description page - berkeley, california · documents pertaining to 7/24/14 agenda items: agenda...

MH Commission Packet July 24, 2014

Office: 3282 Adeline Street, Berkeley, CA 94703 • [email protected] (510) 981-7721 • (510) 981-5255 FAX

Health, Housing & Community Services Mental Health Commission

To: Mental Health Commissioners From: Carol Patterson, Commission Secretary Date: July 15, 2014

Documents Pertaining to 7/24/14 Agenda items: Agenda Item

Description Page

2.A.

July 24, 2014 Agenda

1

2.C.

June 26, 2014 Unadopted Minutes

4

2. E.

Staff Update

28

4.

Recommendation for Appointment to Commission

• Interview Guideline 29 • Albany City Council Minutes 30 • Commission Membership Grid 40 5.

Public Health Priorities

• Memo from Janet Berreman 41 • Public Health Priorities and Budgeting Council Report 6/10/14 42 6.

HR 3717 Helping Families in Mental Health Crisis – Bill Summary

56

8.A.

MHSA 3-Year Plan

60

10.

AB 2198: Mental Health professionals: suicide prevention training

• Bill Text 63 • Email from Commissioner Marasovic 67 Other Items:

Reappointment of Paul Kealoha-Blake Council Report 7/8/14 69 Homeless Outreach Services Scope of Service and Budget 72

Office: 3282 Adeline St. • Berkeley, CA 94703 • (510) 981-7721 • (510) 981-5255 FAX

[email protected]

Health, Housing & Community Services Department Mental Health Commission

Berkeley/Albany Mental Health Commission

Regular Meeting Thursday, July 24, 2014

Time: 7:00 p.m. – 9:00 p.m. North Berkeley Senior Center

1901 Hearst Ave., Classrooms A & B

AGENDA

All Agenda Items are for Discussion and Possible Action

Public Comment Policy: Members of the public may speak on any items on the Agenda and items not on the Agenda during the initial Public Comment period. Members of the public may also comment on any item listed on the agenda as the item is taken up. Members of the public may not speak more than once on any given item. The Chair may limit public comment to 3 minutes or less.

7:00 pm 1. Roll Call

2. PRELIMINARY MATTERS A. Agenda Approval B. Public Comment on items not on the agenda C. Approval of the June 26, 2014 Minutes D. Staff Announcements/Updates

3. Action Item: Election of Chair

4. Action Item: Recommendation for Appointment to Mental Health Commission

A. Interview Judy Kerr for Albany Special Public Interest seat 5. Presentation from Public Health Division on Public Health Priorities –

Janet Berreman (20 minutes) A. Possible Action Item: Recommendation regarding Public Health

priorities 6. Possible Action Item: Referral from Community Health Commission:

Position on HR 3717: Helping Families in Mental Health Crisis A. Create a subcommittee on HR 3717

1

3282 Adeline St. • Berkeley, CA 94703 • (510) 981-7721 • (510) 981-5255 FAX

[email protected]

7. Council Report on Improving Services to Persons in Mental Health Crises

A. Possible Action Item: Identify Commissioner to draft report for September meeting

8. Liaison Reports

A. MHSA Advisory Committee B. City Council (Jesse) C. BMH Safety Committee

9. Possible Action Item: Approval of letter to Director of Alameda County

Behavioral Health Care Services on the need for a peer run respite or crisis house in North County

10. Possible Action Item: Commission response to AB 2198: Mental Health Professionals: Suicide Prevention Training 11. Report from Mental Health Division – Steve Grolnic-McClurg (20 minutes) 12. Presentation: Pacific Center (20 minutes)

13. Agenda Items for September meeting 14. Announcements 9:00 pm 15. Adjournment Communications to Berkeley boards, commissions or committees are public record and will become part of the City’s electronic records, which are accessible through the City’s website. Please note: e-mail addresses, names, addresses, and other contact information are not required, but if included in any communication to a City board, commission or committee, will become part of the public record. If you do not want your e-mail address or any other contact information to be made public, you may deliver communications via U.S. Postal Service or in person to the secretary of the relevant board, commission or committee. If you do not want your contact information included in the public record, please do not include that information in your communication. Please contact the secretary to the relevant board, commission or committee for further information. The Health, Housing and Community Services Department does not take a position as to the content.

Contact person: Carol Patterson, Mental Health Commission Secretary at 981-7721 or

[email protected].

Communication Access Information: This meeting is being held in a wheelchair accessible location. To request a disability-related accommodation(s) to participate in the meeting, including auxiliary aids or services, please contact the Disability Services specialist at 981-6342 (V) or 981-6345 (TDD) at least three business days before the meeting date. Please refrain from wearing scented products to this meeting.

2

3282 Adeline St. • Berkeley, CA 94703 • (510) 981-7721 • (510) 981-5255 FAX

[email protected]

Attendees at trainings are reminded that other attendees may be sensitive to various scents, whether natural or manufactured, in products and materials. Please help the City respect these needs. Thank you. SB 343 Disclaimer Any writings or documents provided to a majority of the Commission regarding any item on this agenda will be made available for public inspection in the SB 343 Communications Binder located at the Family, Youth and Children’s Clinic at 3282 Adeline Street, Berkeley.

3

3282 Adeline St. Berkeley, CA 94704 Tel: 510.981-7721 Fax: 510.981-5255 TDD: 510.981-6903

Department of Health Services Mental Health Commission

Berkeley/Albany Mental Health Commission Unadopted Minutes

North Berkeley Senior Center Regular Meeting 1901 Hearst Ave. June 26, 2014 at 7:00 pm Classrooms A & B Members of the Public Present: Mansour Id-Deen, Paul Kealoha-Blake, Jonah Markowitz, Andrew Phelps Staff Present: Steven Grolnic-McClurg, Carol Patterson, Tenli Yavneh 1. Call to Order at 7:02 pm

Commissioners Present: Jeffrey Davis, Jennifer Fazio, Bart Grossman, Carole Marasovic (Acting Chair), Jean Marie Hervé Michel, Jr, Cameron Silverberg. Commissioners Absent: Jesse Arreguin, Nadine Dixon, Shelby Heda (arrived at 7:10 pm), Shirley Posey (arrived at 7:05 pm).

2. Preliminary Matters A. Approval of June 26, 2014 Agenda

M/S/C (Grossman, Davis) Move to approve the June 26, 2014 Agenda as written. Ayes: Davis, Fazio, Grossman, Marasovic, Michel, Silverberg; Noes: None; Abstentions: None; Absent: Arreguin, Dixon, Heda (arrived after the vote), Posey (arrived after the vote).

B. Public Comment

One person commented on the recent Pacific Islander conference

C. Approval of the May 22, 2014 minutes M/S/C (Michel, Silverberg) Move to approve the May 22, 2014 minutes. Ayes: Davis, Fazio, Grossman, Heda, Marasovic, Michel, Posey, Silverberg; Noes: None; Abstentions: None; Absent: Arreguin Dixon.

D. Staff Announcements i. The May Is Mental Health Month was a success. ii. Upcoming agenda items include: interview of applicant for Albany Special Interest seat, referral from Community Health Commission regarding HR 3717, request from Public Health to comment on public health priorities and a potential referral from the Community Health Commission regarding Tasers.

3. Election of Chair – tabled to next month

4

Mental Health Commission June 26, 2014

4. Response to NAACP Town Hall Report – since the presenter was not present, the Commission skipped forward to the presentation from Steven Grolnic-McClurg

6. Referral from Council: Recommendations for improving services to persons

experiencing mental health crises Mr. Grolnic-McClurg presented his research on how crisis services are provided and recommendations on how to improve them. See attached powerpoint. 3 members of the public commented. M/S/C (Grossman, Michel) The Mental Health Commission endorses the Mental Health Manager’s recommendations to improve services to persons in mental health crises: Recommendation #1: Expand Mobile Crisis Team hours until midnight and increase capacity during peak hours Recommendation #2: Create a Transitional Outreach Team to augment the current Mobile Crisis Team Recommendation #3: Train Stakeholders in how to help in a crisis and the 5150 process Recommendation #4: Develop Consumer/Family Satisfaction Survey for Crisis Services Ayes: Davis, Fazio, Grossman, Heda, Marasovic, Michel, Posey, Silverberg; Noes: None; Abstentions: None; Absent: Arreguin, Dixon.

4. A. Presentation from NAACP- Mr. Id-Deen thanked the group for the information provided by Mr. Grolnic-McClurg. Mr. Id-Deen suggested that Emergency Medical Technicians (EMT) be trained to deal with mental health crises and that Berkeley residents be tracked in the (County) involuntary system. 5. Liaison Reports

A. MHSA Advisory Committee – Commissioner Posey updated the Commission on MHSA planning. The next meeting is July 17 at 2:30. For more information, contact Karen Klatt, MHSA Coordinator at 981-7644.

