CONSIDERATION OF LATE ADDITIONS TO THE AGENDA; ADDITIONS AND DELETIONS TO CONSENT AND REGULAR AGENDAS

[8. Consider an annual report detailing 2025 Future of Public Health Initiative workplan progress, leading causes of morbidity and mortality in Santa Cruz County, and key county health disparities]

NEXT UP, WE HAVE ITEM NUMBER EIGHT.

CONSIDER ANNUAL REPORT DETAILING 2025 FUTURE OF PUBLIC HEALTH

[00:30:03]

INITIATIVE WORK PLAN PROGRESS, LEADING CAUSES OF MORBIDITY AND MORTALITY IN SANTA CRUZ COUNTY AND KEY COUNTY HEALTH DISPARITIES.

A PRESENTATION FROM THE HEALTH SERVICES AGENCY.

UM, I'M GOING TO INVITE OUR SPEAKERS TO COME PRESENT ON THIS ITEM.

BUT BEFORE WE HEAR FROM STAFF, I JUST WANT TO ADVISE HOW I'LL BE PROCEEDING WITH THIS ITEM.

WE'RE GOING TO HEAR A PRESENTATION FROM STAFF AND THEN I'M GOING TO TURN IT BACK TO THE BOARD TO ASK QUESTIONS OF STAFF, THEN I'LL BE OPENING IT UP TO THE PUBLIC FOR COMMENT AND THEN BRINGING IT BACK TO THE BOARD FOR DELIBERATION AND A MOTION.

SO WITH THAT, I BELIEVE WE HAVE HERE TO PRESENT DIRECTOR CONNIE MORENO-PERAZA, OUR DIRECTOR OF COUNTY HEALTH SERVICES AGENCY.

WE HAVE DR. LISA HERNANDEZ, OUR PUBLIC HEALTH DIRECTOR AND WE HAVE PAM CONELLY, OUR PUBLIC HEALTH MANAGER.

GO AHEAD.

- GOOD MORNING CHAIRPERSON MARTINEZ.

CONGRATULATIONS.

AND MEMBERS OF THE BOARD, CONNIE MORENO-PERAZA, THE DIRECTOR OF HEALTH SERVICES AGENCY.

I AM VERY PROUD AND VERY HONORED TO BE HERE WITH OUR AMAZING TEAM IN PUBLIC HEALTH TO SHARE WITH YOU SOME VERY CRITICAL INFORMATION FROM OUR COMMUNITIES AND SOME OF THE GREAT WORK THAT WE'RE GOING TO BE PLANNING TO DO IN THE NEAR FUTURE.

THIS DEPARTMENT IS VERY CRITICAL.

THEY HAVE VERY CRITICAL FUNCTIONS THAT HELPS US WITH THE HEALTH AND WELLNESS OF OUR COMMUNITIES.

SO I'M VERY THANKFUL TO THEM.

AND I WILL PASS IT OVER NOW TO DR. HERNANDEZ.

- GOOD MORNING.

THAT'S FINE.

GOOD MORNING CHAIR MARTINEZ AND MEMBERS OF THE BOARD.

THANK YOU, DIRECTOR MORENO-PERAZA FOR INTRODUCING US AND GIVING US LITTLE PROPS IN TERMS OF OUR WORK.

OFTENTIMES PUBLIC HEALTH IS SUCCESSFUL WHEN YOU DON'T KNOW ABOUT THE WORK THAT WE'RE DOING, SO I DO APPRECIATE THAT INTRODUCTION.

THIS PRESENTATION IS PART OF THE ANNUAL REPORTING REQUIREMENTS FOR THE FUTURE OF PUBLIC HEALTH INFRASTRUCTURE GRANT FUNDING AND THE REQUIREMENT OF THE GRANT ASKS US TO DESCRIBE THE LEADING CAUSES OF MORTALITY AND PREMATURE DEATH IN SANTA CRUZ COUNTY AND ALSO HIGHLIGHT DISPARITIES ACROSS POPULATIONS.

THIS PRESENTATION IS INTENTIONALLY HIGH LEVEL DUE TO THE AMOUNT OF TIME THAT WE HAVE TODAY.

WE COULD SPEND HOURS TALKING ABOUT THIS SUBJECT AND THE ASSOCIATED SOCIAL FACTORS CONTRIBUTING TO THE DATA THAT YOU'LL SEE IN THE NEXT FEW MINUTES.

THERE'S AN ACCOMPANYING ANNUAL REPORT AS I MENTIONED, THAT GOES DEEPER INTO THE DATA AND TRENDS AND CONTEXT.

AND IF YOU ARE EVEN MORE CURIOUS, YOU CAN LOOK AT THE COMMUNITY HEALTH ASSESSMENT WHICH CAN BE FOUND ON THE WEB AT DATA SHARE SANTA CRUZ COUNTY.

PUBLIC HEALTH SERVES AS A PROVIDER OF HEALTH SERVICE, HEALTH STATUS INFORMATION AND IS A CENTRAL PARTNER IN CONVENING AND COORDINATING CROSS SECTOR EFFORTS THROUGHOUT THE COUNTY TO ADDRESS THE KEY ISSUES IMPACTING OUR COMMUNITY.

AND WE WORK ALONGSIDE OUR AGENCY DIVISIONS AS WELL AS COMMUNITY ORGANIZATIONS, HEALTH CARE SYSTEMS AND OTHER STAKEHOLDERS.

AND WE ARE GRATEFUL FOR THEIR CONTINUED PARTNERSHIP AND SHARED COMMITMENT TO PROTECTING AND IMPROVING THE HEALTH OF OUR COMMUNITY.

THESE TWO GRAPHS SHOW ALL CAUSE MORTALITY RATES BY RACE AND ETHNICITY OVER TIME AND IN THE MOST RECENT THREE YEAR PERIOD AND BEFORE I GO INTO THE DATA, I WANT TO MAKE A BRIEF NOTE ON WHAT YOU SEE IN FRONT OF YOU.

DEATH RATES ARE AGE ADJUSTED TO ACCOUNT FOR DIFFERENCES IN AGE DISTRIBUTION ACROSS THE RACIAL AND ETHNIC GROUPS.

AND MULTIPLE YEARS ARE COMBINED TO SHOW BROADER PATTERNS OVER TIME.

THE VOLATILITY IN THE BLACK POPULATION TREND THAT YOU WILL SEE HERE REFLECTS THE RELATIVELY SMALL POPULATION SIZE.

WHERE SMALL CHANGES IN DEATHS CAN PRODUCE SHARP SPIKES UP OR DROPS DOWN.

ON THE LEFT, THE TREND DATA SHOW PERSISTENT DIFFERENCES ACROSS GROUPS.

THE BLACK POPULATION IN THE BLUE LINE HAS THE HIGHEST MORTALITY RATES THROUGHOUT THE ENTIRE PERIOD REFLECTING A LONG STANDING AND SIGNIFICANT HEALTH DISPARITY.

THE WHITE POPULATION IN THE BRIGHT GREEN SHOWS IS THE SECOND HIGHEST RATES WITH AN EARLY DECLINE AND IT'S VERY SUBTLE ON THE SIDE, BUT THERE IS A DECLINE AND THEN RELATIVE STABILITY AFTER THAT.

THE LATINO AND ASIAN POPULATIONS CONSISTENTLY HAVE LOWER MORTALITY RATES THROUGHOUT THE PERIOD.

[00:35:02]

LATINO RATES REMAIN GENERALLY STEADY WITH LIMITED FLUCTUATIONS AND THE ASIAN POPULATION DEATH RATES ARE THE LOWEST OVERALL, GENERALLY ARE STABLE.

HOWEVER, YOU SEE THERE IS A SHARP DROP EARLY ON, LIKELY DUE TO AGAIN THE RELATIVELY SMALL POPULATION SIZE IN OUR COUNTY AS OPPOSED TO AN ACTUAL CHANGE IN THE RISK.

SO JUST WANTED TO SHOW THAT TO YOU.

ON THE RIGHT THIS SHOWS THE DATA FOR THE PERIOD OF 2021 TO 2023.

AND AGAIN, THE DIFFERENCES REMAIN IN TERMS OF THE...

THE DIFFERENCES IN TERMS OF THE RACE AND ETHNIC GROUPS.

MORTALITY RATES ARE HIGHEST AMONG BLACK RESIDENTS, FOLLOWED BY WHITE RESIDENTS.

AND AGAIN, LATINO AND ASIAN RESIDENTS CONTINUE TO HAVE LOWER RATES.

TOGETHER, THESE GRAPHS DEMONSTRATE LONG STANDING DISPARITIES IN MORTALITY BY RACE AND ETHNICITY AND THEY ILLUSTRATE CLEAR PATTERNS AND TRENDS OVER TIME.

BUT THEY DO NOT REALLY SHOW THE UNDERLYING CAUSES OF WHY THESE DIFFERENCES EXIST.

AND THOSE ARE SHAPED BY BROADER SOCIAL, ECONOMIC AND STRUCTURAL FACTORS.

QUITE HONESTLY, IT'S WHAT WE SEE NATIONALLY.

SO IT'S NOT UNIQUE TO OUR COUNTY OR EVEN OUR STATE.

THIS SLIDE SHOWS THE FIVE LEADING CAUSES OF DEATH IN SANTA CRUZ COUNTY IN 2024.

AND THIS IS A DEATH COUNT.

AND YOU'LL SEE THAT ALZHEIMER'S DISEASE, STROKE ACCOUNT FOR THE HIGHEST NUMBER OF DEATHS IN OUR COUNTY, FOLLOWED BY ISCHEMIC HEART DISEASE.

DRUG OVERDOSE CONTINUES TO BE A MAJOR CONTRIBUTOR TO MORTALITY, AND THAT UNDERSCORES WHAT WE KNOW IS IMPACTING OUR COMMUNITY AND NATIONALLY, THE ONGOING OPIOID CRISIS.

THOUGH WE HAVE SEEN DROPS IN DEATHS, FORTUNATELY IT STILL IS A MAJOR CONTRIBUTOR TO OUR DEATHS THAT WE SEE IN OUR COMMUNITY.

HYPERTENSIVE HEART DISEASE ALSO REPRESENTS A SIGNIFICANT SHARE OF OVERALL DEATHS.

IN TOTAL, WE HAD 1,941 DEATHS IN OUR COUNTY.

AND WHAT YOU SEE HERE IS THAT THERE'S AN CONTINUED IMPORTANCE FOR CHRONIC DISEASE PREVENTION, AGE RELATED HEALTH CONDITIONS AND OF COURSE SUBSTANCE USE PREVENTION.

NEXT I WANT TO LOOK AT A LITTLE DEEPER IN TERMS OF OUR HEALTH, OUR DEATH INDICATORS.

WE NEED TO LOOK BEYOND OUR DEATH COUNTS AND NOT JUST OUR NUMBERS BUT ALSO LOOKING AT THE TRUE BURDEN DISEASE IN OUR COMMUNITY.

IN 2024, DRUG OVERDOSE IS A LEADING CAUSE OF PREMATURE DEATH.

SO NOW WE'RE NOT LOOKING AT DEATH COUNTS, WE'RE LOOKING AT PREMATURE DEATH IN OUR COUNTY.

AND WHEN WE LOOK AT THAT, WE SEE OVERDOSE AS NUMBER ONE, ALCOHOL RELATED DEATHS, ROAD INJURIES, ISCHEMIC HEART DISEASE AND SUICIDE AS THOSE CAUSES.

THEY RISE TO THE TOP WHEN WE EXAMINE PREMATURE DEATH USING WHAT WE CALL YEARS OF LIFE LOSS OR YLL, BECAUSE THEY DISPROPORTIONATE...

THESE CONDITIONS OR DEATHS DISPROPORTIONATELY IMPACT YOUNGER POPULATION MIDDLE AGED POPULATION IN OUR COMMUNITY.

YLL MEASURES PREMATURE MORTALITY BY ACCOUNTING FOR THE AGE IN WHICH A DEATH OCCURS.

SO A DEATH AT AGE 25 REPRESENTS 60 MORE YEARS OF LIFE LOSS THAN A DEATH AT AGE 85.

HELPING IDENTIFY WHERE WE'RE SEEING THE GREATEST LOSS OF POTENTIAL LIFE THAT OCCURS IN OUR COMMUNITY.

