum of Care- funded projects and will ensure grant activities are following the Department of Housing and Urban Development rules and regulations; improve individual program performance; and increase provider capacity regarding Continuum of Care compliance and financial management. An update on the Monitoring process was provided to the Oversight committee in November. Performance Based Contracting: After training providers on how to use their performance Health, Housing and Homeless Services (H3) began monitoring performance of programs within the program models through the performance dashboards created in the Homeless Management Information System (HMIS) by the Research, Evaluation and Data (RED) team at H3 with the first quarterly report due in December. COLLABORATIONS Homeless Services-Workforce Development Integration (H-WIN)- These quarterly provide an opportunity for people working in Homeless Services and Workforce Development in Contra Costa to connect with and understand each other’s resources and services. One meeting was held this quarter (10/12/22), with 30 partners in attendance. REGIONAL ACTION PLAN Contra Costa is committed to the Regional Action plan which aims to reduce unsheltered homelessness by 75% by 2024. The Regional Action Plan proposes a 1-2-4 framework which posits that to accomplish this reduction, for every 1 additional interim housing unit funded, 2 permanent housing solutions, and 4 prevention interventions are needed. PATH Innovations Committee: The Plan for Accelerating Transformative Housing (PATH) Innovations Committee of the Council on Homelessness refined their work to examine prevention and rapid exit resources as mechanisms to reduce unsheltered homelessness. The committee also engaged with prevention and rapid exit providers to understand referral processes, program components, and outcomes. The committee drafted and finalized a work plan for 2023 to identify priorities and activities for the upcoming year. Funding Opportunities: All of the funding opportunities mentioned earlier in the report would support Contra Costa’s efforts to achieve the Regional Action Plan goal of reducing unsheltered homelessness by 75% by 2024. FHS Feb 23 2023 Packet Page 154 of 174 COH QUARTERLY REPORT 6 GOVERNANCE/REPORTING • The Chair and Vice Chair presented the Q3 Council on Homelessness report, proposed revisions to bylaws and proposed slate of new Council members at the November FHS Committee meeting. • The revised bylaws were approved by the Board of Supervisors in December 2022 and included the conversion of Public Safety #1 Seat to Lived Experience Advisor #2 Seat; refined transparency and equitable practices section with emphasis on engagement of people with a lived experience of homelessness in Committee and Working Group activities; revised terms of Chair and Vice Chair from 2 years to 1 year to account for staggered expiration of seats and revised/Clarified Committees and Working Group names and descriptions. o Governance Committee will convene in Q1, 2023 and will agendize discussion of seat composition, including possible addition of new seats, such as a Landlord Representative seat, as suggested by this Committee during our last Quarterly report presentation. • The proposed new Council members were approved by the BOS on 12/13/22. (See Appendix B for Roster with District information included, as requested). • Submitted the annual Advisory Committee report to Clerk of the Board in December 2022. MEETINGS, TRAININGS AND EVENTS Council on Homelessness (COH) Meetings: The Council on Homelessness held three (3) regular business meetings. In addition to the regular Council on Homelessness meetings, the following committees met: Committee Purpose Equity Committee Create accessible information, outreach, and educational materials to engage hard to reach or previously unreached communities in Contra Costa County. HMIS Policy Committee Develops and shares updates on HMIS policies and practices, compliance, and troubleshooting; Plans technical assistance and training; Informs standards of practice and monitoring Homelessness Awareness Month Planning Committee Developing materials, tools and events to mark Homelessness Awareness Month in November. Nominating Committee Reviews and revises application process for potential new CoH members and provides recommendations to the full Council. FHS Feb 23 2023 Packet Page 155 of 174 COH QUARTERLY REPORT 7 Oversight Committee Reviewing and assessing the development, implementation, and improvement of the CoC, Coordinated Entry System, HMIS database, and system outcomes PATH