B. City Council – no report C. California Association of Local Mental Health Boards/Commissions –

Commissioner Marasovic reported on the June meeting of the California Mental Health Planning Council and the California Association of Local Mental Health Boards/Commissions.

7. Chair/Vice Chair Report

Commissioner Marasovic reported that she attended the Community Health Commission and provided them with the letters presented to City Council.

8. Commission Applicant Interview Guidelines M/S/C (Grossman, Posey) The Mental Health Commission endorses the following statement as a Applicant Interview Guideline: “Commission applicants may be asked their positions on mental health policy matters laws or administrative regulations, current pending or proposed, state, federal or municipal with the goal of ascertaining the applicant’s experience with and/or knowledge of the mental health system and ability to work with a diverse group of applicants.” Ayes: Davis, Fazio, Grossman, Heda, Marasovic, Michel, Posey, Silverberg; Noes: None; Abstentions: None; Absent: Arreguin, Dixon.

9. Agenda items for July meeting

5

Mental Health Commission June 26, 2014

Tour of Adult Clinic/renovation, letter to Manuel Jimenez recommending a peer run respite or crisis house be located in or near Berkeley, HR 3717, comment on Public Health priorities, Pacific Center presentation, Suicide Prevention legislation

10. Announcements Tabled due to lack of time.

Adjournment at 9:13 pm. Minutes submitted by: ____________________________________ Carol Patterson, Commission Secretary

6

Berkeley Mental Health

Recommendations For Improving

Crisis ServicesCrisis Services

Presented by Steven Grolnic-McClurg, Mental Health Manager

to the

Mental Health Commission

6/26/14

7

Background to Recommendations

• On March 27th, 2014 The Mental Health Commission requested Berkeley Mental

Health staff to present information and

options for improving crisis services including options for improving crisis services including

the cost of 24/7 Mobile Crisis.

8

Input

• The Mental Health Manager and/or the Crisis , Assessment and Triage (CAT) Program

Supervisor met with or participated in

meetings with a wide variety of stakeholder meetings with a wide variety of stakeholder

and subject matter experts to gain input into

these recommendations. Mental Health staff

also reviewed written reports and

recommendations from stakeholder groups.

9

Input

• This included:– Recipients of BMH services

– Mobile Crisis Team staff and interns

– CopWatch report and meeting– CopWatch report and meeting

– NAACP Recommendations

– Berkeley Police

– All staff from Berkeley Mental Health

– Bay Area Mental Health Directors

– Bay Area Crisis Directors

10

More Input

– Staff and managers from Alameda County

Behavioral Health Services and San Francisco

Behavioral Health Services Crisis Units

– HHCS LeadershipHHCS Leadership

– Family Education and Resource Center

– AB1421 ACBHS Taskforce Group

11

Data

• Berkeley Mental Health staff looked at available data around

historical usage (since 2005) of mobile crisis team services.

2000

2500

0

500

1000

1500

2000

10-11

AM

11-12

PM

12-1

PM

1-2

PM

2-3

PM

3-4

PM

4-5

PM

5-6

PM

6-7

PM

7-8

PM

8-9

PM

9-10

PM

10-11

PM

12

Current Program

• Staffing: 3 FTE BMH staff, supplemented by hourly staff and interns.

• Hours: 11:30 am to 10 pm, 365 days a year.

• Operations: – Voice mail can be left 24/7, returned during working hours

(981-5254).– Voice mail can be left 24/7, returned during working hours

(981-5254).

– During MCT operating hours, team is contacted through the BPD non-emergency number (981-5900). Dispatch connects to MCT through police radio.

– From 8 am to 4 pm M-F, MCT can also be contacted (if available) through CAT (981-5244 )or Adult Clinic number (981-5290).

13

Important Considerations

• Goal is to reduce the number of individuals experiencing mental health crises.

• Multiple/competing needs for improving mental health services in Berkeley and Albany.services in Berkeley and Albany.

• MCT staffing is very thin, as is all of Berkeley Mental Health. Any new programming requires additional staff.

• Build upon success of current model.

14

Recent New Funding

• $80,000 of general fund for new staffing.

• Adds .5 BHCII position during peak hours.

• Approved by City Council on 6/24/14.

15

Recommendation #1: MCT Expansion

• Expand MCT until midnight; increase capacity during peak hours.

• Goal: Offer maximum coverage during periods of highest demand and diversify our staff responding highest demand and diversify our staff responding to crisis.

– Remain operational until midnight.

– Add staffing during peak hours to increase ability to respond to calls. (completed)

– Add peer staff make crisis services more comprehensive.

16

MCT Expansion Cost

– TOTAL PROJECTED COST/Year: $264,715 plus additional start up cost of $30,000 for first year (automobile, computers, radios, etc.).

• Senior Behavioral Clinician II: $144,288 (all staffing costs include benefits).

• Asst. Mental Health Clinician (Peer or Family Member Provider): $93,427.

• Automobile expenses: $12,000.

• Additional program expenses: $15,000.

• Total includes Council approved new general fund allocation of$80,000. Additional funds needed to implement -- $184,715/year.

17

Recommendation #2: TOT

• Transitional Outreach Team (TOT) to augment current Mobile Crisis team (MCT).

• Goal: Decrease % of individuals who need crisis interventions.

– The purpose of the TOT will be to reduce future and repeat Mobile Crisis calls – The purpose of the TOT will be to reduce future and repeat Mobile Crisis calls through interventions with people to address issues either immediately after a mental health crisis or before the crisis reaches the level of needing a Mobile Crisis Team/police intervention.

– The TOT would work with people who have been recently released from a 5150 hold, been engaged with our Mobile Crisis team and do not meet the criteria for hospitalization but clearly have mental health needs to be addressed, are identified through partner agencies such as the homeless shelters, senior centers and drop-in facilities among others.

18

TOT Cost

– TOTAL PROJECTED COST/Year: $252,887, additional start up cost of $30,000 for first year (automobile, computers, radios, etc.).

• BHCII : $132,460.• BHCII : $132,460.

• Asst. Mental Health Clinician (Peer or Family Member Provider): $93,427.



19

Recommendation #3: Training

Stakeholders

• Contract with Family and Education Resource Center (FERC) to hold regular trainings in Berkeley and Albany

to inform stakeholders of crisis and 5150 process.

• Goal: Improved experience by community members when

utilizing crisis services .utilizing crisis services .

• FERC has successfully held these trainings throughout

Alameda County, including Berkeley.

• Training would inform stakeholders of what to expect from

and how to best utilize crisis services in Albany/Berkeley.

20

Training Stakeholders Continued

• Conduct Mental Health First Aid Trainings in community.

• 3 BMH staff recently completed Mental Health • 3 BMH staff recently completed Mental Health First Aid training.

• Conduct a minimum of 3 MH First Aid trainings in community annually.

21

Training Stakeholders Cost

• For FERC Training

– $25,000 for first year (four trainings plus

development).

– $10,000 ongoing costs (2 trainings per/yr).– $10,000 ongoing costs (2 trainings per/yr).

• For MH First Aid

– Staff time, no additional cost.

22

Recommendation #4: Develop Consumer/Family

Satisfaction Survey for Crisis Services

• Consumer/Family Satisfaction Survey to provide

quality improvement information for mobile crisis

services.

• Goal: Through feedback, improve mobile crisis service’s

customer experience.

• No cost for implementation. Would require some reallocation

of existing staff time.

23

Considerations

• Recommendations focus on improving existing services, not changing basic model of service

delivery.

• Recommendations focus on strategically using resources.

24

Not Currently Recommended: 24/7

Mobile Crisis Team• Expand MCT to 24/7. This proposal would expand Mobile Crisis

services to 24 hours per day 7 days per week, an increase of 13.5 hours per day. (The proposal as presented includes only one staff person for the overnight shifts.)

• Not recommended for the following reasons:

– Would not increase capacity during peak hours of operation.

– Would result in even greater capacity issues because mental health interns would not accompany staff during overnight MCT shifts.

– Based on experience of San Francisco Crisis Team, minimal utilization of MCT during overnight hours.

25

Cost for 24/7 MCT

– Additional staff needed : 3 FTE BHCIIs, 1 MHC Supervisor plus 2.5 times the hourly BHCII staff currently budgeted. Budget anticipates 1 staff person on at all times. If it was determined that more staff is needed, that would increase program costs.

– TOTAL PROJECTED COST/Year: $639,025, additional start up cost of $7,500 for first year (computers,

– TOTAL PROJECTED COST/Year: $639,025, additional start up cost of $7,500 for first year (computers, radios, etc.).

• 1 Mental Health Clinical Supervisor (Step C): $149,645.

• 3 BHCII (Step C): $397,380.

