Community Health Commission 2017 Meeting Dates

COMMUNITY HEALTH COMMISSION MEETING AGENDA Thursday, June 22, 2017 6:30 pm–9 pm South Berkeley Senior Center, 2939 Ellis St, Berkeley, CA 94703

Community Health Commission (CHC)

Preliminary Matters 1. Roll Call 2. Announcements & Introductions of any new members 3. Approval of Minutes from prior meetings (Attachment 1 & Attachment 2) 4. Confirm note taker 5. Public Comment (Speakers will have up to 5 minutes each)

Presentation Items 1. Health Officer Update: Update 2. Presenter: Steve Lustig, Ashby Village Age-Friendly Berkeley and Berkeley Age-Friendly Continuum-designed to address the needs of the aging population in Berkeley. (Attachment 3) 3. Work plan Progress: All (Attachment 4)

Discussion Items 1. Highlights of Public Health Programs from birth to 5 [Staff] (Attachment 5)

Action Items 1. Action: Chair appointments to subcommittees [Chen] 2. Action: Health Impact Assessment - Proposed Closure of Alta Bates Hospital [Katz] (Attachment 6)

Subcommittee Reports 1. Health Equity Subcommittee Report 2. Healthy Food Security Subcommittee Report 3. Public Outreach & Education Subcommittee Report 4. Other Subcommittee Reports

Break (schedule subcommittee meetings)

Information Items 1. Berkeley resident letter re: joining McGruder effort (Attachment 7)

Future Agenda Items 1. Berkeley Police Department to provide overview on police data [Franklin/Staff] 2. Presentation by Healthy Black Families 3. Continue discussion on Public Health priorities and alignment with Commission work plan

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/ Agenda – Community Health Commission 6/22/2017 Page 2 of 2

Adjournment

Attachments: 1. Draft minutes of 5/25/17 CHC meeting 2. Draft minutes of 4/27/17 CHC meeting 3. Briefing for Jesse Arreguin regarding Berkeley’s Age Friendly Projects – January 12, 2017 4. Community Health Commission work plan 5. Highlights of Public Health Programs from Birth to 5 6. Health Impact Assessment - Proposed Closure of Alta Bates Hospital 7. Berkeley resident letter re: joining McGruder 8. Community Health Commission subcommittee roster 2017 9. Community Health Commission Meeting Calendar 2017 10. City Council and Community Health Commission timelines 11. Athena Chin Op-ed article Daily Cal June 12, 2017

The next meeting of the Community Health Commission is scheduled for July 27th 2017, with a deadline of June 19th, 2017 for the public’s submission of agenda items and materials for the agenda packet. Dates are subject to change; please contact the Commission Secretary to confirm.

Please refrain from wearing scented products to this meeting.

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 981-6346 (V) or 981-6345 (TDD) at least three business days before the meeting date.

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 commission secretary for further information.

Any writings or documents provided to a majority of the Commission regarding any item on this agenda will be made available for public inspection at the North Berkeley Senior Center located at 1901 Hearst Avenue, during regular business hours. The Commission Agenda and Minutes may be viewed on the City of Berkeley website: http://www.cityofberkeley.info/commissions.

Attachment 1 Community Health Commission North Berkeley Senior Center, 1901 Hearst Ave, Berkeley, CA 94709

Community Health Commission

Draft Minutes Regular Meeting, Thursday May 25th, 2017

The meeting convened at 6:37 p.m. with Chair Wertman presiding.

ROLL CALL Present: Commissioners Engelman, Kesarwani (6:40), Morales, Speich, Stein, Carter, Smart, Wong, Teunis, Wertman, Franklin (6:41), Lingas, Chin, Chen, Brosgart (6:56), Wang and Katz.

Absent: None

Excused: None

Staff present: Kelly Wallace and Rebecca Day-Rodriguez

Community Members: None

COMMENTS FROM THE PUBLIC: None

PRESENTATIONS: None

ACTION ON ITEMS

1. M/S/C (Teunis/Chen) Motion to approve assigned commissioners to subcommittees. Commissioner Stein withdrew from the Acute Services subcommittee and assigned to Health Equity subcommittee.