Innovation Committee Work towards the goal of reducing unsheltered homeless in Contra Costa County by 75% by 2024 Trainings • Trauma Informed Care (10/24/22) • Motivational Interviewing (11/28/22) • Case Management (12/12/22) Events • CoC Provider Meetings (3) • CoC Learning Hub: "R.O.O.T.S: Reflecting On Our Truth And Stories (11/14) • H-WIN meeting (10/12) • Homeless Person’s Memorial Event (12/21) The recordings, minutes and materials for trainings and meetings can be found on the H3 website1 and on the County agenda center2, and a calendar of upcoming meetings and events can be found on the H3 website. RECOMMENDATIONS • Direct county departments to build on partnerships created through Measure X, Homekey, and CalAIM to maximize funding toward resources dedicated to people experiencing homelessness in Contra Costa. 1 https://cchealth.org/h3/coc/partners.php#Training 2 https://www.contracosta.ca.gov/agendacenter FHS Feb 23 2023 Packet Page 156 of 174 COH QUARTERLY REPORT 8 APPENDIX A Commonly Used Acronyms and Terms Acronym Definition APR Annual Performance Report (for HUD homeless programs) BIPOC Black and Indigenous People of Color CARE Coordinated Assessment and Resource CCYCS Contra Costa Youth Continuum of Services CDBG, CDBG-CV Community Development Block Grant (federal and state programs) and the federal Community Development Block Grant CARES Act coronavirus allocation. CESH California Emergency Solutions and Housing program (state funding) Continuum of Care (CoC) Continuum of Care approach to assistance to the homeless. Federal grant program promoting and funding permanent solutions to homelessness. Con Plan Consolidated Plan, a locally developed plan for housing assistance and urban development under CDBG. CORE Coordinated Outreach Referral, Engagement program COVID-19 Coronavirus DCD (Contra Costa County) Department of Conservation and Development DOC Department Operations Center EHSD (Contra Costa County) Employment and Human Services Division EOC Emergency Operations Center ESG and ESG- CV Emergency Solutions Grant (federal and state program) and the federal Emergency Solutions Grant CARES Act coronavirus allocation. ESG-CV Emergency Solutions Grant CARES FMR Fair Market Rent (maximum rent for Section 8 rental assistance/CoC grants) HCD Housing and Community Development (State office) HEAP Homeless Emergency Aid Program (State funding) HEARTH Homeless Emergency and Rapid Transition to Housing (HEARTH) Act of 2009 HHAP Homeless Housing and Assistance Program HMIS Homeless Management Information System HOME Home Investment Partnerships (CPD program) HUD U.S. Department of Housing and Urban Development (federal) MHSA Mental Health Services Act NOFA/NOFO Notice of Funding Availability/ Notice of Funding Opportunity PHA Public Housing Authority PUI Persons Under Investigation PWLE People With Lived Experience of Homelessness SAMHSA Substance Abuse & Mental Health Services Administration SRO Single-Room Occupancy housing units SSDI Social Security Disability Income SSI Supplemental Security Income TA Technical Assistance FHS Feb 23 2023 Packet Page 157 of 174 COH QUARTERLY REPORT 9 TAY Transition Age Youth (usually ages 18-24) VA Veterans Affairs (U.S. Department of) VASH Veterans Affairs Supportive Housing VI-SPDAT Vulnerability Index – Service Prioritization Decision Assistance Tool Contra Costa County COVID-19 Resources: Please see below for additional resources on COVID-19. • Health Services COVID Data Dashboard- https://www.coronavirus.cchealth.org/dashboard • Health Services Homeless Specific Data Dashboard- https://www.coronavirus.cchealth.org/homeless-dashboard • Health Services COVID Updates- https://www.coronavirus.cchealth.org/health-services-updates • Health Services Homeless-Specific COVID Resources -https://www.coronavirus.cchealth.org/for-the-homeless FHS Feb 23 2023 Packet Page 158 of 174 COH QUARTERLY REPORT 10 APPENDIX B Council on Homelessness 2023 Members Seat Name Appointee Affiliation District Live District Work Term Ends 1. Affordable Housing Developer Representative Iman Novin Novin Development Consulting 4 All 12.31.24 2. Behavioral Health Representative Margaret Schlitz Portia Bell HumeCenter's West County FSP program N/A 1 12.31.24 3. City Government Representative Teri House CDBG Consultant, City of Antioch 5 3 & 5 12.31.24 4. CoC/ESG Program Grantee Representative Leslie Gleason Executive Director, Trinity Center N/A 4 12.31.23 5. Community Member Representative Keva Dean 1 5 12.31.23 6. Education and Vocational Services Representative Alejandra Chamberlain Homeless Education Liaison, Contra Costa Office of