• Additional hourly BHCII staff: $60,000.



26

Reference

• PowerPoint available at: This PowerPoint is accessible at: G:\MH Commission\PowerPoint

Presentation\Presentations\Berkeley Mental

Health Recommendations For Improving Crisis Health Recommendations For Improving Crisis

Services 6.24.14

27

1

Memorandum

To: Berkeley/Albany Mental Health Commission

From: Carol Patterson, Commission Secretary

Date: 7/16/2014

Re: Staff Update

1) I will be on vacation July 21 – August 5. 2) Agenda item 4A: Judy Kerr is an applicant for the Albany Special Public

Interest seat. The Albany City Council has recommended her for the Commission and I have determined that she is eligible for the Special Interest seat.

3) Agenda item 6: The Community Health Commission has referred the topic of recommendations regarding HR 3717 to the Mental Health Commission. The Acting Chair has suggested that a subcommittee be formed to study the bill in depth. I want to remind the Commission that any recommendations from a subcommittee must come to the full Commission before being sent to the Community Health Commission.

4) Agenda item 7: Berkeley City Council referred this item to the Mental Health Commission after the Commission advised against implementation of AB 1421 (Laura’s Law.) At the June meeting, the Commission took action by endorsing recommendations proposed by the Mental Health Manager. If there are no further recommendations to be considered, the Commission needs to write a report to Council that includes the recommendations considered and endorsed. A draft report could be reviewed and approved at the September Commission meeting before being sent to Council. Please let me know who from the Commission will be writing the report as I can provide a report template and technical assistance in writing the report.

5) The Acting Chair requested that the Mental Health Manager do a presentation on the Homeless Outreach Services. However, Steve is on vacation as I construct this packet and so I have not been able to confirm with Steve whether he would be able to the presentation at the July meeting. I have included the Scope of Services and Budget in the packet at the request of the Carole although it is not on the July agenda.

6) Have an enjoyable and productive meeting!

28

6/26/14

Mental Health Commission Interview Guidelines

Commission applicants may be asked their positions on mental health policy matters

laws or administrative regulations, current pending or proposed, state, federal or

municipal with the goal of ascertaining the applicant’s experience with and/or knowledge

of the mental health system and ability to work with a diverse group of applicants.

The “General Commissioner Qualifications” are listed below for reference.

• Demonstrates interest in community mental health services

• Ready to commit to Commission duties, including preparation for and regular

attendance at monthly Commission and Committee meetings, timely review of

meeting materials and completion of Commission paperwork and training

• Willing and able to work alongside mental health consumers and members of

diverse communities

• Able to constructively handle conflict and differences of opinion

• Reflects the diversity of the Berkeley/Albany community

29

Date Approved: Monday, June 9, 2014

CITY OF ALBANY

MINUTES OF THE

ALBANYCITY COUNCIL

CITY COUNCIL CHAMBER, 1000 SAN PABLO AVENUE

MONDAY, MAY 19,2014

6:45 p.m.

CLOSED SESSION

CALL TO ORDER

OPPORTUNITY FOR THE PUBLIC TO SPEAK ON CLOSED SESSION ITEMS The following people spoke: Maxine Lew; Melissa Geta; Peter Handley; Ron Thayer;

Saul Strand; Barbara Foo.

A summary ofcomments is as follows: expressed concern with the digital billboard

proposed as part of the project and potential impacts on view, environment and property

value.

City Council convened in the Council Chamber and then adjourned to Closed Session to

discuss the following items:

1. Closed session to discuss real property negotiations pursuant to Government Code Section 54956.8:

Property: Negotiating Parties:

540 Cleveland Street, Parcel # 066-2760-014-08 Lessor: Craig Labadie, City Attorney; Patrick O'Keeffe, Project Manager; and Penelope Leach, City Manager for the City of Albany Lessee: Clear Channel Outdoor

Under Negotiation: Price and Terms for Lease ofProperty


Property: Portion of 1000 San Pablo Avenue, Albany, CA 94706

30

City Council Minutes May 19,2014

Agency negotiator: Penelope Leach, City Manager; Craig Labadie, City Attorney; Jeff Bond, Community Development Director; Anne Hersch, City Planner

Negotiating parties: Complete Wireless Inc. representing Verizon Wireless

Under negotiation: Terms ofground lease for installation ofa telecommunications antenna

3. Conference with Legal Counsel to discuss existing litigation pursuant to Government Code Section 54956.9(d)(1) Name of Case: California State Water Resources Control Board et al. v. East Bay Municipal Utility District et al. United States District Court Case Nos. C09-00 186 & C09-05684

7:30 p.m.

CALL TO ORDER

Mayor Thomsen called the meeting to order at 7:30 pm.

1. PLEDGE OF ALLEGIANCE Mayor Thomsen led the Pledge of Allegiance to the Flag.

2. ROLLCALL Present: Council Members Atkinson, Bames, Maass, Vice Mayor Wile, Mayor Thomsen.

3. REPORT ON ACTION TAKEN IN CLOSED SESSION, IF ANY Mayor Thomsen reported that the Council met in closed session to discuss item 1, and that the Council would reconvene to Closed Session following the regular City Council meeting to discuss item 3. 1. Closed session to discuss real property negotiations pursuant to Government

Code Section 54956.8:

Property: 540 Cleveland Street, Parcel # 066-2760-014-08 Negotiating Parties: Lessor: Craig Labadie, City Attorney; Patrick

O'Keeffe, Project Manager; and Penelope Leach, City Manager for the City of Albany Lessee: Clear Channel Outdoor

Under Negotiation: Price and Terms for Lease ofProperty

2

31


Mayor Thomsen reported that the Council gave direction to staff.


Property: Portion of 1000 San Pablo Avenue, Albany, CA 94706

Agency negotiator: Penelope Leach, City Manager; Craig Labadie, City Attorney; Jeff Bond, Community Development Director; Anne Hersch, City Planner

Negotiating parties: Complete Wireless Inc. representing Verizon Wireless

Under negotiation: Terms of ground lease for installation of a telecommunications antenna This item was not discussed.

3. Conference with Legal Counsel to discuss existing litigation pursuant to Government Code Section 54956.9(d)(l)

Name of Case: California State Water Resources Control Board et al. v. East Bay Municipal Utility District et al. United States District Court Case Nos. C09-00186 & C09-05684 Following the regular City Council meeting the Council reconvened to Closed Session to discuss this item. Following the discussion Mayor Thomsen reported that the Council gave direction to staff.

4. CONSENT CALENDAR

4-1. Minutes, May 5, 2014

Staff recommendation: Approve

4-2. Ratification of Payroll

a. Ratification of City of Albany net payroll in the amount of $202,992.26; taxes, benefits & withholdings in the amount of $169,655.79. Total payroll in the amount of $372,648.05. Payroll period: 5/2/2014

b. Ratification of Albany Municipal Services JP A net payroll in the amount of $43,082.69; taxes, benefits & withholdings in the amount of $31,995.52. Total payroll in the amount of $75,078.21. Payroll period: 5/212014

Staff recommendation: Ratify

3

32

http:75,078.21http:31,995.52http:43,082.69http:372,648.05http:169,655.79http:202,992.26


4"3. Ratification of Bills, Claims and Demands against the City of Albany in the amount of: $261,997.05 (5/5/2014); $451,180.56 (5/8/2014); $1,193,846.52 (5/9/2014)

Staff recommendation: Ratify

4"4. Vice Mayor Joanne Wile Nomination of Judy Kerr to the Berkeley/Albany Mental Health Commission

Vice Mayor Wile recommendation: that the Council approve nomination of Judy Kerr to the Berkeley/Albany Mental Health Commission

4-5. Quarterly Cash and Investments Treasury Report for the Quarter Ending March 31,2014

Staff recommendation: Note and file for information only

Mayor Thomsen asked if anyone would like to remove an item, no items were removed from the consent calendar.

MOTION: Moved by Vice Mayor Wile, seconded by Council Member Maass to approve the Consent Calendar items as submitted. AYES: Council Members Atkinson, Barnes, Maass, Vice Mayor Wile, Mayor Thomsen. NOES: None Motion carried and so ordered.

5. PRESENTATION

5"1. Proclamation in recognition of the Albany High School Women's Wrestling Team Council Member Atkinson presented the Proclamation, and acknowledged Assistant Coach Griffith for receiving the assistant coach of the year award.