NOW I WANT TO TAKE A CLOSER LOOK AT YLL AND THIS GRAPH IS, YOU'LL SEE IN THE FOLLOWING SLIDES, THESE ARE SNAPSHOTS FROM OUR DASHBOARD THAT OUR POPULATION HEALTH TEAM PUTS TOGETHER AND I WOULD INVITE YOU TO SPEAK WITH US MORE OR WE COULD PRESENT AT ANOTHER TIME DEEPER AND GO THROUGH THESE SLIDES, THIS DASHBOARD A LITTLE BIT DEEPER.

IT'S BETTER WHEN IT'S INTERACTIVE, THAT'S WHAT I'M SAYING.

WHAT YOU SEE THOUGH IS THAT WE'VE LOST NEARLY 12,000 YEARS OF LIFE LOSS ACROSS ALL CAUSES OF DEATH IN 2024.

AND WHEN WE LOOK DEEPER, AND THAT'S WHAT THESE DIFFERENT GRAPHS SHOW, YOU SEE THE HIGHEST BURDEN IS SEEN AMONG WHITE RESIDENTS, MALES AND ADULTS AGE 35 TO 54.

WHAT STANDS OUT THOUGH, I WANT TO LOOK DEEPER IN THIS PART, IS THAT INJURY, NOT CHRONIC DISEASE, IS A DOMINANT DRIVER OF PREMATURE LOSS IN OUR COMMUNITY.

AND IT ACCOUNTS FOR NEARLY HALF OF ALL YEARS OF LIFE LOSS.

[00:40:02]

AND IT EXCEEDS CANCER AND HEART DISEASE COMBINED.

THESE DEATHS OCCUR DURING THE YEARS WHEN PEOPLE ARE RAISING FAMILIES, CONTRIBUTING TO THE WORKFORCE AND SUPPORTING COMMUNITY LIFE.

A LOSS IS NOT PERSONAL AND FAMILIAL, IT REPRESENTS A LOSS OF KNOWLEDGE, STABILITY AND SOCIAL CONTRIBUTION ACROSS OUR COUNTY.

FINALLY, THERE IS A HEALTH EQUITY DISPARITY EVIDENCE.

ALTHOUGH BLACK RESIDENTS REPRESENT A VERY SMALL SHARE OF OUR COUNTY POPULATION, THEY EXPERIENCE DISPROPORTIONATELY HIGH BURDEN OF YEARS OF LIFE LOSS.

THIS MIRRORS NATIONAL PATTERNS AND REFLECTS PERSISTENT IMPACT OF RACISM AND OTHER SYSTEMS OF OPPRESSION.

NOW LET'S JUST LOOK AT EACH OF THE SPECIFIC CAUSES FOR YEARS OF LIFE LOSS IN MORE DETAIL.

SO THIS SLIDE SHOWS PREMATURE OVERDOSE DEATHS AND WE SEE THE HIGHEST BURDEN AMONG WHITE AND LATINO INDIVIDUALS MALES AND INDIVIDUALS AGED 35 TO 44.

PREMATURE ALCOHOL RELATED DEATHS ARE CONCENTRATED AMONG WHITE RESIDENTS, MALES AND INDIVIDUALS AGED 45 TO 54.

PREMATURE ROAD INJURY DEATHS ARE PREDOMINANTLY AMONG WHITE RESIDENTS, ARE OVER 90% MALE AND ARE CONCENTRATED IN INDIVIDUALS AGES 25 TO 34.

AND FOR MORE INFORMATION ON ROAD INJURY, PLEASE SEE THE 2014/2023 SANTA CRUZ COUNTY CRASH REPORT THAT WAS RELEASED IN JULY OF 2025.

JUST WANTED TO GIVE YOU A LITTLE BIT OF ENCOURAGEMENT TO LOOK AT THAT REPORT THAT WAS RELEASED BY PUBLIC HEALTH EARLIER IN 25.

YEARS OF LIFE LOSS DUE TO HEART DISEASE PRIMARILY AFFECTED WHITE AND LATINO RESIDENTS, MALES AND INDIVIDUALS AGE 45 TO 54 CLOSELY FOLLOWED BY THOSE AGED 65 TO 74 YEARS OF AGE.

AND ONE NOTE, UH, YEARS OF LIFE LOSS IS USING THE BENCHMARK OF DEATH THAT OCCURS BEFORE THE AGE OF 75.

SO THAT'S WHY YOU WILL SEE, UM, THAT MENTIONED SOMETIMES IN MY PRESENTATION.

AND ONE THING THAT YOU MIGHT NOT BE ABLE TO SEE, BUT I WANT TO CALL ATTENTION TO IT, IS AGAIN ANOTHER DISPARITY.

THAT THE PERCENTAGE OF REPORTED YEARS OF LIFE LOST BY RACE ETHNICITY, WE SEE A CONCERNING DATA POINT WHERE INDIVIDUALS WHO IDENTIFY AS MULTIRACIAL MAKE UP ABOUT 3.85% OF OUR POPULATION, HOWEVER, THEY REPRESENT 16.7 OF YEARS OF LIFE LOSS.

SO AGAIN WE ARE SEEING A BURDEN IN THAT COMMUNITY WHEN WE'RE LOOKING AT RACE ETHNICITY OR SUICIDE YEARS OF LIFE LOSS.

NOW I WANT TO SHOW YOU HERE HOW HSA IS STRATEGICALLY ALLOCATING OUR RESOURCES TO ADDRESS THE LEADING CAUSES OF PREMATURE DEATH THAT WE JUST REVIEWED HERE.

OUR AGENCY USES A COMPREHENSIVE COORDINATED APPROACH ACROSS THREE DIVISIONS, PUBLIC HEALTH, BEHAVIORAL HEALTH AND HEALTH CENTERS RATHER THAN WORKING IN ISOLATED MANNER.

DRUG OVERDOSE IS ADDRESSED THROUGH MULTIPLE EFFORTS.

OUR OPIOID SETTLEMENT FUNDS WHICH YOU ARE AWARE OF IS USED TO SUPPORT COMMUNITY PROGRAMS AND EVIDENCE BASED EFFORTS INCLUDING PREVENTION AND SYSTEM LEVEL RESPONSES.

TREATMENT FOR SUBSTANCE USE DISORDERS IS AVAILABLE THROUGH OUR HEALTH CENTERS, BEHAVIORAL HEALTH DIVISION, AND ITS CONTRACTED PROVIDERS, AND OF COURSE, OTHER PROVIDERS IN OUR COMMUNITY.

PUBLIC HEALTH ALSO MAINTAINS OVERDOSE DASHBOARDS FOR REAL TIME MONITORING AND PROVIDES UPSTREAM YOUTH PREVENTION AND EARLY INTERVENTION EFFORTS.

UPSTREAM INTERVENTIONS ADDRESS THE SHARED DRIVERS OF SUBSTANCE USE THAT ALSO WE SEE IN ALCOHOL-RELATED DEATHS.

[00:45:03]

PUBLIC HEALTH LEADS SAFE AND ACTIVE TRANSPORTATION PROGRAMMING WITH COUNTY AND COMMUNITY PARTNERS TO ADDRESS THE ROAD INJURY.

AND THIS CROSS SECTOR APPROACH SUPPORTS SAFER SYSTEMS RATHER THAN RELYING SOLELY ON INDIVIDUAL BEHAVIOR CHANGE.

FOR ISCHEMIC HEART DISEASE, OUR HEALTH CENTERS PROVIDE PRIMARY CARE, FOCUS ON PREVENTION EARLY DETECTION, AND CHRONIC DISEASE MANAGEMENT.

AND PUBLIC HEALTH IS LEADING THE COMMUNITY HEALTH IMPROVEMENT PLAN, WHICH HAS HIGHLIGHTED BARRIERS TO HEALTHCARE ACCESS.

SUICIDE PREVENTION IS A COLLABORATION WITH BEHAVIORAL HEALTH, PUBLIC HEALTH, CONTRACTED PROVIDERS, COMMUNITY-BASED ORGANIZATIONS, AND SCHOOL-BASED PARTNERSHIPS FOCUSED ON EARLY IDENTIFICATION, PREVENTION, GATEKEEPER TRAININGS, AND FOCUS MEANS REDUCTION ACTIVITIES.

AS FEDERAL AND STATE LEVEL CHANGES INCREASINGLY AFFECT OUR ABILITY TO PROVIDE SERVICES, ADDRESSING THESE HEALTH CONDITIONS AND DISPARITIES WILL BECOME MORE CRITICAL THAN EVER.

PAM WILL NOW PROVIDE MORE DETAIL IN THE COMMUNITY HEALTH ASSESSMENT AND THE COMMUNITY HEALTH IMPROVEMENT PLAN THE FEDERAL IMPACTS ON PUBLIC HEALTH AND OTHER KEY TAKEAWAYS.

THANK YOU.

- THANK YOU, DR. HERNANDEZ.

GOOD MORNING, CHAIRMAN MARTINEZ AND MEMBERS OF THE BOARD.

I'M PAM CONELLY, THE PUBLIC HEALTH MANAGER FOR THE PUBLIC HEALTH DIVISION.

DR. HERNANDEZ PROVIDED AN OVERVIEW OF OUR COUNTY'S POPULATION...

CHANGE THE SLIDE HERE, OF OUR COUNTY'S POPULATION DATA.

NOW, I'LL SHARE HOW WE USE THAT DATA TO ENGAGE WITH OUR COMMUNITY TO IMPROVE HEALTH OUTCOMES.

SO EVERY THREE TO FIVE YEARS, HSA CONDUCTS A COMMUNITY HEALTH ASSESSMENT AND A COMMUNITY HEALTH IMPROVEMENT PLAN.

YOU MIGHT RECALL...

IN HERE.

YOU MIGHT RECALL IN SEPTEMBER 2024, OUR PUBLIC HEALTH DIVISION GAVE A DETAILED PRESENTATION TO THIS BOARD, REALLY HIGHLIGHTING ALL OF THE COMPONENTS OF THE COMMUNITY HEALTH ASSESSMENT.

IN THAT ASSESSMENT, WE... AND I'LL NOTE THAT THAT ASSESSMENT IS AVAILABLE ALSO ON DATA SHARES SANTA CRUZ COUNTY, SO IF YOU WANNA VIEW THAT REPORT, IT CAN BE FOUND THERE.

IN THAT ASSESSMENT, WE ANALYZED OVER 300 HEALTH INDICATORS TO UNDERSTAND OUR COUNTY'S HEALTH LANDSCAPE.

WE COMPLETED THE QUANTITATIVE DATA ANALYSIS AND COMPLEMENTED THAT WITH QUALITATIVE INSIGHTS FROM FOCUS GROUP KEY INFORMANT INTERVIEWS, AND OTHER TYPES OF ASSESSMENTS THAT ARE CONDUCTED ACROSS OUR COUNTY.

WE THEN CONVENED OUR COMMUNITY MEMBERS TO REVIEW THIS INFORMATION AND IDENTIFY PRIORITIES THROUGH A NUMBER OF FACILITATED DISCUSSIONS.

SO THIS COMMUNITY-DRIVEN PROCESS INITIALLY IDENTIFIED THE FOUR FOCUS AREAS THAT YOU SEE HERE ON THE SLIDE.

ACCESS TO HEALTHCARE, CHILDREN AND ADOLESCENT HEALTH, HOUSING SECURITY AND HOUSING BURDEN, AND MENTAL HEALTH AND MENTAL DISORDERS.

THESE ARE ALL PRIORITIES FOR IMPROVING HEALTH THAT WERE IDENTIFIED BY OUR COMMUNITY TOGETHER.

I'D LIKE TO NOTE THAT HOUSING SECURITY, AND MENTAL HEALTH TIED FOR 3RD PLACE SO WE INCLUDED BOTH OF THOSE AS PRIORITIES IN THE COMMUNITY HEALTH ASSESSMENT.

I'M TRANSITIONING NOW TO DESCRIBE OUR COMMUNITY HEALTH IMPROVEMENT PLAN STRATEGIC ELEMENTS.

SINCE THE ASSESSMENT DONE IN 2024, WE'VE BEEN USING THE INFORMATION, THAT DATA ANALYSIS AND WHAT WE'VE LEARNED FROM THE COMMUNITY PROCESS TO DEVELOP A COMMUNITY HEALTH IMPROVEMENT PLAN ALSO KNOWN AS OUR CHIP.

OUR CHIP DEMONSTRATES HOW PUBLIC HEALTH USES DATA TO BRING PARTNERS TOGETHER TO WORK ON SHARED HEALTH PRIORITIES.