Ayes: Commissioners Engelman, Kesarwani, Morales, Speich, Stein, Carter, Smart, Wong, Teunis, Wertman, Franklin, Lingas, Chin, Chen, Brosgart, Wang and Katz.

Noes: None

Abstain: None

Absent: None

Excused: None

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/ Attachment 1 Community Health Commission Minutes April 27, 2017 Page 2 of 2

Motion Passed.

ACTION ON ITEMS

1. M/S/C (Stein/Morales) Motion to approve assigned commissioners to subcommittees. Commissioner Speich assigned to Acute Services subcommittee.

Ayes: ` Commissioners Engelman, Kesarwani, Morales, Speich, Stein, Carter, Smart, Wong, Teunis, Wertman, Franklin, Lingas, Chin, Chen, Brosgart, Wang and Katz.

Noes: None

Abstain: None

Absent: None

Excused: None

Motion Passed.

NEXT MEETING The next regular meeting will be on June 25th, 2017, at 6:30 p.m. at the South Berkeley Senior Center.

This meeting was adjourned at 9:00 p.m.

Respectfully Submitted, Rebecca Day-Rodriguez, Secretary. Attachment 2 Community Health Commission North Berkeley Senior Center, 1901 Hearst Ave, Berkeley, CA 94709

Community Health Commission

Draft Minutes Regular Meeting, Thursday April 27th, 2017

The meeting convened at 7:12 p.m. with Chair Wertman presiding.

ROLL CALL Present: Commissioners Kesarwani (7:25), Speich, Stein, Carter, Morales, Brosgart, Wong, Wang, Wertman, Franklin, Lingas, Teunis, Nathan, Chin, Smart (8:05), and Katz.

Absent: None

Excused: Commissioner Engelman and Chen

Staff present: Kelly Wallace and Tanya Bustamante

Community Members: None

COMMENTS FROM THE PUBLIC: None

PRESENTATIONS: None

ACTION ON MINUTES 1. M/S/C (Lingas/Franklin) Motion to approve the draft March 2017 minutes with suggested edits.

Ayes: Commissioners Speich, Stein, Carter, Morales, Brosgart, Wong, Wang, Wertman, Franklin, Lingas, Teunis, Nathan, Chin and Katz.

Noes: None

Abstain: None

Absent: None

Excused: Commissioner Engelman and Chen

Motion Passed.

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/ Attachment 2 Community Health Commission Minutes April 27, 2017 Page 2 of 2

ACTION ON ITEMS

2. M/S/C (Nathan/Brosgart) Motion to approve the creation of ‘Enhancing Immigrant Health Access’ and ‘LGBTQ Health Equity’ subcommittees and make subcommittee appointments as directed.

Ayes: Commissioners Speich, Kesarwani, Smart, Stein, Carter, Morales, Brosgart, Wong, Wang, Wertman, Franklin, Lingas, Teunis, Nathan, Chin and Katz.

Noes: None

Abstain: None

Absent: None

Excused: Commissioner Engelman and Chen

Motion Passed.

NEXT MEETING The next regular meeting will be on May 25th, 2017, at 6:30 p.m. at the North Berkeley Senior Center.

This meeting was adjourned at 9:37 p.m.

Respectfully Submitted, Rebecca Day-Rodriguez, Secretary. Attachment 3

BERKELEY'S AGE-FRIENDLY PROJECTS

There are currently 2 projects in Berkeley focused on the older adult population, their needs and strategies to address them.

Background: By 2030, the older adult population of Berkeley, ages 65 and older, will be 26,519. In 2010‐2014, 23% of those 60+ in Berkeley were living under 200% of the Federal Poverty Level (22-33k, 1-2 people). From local surveys and community forums, the top concerns of older adults are:

In addition to enough money to live on.. Findings: (from questionnaires and community forums)  The ability to stay in Berkeley throughout the aging years;  Housing, housing, housing. Affordable housing, housing that older adults want to live in, housing that facilitates getting needed supports as people age, housing to stay in Berkeley;  In‐Home Supports that are identifiable, affordable and trustworthy;  Easy access to individualized information, linkages and navigational support;  Transportation;  Safety – Safe sidewalks, safety in their homes and in the community;  Social Connectedness, engagement and accessible activities; and  Access to healthy foods and prepared meals.