6. GOOD OF THE CITYIPUBLIC FORUM/ANNOUNCEMENTS

Mayor Thomsen opened Good of the City/Public Forum. Mayor Thomsen announced the Paws for Reading program and Vice Mayor Wile reported that the program is held every Thursday at the Albany Library. Children read to dogs, and the program helps children improve reading scores. The following people spoke: Kim Denton; Bruce Dixon; Allan Maris; Peggy McQuaid; Paul 0'Curry; Julie Winklestein; Signe Matison; Genevive Wilson; Eric Hustead; David Danby; Amber Whitson. A summary of comments is as follows: expressed appreciation for the Council's support of the Albany Relay for Life event, and that the event raised over $25,000; Albany Lion's Club expressed appreciation for the Rebuilding Together program

4

33


funded by the City's Community Development Block Grant program to help repair homes in Albany; expressed appreciation for the Albany High School Women's Wrestling Team, expressed interest in a Resolution in support of the return of the abducted girls in·Nigeria; announced the Albany High Bands concert will be held in Memorial Park Tuesday night and that the event is sponsored by the Albany Community Foundation; expressed concern regarding broken utility box on Masonic Avenue sidewalk; expressed dissatisfaction regarding Albany Bulb; Library Board meeting will be held tomorrow, encourage people to attend to discuss the "weeding" of books from the library.

7. PUBLIC HEARING

8. UNFINISHED BUSINESS

8-1. Update on Sustainability Committee Analysis of Options to Fund Implementation of the Albany Climate Action Plan

Staff recommendation: that the Council direct staff to incorporate Climate Action Plan funding into the forthcoming 2014 City Budget Review session scheduled for the June 9, 2014 Council meeting

Transportation & Sustainability Coordinator Claire Griffing introduced Sustainability Committee Chair Max Wei and Vice Chair Charlie Blanchard. On July 19,2010, the City Council requested the Sustainability Committee prepare recommendations to fund implementation of the City's Climate Action Plan (CAP). The Sustainability Committee formed a finance subcommittee to analyze a variety of funding scenarios, and submitted a proposal recommending an increase in the Utility Users' Tax (UUT). Council reviewed the proposal on April 7,2014, and asked the Committee for more information on what the projected revenues would be used for. Council also requested more information on whether the Board of Education will have a tax measure on the November ballot.

Seeking an increase in the UUT to fund CAP implementation would require a ballot measure and would require 2/3 voter approval. The Sustainability Committee identified six key programs that could be supplemented by UUT funds, and to try to align the funding with the largest greenhouse gas emissions sectors: 1. Accelerate the sidewalk repair program to encourage pedestrian transport 2. Improve striping and signage for bike paths 3. Investigate feasibility of an electric shuttle 4. Support community gardens and Farmer's Market 5. Serve as a reliable source for required matching grant funds, (e.g. augment

Complete Streets projects) 6. Leverage staff time to augment grant writing, project management, and policy

research

5

34


Vice Chair Charlie Blanchard reported that the School District will likely be placing a measure on the November 2014 ballot to replace the expiring parcel tax.

The following people spoke: Caryl O'Keefe; Preston Jordan; Peggy McQuaid; Nick Pilch; Saul Strand. A summary ofcomments is as follows: encouraged the Council to direct staff to analyze implementation of the CAP as part of the budget study, but not to consider a tax at this time to allow the school district the opportunity to propose a tax measure without other tax measures on the ballot, forecasts demonstrate that greenhouse gas reduction goals will be achieved, encouraged Council to seek other ways to fund implementation; expressed support for the utility users tax, the proposed tax is minimal compared to the proposed AUSD tax; expressed concern for a regressive tax that would adversely impact multifamily housing.

A summary of Council comments is as follows: there are likely two other proposed taxes on the November 2014 ballot and a third ballot measure may be too many; expressed interest in reviewing the item as part of the City budget process; expressed interest in more specific items to fund with the UUT such as a Residential Energy Conservation Ordinance; expressed interest in supporting the current understanding with the school district regarding taking turns with ballot measures; expressed appreciation to the Sustainability Committee for all the work done to date on this item.

MOTION: Moved by Council Member Atkinson, seconded by Council Member Maass to

place the utility users tax on the November 2014 ballot and have the

Sustainability Committee identify specific items to be funded with the tax

measure.

A YES: Council Members Atkinson, Maass.

NOES: Council Member Barnes, Vice Mayor Wile, Mayor Thomsen.

Motion failed.

MOTION: Moved by Council Member Barnes, seconded by Vice Mayor Wile to direct staff to incorporate Climate Action Plan funding into the forthcoming 2014 City Budget Review session scheduled for the June 9, 2014 Council meeting. AYES: Council Members Atkinson, Barnes, Maass, Vice Mayor Wile, Mayor Thomsen. NOES: None Motion carried and so ordered.

8-2. Report from the Measure D Working Group Regarding Placing a Measure on the Ballot to Amend Residential Parking Standards

6

35


Staff recommendation: That the City Council accept the policy matrix and provide direction on the following:

a. Identify immediate priorities for changes to parking policies that do not require an amendment to Measure D

b. Identify preference for potential changes to Measure D for either 2014 ballot or 2016 ballot

c. Identify policies to be discussed in the General Plan Update process; and

d. Provide direction to the Working Group regarding any additional analysis desired by the City Council

Community Development Director Jeff Bond delivered the staff report. In November 2013, Council authorized the establishment of the Measure D Working Group, consisting of members of the Planning and Zoning Commission, Traffic and Safety Commission, and Sustainability Committee. The Working Group was tasked with the evaluation of the pros and cons of placing a measure on the ballot to amend voter approved residential parking standards.

In 1978, voters in the City approved an initiative called "Measure D" that among other things, required that all residential uses in all residential districts provide two spaces per dwelling unit. This measure has been incorporated into Section 20.28.040 of the Planning and Zoning Code. As a result of Measure D, current practice is to require new residential units, regardless of size, number of bedrooms, or type of housing, to provide two off-street parking spaces. In addition, implementation of the measure requires that parking be provided when additions are made to single-family structures that increase the original floor space by more than 25 percent or 240 square feet (whichever is less).

The City's parking requirements affect the cost and design of housing and the feasibility of developing multi-family housing on smaller parcels. The requirements also make it difficult to modify existing buildings to add new housing units.

The working group prepared a policy matrix summarlzmg options to amend Measure D including immediate opportunities for changes to parking policies that do not require an amendment to Measure D, and potential changes to Measure D for either the 2014 ballot or 2016 ballot.

Task Force Member Pilch addressed the Council. The two parking space requirement limits development of secondary units; changing Measure D can help encourage housing development, encouraged environmental analysis in advance

7

36


of a ballot measure and possibly polling the voters to get a sense of support for the

possible measure.

Task Force Member Charlie Blanchard addressed the CounciL Increasing the

density ofhousing helps minimize the amount ofdriving within the area.

Task Force Member Peggy McQuaid addressed the CounciL The Traffic & Safety

Commission is interested in paid parking programs.

The following people spoke: Robert Cheasty; Clay Larson.

A summary ofcomments is as follows: Measure D was a response to development

of multifamily dwellings occurring along streets near San Pablo A venue;

encouraged engagement with entire community prior to moving forward with any

changes; additional study is needed to identify actual changes to Measure D.

A summary of Council comments is as follows: asked about CEQA analysis,

asked about other cities and how parking is managed for secondary units,

expressed support for conducting additional study and a possible ballot measure in

2016; expressed support for amending Measure D; expressed support for

implementing policy changes that do not require an amendment to Measure D,

and also a ballot measure for 2014 to amend Measure D; expressed interest for

voter education in advance of the ballot measure.

MOTION: Moved by Council Member Barnes, seconded by Vice Mayor Wile to a. Identify immediate priorities for changes to parking policies that do not

require an amendment to Measure D

b. Identify preference for potential changes to Measure D for the 2016 ballot

c. Identify policies to be discussed in the General Plan Update process; and

d. Ask the Working Group to research how to educate voters regarding the potential ballot measure

AYES: Council Members Atkinson, Barnes, Maass, Vice Mayor Wile, Mayor Thomsen. NOES: None Motion carried and so ordered.

8-3. Public Works Service Center - Resolution No. 2014-43, Approving the Preliminary Design and Specifications for a New Public Works Service Center at 540 Cleveland Avenue, and Authorization for Staff to Issue a Request for Proposals from Design Build Developers/Contractors

Staff recommendation: that the Council adopt Resolution No. 2014-43 approving the design plans and specifications, and authorizing staff to issue the Request for Proposals from developer/contractors for the new Public Works Service Center at 540 Cleveland Avenue

8

37


Project Manager Pat O'Keeffe delivered the staff report. The existing Public Works service center at 548 Cleveland is located in a leased facility that is inadequately sized for the public works operations. The lease will expire in January 2015. The escrow process on the 540 Cleveland parcel for the Public Works service center is now complete. The purpose of this item is to approve the completed design plans and specifications, approve a Request for Proposals (RFP) for design build proposals for facility construction, and to authorize staff to distribute the RFP to a select group of five design build teams that responded to the RFQ.