Education 3 All 12.31.24 7. Emergency Solutions Grants Representative Gabriel Lemus Contra Costa Department of Conservation and Development 5 All 12.31.24 8. Employment and Human Services (EHSD) Representative Angela Bullock-Hayes Division Manager, EHSD 3 4 12.31.23 9. Faith Community Representative Wayne Earl Pastor, Rock Harbor Christian Fellowship 1 1 12.31.23 10. Health Care Representative Mia Fairbanks Healthcare for the Homeless 5 All 12.31.24 11. Homeless Service Provider Representative Deanne Pearn Executive Director, Hope Solutions 2 All 12.31.24 12 Lived Experience Advisor #1 Juno Hedrick 1 N/A 12.31.24 13. Lived Experience Advisor #2 Jo Bruno Person with lived experience 3 3 12.31.24 14. Public Housing Authority Representative Tony Ucciferri Special Assistant to the Executive Director, Housing Authority of County of Contra Costa 4 5 12.31.23 FHS Feb 23 2023 Packet Page 159 of 174 COH QUARTERLY REPORT 11 15. Public Safety Representative #2 Shawn Ray Lieutenant, San Pablo Police Department 2 1 12.31.23 16. Reentry Services Representative Pat Mims Director, Reentry Success Center 1 1 12.31.23 17. Veterans Administration Representative Jai De Lotto Northern California VA Healthcare System N/A All 12.31.24 18. Workforce Development Representative Janae Thomas Swords to Plowshares N/A All 12.31.24 19. Youth Representative Anastasia Flores TAY with Lived Experience 1 N/A 12.31.24 FHS Feb 23 2023 Packet Page 160 of 174 Q4, 2022 REPORT FROM THE COUNCIL ON HOMELESSNESS February 27, 2023 FHS Feb 23 2023 Packet Page 161 of 174 SYSTEM FUNDING Federal •HUD Special Unsheltered NOFO •Housing Stability Voucher Program: State •Bringing Families Home •Homeless, Housing and Assistance Program •Homekey 3 Local •Measure X FHS Feb 23 2023 Packet Page 162 of 174 SYSTEM INITIATIVES Equity People with lived experience HMIS Evaluation Homelessness Awareness Month Monitoring Performance Based Contracting FHS Feb 23 2023 Packet Page 163 of 174 COLLABORATIONS Homeless Services- Workforce Development Integration (H-WIN) FHS Feb 23 2023 Packet Page 164 of 174 REGIONAL ACTION PLAN PROGRESS PATH Innovations Committee Funding Opportunities FHS Feb 23 2023 Packet Page 165 of 174 GOVERNANCE/REPORTING Revised Bylaws New Members Annual Advisory Board report FHS Feb 23 2023 Packet Page 166 of 174 MEETINGS, TRAININGS AND EVENTS Committees •Equity •HMIS Policy •Homelessness Awareness Month •Nominating •Oversight •PATH Innovations Trainings •Trauma Informed Care •Motivational Interviewing •Case Management Events CoC Provider Meetings CoC Learning Hub: "R.O.O.T.S: Reflecting On Our Truth And Stories H-WIN meeting Homeless Person’s Memorial Event FHS Feb 23 2023 Packet Page 167 of 174 RECOMMENDATIONS Direct county departments to build on partnerships created through Measure X, Homekey, and CalAIM to maximize funding toward resources dedicated to people experiencing homelessness in Contra Costa. FHS Feb 23 2023 Packet Page 168 of 174 QUESTIONS? FHS Feb 23 2023 Packet Page 169 of 174 CONTACT Jaime Jenett, Staff to the Council on Homelessness Jaime.jenett@cchealth.org 925-464-0152 FHS Feb 23 2023 Packet Page 170 of 174 FAMILY AND HUMAN SERVICES COMMITTEE 10. Meeting Date:02/27/2023   Subject:2023 Family and Human Services Committee Workplan Submitted For: FAMILY & HUMAN SERVICES COMMITTEE,  Department:County Administrator Referral No.: N/A   Referral Name: N/A  Presenter: Danielle Fokkema Contact: Danielle Fokkema, 925-622-2047 Referral History: Family and Human Services Committee (Committee) Referrals: During the 2022 calendar year, the Committee heard a total of 19 reports for the following 13 Committee referrals:  Referral #5 – Homeless Continuum of Care Plan for the Homeless / Healthcare for the Homeless Referral #20 – Public Service Recommendations of the County’s Community Development Block Grant and Emergency Services Grant Action Plan Referral #45 – Adult Protective Services and Challenges for Aged & Disability Populations, Including the Status of the Master Plan on Aging Referral #61 – HIV Prevention/Needle Exchange Program Referral #78 – Community Services Bureau/Head Start Oversight Referral #82 – Secondhand Smoke Ordinance Referral #93 – Youth Services Report, Including the Independent Living Skills Program Referral #103 – SNAP/CalFresh (formerly known as Food Stamp) Program Referral #107 – Assisted Outpatient Treatment Program (Laura’s Law) Referral #109 – Workforce Innovation and Opportunity Act Referral #110 – Innovative Community Partnerships Referral #111 – Family Justice Center & Commercially Sexually Exploited Children Referral #112 – Policy Options to Protect