MISSION: To ensure implementation of an integrated continuum of supports and services for older adults and people with disabilities as they navigate the transitions of aging.

INITIAL GEOGRAPHIC AREA: Pilot the effort in the City of Berkeley, and expand to contiguous jurisdictions as the model and capacity develops.

Key Activities:  Engage and facilitate partnerships and collaborative work teams to address key needs via projects and advocacy;  Leverage existing and develop new resources to support an expanded and coordinated system of supports for aging in community;  Seek opportunities to educate, advocate and support aging in all policies;  Foster innovation in both service and technologies to support aging in the community. Document, evaluate and share findings about what works and doesn't work.

Attachment 3 BRIEFING FOR JESSE ARREGUIN REGARDING BERKELEY'S AGE FRIENDLY PROJECTS JANUARY 12, 2017

THE PROJECTS

Age Friendly Berkeley

Partners: The City of Berkeley , Lifelong Medical Care, The Center for Independent Living, Ashby Village

Funding: The Pilgrimage Foundation

Modeled After: WHO (The World Health Organization) Age-Friendly Cities and Communities. WHO requires cities assess themselves across 8 domains (see footnote1).

Affiliate: AARP is the North American affiliate that provides entry into the WHO network. Current status: Assessment and application completed; Berkeley has been accepted into both the AARP and WHO Network (see attached letter from Tom Bates, page 4)

Next steps:  Re-opening of the South Berkeley Senior Center will also be a time to announce our launch of the Age-Friendly Cities Project and induction into the WHO network.  A plan addressing priorities over the next 3 years is due November 17, 2017.  We will continue ongoing meetings with the Commission on Aging

Berkeley Age-Friendly Continuum: Summary of key activities and findings to- date

Goal: The goal of the Berkeley Continuum is to implement an integrated, replicable continuum of services and supports for older adults and people with disabilities as they navigate the transitions of aging.

Funding: Kaiser Permanente, Sutter Health/Alta Bates Summit Medical Center, City of Berkeley.

Planning Phase (July 2016 – April 2017) 1. Assess Need: Build on existing assessments to-date; conduct a comprehensive needs assessment to consider resources, gaps and partners/potential partners. 2. Plan: Define the Continuum in detail – with 10-year vision and 3-year objectives – so that it can be governed, financed, and implemented in stages. 3. Develop Support: Develop support and approval for Phase II (3 year) Implementation Plan.

1 Domain 1: Outdoor Spaces and Buildings; Domain 2: Transportation; Domain 3: Housing; Domain 4: Social Participation; Domain 5: Respect and Social Inclusion; Domain 6: Civic Participation and Employment; Domain 7: Communication and Information; Domain 8: Community and Health Services.

Attachment 3 BRIEFING FOR JESSE ARREGUIN REGARDING BERKELEY'S AGE FRIENDLY PROJECTS JANUARY 12, 2017

Status Update: In addition to the background research, the Continuum has conducted two formal planning sessions which has led to a first-draft of a 10-year “vision” for the services, supports, policies and activities needed to support an Age-Friendly Berkeley. The initiative is now defining next steps, projects, and activities needed in the first three years to move toward that vision.