In January 2014, the Council approved an ordinance establishing the design build method as an alternate means ofpublic works facility procurement allowing the request for proposals to be issued for developer/contractor solicitation. In February 2014, the Council approved an amendment to the zoning code to allow the installation of electronic advertising signs to provide for installation of a sign on 540 Cleveland Ave. that would help pay for the new facility, and the issuance of a Request for Qualifications for design build developer/contractor teams and received ten submittals in response. Pursuant to a staff evaluation a short list of five proposals is recommended for further consideration. In March 2014, the City'S design team, Gills + Panichapan Architects Inc. (GPa), completed the preliminary design and specifications for the RFP for the developer/contractor team solicitation. O'Keeffe introduced the design team Gillis + Panichapan Architects Inc to present the project design.

The following people spoke: Ginny March; Tom Thomas; Wendy Hui; Li Yang; Maria Ling; Ella Eng; Dee Jacobson; Barbara Foo; Robert Cheasty; Robert Benjamin; Keiki Shaw; Saul Strand; Janet Linn; Edel Alon; Chris Kirkham; Brian Parker; Norman Laforce; Peggy McQuaid.

A summary of comments is as follows: requested consideration for residents along Pierce Street; expressed concern with the digital billboard proposed as part of the project; asked about the environmental review process (CEQA) for the proposed billboard; encouraged consideration of other mechanisms to fund the project; raised concern with the proposed size of the building; light impacts from the billboard will have impacts on the mudflats.

A summary of Council comments is as follows: expressed appreciation for the speakers; expressed concern with the height of the billboards; expressed interest in having the billboard conform with the height limits; expressed interest in additional information regarding environmental impacts associated with billboard lighting; asked for other funding options for the project to be researched;

9

--------------- ....

38


expressed concern with blight associated with billboards; requested additional detail regarding proposed size and design of the building. The Council agreed to continue this item to the June 9th meeting. Staff will return with additional information regarding the billboard, project size, and project funding options.

The following items were postponed to the June 9th City Council meeting.

9. NEW BUSINESS 9-1. General Fund Quarterly Report of Revenue and Expenditures and Mid-Year

Budget Adjustments (Quarter 2: October 2013 - December 2013)

Staff recommendation: that the City Council: 1) Approve the Budget Changes as presented and 2) Accept and file the report

9-2. Designation of Voting Delegates and Alternates for the League of California Cities Annual Conference

Staff recommendation: that the Council designate a voting delegate and alternates for the League of California Cities Annual Conference

10. OTHER BUSINESS, REPORTS ON MEETINGS ATTENDED, ANNOUNCEMENT OF EVENTSIFUTURE AGENDA ITEMS.

10-1. The next City Council Meeting has been rescheduled to Monday, June 9th at 7:30 PM in the Council Chambers.

11. ADJOURNMENT

Reconvene to Closed Session

10;33 pm. There being no further business before the City Council it was moved

and seconded to adjourn the meeting.

The Council reconvened to Closed Session.

Minutes submitted by Nicole Almaguer, City Clerk.

~w

~' Vice Mayor

Attest:

~/I/f~.

NIcole Almague14' CIty Clerk

I

10

----------------~ '~-,

39

Mental Health Commission Membership Grid

Berkeley Special Interest Name Applicant Consumer 1 1) Jean-Marie Hervé Michel, Jr

2 2) Jeffrey Davis

3 3) Nadine Dixon

Family 1 4) Shirley Posey 2 5) Shelby Heda 3 6) Jennifer Fazio

Albany Special Interest Consumer OR Family 1 (open) Judy Kerr

Berkeley General Interest

1 7) Carole Marasovic

2 8) Paul Kealoha-Blake

3 9) Cameron Silverberg

4 (open)

Albany General Interest 1 10) Bart Grossman Berkeley Mayor Appointee

1 11) Jesse Arreguin Commission Openings 7/9/14 Berkeley Special Interest: 0 Albany Special Interest: 1 (there is an applicant for this seat) Berkeley General Interest: 1 Albany General Interest: 0 Total Openings: 2

40

Health, Housing & Community Services Department Public Health Division

A Vibrant and Healthy Berkeley for All

1947 Center Street, 2nd

Floor, Berkeley, CA 94704 Tel: 510. 981.5300 TDD: 510.981.6903 Fax: 510. 981.5395 E-mail: [email protected] - - http://www.cityofberkeley.info/health/

MEMORANDUM

To: Mental Health Commission From: Janet Berreman, MD, MPH, Health Officer, HHCS Date: July 3, 2014 Subject: Public Health Priorities and Budgeting: Health Happens in Berkeley The Public Health Division of HHCS is engaged in a health priority-setting process. These priorities will form the foundation of the “Health Happens in Berkeley” initiative. We are seeking input from Commissions which might have an interest in this area. The identified Commissions are:

• Community Health Commission

• Commission on Aging

• Mental Health Commission

• Children, Youth, and Recreation Commission The priorities and how we arrived at them are described in our June 10, 2014 Information Report to Council, available here: http://www.cityofberkeley.info/Clerk/City_Council/2014/06_Jun/Documents/2014-06-10_Item_54_Public_Health_Priorities.aspx. We are interested in the Commission’s feedback about the 4 preliminary priority areas. Specifically, we would like to know:

1. Does the Commission support the preliminary priorities selected? 2. Does the Commission have particular interest in any of the 4 areas? 3. Is there anything in the priorities to which the Commission has strong objection?

Thank you for your time, attention, and thoughtful feedback.

41

Office of the City Manager

2180 Milvia Street, Berkeley, CA 94704 ● Tel: (510) 981-7000 ● TDD: (510) 981-6903 ● Fax: (510) 981-7099 E-Mail: [email protected] Website: http://www.CityofBerkeley.info/Manager

INFORMATION CALENDAR June 10, 2014

To: Honorable Mayor and Members of the City Council

From: Christine Daniel, City Manager

Submitted by: Jane Micallef, Director, Health, Housing & Community Services

Subject: Public Health Priorities and Budgeting

INTRODUCTION In response to Berkeley’s Health Status Report 2013 (HSR 2013), presented at the October 29, 2013 Council worksession, City Council asked the Public Health Division (PHD) to ensure that the City’s public health activities effectively address health inequities identified in the report. Council suggested a priority-based budgeting approach. The Public Health Division and Health, Housing & Community Services (HH&CS) Department fully embrace the need to focus their work, maximize their impact, and improve their accountability for health outcomes and have embarked on a comprehensive initiative to do so. The initiative is called “Health Happens in Berkeley.” This report presents staff work to date, including:

I. Preliminary list of health priorities, II. Analysis of a priority-based budgeting approach, including assessment of

funding and programmatic flexibility, III. Timeline, and IV. Program examples.

Spurred by Council’s call to action, the Division is assessing what is already working well, which programs have the strongest basis in evidence, and how resources can be directed to have even more impact going forward. The work may include both fortifying existing efforts which have proven effective and initiating new efforts to close identified gaps.

SUMMARY On October 29, 2013, City Council asked the PHD to ensure that the City’s public health activities effectively address health inequities identified in the HSR 2013. PHD has begun work on an initiative to identify community-established health priorities, align PHD activities to these priorities using evidence-based practices, and establish outcome measures to gauge its impact.

42

rthomsenTypewritten Text54

Public Health Priorities and Budgeting INFORMATION CALENDAR June 10, 2014

Page 2

Since the October meeting, PHD completed an internal priority-setting process in order to prepare for engaging the community in refining and/or confirming these priorities. Initially identified priorities described in more detail in the report are summarized below. Each of these is a health outcome for which Berkeley has significant racial/ethnic health inequities and for which the City does not fully meet national Healthy People 2020 (HP2020) goals:

Cardiovascular disease, including heart conditions, high blood pressure, and stroke. All of these diseases are closely linked to the underlying health conditions of obesity and diabetes, which in turn are related to nutrition, physical activity, tobacco use, and environmental stress.

Asthma hospitalizations among Berkeley children under 15 years of age are higher than in Alameda County. For all children under 5 years of age, asthma hospitalizations exceed HP2020 goals.

Low birth weight (LBW) and prematurity put infants at increased risk for health problems during infancy and for long-term disability. The last decade has seen significant reduction of health inequities in these areas, but African American infants are still more than twice as likely as others to be born too small or too soon.

Reproductive and Sexual Health refers to family planning, pregnancy, and sexually transmitted infections (STIs). Teen births, chlamydia rates among young women and syphilis rates among men are of particular concern.