IT'S BUILT ON LISTENING TO COMMUNITY MEMBERS, LEVERAGING OUR COLLECTIVE RELATIONSHIPS AND RESOURCES TO ADDRESS WHAT MATTERS THE MOST TO RESIDENTS.

LAST YEAR, WE CONVENED FOUR COUNTY-WIDE COMMUNITY CONVERSATIONS AND CONTINUED TO GATHER AND ANALYZE INFORMATION.

AND THROUGH THIS PROCESS, IN PART DUE TO THE FEDERAL AND STATE CUTS TO MEDICAID, THE COMMUNITY AGREED TO FOCUS ON ACCESS TO CARE A PRIMARY STRATEGIC ELEMENT THAT INTERSECTS WITH THE OTHER AREAS OF THE COMMUNITY HEALTH ASSESSMENT PRIORITY AREAS.

WE THEN DID A DEEPER DIVE INTO THE DATA AND DID FURTHER ANALYSIS WITH WHAT WE HAVE AVAILABLE TO US AS AVAILABLE DATA TO IDENTIFY THE MOST HEALTH-BURDENED GEOGRAPHIC AREA IN OUR COUNTY.

THIS ANALYSIS LED TO IDENTIFY CENSUS TRACT 1104.01, JUST A COMMUNITY THAT IS ON THE PAJARO RIVER IN WATSONVILLE.

WE RECONVENED OUR COMMUNITY PARTNERS, SO WE COULD LOOK AT THIS DATA AGAIN AND GO EVEN DEEPER.

TOGETHER WE IDENTIFIED THAT BOTH THE GEOGRAPHIC FOCUS ON THAT CENSUS TRACT AND A PRIORITY POPULATION BEING PREGNANT, LATINX INDIVIDUALS, AND PARENTS OF CHILDREN AGES 0 TO 5.

SO FOR THE STRATEGIC ELEMENT OF ACCESS TO CARE, WE'RE REALLY TAKING AN INCH WIDE AND A MILE DEEP APPROACH, CONCENTRATING RESOURCES IN OUR MOST HEALTH-BURDENED CENSUS TRACT

[00:50:03]

REALLY PRIORITIZING THIS POPULATION ACROSS THE FULL CONTINUUM OF CARE.

SO INCLUDING OB CARE, PEDIATRICS, PRIMARY CARE, BEHAVIORAL HEALTH, ORAL HEALTH, AND GENDER AFFIRMING CARE.

SO, THIS COMMUNITY-DRIVEN WORK IS CURRENTLY IN PROGRESS.

AS OF YESTERDAY AFTERNOON, WE WERE STILL DOING SOME COLLECTION OF INFORMATION.

OUR TEAM IN PARTNERSHIP WITH VENTURES, MET WITH 15 FAMILIES IN THE CENSUS TRACT, TO GATHER MORE INFORMATION AND UNDERSTANDING WHAT THEY BELIEVE WILL HELP IMPROVE HEALTH FOR THEIR COMMUNITY.

SO THERE WILL BE MORE TO SHARE IN THE DEVELOPMENT OF THIS ELEMENT SOON.

THE OTHER TWO STRATEGIC ELEMENTS THAT YOU SEE HERE ARE, DR. HERNANDEZ PRESENTED THE MORTALITY DATA ON, AND THE SECOND IS OVERDOSE PREVENTION.

SO HAVING THAT IN OUR CHIP ACKNOWLEDGES THAT THE LIVES WE'RE LOSING AND THE COMPLEX ISSUES BEHIND THIS CRISIS ARE REALLY IMPORTANT.

IT RECOGNIZES THAT WE'VE BEEN WORKING ACROSS DEPARTMENTS REALLY COUNTY-WIDE TO TACKLE IT, AND THAT THIS PRIORITY BRINGS SUBSTANCE USE TREATMENT, HARM REDUCTION, AND PREVENTION TOGETHER IN A COORDINATED EFFORT.

INCLUDING SUICIDE PREVENTION AND THE CHIP ACKNOWLEDGES WE NEED TO DO MORE IN THIS AREA.

AND THE BEHAVIORAL HEALTH SERVICES ACT PROVIDES BOTH A FRAMEWORK AND AN EXPECTATION FOR THIS WORK, FOCUSING ON YOUTH SERVICES, LGBTQ SUPPORT, MENTAL HEALTH ACCESS, AND PREVENTION PROGRAMMING.

SO, I'M GOING TO...

I'M GOING TO SWITCH OVER A LITTLE BIT HERE TO JUST HIGHLIGHT OUR FEDERAL IMPACTS FOR OUR LOCAL...

FOR OUR LOCAL PUBLIC HEALTH DEPARTMENT.

WE'VE GOT OUR... THE SCIENTIFIC, AUTHORITY HAS BEEN UNDERMINED.

WE'VE SEEN WITH THE POLITICIZATION OF CDC GUIDANCE AND PUBLIC HEALTH SCIENCE, BUT THERE'S A REDUCED TRUST IN PUBLIC HEALTH, OVERALL, AND IN HEALTH SERVICES.

WE'VE ALSO KNOW THAT THERE'S A REDUCED PREVENTION CAPACITY, SO CUTS TO REPRODUCTIVE HEALTH AND OTHER CHRONIC DISEASE PROGRAMS REALLY PUTS OUR COMMUNITIES AT RISK, AND IT MAKES THE WORK HARDER WHEN WE LOSE A LOT OF THIS INFRASTRUCTURE.

WE ALSO KNOW THAT OUR VACCINE SCHEDULE CHANGES, UNSUPPORTED BY EVIDENCE REALLY PUT OUR COMMUNITY AT RISK FOR BEING UNDER VACCINATED AND NOT ABLE TO HAVE THE COMMUNITY AS HEALTHY AS IT POTENTIALLY COULD BE WHEN WE'RE ALL VACCINATED.

WE ALSO HAVE BARRIERS TO CARE ACCESS, SO ACTIONS REALLY UNDERMINING THE AFFORDABLE CARE ACT, RISING AND INSURED RATE FOR OUR MOST VULNERABLE POPULATION AND THE REDUCTION IN PREVENTATIVE AND PRIMARY CARE ACCESS.

INCLUDING REDUCED ACCESS TO GENDER AFFIRMING CARE, ALL OF WHICH WE KNOW ARE REALLY IMPORTANT FOR OUR COMMUNITY TO BE HEALTHY AND WHOLE.

WE ALSO HAVE SEEN INCREDIBLE WEAKENED HEALTH EQUITY PROGRAMMING BECAUSE OF THE ROLLBACKS OF DISPARITY, FUNDING OR FUNDINGS FOR DISPARITY WORK AND DISPARITY REDUCTION PROGRAMS. SO WE'VE GOT DIMINISHED DATA COLLECTION AND ALSO DIMINISHED DATA COLLECTION FOR OUR VULNERABLE POPULATIONS.

SO WE DON'T KNOW EVERYTHING THAT'S HAPPENING FOR OUR POPULATIONS BECAUSE WE'VE GOT REDUCED DATA COLLECTION HAPPENING ACROSS THE BOARD.

LASTLY, I WILL JUST GIVE SOME KEY TAKEAWAYS.

WE'VE DONE A LOT OF TALKING, WE'VE SHARED A LOT OF DATA, SO I JUST WANT TO HIGHLIGHT A FEW THINGS THAT WE WANT TO MAKE SURE YOU TAKE BACK WITH YOU.

SO FIRST, OUR DATA SHOWS THAT HEALTH DISPARITIES PERSIST IN SANTA CRUZ COUNTY.

MORTALITY RATES VARY SIGNIFICANTLY BY RACE AND ETHNICITY WITH BLACK AND WHITE POPULATIONS EXPERIENCING HIGHER RATES, WHILE LATINO AND ASIAN POPULATIONS HAVE LOWER RATES.

THESE DISPARITIES DRIVE OUR FOCUS ON HEALTH EQUITY.

WHEN WE LOOK AT PREMATURE DEATH THROUGH YEARS OF POTENTIAL LIFE LOST, DRUG OVERDOSES EMERGE AS THE LEADING CAUSE.

WHILE CHRONIC... EXCUSE ME.

WHILE CHRONIC DISEASE DRIVES OVERALL MORTALITY IN OUR AGING POPULATION, INJURY DEATHS OCCUR AT YOUNGER AGES REPRESENTING SIGNIFICANT LOST POTENTIAL IN OUR COMMUNITY.

OUR COMMUNITY HEALTH IMPROVEMENT PLAN IS COMMUNITY-DRIVEN AND STRATEGIC.

WE'RE TAKING THIS INCH-WIDE, MILE-DEEP APPROACH, CONCENTRATING RESOURCES AND OUR MOST HEALTH BURDEN CENSUS TRACT WHILE ALSO ADDRESSING OVERDOSE AND SUICIDE PREVENTION, WHICH YOU HEARD ABOUT IN DR. HERNANDEZ'S MORTALITY DATA.

THE WORK REQUIRES INTEGRATION ACROSS OUR AGENCIES, SO PUBLIC HEALTH, BEHAVIORAL HEALTH AND HEALTH CENTERS, OUR ONE HSA, ARE WORKING TOGETHER WITH COMMUNITY PARTNERS TO ADDRESS THESE PRIORITIES.

WE'VE GOT COORDINATED EFFORTS AND COORDINATED STRATEGIC OPERATIONS ACROSS THESE AREAS.

FINALLY, WE IN PUBLIC HEALTH ARE COMMITTED TO ACCOUNTABILITY AND TRANSPARENCY.

SO WE WILL BE PROVIDING AN ANNUAL PROGRESS REPORT ON OUR COMMUNITY HEALTH IMPROVEMENT PLAN, CONTINUED INFORMATION AROUND HEALTH DATA IN OUR COMMUNITY, AND JUST TO ENSURE THAT WE ARE TRANSPARENT AND SHARING THAT WE HAVE OUR...

THAT WE ARE DOING DATA-DRIVEN ADJUSTMENTS

[00:55:02]

TO OUR STRATEGIES AS WE CONTINUE THE WORK.

THANK YOU, BOARD, FOR YOUR CONTINUED SUPPORT FOR PUBLIC HEALTH AND THE HEALTH OF OUR COMMUNITY.

PLEASE LET US KNOW WHAT QUESTIONS YOU HAVE.

- THANK YOU FOR THE PRESENTATION.

I'M NOW GOING TO TURN IT BACK TO THE BOARD TO SEE IF THERE ARE ANY QUESTIONS FOR THE STAFF.

- THANK YOU FOR THIS PRESENTATION.

I DO HAVE A COUPLE OF QUESTIONS.

SOME OF THESE REPORTS THAT YOU'VE REFERENCED, ARE VERY COMPREHENSIVE, AND I'D LIKE TO BE ABLE TO, LIKE, LOOK AT THE CRASH REPORT FROM JULY, AND A COUPLE OF THE OTHER REPORTS YOU REFERENCED.

ARE THOSE READILY AVAILABLE ON THE WEBSITE? UNDER THE PUBLIC HEALTH SECTION OR...

- YES. THEY SHOULD BE ON THE HSA WEBSITE.

IF YOU GO TO PUBLIC HEALTH, YOU CAN SEE A LINK BOTH TO THE COMMUNITY HEALTH ASSESSMENT AND TO THE CRASH WORK.

- OKAY. THANK YOU.

SO IN A BOARD ACTION A LITTLE EARLIER THIS YEAR WE HAD TO MAKE SOME REDUCTIONS ACROSS OUR HEALTH SERVICE THIS AGENCY, AND ONE OF THOSE POSITIONS WAS A SUICIDE PREVENTION COORDINATOR OR A PROGRAM MANAGER, I CAN'T REMEMBER EXACTLY, BUT GIVEN THE DATA THAT I SEE IN FRONT OF ME, I'M CONCERNED, AND WE ALL SHOULD BE VERY CONCERNED, THAT THESE PREVENTION EFFORTS, WE NEED TO PUT INTO HIGH GEAR, I THINK.

CAN YOU SPEAK TO, NOW THAT WE HAVE THIS DATA AND WE'VE ANALYZED IT, WHAT ARE SOME OF THE PREVENTION STRATEGIES WE'LL BE USING AND IMPLEMENTING IN OUR COMMUNITY? - WE'RE JUST TRYING TO FIGURE OUT WHO CAN ANSWER.

I THINK THAT WE CAN ALL ANSWER.