Youth from Tobacco Influences in the Retail Environment Due to scheduling conflicts, vacancies in leadership positions, and/or the ongoing demands of the County’s COVID-19 response, the Committee did not receive reports in 2022 for the following referrals:  Referral #44 – Challenges for EHSD (Continuum of Care Reform) Referral #56 – East Bay Stand Downs for Homeless Veterans / Stand Down on the Delta Referral #81 – Local Child Care & Development Planning Council Activities Referral #92 – Local Planning Council – Child Care Needs Assessment Referral #114 – Impacts of Technology on Access to Public Benefits Referral #116 – Public Mental Health Care Systems, Including Psychiatric Services to Children and Youth The Board of Supervisors, at is May 24, 2022, meeting referred to the Committee the topic of Healthy Options at Point of Sale (HOPS) and provided direction for Health Services Department Public Health Division staff to collaborate with HOPS youth advocates to look further into the issues presented and to prepare policy or ordinance recommendations that this Committee could forward on for the full Board's consideration. This referral has been added as Family and Human Services Referral No. 122 and is entitled, Policy Options for Healthy Options at Point of Sale (HOPS). Standing Committee Schedule and Format:FHS Feb 23 2023 Packet Page 171 of 174 Standing Committee Schedule and Format: The Committe's 2023 standing meeting date and time is set for the fourth Monday of each month at 10:30 a.m. Due to scheduling conflicts, four meeting dates are proposed as follows:  Cancel the March 27th meeting and set a special meeting for that month on Thursday, March 23rd at 10:30 a.m. Cancel the April 24th meeting and set a special meeting for that month on Friday, April 28th at 10:00 a.m. Cancel the July 24th meeting and set a special meeting for that month on Monday, July 31st at 10:30 a.m.  Cancel the December 25th meeting due to the County holiday, and if the need to hold a meeting in December is determined later in the year, a special meeting can be scheduled by staff Effective March 1, 2023, the Board's standing committees have been directed by the Board to use a hybrid meeting format that will enable the public to continue to participate in meetings electronically from remote locations. Under new legislation, Committee members may attend meetings remotely for limited "just cause" or "emergency" reasons no more than two times nor more than 20% of the regular meetings per calendar year, as long as at least one Committee member (a quorum) participates in person. Additionally, the Brown Act and County's Better Government Ordinance permits remote participation of a Committee member under these rules:  At least a quorum of the Committee (one member) must participate from a location in the county. Each telephone conference location and the meeting location must be shown on the agenda for the meeting. In addition, the agenda must provide an opportunity for members of the public to give public comment from each teleconference location. In addition to the usual agenda-posting agenda locations and the County website, an agenda must be posted at each teleconference location 96 hours in advance of the meeting. Each teleconference location must be open and accessible to members of the public. All votes taken during a teleconference meeting must be by roll call. A hybrid format would consist of either a two-way audiovisual platform, or a two-way telephonic service and a live webcasting of the meeting, so that the public may remotely hear and visually observe the meeting, and remotely address the body. The Board's standing committees are scheduled to meet in Conference Room 110 at the County Administration Building, 1025 Escobar Street, Martinez. This room is equipped to host hybrid meetings. Referral Update: Based on the actions taken by the 2022 Family and Human Services Committee and the Board of Supervisors, the following FHS referrals will continue in 2023, unless otherwise directed by the Committee:  Referral #5 – Homeless Continuum of Care Plan for the Homeless / Healthcare for the Homeless Referral #20 – Public Service Recommendations of the County’s Community Development Block Grant and Emergency Services Grant Action Plan Referral #44 – Challenges for EHSD (Continuum of Care Reform) Referral #45 – Adult Protective Services and Challenges for Aged & Disability Populations, Including the Status of the Master Plan on Aging Referral #56 – East Bay Stand Downs for Homeless Veterans / Stand Down on the Delta Referral #61 – HIV Prevention/Needle Exchange