Once the priorities have been established, PHD will identify upstream factors that help determine health outcomes, and then identify evidence-based practices for addressing those factors. The priorities will inform which current PHD programs will be retained and strengthened, and where activities should be expanded to maximize impact. This work will leverage existing resources and will require new resources to fund new or expanded activities. The goal will be to incorporate evidence-based practices into all PHD programs to improve outcomes in the identified priority areas. An example of this strategy is as follows: If cardiovascular disease were adopted as a priority, PHD could focus division activities on preventing overweight and obesity, since these are known to increase the risks of cardiovascular disease. Evidence shows that improving access to affordable, appealing, fresh produce improves healthy eating and helps prevent obesity and overweight. PHD could use existing resources to continue and strengthen its related work in WIC, Heart 2 Heart (H2H), and the Nutrition Education/Obesity Prevention programs, while seeking opportunities for funding and partnerships to expand H2H to additional neighborhoods. The PHD currently provides services related to all of the priority areas outlined above, but the HSR 2013 shows that there is much more work to be done. PHD’s ability to re-focus its efforts on the selected priorities is limited by certain constraints:

43


Page 3

Categorical (non-flexible) funding and programs, with narrowly defined eligible activities established at the State and Federal levels;

Mandated activities (including unfunded mandates) required of all local health jurisdictions; and

Labor agreements and the civil service context in which the City operates. Due to the constraints outlined above, a wholesale restructuring of PHD activities is not feasible. But the re-focusing of Public Health programs incrementally can occur in many ways. In order of increasing time and effort to implement, these steps are as follows:

Revising workplans in existing categorical programs;

Re-directing General Funds to strategic priorities;

Building strategic partnerships; and

Identifying new resources. It is important to note that all PHD funding is fully allocated to the Division’s twenty programs. Any redirection of those funds will require reduction or elimination of an equivalent level of current services. PHD plans to return to Council in October 2014 for a worksession to further discuss the Health Happens in Berkeley priority-based budgeting approach and to finalize the community-identified priorities.

CURRENT SITUATION AND ITS EFFECTS Public Health Priorities Since the October 29, 2013 Council worksession, Public Health completed an internal priority-setting process in order to prepare for engaging the community in refining and/or confirming these priorities. The top four public health priorities the Division identified are:

Cardiovascular disease (heart disease and high blood pressure);

Asthma hospitalizations in children (up to 15 years of age);

Low birth weight and prematurity; and

Reproductive and sexual health (including teen births and sexually transmitted infections).

All PHD staff participated in the process to select these priorities, which included an analysis of where, according to the HSR 2013, Berkeley is falling short of the national HP2020 goals and where significant health inequities exist. Clear consensus about these four priority areas arose out of the many areas of concern considered. A brief discussion of each priority follows.

44


Page 4

Cardiovascular disease includes heart conditions, high blood pressure, and stroke. All of these diseases are closely linked to the underlying health conditions of obesity and diabetes, which in turn are related to nutrition, physical activity, tobacco use, and environmental stress. Cardiovascular diseases are a leading cause of death in Berkeley, and are areas of significant health inequities. The HSR2013 shows health inequities in high blood pressure, heart disease, stroke, diabetes, and tobacco use. Berkeley’s death rates from stroke and coronary heart disease in the African American population do not meet HP2020 goals. Over 40% of BUSD 9th graders are overweight—setting the stage for cardiovascular disease in adulthood. Asthma hospitalizations among Berkeley children under 5 years of age, and school-aged children from 5 to 15 years of age, are higher than in Alameda County. For children under 5 years of age, asthma hospitalizations exceed HP2020 goals for all children. Hospitalization rates are higher for African American and Latino children and youth than for other racial/ethnic groups, with the largest inequity being among African American children younger than five. Poorly controlled asthma affects school attendance and performance, physical activity, and daily quality of life. Low birth weight (LBW) and prematurity put infants at increased risk for health problems during infancy and for long-term disability. Berkeley has made significant improvement in this area, with marked decreases in the rates of LBW and premature infants and a narrowing of the gap between African American infants and others. Nevertheless, African American infants are more than twice as likely as others to be born too small or too soon. African American infants do not meet the HP2020 goal for preterm births. Reproductive and Sexual Health refers to family planning, pregnancy, and sexually transmitted infections (STIs). Although the number of births to teen mothers in Berkeley is consistently among the lowest in the State, the vast majority of those births occur among African American young women. Teen mothers and their infants in Berkeley do not meet HP2020 goals for prenatal care and birth weight. STIs, and particularly chlamydia infections, disproportionately affect young women of color. These infections can affect future fertility and reproductive health. Rates of new syphilis infections among men in Berkeley do not meet HP2020 goals.

Although existing public health programs target many aspects of these priorities and serve the populations bearing the burden of health inequities, it is clear that their impact has not been as great as hoped and that more progress is needed. See Attachment 1 for a brief description of current PHD programs. PHD staff-developed priorities are a first step in setting City public health priorities. In the coming months, the Division will seek input from City Council, relevant

45


Page 5

Commissions, partner agencies, and other stakeholders via a series of Commission presentations, partner meetings, and a Community Health Forum. Input will be sought within the same framework the PHD used: a focus on the data, informed by the experiences in and of the community. PHD plans to return to Council for a worksession in October 2014 to confirm the priorities identified.

Priority-Based Budgeting Given a number of constraints, PHD cannot approach this work with a clean slate. Public Health programming and budgeting limit the ways available resources can be directed to locally determined health priorities. These constraints are:

Categorical (non-flexible) funding and programs, with narrowly defined eligible activities established at the State and Federal levels;

Mandated activities (including unfunded mandates) required of all local health jurisdictions; and

Labor agreements and the civil service context in which the City operates. The PHD has been successful in leveraging categorical funds and in working within program constraints to provide services appropriate to Berkeley. The Division commits General Fund to the support of these programs, as explicit matching funds, as in-kind administrative and management support, and to meet personnel costs which exceed levels allowed by funders. As the City re-focuses its priorities and strategies it will seek funding to support new programs and initiatives. The PHD has a successful track record raising funds to support its work, and this effort takes time. Interim steps are necessary to ensure progress in addressing health inequities and will involve assessing the flexibility of existing funding sources and the activities they support, so that resources can be allocated for maximum impact. This effort includes determining how best to:

Focus resources on priorities while ensuring mandated functions;

Enhance or incorporate priority area work in existing categorical programs;

Leverage categorical funding to meet priority needs;

Assess appropriate levels of mandated activities.

Funding Assessment The annual PHD budget is $8.7 million for twenty programs. City General Fund and State Realignment funds together account for approximately $4.3 million of this budget. Special funds including State grants, Alameda County grants, and other program grants make up the remaining $4.4 million of the budget. For the most part only City General Fund and State Realignment are flexible in the programmatic activities they support. The bulk of the special funds are categorical, meaning they only support specific

46


Page 6

activities. Within categorical grants, there are varying—but limited—degrees of local flexibility at the program level. City General Fund and State Realignment in the PHD budget support a variety of specific functions.

First, they provide the matching local expenditures required to leverage State and other categorical funds. For example, the City receives approximately $430,000 in State funds for Targeted Case Management annually, and must spend an equal amount in local funds as match.

Second, these funds cover the costs of unfunded mandates that the PHD is required to meet as a public health jurisdiction. For example, communicable disease control is a mandatory function costing approximately $600,000 annually. Only $42,000 of these annual costs are covered by categorical funding sources.

Third, City General Fund supports Council-identified priority programs, such as Hypertension and Health Disparities (the Heart 2 Heart program), and the Black Infant Health program.

Finally, City General Fund is used to provide $150,000 in annual public health grants to community agency programs. These grants are $50,000 each to the Berkeley Free Clinic, the NEED needle exchange program, and the Oral Health program at Berkeley Unified School District (BUSD) schools.

The level of General Fund and State Realignment support varies significantly from program to program, but when the full costs—including Division management and administration—are taken into account, every PHD program relies on these non-categorical funding sources. The following table provides examples of the extent to which PH programs require General Fund and State Realignment support.

47


Page 7

Public Health Program Examples by Proportion of City General Fund/State Realignment Support

General Fund/Realignment Support

Program Examples

High General Fund/Realignment (>80%)

Heart 2 Heart hypertension and cardiovascular disease prevention program

Communicable disease, Tuberculosis, and STD control (mandatory function)

Immunization Clinic Mix of Categorical Grants and City General Fund/Realignment

Public Health Clinics (Ann Chandler, Berkeley High School, Berkeley Technology Academy)

Public Health Emergency Preparedness Vital Statistics1 (mandatory function)

Low General Fund/Realignment (


Page 8

collaboration between BUSD and the Prescott-Joseph Center exemplify this flexibility.

Somewhat flexible programs have more constraints on the scope of work, but do include opportunities to shape proscribed activities to align with local priorities. For example, the Nutrition Education/Obesity Prevention program offers a selection of workplan options for delivery to eligible populations, allowing Berkeley to participate in the State and National “Rethink Your Drink” campaign for healthier beverages. Thus the PHD took advantage of an opportunity to align the program with local priorities.