Next Steps:  Testing start-up programs and activity ideas with key stakeholders (January)  Holding planning meeting on 2-3 Year start-up objectives and activities (January)  Articulating structure, finance and governance for both start-up and long-term (Feb-Mar)  Seeking funds for start-up activities (March-ongoing)  Finalizing grant report with needs assessment, long and short-term objectives and program plans, as well as fiscal and governance plans (April)

Berkeley Continuum Leadership Team:  Chair: Steve Lustig, Associate Vice Chancellor Emeritus, UC Berkeley; Ashby Village Board member  City of Berkeley: Jesse Arreguin, Mayor; represented by Paul Buddenagen  Andra Lichtenstein, Chair, Ashby Village Board; Principal, Capital Incubator  David Lindeman, Director, Center for Technology and Aging, UC Berkeley  Marty Lynch, CEO, Lifelong Medical Care  Kevin Gerber, President and CEO of Episcopal Senior Communities  Charlene Harrington, Professor Emeritus, UCSF School of Nursing, Principal of CalQualityCare  KJ Page Administrator, Chaparral House  Carla Woodworth, Co-Founder of California Advocates for Nursing Home Reform, former member of Berkeley City Council

Partners:  Ashby Village: Andy Gaines, Executive Director;  Community Benefits Program, Kaiser Permanente Northern California: Jean Nudelman, Director; Sutter Health /Alta Bates Summit Medical Center, East Bay Region: Chuck Prosper, CEO;  Alameda County Health Care Services Agency: Rebecca Gebhart, Acting Director;  Northern California Presbyterian Homes and Services: Janet Howley, Vice President;  Center for Independent Living, Inc. (CIL): Thomas Gregory, Deputy Director;  Center for Elders Independence (CEI): Lenore McDonald, CFRE, Director of Development;  Episcopal Senior Communities: Tracy Powell, Vice President Community Services;

Attachment 3 BRIEFING FOR JESSE ARREGUIN REGARDING BERKELEY'S AGE FRIENDLY PROJECTS JANUARY 12, 2017

 Center for the Advanced Study of Aging Services, UC Berkeley: Andrew Scharlach, Director;  J‐Sei: Diane Wong, Executive Director.

Potential Projects for Both Initiatives:

 Housing o expanding availability of affordable independent community living, o pilot models for more service-linked housing, o participate in efforts to move homeless seniors into housing, and o support stimulation of more subsidized housing at all levels of care  Re-Branding of Senior Centers and possible build-out of 6th St Senior Center  Working with local and county agencies to develop a more integrated system of services and supports that seniors can access as needed  A more robust and interactive Information and Referral (I&R) Website  Transportation  An Expanded Care Management Continuum “partnering” with major medical providers

NOTE: Ashby Village is managing the grants for both of these projects. The support letter from Tom Bates for Age Friendly Berkeley follows.

Attachment 3

August 23, 2016

Nancy McPherson, State Director AARP California 1415 L Street, Suite 960 Sacramento, CA 95814

Dear Ms. McPherson:

As Mayor of the city of Berkeley, I am writing to endorse Berkeley becoming a member in AARP’s Network of Age-Friendly Communities. I welcome AARP’s partnership and support as we move Berkeley into the World Health Organizations Global Network of Age-Friendly Cities and Communities.

I have been involved for many years in Berkeley’s efforts to create improved conditions for aging in place, and in working across our community to create a stronger network of support. While previously serving in the Assembly, I championed turning Redwood Gardens into senior living after the School of the Deaf closed. My efforts to secure funding for affordable housing developments for seniors continued once I became Mayor of Berkeley. One such example is the Mabel Howard Apartments, which were designed to have a health clinic on the ground level with senior housing on top.

Berkeley is already moving on multiple fronts toward becoming Age-Friendly. We have designed and gained initial funding to create and implement what we call the Berkeley Age-Friendly Continuum. The Continuum is a collaboration across aging resources and services and health plans that will provide an integrated and comprehensive approach to aging in community, with the goal of maximizing older adults’ independence and quality of life. We have secured $150,000 - of which the city of Berkeley contributed $25,000 to supply a local match, to conduct a 9-month research study, which includes an environmental scan and assessment of senior services. We are hoping to create a replicable city-wide model of linkages across all the types of resources and supports that older adults can connect to when needed. The Continuum will leverage existing resources and address key gaps as they become evident, such as transportation, housing and geriatric case management. The City of Berkeley also has a successful Aging Services Division, which supports the quality of life for seniors in Berkeley through meals on wheels, transportation services, senior center program offerings and overall compressive case management services.