YEAH. WELL, WHAT I WILL SAY ABOUT OUR CURRENT, SUICIDE PREVENTION PROGRAM IS WE, IN PUBLIC HEALTH, ARE PARTNERING WITH BEHAVIORAL HEALTH DIVISION, AND THERE IS WORK.

WE'VE GOT A POSITION.

WHEN THAT POSITION THAT YOU SPOKE OF ENDED, WHAT WE DID IS WE HAD SOMEONE WHO, A SENIOR HEALTH EDUCATOR IN PUBLIC HEALTH, THAT WE HAD SOME CAPACITY TO MOVE INTO COMPLETING SOME OF THE WORK FOR THE GRANT THAT ENDS AT THE END OF THIS YEAR.

AND WE EXPECT THAT THROUGH THE BEHAVIORAL HEALTH SERVICES ACT, THAT THERE WILL BE MONEY COMING FROM CDPH FOR SUICIDE PREVENTION SO WE ARE POISED.

WE'RE CONTINUING THE WORK, WE'RE HOLDING THOSE THREADS, AND WE'RE POISED TO CONTINUE THE WORK ONCE WE UNDERSTAND THAT THE ALLOCATION WILL BE FROM THE STATE AND WHAT THE EXPECTATIONS OF THAT FUNDING WILL BE.

- AND I THINK THERE'S BEEN AN EFFORT YOU KNOW, OVER THE LAST DECADE OR MORE TO REALLY LOOK AT YOUNG GIRLS ESSENTIALLY IN OUR SCHOOLS AND OUR COMMUNITIES AND TO GIVE THEM SOME SERVICES, TO HELP THEM IN STEM, AND...

OR, YOU KNOW, GIRLS INC. AND GIRLS...

[SILENCE] DIFFERENT CURRICULUM OUT THERE TO HELP YOUNG GIRLS WITH SELF-ESTEEM AND CONFIDENCE AND MAKING SURE THAT THEY'RE, YOU KNOW, ON A...

GIVE THEM [INAUDIBLE] LIVES.

- YOU KNOW, [INAUDIBLE] THAT YOU'RE THINKING ABOUT IMPLEMENTING AND MAYBE TODAY IS NOT THE RIGHT TIME FOR THAT.

MAYBE YOU COULD COME BACK.

- OF COURSE [CROSSTALK]. - BUT TODAY IS NOT THE RIGHT DAY.

- HAPPY TO SHARE THAT AT A LATER DATE.

AND I'M SURE MY COLLEAGUE, DR. MARNI SANDOVAL, CAN HELP WITH THAT.

BUT I WILL SAY THAT WE ARE WAITING, OF COURSE, TO UNDERSTAND WHAT THE STATE EXPECTATIONS FOR THE ALLOCATION IS BUT WE ALSO KNOW THAT WE ARE A RESPONSIVE HEALTH DEPARTMENT, A RESPONSIVE AGENCY, AND WE'LL MAKE SURE THAT WE ARE TOUCHING EVERYTHING THAT WE CAN WHEN WE UNDERSTAND WHAT THOSE EXPECTATIONS ARE.

- THANK YOU.

- SUPERVISOR KOENIG? - THANK YOU, CHAIR.

ONE OF THE THINGS THAT JUMPED OUT AT ME IN THE REPORT IS JUST OF HOW MUCH TRAFFIC INJURIES ACTUALLY ARE ONE OF THE LEADING CAUSES OF PREVENTABLE DEATHS.

AND, YOU KNOW, I WENT BACK, AND I'M LOOKING AT THE CRASH REPORT NOW AND ALSO CHECKED THE OFFICE OF TRAFFIC SAFETY FOR THE STATES RANKINGS.

AND I WAS SHOCKED TO SEE THAT WE...

I THINK WE ADVANCED TO THE WORST COUNTY IN THE STATE FOR BICYCLE INJURIES AND DEATHS.

AND I WOULDN'T BELIEVE THAT IF I DIDN'T ACTUALLY KNOW SO MANY PEOPLE THAT HAVE ACTUALLY...

I MEAN, I JUST THINK OF THREE THAT ARE AT THE TOP OF MY HEAD ONE WHO DIED, AND TWO WHO HAVE HAD SUSTAINED SERIOUS INJURIES ON BIKES.

I'M JUST CURIOUS, DOES THE...

DO YOU AND PUBLIC HEALTH WORK WITH PUBLIC WORKS AT ALL ON WAYS TO PREVENT? IF YOU'RE SEEING PROBLEM AREAS

[01:00:02]

WHERE WE SEE REPEATED INJURIES OR CRASHES, ARE YOU WORKING WITH PUBLIC WORKS TO IDENTIFY SOLUTIONS AND ENGINEERING FIXES? - PUBLIC HEALTH HAS A SAFE AND ACTIVE TRANSPORTATION COALITION.

I CANNOT...

I DON'T KNOW IF PUBLIC HEALTH...

PUBLIC WORKS IS PART OF THAT GROUP.

SO WE CAN COME BACK TO YOU AND LET YOU KNOW.

IT SEEMS LIKE THE DIRECTOR IS STANDING UP AND CAN ANSWER THAT SO I WILL HAND IT OVER TO DIRECTOR MACHADO.

- SO TO ANSWER YOUR QUESTION...

OH, THERE WE GO. THANK YOU.

WE ARE A PART OF THE VISION ZERO PROGRAM WITH HEALTH AND WE ACTUALLY TEAMED TOGETHER AND RECEIVED A GRANT FROM THE SS FOR A FEDERAL PROGRAM, AND WE'RE DEVELOPING AN ACTION PLAN RIGHT NOW, WHICH THAT WILL IDENTIFY ALL THE CHALLENGES AND ALL THE AREAS OF NEEDED IMPROVEMENT.

AND THEN ONCE THAT PLAN IS APPROVED, WE'LL BE ELIGIBLE FOR IMPLEMENTATION OF THOSE INDIVIDUAL, NEEDED PROJECTS AND PROGRAMS. AND IT'S NOT ALL JUST PROJECTS.

SOME OF IT IS, YOU KNOW, MORE EDUCATION.

SOME OF IT'S WORKING WITH PUBLIC SAFETY WITH THE HEALTH GROUPS.

AND SO, IT'S A LOT OF DIFFERENT PROGRAMS THAT WE'LL BE INVESTING IN THROUGH, FEDERAL IMPLEMENTATION GRANTS.

SO IT'S IN OUR...

IT'S ON OUR RADAR, AND WE'RE PURSUING ALL AVENUES WE CAN TO ADDRESS THE VERY CONCERN THAT YOU RAISED? - GREAT. AND SO THE TITLE OF THAT IS THE VISION ZERO ACTION PLAN OR...

- IT'S A...

IT IS. IT'S CALLED A ...

IT'S AN ACTION PLAN.

LET ME THINK OF IT.

I DON'T THINK VISION ZERO IS IN THE TITLE OF IT, BUT IT IS A...

IT'S A...

IT IS AN ACTION PLAN.

I CAN GET YOU MORE INFORMATION.

I CAN GET YOU A COPY OF THE DRAFT THAT WE'RE...

OUR CONSULTANT IS DRAFTING NOW. - OKAY.

I'LL SEND YOU SOME INFORMATION ON IT.

- WHEN DO WE ANTICIPATE IT BEING FINALIZED? - IT IS BEING...

I DON'T KNOW THE DATE OF WHEN IT'LL BE FINALIZED, BUT I'LL GIVE YOU THAT INFORMATION AS WELL.

WELL, I'LL INCLUDE IT ALL.

- THANK YOU VERY MUCH.

- THANK YOU.

- SUPERVISOR CUMMINGS? - OH.

THANK YOU CHAIR. I'M JUST GOING TO PIGGYBACK A LITTLE BIT ON SUPERVISOR DE SERPA'S COMMENTS, BECAUSE, YOU KNOW, THE DATA THAT HE SHOWED REGARDING, YOU KNOW THE WHITE AND BLACK POPULATIONS AND MALES WITHIN THE COMMUNITY EXPERIENCING THE HIGHEST RATE OF MORTALITY, I'M JUST CURIOUS WHAT STRATEGIES MIGHT BE CONSIDERED OR IMPLEMENTED TO HELP REDUCE MORTALITY RATES AMONGST THOSE POPULATIONS.

AND PARTICULARLY WITH THE BLACK POPULATION, I MEAN, BLACK RESIDENTS MAKE ABOUT 1% OF THE TOTAL POPULATION OF SANTA CRUZ COUNTY, WHICH IS LIKE 2,500 PEOPLE.

THAT SEEMS LIKE A PRETTY EASY POPULATION TO BE ABLE TO TARGET, YOU KNOW, GIVEN THE RESOURCES THAT WE HAVE, SINCE THERE'S SO FEW PEOPLE WHO MAKE UP THAT POPULATION AND YET THERE'S SO MUCH HIGHER MORTALITY AMONGST THEM, SO JUST CURIOUS ACROSS THOSE DEMOGRAPHICS, WHAT MIGHT BE IMPLEMENTED OR CONSIDERED IN TERMS OF TRYING TO HELP REDUCE THOSE RATES OF MORTALITY? - THANK YOU, SUPERVISOR CUMMINGS.

IT'S ACTUALLY LESS THAN 1%.

IT IS A VERY SMALL POPULATION.

SO I UNDERSTAND YOUR... YOUR...

WHAT I WOULD SAY IS ALMOST A REACTIVE TO WORK CLOSER WITH...

THERE ARE COMMUNITY ORGANIZATIONS IN THE COUNTY THAT WE NEED TO WORK CLOSER WITH.

AND WHEN YOU DO A DEEPER DIVE IN THE DATA FOR PREMATURE DEATH THE TWO AREAS WHERE A BLACK AFRICAN AMERICAN POPULATION SEEMS TO HAVE THE HIGHEST LOSS IN PREMATURE DEATH IS, ONE, ISCHEMIC HEART DISEASE.

THAT'S ONE THING THAT'S NOT A SURPRISING ONE, BUT THE OTHER IS DRUG-RELATED DEATHS.

SO WE DO NEED TO LOOK AT THOSE TWO AREAS AND FOCUS, AND WORK WITH OUR COMMUNITY PROVIDERS, FOR THAT, FOR THOSE... ESPECIALLY THOSE TWO AREAS.

AND THAT'S THAT.

- YEP. THANK YOU.

- THANK YOU. SUPERVISOR HERNANDEZ? - THANK YOU. WELL, FIRST OF ALL, I WANT TO THANK PAM CONELLY AND CONNIE MORENO AND LISA HERNANDEZ FOR THE PRESENTATION.

YOU KNOW, KIND OF PIGGYBACKING ON, SUPERVISORY KOENIG'S COMMENTS WITH THE ROAD-RELATED FATALITIES, YOU KNOW, IN MY DISTRICT, DISTRICT 4, IT DOES REPRESENT AN AREA THAT PER CAPITA HAS THE HIGHEST NUMBER OF FATALITIES AND SERIOUS COLLISIONS IN THE STATE, AS WELL IN WATSONSVILLE.

SO I LOOK FORWARD TO ALL THE WORK THAT'S BEING DONE WITH THE SAFE STREETS AND THE WORK ON THE COUNTY'S VISION ZERO PLAN, WHICH IS LED ALSO BY THE HEALTH SERVICES DEPARTMENT, AS WELL.

[01:05:04]

HOPEFULLY, WE CAN DO MORE THINGS LIKE DIFFERENT...

THERE'S DIFFERENT PLACES LIKE IN OREGON THAT ARE WORKING ON LOWERING SPEED LIMITS, WHICH IS A PROVEN TACTIC TO SAVE LIVES OF BOTH PEDESTRIANS AND DRIVERS, AND BICYCLISTS, ALTOGETHER.

AND OF COURSE THE NEED FOR SIDEWALKS IN PARTS OF OUR DISTRICTS, DEDICATED BIKE PATHS AND, OF COURSE, THE FLASH BEACON CROSSWALKS.

I THINK ALL THOSE CONTRIBUTE TO SAVING LIVES OF BOTH PEDESTRIANS AND DRIVERS ALIKE.

SO, HOPEFULLY, WE CAN WORK ON THAT AND HAVE A PRESENTATION SOMETIME IN THE FUTURE ABOUT THAT, BECAUSE IT IS SIGNIFICANT THAT WE DO HAVE THE COUNTY AND ONE OF THE CITIES WITH THE HIGHEST FATALITY AND SERIOUS COLLISION RATES IN THE STATE OF CALIFORNIA.