Programs with no flexibility are not amenable to adaptation to fit local priorities. Public Health Emergency Preparedness grants are an example of highly proscribed programs, with very little room for local flexibility. The annual scopes of work are set by the State and must be met in order to receive local funding.

Over time the number, complexity, and specificity of mandated tasks in the Division’s funding portfolio have increased while the number of staff in the PHD has decreased. Despite dramatic cuts in funding, the PHD has strived to continue to meet the public health needs of the community. The result is that today half of PHD programs have 2.0 or fewer FTEs to provide direct services, and fewer administrative staff to assimilate new and increasingly strict programmatic regulatory requirements, as well as to explore and implement opportunities to adapt scopes of work to changing priorities. Some categorical funds can be passed on to community partners. The PHD is experienced at taking advantage of such opportunities. Examples this year are $70,000 contracted to Berkeley Youth Alternatives for tobacco prevention work with Berkeley youth and $100,000 contracted to BUSD for school-based nutrition education and obesity prevention.

49


Page 9

Timeline The following table shows the PHD’s proposed timeline for this initiative:

Proposed Timeline for Health Happens in Berkeley Summer 2014 Community input into PH Priorities Fall 2014 Finalize PH Priorities; Council Worksession October 2014 Winter 2014 Select upstream factors to target with PH interventions

Remainder FY2015

Identify evidence-based and best practices Identify measurable indicators and outcomes Identify and enhance existing PH program work that aligns with priorities

FY2016/ FY2017

Identify opportunities to implement and fund evidence-based and best practices to fill program gaps Strengthen outcomes measures and indicators Further focus and enhance priority work within existing PH programs. Re-direct resources as necessary to support priority work.

Program Examples Once priorities have been determined, PHD will propose intervention strategies by analyzing upstream factors, then identifying evidence-based interventions, possible program changes, and outcome measures that can be used to evaluate their effectiveness. Following is an illustration of this work, based on the example of cardiovascular disease:

50


Page 10

Health Priority Illustration: Cardiovascular Disease2 Upstream

factors influencing

priority area:

Evidence-based practices which affect

each factor

Current Public Health Programs

Opportunities to add or enhance program activities

Outcome Measures and Indicators3

Overweight & obesity , in childhood and adulthood, increase the risk of cardiovascular disease

Ready access to affordable, appealing fresh produce

Safe and walkable neighborhoods and parks

Breastfeeding for the first year of life decreases lifetime risk of obesity and overweight

WIC Nutrition

Education/Obesity Prevention

Heart 2 Heart (H2H)

Black Infant Health Nursing Case

Management

Expansion of H2H place-based work to all Berkeley neighborhoods bearing burdens of health inequities

Community-based physical activity initiative

Healthy food & beverage/healthy procurement policy for City-sponsored events and city-funded community agencies

Community based breastfeeding peer support program

Overweight & obesity in Berkeley youth & adults

Indicators of healthy diet: rates of consumption of sugar-sweetened beverages, fresh fruits & vegetables, whole grains, etc.

Rates of breastfeeding among Berkeley infants from birth to 1 year of age

Poorly controlled diabetes increases the risk of cardiovascular disease

Early screening and intervention

Ready access to affordable, culturally and linguistically appropriate primary health care

Heart 2 Heart Nursing Case

Management linkage to care

Diabetes registry for tracking all Berkeley residents with diabetes

Community-based diabetes management collaborative including health care and education partners

“Medical homes” among residents with diabetes

Rates of diabetes screening in the population

Diabetes rates among Berkeley youth & adults

Tobacco use & exposure increase the risk of cardiovascular disease

Smoke-free multi-unit housing

Smoking cessation counseling by health care providers

Healthy Homes initiatives

Smoke-free multi-unit housing ordinance effective 5/1/14

Free smoking cessation classes

Smoking assessment & brief counseling at PH clinic visits

Restrict tobacco sales and marketing near schools

Regulate e-cigarettes as other forms of tobacco use

Tobacco cessation initiatives specifically designed for vulnerable populations

Rates of indoor smoking or exposure to 2nd hand smoke

Tobacco cessation program completion and “quit rates”

Tobacco use among residents (youth and adults)

2 This table contains examples only. These are not final recommendations or plans. 3 Data sources and data collection methodologies need to be developed for most measures. Outcomes will be selected to measure the impact of selected interventions.

51


Page 11

The selection of specific evidence-based or best practices in each priority area will require consideration of a number of factors, including:

Anticipated impact in Berkeley Fit with existing programs and staffing Fit with work of partner organizations Fit with regional initiatives Impact on more than one priority Cost Expertise/experience in Berkeley

Conclusion Due to the challenges outlined above, a wholesale restructuring of PHD activities is not feasible. But the re-focusing of Public Health programs incrementally can occur in many ways. In order of increasing time and effort to implement, these are as follows.

Revise existing workplans (in categorical programs). Existing activities that are well-aligned with priorities, and are evidence-based or best practices, form a foundation on which to build the priority work. See column 3 in the above table for examples. Additionally, some existing programs are flexible enough to allow the incorporation of new activities related to priorities. For example, the Public Health Clinic has incorporated tobacco cessation assessment and referrals into its baseline reproductive and sexual health services. Other PH programs can incorporate priority work without jeopardizing their proscribed activities.

Re-Direct General Fund to strategic priorities. One option to support new programs is to re-direct City General Fund from lower priority work. Re-directing City General Fund will require decreasing or giving up existing activities. In addition, freeing up and re-directing General Fund could undermine the viability of existing programs which rely on General Fund as required match or to support the actual cost of program delivery.

Building strategic partnerships. Partnerships are an essential part of PHD work and are another path to implementing new programs. Partner organizations are in some cases better situated than PHD to do priority work, and may have access to funding streams that the City does not. Health Happens in Berkeley will provide direction for health interventions by all sectors in the City.

Identifying new resources. Implementing new programs requires sustainable funding streams. New programs can be supported by seeking new grant funding. The funding climate is improving, and the Health Happens in Berkeley initiative, along with HSR 2013 data, put Berkeley in a strong position to seek new sources of grant funding for programs to address priority health inequities.

52


Page 12

FISCAL IMPACTS The approach described for Health Happens in Berkeley is budget neutral. Current funding will be leveraged so that its use is more strategic and is aligned with public health priorities. Shifting funding toward new uses and priorities may mean decreasing or giving up existing activities that are less directly connected with or not as effective at addressing the priorities identified. New funding sources to support additional priority work will be actively pursued. BACKGROUND The HSR 2013 shows striking health inequities. Health inequities by race and ethnicity are a consistent feature of the health landscape in this country, reflecting long-established and deeply embedded patterns of unequal access to opportunities and resources. Berkeley has a long commitment to addressing and eliminating health inequities. Existing public health programs, and indeed programs throughout HH&CS, serve the populations identified in the HSR 2013 as bearing the burden of health inequities. These programs address issues identified in the report: heart disease, nutrition and obesity, health during pregnancy and infancy, asthma, reproductive and sexual health, and more.

There has been improvement in many of these areas: most notable is the narrowing of the disparities in rates of low birth weight infants. Despite the City’s commitment, programming, and progress to date, it is clear that the impact has not been as great as hoped and that more progress is needed.

The City has a long history and strong public health and community foundation on which to build. Thus the City is positioned to make sure that “Health Happens” for everyone in Berkeley. The City Council asked the division to reconfigure its work to address these findings. This report is the initial response to the directive. In recent years the PHD has had considerable experience with priority-setting and re-configuration, driven by budget reductions. It welcomes the opportunity to apply that experience to enhancing the impact and effectiveness of the Division’s work.

ENVIRONMENTAL SUSTAINABILITY There are no specific identifiable environmental effects or opportunities associated with the subject of this report. However, PHD and HH&CS are committed to identifying such opportunities as Health Happens in Berkeley evolves. Environmental sustainability is closely linked to healthy communities. CONTACT PERSON Janet Berreman, Health Officer, Health, HHCS, (510) 981-5301

Attachments: 1. Public Health Program Summary

53

Attachment 1: Public Health Division Programs FY 2014

by Program Goal and Full Time Equivalents (FTE)

Program Goals FTE

Public Health Clinic: Reproductive & Sexual Health

Provide pregnancy testing/counseling, birth control, reproductive health exams; sexually transmitted infection testing, diagnosis, treatment, and prevention; and HPV and Hepatitis (A & B) vaccinations

6.65

High School Health Centers

Provide BUSD high school students access to first aid; reproductive and sexual health services; medical care and insurance referrals; and Mental Health services provided on-site by HHCS Mental Health Division

5.25

Nursing Case Management

1) Home-based case management for underserved and underinsured individuals and families

2) Nurse of the Day telephone service 3) Surge capacity for the communicable disease and emergency

preparedness programs

5.15

Women, Infants and Children (WIC)

Provide supplemental food, nutrition education, breastfeeding support, and referrals for low-income women and their children under 5 years of age

3.85

Child Health and Disability Prevention

1) Quality assurance and follow-up for pediatric well care for Medi-Cal and Medi-Cal eligible children

2) Assure access and continuity of care for foster youth

3.63

Communicable Disease, Tuberculosis & Sexually Transmitted Disease Control

Track and control the spread of communicable diseases, including tuberculosis, sexually transmitted diseases, HIV/AIDS, and other reportable and novel conditions.