In addition to being a community leader, I am an aging adult and I see the importance of this work on multiple levels. I am committed to Berkeley being an innovative leader in the field of aging with the help of the civically engaged older adults within our community. This city has a history of rallying together diverse cultures, communities and generations, along with nonprofits and businesses to fight for the common good of the citizens. Our rich and diverse population makes Berkeley a unique laboratory to move the needle of aging standards forward.

Our current efforts, and those of the past years, are timely and vital to me and my team as we create a healthier and flourishing city. We are excited to have this opportunity to join in AARP’s efforts.

Respectfully,

Tom Bates Mayor, City of Berkeley

Attachment 4 Attachment

Community Health Commission Work Plan 2017 Guiding Philosophy: To look at health through the lens of equity, and to address, ameliorate, and abolish health inequities in Berkeley through our work while advancing other public health efforts.

Mission/Purpose: 1. Collaborate with the community and the Berkeley Public Health Division, and City of Berkeley to eliminate health inequity by:

• Advocating for good policy to council that has the potential to improve the health of Berkeley residents that can be implemented, monitored, and evaluated. • Representing the community through the diversity of this commission • Increasing the public education/social marketing efforts, understanding, and awareness of issues • Advocating together with the residents of Berkeley most affected by institutional, social, organizational inequities/disparities • Providing a public forum for all community members to share concerns, ideas

2. Achieve general public health progress by being responsive to community needs and facilitating general health and safety.

Overall goals, issues & priorities: All issues can be addressed through a health equity lens.

1. Increase healthy food security 2. Advocate for the expansion of affordable housing 3. Continue to urge that Alta Bates Berkeley Medical Campus remain open while also helping to suggest actions to address consequences of planned closure 4. Be responsive in potential recommendations to help Berkeley residents, and care providers and clinics cope with the potential federal repeal of the Patient Protection and Affordable Care Act and other federal spending cuts 5. Further address more social determinants of health, such as by increasing parental support in the form of education and resource campaigns 6. Continue to be a community advocate to City Council to address structural, institutional, and health inequities impacting all minority groups 7. Work to have community health data measures documented in a timely manner and to promptly evaluate and act on novel data such as the Health Status Report

General steps and actions needed to meet priorities:

1. Better follow up with council implementations 2. Collaborate with other commissions to share resources and support recommendations 3. Focused/specialized ad-hoc subcommittees 4. Keep track of local, state, and federal policy and data flow Attachment 4

Specific steps and actions needed to meet priorities:

v Subcommittees o Acute Services for Berkeley ▪ Continue to recommend actions to keep Alta Bates open ▪ Consider ways to increase emergency care access in Berkeley

o Healthy Food Security § Identify food deserts § Connect communities with resources § Propose policies to mitigate unhealthy food consumption § Advocate for food surplus and food recovery donation systems § Change perception of tossing food & poor hygiene § Recommend private-public partnerships, i.e. ALL IN Alameda County

o Policy tracking § Track City Council minutes, state, and national legislative actions

o Health Equity Subcommittee § Continue work to get African-American resource center in South Berkeley § Identify and address social determinants of health that are close to, and also those that are less proximate to, causes of health inequities such as sources of structural and institutional inequity § Research and provide recommendations to increase affordable housing, expand parental support services, advocate for more marginalized groups such as, but not limited to Native Americans and other people of color, and utilize a holistic view to fight for the realization of health equity in Berkeley.

o Chronic Disease Prevention § Focus on recommendations to help address significant chronic diseases such as, but not limited to diabetes and cardiovascular/heart disease.

o Public Outreach and Education § Continue efforts to share health information and empower the community § Collaborate with community partners

o Ad-hoc subcommittees as needed to quickly address City Council referrals

v Liaisons to other commissions o Housing Advisory Commission o Homeless Commission o Zero Waste Commission o Mental Health Commission o Human Welfare and Community Action Commission o Community Environmental Advisory Commission o Sugar Sweetened Beverage Panel