- THANK YOU. I JUST HAVE A COUPLE OF QUICK QUESTIONS.

ONE, CAN YOU SPEAK TO THE DRUG OVERDOSE TRENDS OVER THE LAST FEW YEARS? I THOUGHT I HAD HEARD THAT THEY HAD GONE DOWN, BUT WHAT DO YOU THINK IS CONTRIBUTING TO THAT? - YES, THEY HAVE GONE DOWN, THANKFULLY, AND I HOPE THEY CONTINUE TO DECLINE.

IT'S A MULTIFACTORIAL... I DON'T WANT TO CALL IT A SUCCESS CONTRIBUTION OF THAT DECLINE.

ONE IS THAT WE ARE SEEING LOWER DRUGS.

I MEAN THE AMOUNT OF DRUGS COMING INTO OUR COMMUNITY, AND THAT STARTED YEARS AGO.

BEFORE THIS CURRENT PRESIDENT, WE DID SEE THAT COMING.

SO THAT WAS A LONGSTANDING CAMPAIGN.

SO THAT'S ONE THING.

THE OTHER THING I REALLY WANT TO TALK ABOUT, NOT ONLY OUR MAT TREATMENT THAT WE HAVE, OUR MEDICAID ASSISTED TREATMENT IN OUR COMMUNITY, OUR HEALTH SERVICES AGENCY HEALTH CENTERS, BEHAVIORAL HEALTH, AND OUR PROVIDERS IN THE COMMUNITY TRULY HAVE STEPPED UP TO WORK WITH OUR COMMUNITY, TO PROVIDE THAT LEVEL OF SUCCESS.

AND LAST BUT NOT LEAST, NARCAN.

NARCAN, AS MANY OF US KNOW, NALOXONE, HELPS TO REVERSE DRUG OVERDOSE, AND IT IS LIFE SAVING.

AND IT IS THROUGHOUT OUR COMMUNITY, FROM SCHOOLS TO LAW ENFORCEMENT TO INDIVIDUALS HERE IN OUR COMMUNITY CAN...

I HAVE ONE ON MY PERSON.

I GAVE IT TO MY CHILDREN.

SO THEY HAVE IT.

AND THAT IS BASICALLY THE CULTURE OF OUR COMMUNITY IN TERMS OF PROVIDING THAT LEVEL OF LIFESAVING EFFORTS.

I DON'T KNOW IF ANYONE WANTS TO ADD TO THAT, BUT THAT'S WHAT WE ARE SEEING.

- THANK YOU. - I THINK THE OTHER THING I WANTED TO JUST ADD, I KNOW DR. SANDOVAL'S IN THE AUDIENCE.

I KNOW BEHAVIORAL HEALTH, HAVING SUBSTANCE ABUSE UNDER THAT DIVISION HAVE BEEN VERY, VERY ACTIVE.

AND WHAT I APPRECIATE THE MOST ABOUT THIS DECREASE, EVEN THOUGH IT'S TOO MANY STILL ONE LIFE LOSS IS TOO MANY, RIGHT ONE OVERDOSE, TOO MANY A LOT OF THE WORK THAT SHE'S BEEN DOING AS WELL WITH A LOT OF THE TREATMENT, AVAILABILITY OF SERVICES ALSO FOR THE YOUNG PEOPLE AS WELL AS OUR ADULT.

AND THEN I THINK ALSO THE EDUCATION THAT HAS BEEN HAPPENING HAS BEEN JUST TREMENDOUS.

AND IT REALLY, REALLY HELPS.

THE WAY THAT YOU ADMINISTER NARCAN IS VERY EASY.

YOU CAN SEE IT IN YOUTUBE, AND THAT EASY WAY TO DO IT HAS REALLY ENCOURAGED A LOT OF FOLKS TO CARRY IT ON THEIR PURSES OR THEIR BACKPACKS AND UTILIZE IT AND HELP US SAVE LIVES.

SO IT DOES TAKE A MULTI-DEPARTMENT, MULTI-COMMUNITY BASED APPROACH TO REDUCE THESE NUMBERS.

THANK YOU.

- I WOULD NOW LIKE TO INVITE THE PUBLIC TO COMMENT ON THIS ITEM.

IF YOU INTEND TO SPEAK, I ASK THAT YOU PLEASE LINE UP SO WE CAN GET A SENSE OF HOW MANY PEOPLE INTEND TO SPEAK ON THIS ITEM.

AND IF YOU'RE PARTICIPATING VIA ZOOM, PLEASE USE YOUR BUTTON TO RAISE YOUR HAND OR DIAL STAR NINE IF YOU'RE ON THE PHONE.

CLERK OF THE BOARD, HOW MANY PEOPLE DO YOU SEE ONLINE? - CHAIR, CURRENTLY I SEE ONE SPEAKER, AND JUST TO MAKE SURE EVERYONE ONLINE IS, ABLE TO CONNECT OR INDICATE I BELIEVE IT MAY BE STAR SIX TO RAISE, WAIT, NO, I'M SORRY.

YOU'RE CORRECT. STAR NINE TO RAISE YOUR HAND AND THEN STAR SIX TO MUTE OR UNMUTE YOURSELF.

WE DO SEE SPEAKERS CONTINUING TO RAISE THEIR HAND ONLINE.

WE NOW HAVE THREE PEOPLE IN LINE ON VIRTUALLY.

- THANK YOU.

AND IT LOOKS LIKE WE HAVE ABOUT SIX OR SEVEN SPEAKERS.

THAT BEING THE CASE, I'D LIKE TO SET THE COMMENT PERIOD FOR TWO MINUTES EACH.

GO AHEAD.

- OKAY.

YEAH, GO? OKAY. SPEAKING OF COURSE, ON THE LITHIUM ION BATTERIES STORAGE FACILITIES.

[01:10:03]

CAN YOU HEAR? - WRONG ITEM.

- OH, OKAY.

OKAY.

SPEAKING ON THE LITHIUM ION BATTERY STORAGE FACILITIES.

- MA'AM, SORRY TO INTERRUPT.

RIGHT NOW WE ARE SPEAKING ON ITEM NUMBER EIGHT, WHICH IS THE PRESENTATION THAT WE JUST HEARD AND WE'RE ACCEPTING COMMENTS ON THAT ITEM.- OKAY. I'M SORRY. I THOUGHT...

YEAH. I'VE GOT AN APPOINTMENT DOWN IN THE SOUTH BAY AND I'VE GOT, OKAY, I WOULD ON THE HEALTH OF THE COMMUNITY I'VE SPENT DECADES IN THE HEALTHCARE, AND I WANNA SAY THAT I THINK THE BIG ELEPHANT IN THE ROOM THAT WE'RE MISSING IS NUTRITION.

NUTRITION, GOOD, HEALTHY NUTRITION.

IF WE COULD ALLOW EVERYONE IN THIS COMMUNITY TO HAVE ACCESS TO ORGANIC PRODUCE, HOPEFULLY IF THEY EAT MEAT AND CHICKEN INSTEAD OF ALL THE CHEMICAL LADEN STUFF, THE GUT BRAIN RELATIONSHIP, WE'D SEE LESS CRIME.

WE'D SEE LESS DEPRESSION.

THE SUICIDES THAT PROBABLY WOULDN'T GO SO MUCH TO DRUGS ALCOHOL.

THAT'S VERY IMPORTANT, NUTRITION AND ENVIRONMENT.

A CLEAN ENVIRONMENT IN THEIR HOME, IN THEIR BACKYARD.

WE NEED TO RID THE PESTICIDES IN THIS COMMUNITY.

THERE ARE XENOESTROGENS AND THEY'RE KNOWN TO CAUSE HORMONE CANCER, IT'S BREAST AND PROSTATE.

AND, WE NEED TO MAKE SURE THAT EVERYONE IS, KNOWS TO GET OUT IN THE SUNSHINE TO EARTH.

EARTHING IS ACTUALLY SCIENCE NOW, WALKING IN THE SAND BAREFOOT.

WE HAVE THE SALT FROM THE OCEAN, VERY IMPORTANT SIMPLE CONCEPTS.

SOME MIND PRACTICE MEDITATION, A ZEN MIND PRACTICE SO THAT THEY CAN KIND OF GO INTERNAL.

WE'RE LOOKING EXTERNALLY.

THAT'S, YOU KNOW, OUR MEDICAL COMMUNITIES ARE GONNA FIX EVERYTHING.

IT'S AN INSIDE JOB.

AND IF EVERY CHILD COULD HAVE A LITTLE MEDITATION IN THE MORNING WHEN THEY FIRST ENTERED SCHOOL AND JUST CALM THEMSELVES DOWN, I MEAN, THEY'RE LOADED WITH ENERGY AND THEIR HORMONES ARE FLYING OFF THE CHART WHEN THEY'RE TEENAGERS AND THEY'RE IMPULSIVE AND THEY GET IN THE CAR AND GO HOME AND, YOU KNOW, FLY ACROSS THE HIGHWAY ONE AND 17.

I MEAN, I THINK WE COULD REALLY, REALLY TAKE CARE OF THINGS.

NOW YOU CAN'T PATENT THESE THINGS, SO YOU DON'T HEAR ABOUT HOW WONDERFUL THEY ARE, BUT THEY ARE.

AND ALSO...

- THANK YOU.

- OH, IS MY TWO MINUTES UP? OKAY. THANK YOU.

- KARELL READE FROM CORRALITOS.

I HAVE TO SAY THAT MENTAL HEALTH AND SUICIDE PREVENTION KIND OF ROSE UP TO THE TOP OF MY PRIORITIES LAST WEEK.

WHEN I HAD A CONVERSATION WITH ONE OF MY DEAR FRIENDS WHO HAS A 12-YEAR-OLD SON, AND SHE INFORMED ME THAT HE HAD ABOUT THREE WEEKS AGO NOW, MAYBE FOUR, HE HAD WRITTEN ON ONE OF HIS PAPERS THAT HE TURNED INTO HIS TEACHER, THANK GOODNESS THAT HE DIDN'T WANNA LIVE ANYMORE.

HE WAS HOPING SOMEBODY WOULD UNLIVE HIM.

AND I WAS KIND OF SHOCKED AND HORRIFIED.

I KNOW YOU, I KNOW THIS YOUNG MAN.

HE'S A VERY WONDERFUL YOUNG GUY, AND WE KNOW THAT THE YOUTH HAVE A LOT OF COMPLEX ISSUES AND PRESSURES ON THEM NOW, AND THERE'S NO ONE CAUSE FOR WHY A YOUNG MAN LIKE HIM WOULD HAVE SUICIDE IDEATION.

HOWEVER, ONE OF THE CAUSES THAT SHE AND I DISCUSSED THAT WAS PROBABLY PRETTY PREVALENT IN HIS THINKING IS BULLYING IN HIS SCHOOL.

AND I'M JUST HOPING THAT SOMEWHERE IN YOUR LIST OF PROJECTS AND IDEAS, THAT THERE IS A WAY TO MAYBE FIRST OF ALL, RAISE AWARENESS OF EDUCATORS, CLASSROOM TEACHERS OF ALL LEVELS.

HE'S ONLY 12, NOT EVEN IN HIGH SCHOOL YET.

AND GIVE THEM TOOLS TO HELP YOUNG PEOPLE, HELP THEM SPOT BULLYING, HELP THEM CURB IT.

AND THEN SECOND OF ALL, GIVE PROGRAMS FOR YOUNG PEOPLE WHO ARE STRUGGLING TO HAVE A TOOLBOX TO HELP BATTLE BULLYING BECAUSE WE CAN SEE THAT THIS IS MAYBE THE STRAW THAT BROKE THE CAMEL BACK IN HIS CASE.

AND I'M HOPING THAT THERE'S SOME WAY THAT HE WILL FIGHT THIS AND BECOME A, YOU KNOW, HEALTHY, MENTALLY HEALTHY YOUNG MAN.

BUT PLEASE LOOK INTO THAT.

- THANK YOU.

- GOOD MORNING.

MY NAME IS ANA VENTURA FERRIS, AND CONGRATULATIONS, SUPERVISOR MARTINEZ.

I'M IN YOUR DISTRICT.

USED TO BE IN FELIPE'S FOR A MILLION YEARS SO I LOVE THE WHOLE COUNTY.