Program Referral #78 – Community Services Bureau/Head Start Oversight Referral #81 – Local Child Care & Development Planning Council Activities Referral #82 – Secondhand Smoke Ordinance Referral #92 – Local Planning Council – Child Care Needs Assessment Referral #93 – Youth Services Report, Including the Independent Living Skills Program Referral #103 – SNAP/CalFresh (formerly known as Food Stamp) Program Referral #107 – Assisted Outpatient Treatment Program (Laura’s Law) Referral #109 – Workforce Innovation and Opportunity Act Referral #110 – Innovative Community Partnerships Referral #111 – Family Justice Center & Commercially Sexually Exploited Children Referral #112 – Policy Options to Protect Youth from Tobacco Influences in the Retail Environment Referral #114 – Impacts of Technology on Access to Public Benefits Referral #116 – Public Mental Health Care Systems, Including Psychiatric Services for Children and Youth Referral #112 – Policy Options for Healthy Options at Point of Sale (HOPS) The recommended 2023 referrals include all 2022 referrals, with the exception of Referral #61 – HIV Prevention Needle Exchange Program since that report is a biennial report to this Committee on even years and a biennial consent report directly to the Board of Supervisors on odd years. Additionally, the 2023 referral recomendations include the new referral on the topic FHS Feb 23 2023 Packet Page 172 of 174 of Healthy Options at Point of Sale. Attached for the Committee's review is the proposed meeting schedule and work plan for hearing each of the 2023 referrals. Recommendation(s)/Next Step(s): APPROVE the proposed 2023 Family and Human Services Committee meeting schedule, referral workplan, and meeting format, or provide direction to staff regarding any changes thereto. Fiscal Impact (if any): There is no fiscal impact. Attachments Proposed 2023 FHS Workplan FHS Feb 23 2023 Packet Page 173 of 174 Meeting Details Agenda Items #121: Healthy Options at Point of Sale #82: Secondhand Smoke Ordinance and #112: Policy Options for Protecting Youth from  Tobacco Influences in the Retail Environment FHS 2023 Meeting Schedule, Workplan and Format‐ Staff Report #5: Homeless Continuum of Care (Health, Housing and Homeless Services) Quarterly Report Advisory Body Appointment Recommendations (as needed) #78:  Community Services Bureau (non‐Head Start services) #45:  Adult Protective Services and Challenges for Aged & Disability Populations including  status of the Aging Master Plan #20: Public Service Recommendations of the County's FY2023/24 CDBG Public Service and  ESG Advisory Body Appointment Recommendations (as needed) #114:  EHSD Technology (Including CalSAWS Transition) #116: Public Mental Health Care System Advisory Body Appointment Recommendations (as needed) #109:  Workforce Investment Act Update / Workforce Innovation and Opportunity Act #5: Homeless Continuum of Care (Health, Housing and Homeless Services) Quarterly Report Advisory Body Appointment Recommendations (as needed) #111: FJC & commercially Sexually Exploited Children #103:  SNAP/CalFresh Update Advisory Body Appointment Recommendations (as needed) #44:  Challenges for EHSD (Includes Continuum of Care Reform Report) #56 Stand Downs for Homeless Veterans (Standdown on the Delta) Advisory Body Appointment Recommendations (as needed) #93:  Youth Sevices Report (Includes Independent Living Skills Program Report) #107: Assisted Outpatient Treatment (AOT)  #115: Child/Adolescent Mental Health Services Advisory Body Appointment Recommendations (as needed) #5: Homeless Continuum of Care (Health, Housing and Homeless Services) and Healthcare  for the Homeless Annual Reports Advisory Body Appointment Recommendations (as needed) #110: Innovative Community Services (Including Measure X Programs) Advisory Body Appointment Recommendations (as needed) #120:  Role of the FACT Committee #5: Homeless Continuum of Care (Health, Housing and Homeless Services) Quarterly Report Advisory Body Appointment Recommendations (as needed) PROPOSED 2023 Family and Human Services Committee Workplan October, Monday 23rd at 10:30am November, Monday 27th at 10:30am December 25th Recommendation to cancel meeting due to County Holiday May, Monday 22th at 10:30am June, Monday 26th at 10:30am July, Monday 31st at 10:30am ‐          Special Meeting August, Monday 28th at 10:30am September, Monday 25th at 10:30am January No Meeting February, Monday 27th at 10:30am March, Thursday 23rd at 10:30am ‐  Special Meeting April, Friday 28th at 10:00am ‐           Special Meeting as presented on 2/27/2023 FHS Feb 23 2023 Packet Page 174 of 174