Page 2 CHC Work Plan 2017 Attachment 5

Highlights of Public Health Birth to 5 Services June 22nd, 2017

1 Attachment 5

BE A STAR Berkeley Black Infant Health (BBIH) Program (Behavioral, Emotional, Assessment, Treatment and Referral) is a Public Health program that promotes Berkeley’s BIH program aims to improve birth developmental screening of children birth to 5 years of outcomes and reduce health disparities affecting age. Through partnerships with Help Me Grow- African American women and their babies. Through Alameda County, Berkeley Pediatric Health Care culturally affirming group education and complementary Providers, BUSD preschools, home visiting Public case management, the program works to empower Health Nurses and our Berkeley WIC program we are African-American mothers and their families, build attempting to screen all Berkeley infants and children social support, parenting and life skills, stress under the age of 5. The overarching goal of the management tools, promote healthy behaviors and program is to not only identify children who have relationships, support a healthy pregnancy, along with developmental delays and provide referrals to providing resource linkages to assist participants in services, but also to help parents feel the success of connecting with the community, social, and health when their child is developing typically and meeting services to meet their needs. milestones. By both engaging parents in the conversation around their child’s development and by identifying children who may need extra resources, we can better support parents in the important early childhood development years which helps their children to be better prepared to enter kindergarten.

2 Attachment 5

Child Health and Disability Prevention Program Childhood Lead Poisoning Prevention Program (CHDP) (CLPPP) CHDP improves health care access for Medi-Cal and The Childhood Lead Poisoning Prevention Program low-income children in Berkeley by providing outreach, offers free workshops for parents, medical and education, and linkages to regular, no cost, health childcare providers, and teachers with information on check-ups. CHDP pediatricians provide well-child lead screenings, products that contain lead, and how to check-ups that include immunizations, developmental prevent child lead exposure. CLPPP services include and dental assessments, physical exams, vision and education to parents of infants and young children, hearing screening, health education and appropriate medical providers, childcare providers and teachers on lab tests for infants, children and teens with Medi-Cal how to prevent lead poisoning, case management to or who meet other eligibility requirements, including families of children with lead poisoning. This includes undocumented children, low-income children with no coordination of medical care and testing, assessment other health insurance, children in foster care or in of nutrition status and child development, referrals to Head Start and state preschool programs. other services as needed, and referrals to environmental investigations of the home. CLPPP works in partnership with Alameda County’s Health Homes Department.

3 Attachment 5

Early and Periodic Screening, Diagnostic, and Healthy Berkeley Treatment Program (EPSDT) Initiated in 2015, this program stemmed from The EPSDT Program is a federally mandated program Berkeley’s historic passing of an excise tax (1 cent/oz.) that provides comprehensive and preventative health on the distribution of sugar-sweetened beverages care services for children under age 21 who are (SSB). The program goal is to reduce the consumption enrolled in Medi-Cal, with a focus on assuring that all of SSB as a pathway for decreasing the rates of Type 2 eligible children receive preventative health care diabetes, obesity, and tooth decay in Berkeley. The services. Public Health Nurses provide families with Healthy Berkeley program offers multi-year community intensive informing, assistance to overcome barriers, agency grants for programs designed to reduce SSB and follow-up to assure that children and adolescents consumption and promote healthy beverages such as receive appropriate preventative, dental, mental health, tap water in low-income communities, particularly and developmental services. children and youth targeted by the beverage industry; the Sugar-Sweetened Beverage Product Panel of Experts (SSBPPE) Commission makes agency funding recommendations to the City Council. The Healthy Berkeley program collaborates with the Bay Area Nutrition and Physical Activity Collaborative (BANPAC), Healthy Food America, University of California in Berkeley, and the Public Health Institute.