[01:15:02]

BUT I'M HERE TODAY BECAUSE I AM ON THE BOARD OF JANUS, THE LEADER IN ADDICTION TREATMENT IN SANTA CRUZ COUNTY.

AND I HAVE SEEN THE TREMENDOUS GROWTH AND WORK THAT THEY HAVE DONE ACROSS THE BOARD FOR ALL PEOPLE THROUGHOUT THE COUNTY, OPEN ACCESS, ANY TIME TO COME IN TO RECEIVE TREATMENT FOR ALCOHOL AND SUBSTANCE ABUSE.

SO I WAS GOING TO SPEAK A LITTLE EARLIER BECAUSE YOU APPROVED AN AGREEMENT FOR JANUS TO CONTINUE OUR WORK, BUT IT TURNED OUT EVEN BETTER BECAUSE I GOT TO LISTEN TO THESE WONDERFUL PROFESSIONALS HERE IN PUBLIC HEALTH TALK ABOUT THE IMPORTANCE OF WORKING, IN THE COMMUNITIES TO LET THEM KNOW THAT IT IS A DISEASE JUST LIKE ANY OTHER CHRONIC DISEASE, WHEN YOU GET TO ADDICTION IN DRUG OR ALCOHOL ABUSE, THERE'S A LOT OF MEDICAL EVIDENCE BEHIND THAT.

IN JANUS, WE HAVE A MEDICAL TEAM, WE HAVE A DOCTOR.

I'VE BEEN LEARNING A LOT ABOUT IT.

AND YOU ARE RIGHT, THE LOSS OF LIFE OF PEOPLE THAT ARE YOUNG AND SHOULD BE STILL LIVING AND STILL BE WITH THEIR FAMILIES IS IMPORTANT FOR THE HEALTH OF A FAMILY AND THE COMMUNITY.

SO I WANNA THANK THE COUNTY FOR BEING A WONDERFUL COUNTY GOVERNMENT, DEPARTMENT THAT WORKS WITH YOUR PARTNERS, INCLUDING US, JANUS.

AND STAY TUNED, WE HAVE A LOT MORE TO EXPAND OUR SERVICES FROM ESPECIALLY IN WATSONVILLE.

SO THANK YOU SO MUCH.

THANK YOU COUNTY BOARD OF SUPERVISORS FOR CONTINUING TO SUPPORT US.

AND I JUST WANNA SAY THE LAST MINUTE, NARCAN, WE'VE BEEN WORKING HARD WITH THAT, SPREADING THAT EVERYWHERE AND WE ARE PLEASED WITH, YOU KNOW, ALMOST 60% PLUS DECLINE OF FENTANYL.

WE'VE BEEN WORKING HARD ON THAT TOO. THANK YOU SO MUCH.

- GOOD MORNING. MY NAME IS ELAINE SALTER.

I LIVE IN BEN LOMAN.

AND GREAT JOB.

YOU GUYS ARE WORKING REALLY HARD.

THANK YOU FOR THE REPORTS.

I TOO WORKED IN ADDICTION TREATMENT FOR 30 YEARS AND AM VERY GRATEFUL FOR NARCAN BEING AVAILABLE.

I JUST WANTED TO SAY THANK YOU FOR SPEAKING SPECIFICALLY ABOUT HAVING IT READY AVAILABLE FOR EVERYBODY.

BOTH MY TEENAGE DAUGHTER, MY GRANDDAUGHTER, SHE'S MY TEENAGE GRANDDAUGHTER.

MY...

EVERYBODY HAS THEM IN THEIR CARS.

I HAVE TWO IN MY TRUCK.

I BRING THEM EVERYWHERE I GO.

AS A COMMUNITY, THE ONLY WAY WE'RE GONNA BE ABLE TO GET BACK OUR POPULATION IS TO BE EDUCATED ABOUT THINGS.

THE OTHER THING I WANTED TO SPEAK TO IS OUR ROADWAYS BEING THE INDIANAPOLIS ROADWAY.

I LIVE RIGHT ON HIGHWAY 9.

I HAVE A CRASH IN FRONT OF MY HOUSE PROBABLY AT LEAST FOUR TIMES A YEAR.

I LIVE ON A CURVE.

I'VE SEEN THINGS, YOU KNOW.

I AM A FIRST RESPONDER TOO, SO I'VE ACTUALLY HAD TO HOLD PRESSURE ON PEOPLE.

THAT'S ONE OF THE THINGS THAT I THINK THAT IS CONTRIBUTING TO THE ACCIDENTAL DEATH IS, YOU KNOW, PEOPLE ARE ACTUALLY USING OUR HIGHWAY 9, HIGHWAY 35, HIGHWAY 17 AS THEIR YOU KNOW, PLAYGROUND.

AND SO I DON'T KNOW HOW YOU COMBAT THAT, BUT DEPARTMENT OF TRANSPORTATION, MAYBE THAT'S PART OF WHAT YOU GUYS GET TO FIGURE OUT AS WELL.

SO THANK YOU GUYS FOR ALL YOUR HARD WORK.

I APPRECIATE WHAT YOU DO.

- THANK YOU.

- GOOD MORNING. BECKY STEINBRUNER.

I'M A RESIDENT OF RURAL APTOS IN DISTRICT 2.

WITH ALL THE TALK OF NARCAN, I THINK IT WOULD BE NEGLIGENT NOT TO REQUEST AGAIN, A PILOT PROJECT HERE IN THE COUNTY OF SANTA CRUZ USING IBOGAINE.

IT IS A VERY EFFECTIVE TREATMENT THAT REMOVES THE ADDICTIVE QUALITIES THAT A PERSON HAS BEEN SHOWN EFFECTIVE AROUND THE WORLD.

I HAVE A PERSONAL FRIEND THAT WAS IN THE HOMELESS COMMUNITIES AND HIS GIRLFRIEND WAS ABLE TO GIVE HIM SOME, AND HE IS NOW DRUG FREE, ALCOHOL FREE, AND A VERY PRODUCTIVE MEMBER OF SOCIETY.

PLEASE CONSIDER INITIATING A PILOT PROGRAM USING IBOGAINE IN SANTA CRUZ COUNTY.

I HEARD NOTHING IN THE REPORT ABOUT VETERANS, AND THAT TROUBLES ME, BECAUSE I KNOW THAT'S A HUGE SECTOR

[01:20:03]

OF SUICIDE DRUG AND ALCOHOL PROBLEMS. AND WE'VE GOT TO DO MORE TO HELP OUR VETERANS.

THAT'S ANOTHER COMMUNITY WE SHOULD BE FOCUSING ON, REGARDLESS OF THE COLOR OF THEIR SKIN.

FOR SUICIDES, I HAVE HAD FRIENDS, UNFORTUNATELY, COMMIT SUICIDE YOUNG AND OLD.

THE COMMON THREAD WAS ISOLATION AND FEELING OF HOPELESSNESS.

IT HAS BEEN SHOWN MANY TIMES THAT COMMUNITY GARDEN SPACES ARE VERY GOOD PLACES FOR PEOPLE TO COME TOGETHER AND CONNECT WITH EACH OTHER IN A PERSONAL WAY AND NOT ON A SCREEN PRONE TO BULLYING.

SO, ESPECIALLY AS THIS COUNTY IS ABOUT TO EXPLODE WITH RENA NUMBER BUILDING, MAKE SURE THAT THERE ARE COMMUNITY GARDEN SPACES REQUIRED TO BE INCLUDED IN ANY AND ALL SPACES.

AND ADDRESSING, UH, E-BIKES, THAT IS ANOTHER ISSUE THAT WE MUST DO WITH DISTURBED DRIVER, DISTRACTED DRIVERS AS WELL. THANK YOU.

- GOOD MORNING. MY NAME IS CAROL BJORN.

THANK YOU FOR THE PRESENTATION TODAY.

AND I WANTED TO PIGGYBACK OFF OF WHAT JOANNE SAID AND ALSO WHAT, BECKY SAID.

SO ONE THING THAT WASN'T MENTIONED IN THE PRESENTATION WAS TOXINS.

AND JOANNE KIND OF TOUCHED ON THAT WITH THE FOOD AND NUTRITION BUT WE GET TOXINS IN OUR ENVIRONMENT QUITE OFTEN THROUGH THE AIR THROUGH THE FOOD, THROUGH PHARMACEUTICALS, HONESTLY.

AND SO WE NEED TO BE DETOXING REGULARLY AND HAVING A MORE CLEAN ENVIRONMENT, MORE CLEAN FOOD.

A LOT OF THE ILLNESS, A LOT OF THE MENTAL ILLNESS IS BECAUSE OF THE TOXINS.

AND SO IF WE COULD JUST DETOX, THAT WOULD BE REALLY A PREVENTATIVE PRACTICE, WHICH IS, IT WOULD BE GREAT TO START FOCUSING MORE ON, AS MUCH AS WE CAN, FOCUSING ON PREVENTIONS.

AND I KNOW A LOT OF WHAT YOU DO IS A SAFETY NET, WHICH IS WONDERFUL, BUT IF WE CAN ALSO INCLUDE MORE LIKE PREVENTATIVE, LIKE THE COMMUNITY SPACES THAT BECKY MENTIONED.

AND ALSO IN THE PRESENTATION, IT LOOKED LIKE THE TWO GROUPS THE HISPANIC AND ASIANS WERE THE LOWEST MORTALITIES.

AND IT COULD BE BECAUSE THOSE TWO GROUPS HAVE A REALLY, A GREAT SENSE OF COMMUNITY.

AND THERE ARE BOOKS ON LONGEVITY AND SO FORTH, AND PEOPLE THAT FEEL LIKE THEY HAVE A COMMUNITY AND THEY'RE SUPPORTED TEND TO LIVE LONGER.

SO I WOULD JUST PROPOSE THAT AS A WAY TO PREVENT ILLNESS AND DISEASE.

JOANNE ALSO MENTIONED MINDFULNESS PRACTICES LIKE MEDITATION.

I JUST ALSO WANNA POINT OUT QIGONG IS A VERY AMAZING, PROACTIVE PREVENTATIVE PRACTICE.

IT'S ACTUALLY KNOWN AS THE ART AND SCIENCE OF PROLONGING LIFE AND PREVENTING DISEASE.

WE HAVE A QIGONG MASTER HERE IN SANTA CRUZ COUNTY.

HIS NAME IS LEE HOLDEN.

AND HE HAS MANY TEACHERS THROUGHOUT THE COUNTY THAT REGULARLY TEACH QIGONG, OFTEN IN PARKS, IN THE COMMUNITY SPACES, SOMETIMES INDOORS IN THE WINTER.

BUT THAT'S ALSO A GREAT WAY TO PREVENT DISEASE.

IT'S ALSO EXTREMELY HELPFUL FOR ADDICTION AND MENTAL ILLNESS.

SO THOSE ARE MY IDEAS.

THANK YOU.

- THANK YOU.

WE WILL NOW OPEN IT UP TO SPEAKERS WHO ARE ON THE CALL.

JUST AS A REMINDER FOR THOSE SPEAKERS, WE ARE CURRENTLY ON ITEM NUMBER EIGHT, THE FUTURE OF PUBLIC HEALTH INITIATIVE.

SO PLEASE KEEP YOUR COMMENTS TO NUMBER EIGHT.

- CALL IN USER ONE, YOUR MICROPHONE'S NOW AVAILABLE.

- THANK YOU TO THE PUBLIC COMMENT I JUST HEARD AND I WOULD LIKE TO SEE THIS REPORT EXPAND TO CAUSES OF ILL HEALTH.

THREE MAJOR ONES ARE PESTICIDE EXPOSURE.

AND IF WE HAVE MANDATED ECOLOGICAL ORGANIC AGRICULTURE AND BANNING OF PESTICIDES, WE'D HAVE MUCH BETTER HEALTH DATA IN THIS COUNTY AND ELSEWHERE.

ANOTHER CAUSE OF PEOPLE SICKNESS IS RADIATION EXPOSURE FROM WIRELESS TECHNOLOGY.

AND I'LL READ YOU A LITTLE BIT FROM ARTHUR FIRSTENBERG, CELLULAR PHONE TASK FORCE.

MICROWAVE RADIATION EXISTS IN NATURE ONLY AT LEVELS, BILLIONS OF TIMES LOWER THAN IS EMITTED BY ANY OF OUR WIRELESS DEVICES.

AND PULSE DIGITAL FREQUENCIES DO NOT EXIST AT ALL IN NATURE.