3.10

Public Health Emergency Preparedness

1) Plan for public health emergencies such as pandemic influenza and health aspects of a natural disaster such as earthquake, fire, or flood.

2) Ensure coordination with health care providers, clinics and hospitals on issues such as emergency surge capacity and distribution of medications or vaccines.

3) Build and maintain capacity of the HHCS Department Operations Center

2.95

Vital Statistics Register all births and deaths occurring in Berkeley; issue birth and death certificates; collect and analyze related data

2.60

54

Program Goals FTE

Tobacco Prevention Prevent tobacco use and its health consequences

2.24

Black Infant Health Improve Perinatal health and birth outcomes among African American mothers and infants and achieve health equity in pregnancy outcomes

1.85

Nutrition Education & Obesity Prevention

Provide nutrition education and obesity prevention to residents in income-qualifying census tracts or equivalent populations

1.15

Measure GG (Emergency Preparedness)

Improve disaster preparedness in the Community, with specific focus on vulnerable populations.

1.10

Maternal, Child & Adolescent Health

Identify and link eligible populations to Medi-Cal services and providers; Perinatal services coordination and SIDS prevention

1.10

School Linked Health Services

Partner with Berkeley Unified School District to improve health and education outcomes in BUSD Kindergarten through 5th grade students

1.05

Hypertension/Heart 2 Heart

Eliminate cardiovascular disease health inequities by focusing on community health improvement in a south Berkeley neighborhood

0.95

Immunization Clinic Provide immunizations to adults and middle- and high-school age youth; provide seasonal influenza vaccine and tuberculosis testing; provide immunizations to control disease outbreaks.

0.90

Be A STAR Ensure periodic, standardized developmental screening of infants and toddlers ages birth to 5 years

0.80

Lead Poisoning Prevention

Prevent lead poisoning in high-risk populations, and provide nursing case management for individuals determined to have lead poisoning

0.78

Epidemiology and Surveillance

Monitor community health status and maintain awareness of local public health conditions, such as health inequities and disease outbreaks

0.45

Immunization Program

Provide immunization resources to Berkeley health care providers and assess immunization rates among Berkeley preschool and school-age children

0.25

55

More on This

Bill

Constitutional

Authority

Statement

Subject —

Policy Area:

Health

View subjects

H.R.3717 - Helping Families in Mental Health Crisis Act of 2013113th Congress (2013-2014)

BETA

Introduced Passed House Passed Senate To President

Became Law

Sponsor: Rep. Murphy, Tim [R-PA-18] (Introduced 12/12/2013)

Committees: House - Education and the Workforce; Energy and

Commerce; Judiciary; Science, Space, and Technology;

Ways and Means

Latest Action: 04/03/2014 Subcommittee Hearings Held.

Tracker:

BILL

Hide Overview

Summary: H.R.3717 — 113th Congress (2013-2014)

There is one summary for this bill. Bill summaries are authored by CRS.

Shown Here:

Introduced in House (12/12/2013)

Helping Families in Mental Health Crisis Act of 2013 - Creates in the Department of Health and Human Services (HHS) an

Assistant Secretary for Mental Health and Substance Use Disorders, who shall supervise and direct the Administrator of the

Substance Abuse and Mental Health Services Administration (SAMHSA).

Directs the Assistant Secretary to establish a National Mental Health Policy Laboratory to: (1) identify and implement policy

changes and other trends likely to have the most significant impact on mental health services; (2) collect information from

grantees; and (3) evaluate and disseminate to such grantees evidence-based practices and services delivery models, using

the best available science shown to reduce program expenditures while enhancing the quality of care furnished to individuals

by other such grantees.

Summary (1) Text (1) Actions (12) Titles (2) Amendments (0) Cosponsors (92)

Committees (5) Related Bills (7)

Page 1 of 4H.R.3717 - 113th Congress (2013-2014): Helping Families in Mental Health Crisis Act of...

7/3/2014https://beta.congress.gov/bill/113th-congress/house-bill/3717

56

Amends the Public Health Service Act (PHSA) to require the Assistant Secretary to establish: (1) an Interagency Serious

Mental Illness Coordinating Committee; and (2) a four-year pilot program to award up to 50 grants each year to counties,

cities, mental health systems, mental health courts, and any other entities with authority under state law to implement, monitor,

and oversee assisted outpatient treatment programs.

Directs the Assistant Secretary to establish a program of tele-psychiatry and primary care physician training grants to states to

promote the use of qualified telehealth technology for the identification, diagnosis, mitigation, or treatment of a mental health

disorder.

Directs the HHS Secretary (Secretary), in coordination with the Assistant Secretary, to award planning grants to enable up to

10 states to carry out 5-year demonstration programs to improve the provision of behavioral health services by federally

qualified community behavioral health clinics.

Requires the Assistant Secretary to certify federally qualified community behavioral health clinics that meet specified criteria.

Requires the caregiver of an individual with a serious mental illness to be treated as the individual's personal representative

with respect to protected health information, even though the individual has not consented to disclosure of such information to

the caregiver, when the individual's service provider reasonably believes it is necessary for protected health information to be

made available to the caregiver in order to protect the individual's health, safety, or welfare or the safety of one or more other

individuals.

Amends the General Education Provisions Act to allow an educational agency or institution to disclose to such a caregiver the

individual's education record in certain related circumstances.

Amends the Omnibus Crime Control and Safe Streets Act of 1968 to make available: (1) Edward Byrne Memorial Justice

Assistance Grants for mental health programs and operations by law enforcement or corrections officers, and (2) public safety

and community policing grants to provide specialized training to law enforcement officers to recognize and intervene properly

with individuals who have mental illness.

Reauthorizes and revises requirements for the Mentally Ill Offender Treatment and Crime Reduction Act of 2004.

Authorizes the Attorney General to award grants to: (1) establish or expand veterans treatment court programs; and (2)

enhance the capabilities of a correctional facility to identify, screen, and treat inmates with a mental illness, as well as develop

and implement post-release transition plans for them.

Requires any data prepared by or submitted to the Attorney General or the Director of the Federal Bureau of Investigation

(FBI) with respect to homicides, law enforcement officers killed and assaulted, or individuals killed by law enforcement officers

to include data about the involvement of mental illness in such incidences, if any.

Directs the Comptroller General (GAO) to detail the cost of federal. state, or local imprisonment for persons who have serious

mental illness.

Amends title XIX (Medicaid) of the Social Security Act (SSA) to prohibit a state medical assistance plan from prohibiting

payment for a same-day qualifying mental health service or primary care service furnished to an individual at a federally

qualified community behavioral health center or a federally qualified health center on the same day as the other kind of

service.

Allows states the option to provide medical assistance for inpatient psychiatric hospital services and psychiatric residential

treatment facility services for individuals age 21-65.

Amends both SSA titles XIX and XVIII (Medicare) to cover prescription drugs used to treat mental health disorders.

Amends the PHSA to increase funding for the brain initiative at the National Institute of Mental Health.

Transfers responsibility for the administration of community mental health block grants to the Assistant Secretary from the

Page 2 of 4H.R.3717 - 113th Congress (2013-2014): Helping Families in Mental Health Crisis Act of...

7/3/2014https://beta.congress.gov/bill/113th-congress/house-bill/3717

57

Director of the Center for Mental Health Services (CMHS).

Revises requirements for the funding agreement under a formula block grant to a state for community mental health services

to prescribe the general standard under state law for court ordered impatient or outpatient mental health treatment as well as

assisted outpatient treatment.

Requires the Assistant Secretary to evaluate the combined paperwork burden of certain community mental health centers as

well as of certified federally qualified community mental health clinics.

Directs the Secretary of Education, along with the Assistant Secretary, to organize a national awareness campaign to assist

secondary school students and postsecondary students in: (1) reducing the stigma associated with serious mental illness; (2)

understanding how to assist an individual demonstrating signs of a serious mental illness; and (3) understanding the

importance of seeking treatment from a physician, clinical psychologist, or licensed mental health professional when a student

believes the student may be suffering from a serious mental illness or behavioral health disorder.

Amends the PHSA to include as health care providers any behavioral and mental health professionals, substance abuse

professionals, psychiatric hospitals, certain community mental health centers (including one operated by a county behavioral

health agency), and residential o