4 Attachment 5

Oral Health Program School-Linked Health Services Program The Oral Health Program provides free preventative School Linked Health Services (SLHS) works to treatments for elementary aged children in Berkeley enhance the capacity of the Public Health Division and (2nd and 5th grade) through the school-based the Berkeley Unified School District (BUSD) to provide program, increasing the number of children receiving health services to elementary aged youth and to fluoride, sealants and oral health screenings. The Oral facilitate collaboration among programs. This includes: Health Program provides coordination of follow-up for partnering to reduce barriers to learning and those children at highest risk such as those currently addressing health as a means to educational equity; uninsured or unconnected to a dental health provider continued capacity building for BUSD to address unmet but in need of care. The Alameda County Office of student health and safety needs; seeking opportunities Dental Health provides the dental screenings, dental for parent education and engagement; health sealants and preventative dental education. consultations; policy recommendations and strengthening coordination of Public Health Division programs working in schools. While SLHS primarily serves elementary aged youth, SLHS scope of services include BUSD K-8 youth and their families.

5 Attachment 5

Targeted Case Management Program (TCM): WIC TCM is a home visitation program that provides The Women, Infants & Children (WIC) Program comprehensive nursing case management service to provides free, for those who qualify, nutrition education; individuals and families across the lifespan, and assists food vouchers; breastfeeding support; and referrals for them in accessing medical, social, educational, and low-income, pregnant women and low-income children other needed services. The goal of the TCM program is under the age of five (5). The WIC Program offers to assure clients receive a continuum of health care, services in the following areas: food vouchers that can resources, information, and supportive services that be used to purchase foods high in protein, calcium, iron optimally benefit their health outcomes. and vitamin C, nutrition and breastfeeding education for pregnant women, nursing mothers and infants and children, individual nutrition counseling and general nutrition education, a breastfeeding component that includes breastfeeding peer counselors who educate and assist pregnant and breastfeeding women, as well as an electric pump loan program and breastfeeding classes. Referrals to doctors, dentists, family planning services, the California Department of Social Services, Public Health Nursing and other related resources.

6 Attachment 6

Date: July 25, 2017

To: Berkeley City Council

From: Community Health Commission

Subject: Health Impact Assessment of the Proposed Closure of Alta Bates

RECOMMENDATION

Adopt a Resolution supporting the preparation of a Health Impact Assessment, incorporating a proposed scope, and referring to the City Manager a request that the Public Health Division assist with (1) identification of matching funds for conducting the HIA, (2) contracting with the University of California, Berkeley, Alameda County, and/or another governmental entity or consultant(s) to conduct the Assessment, (3) access to data for researchers conducting the HIA, and (4) supporting educational opportunities for community members.

BACKGROUND

Alta Bates Summit Medical Center has been providing “full service” Acute Care hospital services in Berkeley, serving the East Bay I-80 corridor at the Herrick Campus since 1904, and at the Alta Bates Campus since 1905, and from their merger in 1984. Alta Bates’ Berkeley facility is crucial for providing timely health care services for residents of Berkeley and neighboring communities. In spite of this, Sutter Health Corporation has announced its intention to close Alta Bates’ Berkeley facility. Sutter has also closed the Cardiac Catheterization Unit and the Pulmonary Sub-Acute Unit at Alta Bates, requiring cardiac and stroke cases to be rerouted to further locations such as Summit.

Many hospital departments are often at capacity, and all of the local Emergency Departments reportedly have long delays in service. These delays will only be exacerbated by the merging of the two full-service Acute Care Hospitals, Alta Bates and Summit, to one Oakland location, increasing even further wait and admission times. The increased travel time to a more distant location raises questions about the potential for negative health outcomes, particularly for cardiac, stroke, and pulmonary patients. Further, when Berkeley’s first responders are mandated to travel to Summit Campus in Oakland, they may take longer to respond to subsequent emergencies in Berkeley, raising questions about the impact that the closure of Alta Bates may have on public safety.

FINANCIAL IMPLICATIONS Short-term costs to conduct the Assessment. Long-term savings to the Police, Fire, and Health, Housing, Community Services Departments.

ENVIRONMENTAL SUSTAINABILITY Consistent with Berkeley’s Environmental Sustainability Goals and no negative impact.