WE EVOLVED WITHOUT THEM, AND THEY INTERFERE WITH OUR LIFE FORCE BECAUSE PEOPLE ARE IRRADIATED BY THEIR CELL PHONES DAY AND NIGHT, EVEN WHEN TURNED OFF.

[01:25:04]

PEOPLE DO NOT KNOW OR RECOGNIZE THAT THEIR PHONES ARE DOING TO THEM, WHAT THEY ARE DOING.

THEY THINK THEY'RE TROUBLE SLEEPING, THEIR BODY ACHES, THEIR TINNITUS, THEIR UNSTABLE BLOOD PRESSURE, THEIR MEMORY LOSS, THEIR HAIR LOSS, HEARING LOSS, AND THEIR VISION LOSS ARE NORMAL AND THAT CANCER, DIABETES OBESITY, OR HEART DISEASE ARE DUE TO 'SOMETHING ELSE'.

WE SHOULD BE REMOVING MICROWAVE RADIATION SOURCES.

THE THIRD PROBLEM IS VACCINES, WHICH ARE TOXIC, EVEN IN A DECISION OF THE SUPREME COURT IN EIGHTY...

- BERNIE, YOUR MICROPHONE'S NOW AVAILABLE.

- GOOD MORNING BOARD OF SUPERVISORS.

HAPPY NEW YEARS, AND CONGRATULATIONS SUPERVISOR MARTINEZ FOR TAKING UP THE HELM OF THIS BOARD AND LOOK FORWARD TO YOUR LEADERSHIP.

THIS IS BERNIE GOMEZ WITH MILPA.

YOU KNOW THAT I'VE ALWAYS THOUGHT OF PUBLIC HEALTH AS A CRITICAL COMPONENT TO CREATE ACTUAL PUBLIC SAFETY AND, YOU KNOW, STRATEGIES AND IDEAS.

THOSE ARE ALWAYS GONNA COME.

YOU'RE ALWAYS GONNA HAVE TO EVOLVE, RIGHT? AND BE REDEVELOPED.

'CAUSE THE IMPACTS OF POVERTY, RIGHT, OF THE UNMET SOCIAL DETERMINANTS OF HEALTH ARE ALWAYS, EVEN THOUGH THEY STAY THE SAME, BUT THEY'RE ALWAYS CHANGING, YOU KNOW, AND THEY'RE CHANGING THE WAY IT IMPACTS PEOPLE.

YOU KNOW, SOME PEOPLE MIGHT GET START DOING GOOD AND MAYBE IN THEIR, THE PHYSICAL HEALTH, BUT, YOU KNOW, AND THEY START FACING, YOU KNOW, HOUSING INSECURITY, WHICH CREATES MENTAL HEALTH, INSTABILITY AND SO ON AND SO FORTH.

SO, THOSE STRATEGIES I THINK ARE BEST MET WHEN YOU BRING PEOPLE TOGETHER, WHEN YOU BRING LIKE PARALLEL HEALTH CENTERS, YOU KNOW, LOCAL, WHICH I CONSIDER LOCAL ORGANIZATIONS THAT ARE WORKING DIRECTLY WITH PEOPLE BEING IMPACTED, RIGHT? AS SUCH COMING TOGETHER AND YOU KNOW, JUST THE STRENGTHENING THE FABRIC OF THE HEALTH SECTOR HERE IN THIS COUNTY.

I KNOW THAT IN THIS COUNTY AND MOST COUNTIES PROBABLY THAT THE LARGEST CONTRIBUTION FROM THE GENERAL FUND IS NOT TO THE PUBLIC HEALTH CENTER OR THE PUBLIC HEALTH DEPARTMENTS, RIGHT? AND I THINK THAT'S SOMETHING THAT THE COUNTY CAN DO IS RESTRUCTURE THE WAY IT'S SPENDING MONEY RIGHT NOW BASED ON THE IMPACTS OF THE FEDERAL ATTACKS ON THE HEALTH SECTOR.

SO, YEAH, JUST MAKING THIS COUNTY'S PRIORITIES, PRIORITIZE THE PUBLIC HEALTH SECTOR.

THANK YOU.

- BEVERLY, YOUR MICROPHONE'S NOW AVAILABLE.

- GOOD MORNING.

MY NAME IS BEVERLY DESCHAUX AND NORMALLY YOU HEAR ME IN ANOTHER CONTEXT, BUT I'M A RETIRED THERAPIST.

AND FIRST I HAVE A QUESTION ABOUT THE REPORT.

GREAT REPORT, BY THE WAY.

I HAVE A QUESTION ABOUT THE LOWER RATES IN LATINO THE HEALTH ISSUES.

AND I'M WONDERING HOW MUCH IT HAS TO DO WITH LACK OF REPORTING, IN FACT, THAT MAYBE PEOPLE ARE NOT COMING FOR HEALTHCARE TO HAVE THEIR STATUS REGISTERED POSSIBLY BECAUSE OF IMMIGRATION STATUS I DON'T KNOW, BUT I QUESTION THAT.

REGARDING BIKE LANES, GREAT TOPIC.

I THINK THE ONLY WAY THAT THAT IS GONNA GET HANDLED IS NOT BY HAVING US RIDING OUR BIKES BESIDE CARS WHO DON'T PAY ANY ATTENTION TO THAT WE'RE THERE AND IS TO HAVE THEM BE SEPARATED.

AND ONE SOLUTION THAT OCCURS TO ME IS USING SIDEWALKS AS BIKE LANES BECAUSE I DON'T SEE PEOPLE WALKING EXCEPT DOWNTOWN.

SO THAT MIGHT BE A SOLUTION.

I MYSELF WAS KNOCKED OFF MY BIKE TWICE AND ONCE VERY SERIOUSLY AND 30 YEARS LATER, I'M STILL EXPERIENCING PROBLEMS. WE NEVER HAVE ENOUGH MENTAL HEALTH SERVICES.

WE JUST DON'T.

SO AND SUICIDE RELATES TO SUBSTANCE ABUSE AND SUBSTANCE ABUSE RELATES TO...

THEY GO BACK AND FORTH.

PEOPLE DON'T COME FOR SUBSTANCE ABUSE IN MY EXPERIENCE, THEY COME FOR OTHER ISSUES AND I MIGHT HAVE DETECTED IT.

BULLYING.

[01:30:02]

MY DAUGHTER WAS BULLIED AND WHEN I SPOKE WITH HER TEACHER ABOUT IT, SHE WAS COMING HOME CRYING EVERY DAY.

HER TEACHER SAID, YEAH, THAT'S JUST HOW KIDS ARE.

70% OF OUR EMISSIONS IN THE COUNTY COME FROM VEHICLES AND OTHER FOSSIL FUEL RELATED THINGS.

SO THOSE ARE SERIOUS HEALTH ISSUES THAT WE NEED TO...

- GUEST USER, YOUR MICROPHONE'S NOW AVAILABLE.

- YES. UM, HELLO.

AND I ALSO WOULD LIKE TO HEAR ABOUT THE CORRUPT MIND PROGRAM.

I THINK ALL EDUCATED PEOPLE AWARE OF THAT PROGRAM, AND THIS IS A HUGE DANGEROUS ISSUE.

AND WHEN IT'S ALSO ALONG, GO ALONG WITH THE ILLEGAL DRUGS, THIS IS WHEN IT CHANGE PEOPLE AND MAKE THEM LOOK LIKE ZOMBIE.

I ALSO WOULD LIKE TO NOT SEE ANY MORE HOMELESS PEOPLE WHO SCREAMING OUT LOUD IN PUBLIC.

I THINK IT IS A GRAVE DISABILITY, VISIBLE GRAVE DISABILITY.

WHY THOSE PEOPLE NOT TAKEN CARE OF RIGHT AWAY? YOU KNOW, THIS IS, IT'S I THINK IT'S NOT GOOD FOR ANY VULNERABLE PERSON TO SEE AND HEAR, AND IT'S A NONSENSE.

IT'S SHOULD BE TAKEN CARE OF.

AND ALSO PREVENTION IS A HUGE ISSUE IN OUR COUNTY.

THERE IS NO ACTUAL PREVENTION.

AND THIS, I BELIEVE BECAUSE WE DON'T HAVE LEGAL HELP.

IF NEED THE LEGAL HELP SO NO CRLA OR SENIOR CITIZENS OR OMBUDSMAN WILL HELP.

AND OMBUDSMAN IS A GREAT ISSUE.

RIGHT NOW IT SEEMS LIKE IT'S ALSO RUNS BY CRIMINALS.

IT DOES NOT DO THEIR JOB AT ALL.

I WOULD LIKE TO ASK THE PUBLIC HEALTH AND THE HEALTH SERVICE AGENCY TO LOOK INTO THAT AND DO SOMETHING ABOUT IT BECAUSE WE DO NOT HAVE OMBUDSMAN IN THIS COUNTY.

SO PLEASE, ACCOUNTABILITY ALSO IS NECESSARY.

IF THE PEOPLE DO NOT HOLD ACCOUNTABLE, SO THE ISSUE WILL COME IN ALL OVER AGAIN, AGAIN AND AGAIN AND JUST WILL GROW UP.

THANK YOU.

- THANK YOU.

- WE HAVE NO FURTHER SPEAKERS ONLINE CHAIR.

- THANK YOU.

I'LL NOW TURN IT BACK TO THE BOARD FOR A MOTION OR DISCUSSION.

- CHAIR, I JUST WANTED TO DISCUSS ONE TOPIC A LITTLE BIT MORE, WHICH IS FOOD.

IT WAS MENTIONED BY ONE OF THE SPEAKERS, AND REALLY IT IS SORT OF A SUBTEXT THROUGH BOTH LEADING CAUSES OF DEATH AND LEADING CAUSES OF PREMATURE DEATH.

AND PERHAPS MOST OBVIOUSLY LEADING CAUSE OF PREMATURE DEATH ISCHEMIC HEART DISEASE.

I THINK THAT THERE'S A PRETTY STRONG CORRELATION BETWEEN AN UNHEALTHY DIET AND A HEART ATTACK, WHICH ISCHEMIC HEART DISEASE IS.

AND THEN EVEN ON LEADING CAUSE OF DEATH, ALZHEIMER'S DISEASE HAS BEEN CALLED TYPE THREE DIABETES.

I DON'T KNOW IF THAT'S ENTIRELY APPROPRIATE, BUT I MEAN IT DOES, SORT OF SUGGEST SOME OF THE RESEARCH ON THIS TOPIC.

HEART ATTACK STILL UP THERE AS A LEADING CAUSE OF DEATH.

AND, YOU KNOW, ARGUABLY EVEN THINGS LIKE SUICIDE OR DRUG USE COULD BE INFLUENCED BY POOR DIETS.

IF PEOPLE FELT BETTER, MAYBE THEY WOULDN'T TURN TO DRUGS, IN ORDER TO TRY TO SELF-MEDICATE.

I'M JUST CURIOUS WHAT ARE SOME OF THE CURRENT THINKING WITHIN THE DEPARTMENT? WHAT ARE [INAUDIBLE]...

HAVE ANY PROGRAMS OR POLICIES THAT REALLY SUPPORT HEALTHY EATING WITHIN OUR COMMUNITY? AND OBVIOUSLY WE'RE BEING CALLED TO DO MORE OF THIS WITH SOME OF THE THREATS TO SNAP AND FOOD ASSISTANCE IN GENERAL.

AND SO MAYBE THERE'S SOME NATURAL SYNERGIES AS THE COUNTY IS FORCED TO TAKE MORE OF A LEADING ROLE IN FOOD ASSISTANCE THAT WE CAN ALSO PROMOTE HEALTHIER EATING.

- I HAVE TO THINK ABOUT THAT.

IT...

HOW DO I MAKE THIS SOUND POSITIVE? ONE OF THE THINGS I MENTIONED AND PAM HIGHLIGHTED WAS THE INCREASING THREATS TO PUBLIC HEALTH.

AND ONE THING THAT IS AN ACTUAL, AN ACTUALITY IS THAT OUR SNAP ED FUNDING WAS CUT.

SO OUR EDUCATION THAT OUR FUNDING FOR EDUCATION, FOR HEALTHY EATING HEALTHIER LIFESTYLE WAS BASICALLY TAKEN AWAY FROM US.

SO, IN THE RISING...

WITH THE RISING THREATS AND OUR NEW FOOD PYRAMID THAT WAS JUST PRESENTED LAST WEEK WE ARE GONNA FACE MORE CHALLENGES.

[01:35:02]

POTENTIALLY POORER HEALTH BECAUSE OF FEDERAL ACTIONS, BOTH IN POLICY AND IN FUNDING.

WE DO HAVE OUR HEALTH CENTERS, OUR PRIMARY CARE PROVIDERS IN THE COMMUNITY THAT WE WILL BE RELYING ON MORE AND MORE.

BECAUSE THEY WILL STILL SEE INDIVIDUALS IN THE COMMUNITY TO BE WHETHER HOPEFULLY IT'S PRIOR TO WORSENING OF CONDITIONS OR ANY DIAGNOSIS OF THE CONDITION HOWEVER IT'S GONNA BE TOUGH.

I DON'T KNOW IF PAM CAN SAVE ME AND MAKE IT SOUND ANY MORE POSITIVE.

HOWEVER WE ARE...

THIS IS WHERE WE WILL CALL ON THE COMMUNITY TO HELP US.

WE HAVE OUR COMMUNITY HEALTH IMPROVEMENT PLAN, WHICH IS FOCUSING ON ACCESS TO HEALTHCARE.

AND AS SHE HIGHLIGHTED IN A CENSUS TRACK WITH ESSENTIALLY THE POOREST OF HEALTH.

AND WHEN YOU FOCUS ON THAT AREA THE EFFORTS THAT WE FOCUS ON IN THE "WORSE" COMMUNITY, WORSE HEALTH IN TERMS OF HEALTH OUTCOMES IN OUR COMMUNITY, WE WILL SEE THOSE STRATEGIES HELP THE WHOLE COUNTY AS A WHOLE.

ONE OF THE THINGS THAT I SAW YEARS AGO THAT SPOKE TO ME AT A DEMONSTRATION WAS EVERYONE DOES BETTER WHEN EVERYONE DOES BETTER. RIGHT? SO THAT IS REALLY THE HOW I SEE THE PHILOSOPHY OF PUBLIC HEALTH.

AND YES, SUPERVISOR KOENIG IT'S GOING TO BE TOUGH.

I WILL STOP HERE AND HAND IT OVER TO DIRECTOR MORENO-PERAZA.

- EXCUSE ME. I DO WANNA TAKE THAT FEEDBACK, BACK TO HSA AND SEE IF THROUGH OUR OTHER DIVISIONS.

I AGREE WITH EVERYTHING DR. HERNANDEZ HAS SAID.

BUT I THINK THIS IS A TIME OF CRISIS WHERE SOMETIMES CRISIS BRINGS US TOGETHER TO COME UP WITH SOME SOLUTIONS.

BEING HISPANIC, UH, MYSELF, I DO KNOW THAT IN SOME OF OUR DIFFERENT CULTURAL GROUPS THE DIFFERENT FOODS THE WAY THEY'RE COOKED, ET CETERA, ET CETERA, VERSUS GOING OUT TO EAT OR BUYING FOOD, FAST FOOD, THERE ARE SOME CULTURAL DIFFERENCES SOMETIMES IN HOW WE EAT AND DIET THAT WE CAN PROBABLY LEARN.

I THINK IT WAS MENTIONED BY ONE OF THE SPEAKERS AS WELL.

I THINK THERE ARE SOME PROGRAMS OUT THERE IN OTHER COUNTIES WHERE NUTRITION IS INCORPORATED, HEALTHY EATING AS EVIDENCE-BASED PRACTICE IN OTHER COUNTIES THAT I CAN DISCUSS WITH OUR TEAM TO SEE IF OUR FUNDING ALLOWS US TO PRIORITIZE WITH OUR PARTNERS AND LOOK AT IT STRATEGICALLY.

BUT AS SHE SAID WITH ALL THE CHANGES THAT ARE HAPPENING WE HAVE TO BE VERY INNOVATIVE AND CREATIVE.

SO, WE'LL TAKE IT BACK AND REVIEW THE FEEDBACK.

THANK YOU.

- WELL, THANK YOU.

I WOULD LOVE TO HEAR SOME MORE CONCRETE OPTIONS.

IT DOESN'T HAVE TO BE TOMORROW, BUT AT SOME POINT AS SOON.

SO TO THAT EFFECT, I'D LIKE TO MOVE THE RECOMMENDED ACTION WITH THE ADDITIONAL DIRECTION THAT HSA RETURN NO LATER THAN NEXT YEAR'S REVIEW OF THIS ANNUAL REPORT WITH POLICY OPTIONS TO SUPPORT AND INCENTIVIZE HEALTHY EATING FOR SANTA CRUZ COUNTY RESIDENTS.

- SECOND. - WE HAVE A MOTION.

WE HAVE A MOTION FROM SUPERVISOR KOENIG AND A SECOND FROM SUPERVISOR HERNANDEZ.

IS THERE FURTHER DISCUSSION FROM THE BOARD? SUPERVISOR CUMMINGS.

- YEAH. I DON'T KNOW IF THIS NEEDS TO BE A FRIENDLY AMENDMENT.

BUT I THINK THROUGH THE DISCUSSION WE ALSO DISCUSSED WAYS TO REDUCE MORTALITY IN SOME OF THE GROUPS THAT WE'RE SEEING THE HIGHEST LEVELS OF MORTALITY.

AND SO I HOPE THAT WE CAN ALSO WORK ON THAT AND HOPEFULLY WHEN THIS COMES BACK, IF THERE'S BEEN POLICIES THAT HAVE BEEN IMPLEMENTED WE CAN UNDERSTAND HOW THOSE HAVE HOPE TO REDUCE MORTALITY AMONGST THOSE GROUPS WHERE WE'RE SEEING HIGH LEVELS OF MORTALITY - SUPERVISOR CUMMING, THANK YOU.

IF I MAY SAY WHAT I'M LEARNING IN THE COMMUNITY YOU KNOW, FOR THE SHORT TERM I'VE BEEN HERE IS THEY REALLY WANT INFORMATION.

SO I MIGHT BE PARTNERING WITH OUR TEAM HERE AND SEE WE CAN SET UP A PROCESS TO REALLY GO OUT IN THE COMMUNITIES AND SHARE THIS INFORMATION AND OPEN IT UP FOR THEIR IDEAS AND SUGGESTIONS.

'CAUSE SOMETIMES THE ANSWERS ARE IN THE COMMUNITY.

OUR PARTNERS HAVE A LOT OF ANSWERS.

SO I'M LEARNING MORE AND MORE THE IMPORTANCE OF HSA AND OF PARTICULARLY PUBLIC HEALTH, WHO IS SUCH A CRITICAL DIVISION IN HSA.

THEY DO AMAZING WORK THAT I... WITH THIS PRESENTATION, I GOT VERY EXCITED FOR US TOO, GO OUT THERE AND FIND SOME SOLUTIONS.

I KNOW WE'RE IN A FINANCIAL CRISIS OR STARTING ONE, BUT I DO THINK THAT WE ARE GONNA GO THROUGH SOME OF THESE PROCESSES AND HOPEFULLY COME UP WITH SOME SOLUTIONS.

BUT WE WILL DEFINITELY TAKE ALL THAT FEEDBACK SUPERVISOR CUMMINGS. - THANK YOU.

- THANK YOU. AND AS MY FINAL COMMENTS, I JUST WANNA THANK THE STAFF FOR THIS REALLY IMPORTANT PRESENTATION.

YOU KNOW, WHAT YOU'RE SHARING I THINK SHOULD GROUND THE CONVERSATIONS THAT OUR BOARD HAS AROUND STRATEGIC PLANNING.

YOU KNOW, AS A BOARD WE HAVE REALLY ENDORSED THE IDEA OF HEALTH IN ALL POLICIES.

AND EVERY DAY POLICIES COME BEFORE THE BOARD, WHETHER IT'S RELATED TO ROAD, INFRASTRUCTURE, OUR SOCIAL SERVICES, OUR ALLOCATION OF RESOURCES

[01:40:02]

THAT HAVE AN IMPACT ON OVERALL HEALTH AND OVERALL LONGEVITY OF OUR COMMUNITY.

AND SO WHAT YOU PRESENT TODAY IS REALLY IMPORTANT AND WILL HELP US GROUND OUR CONVERSATIONS AS WE MAKE DIFFICULT DECISIONS AND DIRECTIONS IN THE COMING YEARS.

SO THANK YOU SO MUCH.

WE HAVE SUCH A COMPETENT PUBLIC HEALTH TEAM AND I'M VERY PRIVILEGED TO BE ABLE TO WORK WITH ALL OF YOU.

THANK YOU FOR BEING HERE.

SO WITH THAT, WE HAVE A MOTION AND A SECOND, AND WITH NO FURTHER DISCUSSION, I'LL ASK THE CLERK TO CALL THE ROLL.

- SUPERVISOR CUMMINGS.

- AND MARTINEZ. - AYE.

MOTION PASSES FIVE O.

SO BEFORE WE MOVE ON TO THE NEXT ITEM, ITEM NUMBER NINE, I'M GONNA CALL A FIVE MINUTE RECESS.

WE WILL RETURN AT...

ACTUALLY LET'S JUST RETURN AT 10:50.

[SILENCE]

[9. Consider approval in concept of "An ordinance amending section 2.37.040 of the Santa Cruz County code (purchasing procedures) regarding the surplus property declaration threshold and purchasing agent authority" and schedule the ordinance for second reading and final adoption on January 27, 2026]

[10. Consider principal components of ordinance allowing for the development of Energy Storage System Facilities in the unincorporated area, direct staff to conduct environmental review of the potential ordinance under the California Environmental Quality Act, and take related actions]

I'LL NOW CALL ITEM NUMBER NINE.

CONSIDER PRINCIPAL COMPONENTS OF ORDINANCE ALLOWING FOR THE DEVELOPMENT OF ENERGY STORAGE SYSTEM FACILITIES IN THE UNINCORPORATED AREA.

DIRECT STAFF TO CONDUCT ENVIRONMENTAL REVIEW OF THE POTENTIAL ORDINANCE UNDER THE CALIFORNIA ENVIRONMENTAL QUALITY ACT, AND TAKE RELATED ACTIONS AND ITEM SUBMITTED BY COMMUNITY DEVELOPMENT AND INFRASTRUCTURE.

SO AS WE GO FORWARD WITH THIS ITEM, I WOULD JUST LIKE TO TAKE A MOMENT TO CLARIFY WHAT WE ARE DISCUSSING TODAY.

PRIMARILY TODAY WE'RE DISCUSSING THE PROPOSED DRAFT AMENDMENTS TO THE GENERAL PLAN AND THE COUNTY CODE IN ALIGNMENT WITH BOARD DIRECTION GIVEN AT OUR MEETING ON NOVEMBER 18TH OF LAST YEAR.

IN ORDER TO RETURN TO THE BOARD WITH RECOMMENDATIONS FOR ADOPTION OF AN ORDINANCE NO LATER THAN NOVEMBER OF THIS YEAR THIS WHAT WE'RE DISCUSSING IS AN ORDINANCE THAT WOULD APPLY TO ANY ENERGY STORAGE SYSTEM BROUGHT BEFORE THE BOARD.

AND I REALIZE THAT WE'VE RECEIVED A LOT OF PUBLIC COMMENT AND FEEDBACK REGARDING A SPECIFIC POTENTIAL ENERGY STORAGE SYSTEM ON MINTO ROAD BUT THE ITEM BEFORE US TODAY IS REALLY FOCUSED ON THE ORDINANCE ITSELF.

SO I JUST WANNA CLARIFY THAT AS WE CALL THIS ITEM.

AS A REMINDER FOR PROCESS, I'M GONNA INVITE STAFF TO PRESENT ON THE ITEM, THEN I'LL ASK THE BOARD FOR QUESTIONS TO STAFF.

I'LL THEN INVITE THE PUBLIC TO SHARE THEIR THOUGHTS ON THIS ITEM AND THEN BRING IT BACK TO THE BOARD TO HAVE AN OPPORTUNITY TO DISCUSS AND PROVIDE DIRECTION.

SO WITH THAT, I WOULD LIKE TO INVITE ASSISTANT DIRECTOR OF PLANNING, STEPHANIE HANSON TO PRESENT THE ITEM.

- GOOD MORNING CHAIR AND SUPERVISOR, STEPHANIE HANSON ASSISTANT DIRECTOR OF COMMUNITY DEVELOPMENT AND INFRASTRUCTURE.