CONTACT PERSON - Andy Katz, Community Health Commission, 510-465-4400 1

Attachment 6

RESOLUTION

WHEREAS, The Berkeley City Council has previously adopted a resolution in opposition to the proposed closure of Alta Bates Medical Center, and

WHEREAS, The closure of Alta Bates Medical Center is expected to have serious impacts on the health of Berkeley and East Bay residents, and

WHEREAS, The health impacts likely include delay of care for emergency medicine events, impacting patient health outcomes for cardiac and stroke, pulmonary, obstetrics, psychiatric, alcohol and drug poisoning, and trauma emergencies, and

WHEREAS, The health impacts likely include impacts to safe hospital operations, including hospital acquired infections, inpatient bed capacity, and

WHEREAS, The health impacts likely include impacts to community access to primary and specialty care, reduction in services for safety-net and special needs populations, and

WHEREAS, The health impacts likely include impacts to first responder operations and heightened risk in a disaster event, and

WHEREAS, A Health Impact Assessment is an analysis and community education tool for the community to learn about the health impacts and participate in actions affecting public health, and

WHEREAS, The Berkeley Mayor’s Office has identified faculty at the U.C. Berkeley School of Public Health to conduct a Health Impact Assessment, and

WHEREAS, The Community Health Commission has proposed a Scope of a Health Impact Assessment of the proposed closure of Alta Bates Medical Center,

NOW THEREFORE BE IT

RESOLVED, that a Health Impact Assessment (HIA) should be conducted regarding the proposed closure of the Alta Bates Medical Center, including the scope recommended by the Community Health Commission, and be it

RESOLVED, that the City Council refers to the City Manager a request that the Public Health Division assist with (1) identification of matching funds for conducting the HIA, (2) contracting with the University of California, Berkeley, Alameda County, and/or another governmental entity or consultant(s) to conduct the HIA, (3) access to data for researchers conducting the HIA, and (4) educational opportunities for community members.

Attachment 6

Proposed Scope Health Impact Assessment of the Proposed Closure of Alta Bates

I. Overview

The Health Impact Assessment (HIA) should seek to identify qualitatively and to the extent feasible, quantitatively, all impacts to community health from the closure of the Alta Bates Medical Center in Berkeley, including, but not limited to looking back prior to the recent closure of the Cardiac Catheterization unit, Stroke unit, Cancer unit, and Pulmonary Sub-Acute unit, and taking into account the needs resulting from the closure of Doctor’s Medical Center in San Pablo. This proposed scope is intended to guide public health, emergency medicine, and epidemiological experts in identifying potential impacts of concern and supporting medical and epidemiological research, but not to limit identification of new impacts and primary research studies for review. Indeed, a HIA is also in the context of a population-based needs assessment, to fully assess long-term community health needs. The research team and community participants should reflect diversity in the community, and consider specialized populations that would be disproportionately impacted.

II. Emergency Medicine Impacts

The HIA should apply a review of the literature to Berkeley’s projected population to assess and quantify possible increases in loss of life and adverse prognosis from a range of emergency conditions. Research in emergency medicine epidemiology has identified quantifiable health impacts associated with hospital closures. For example, one study examined the association of hospital closures with inpatient mortality rates at nearby hospitals, finding that hospital admissions impacted by a closure had 5 percent higher odds of mortality, with the overall risk increased by 10% for seniors and 15% for heart attack and stroke patients.1 The HIA should utilize Geographic Information System (GIS) analysis to calculate increased travel time for patients from West Contra Costa County through Berkeley and the I-80 corridor, taking into account expected population growth and aging trends, similarly to a study commissioned by then-Public Advocate Bill de Blasio in New York City.2 The HIA would then expand on the distance and travel time data by estimating prevalence of projected health impacts based on the epidemiological literature. Medical care needs of U.C. Berkeley students and employees should also be considered.

A. Cardiac and Stroke

Medical journals report an association between Emergency Department closure and health outcomes among patients impacted by a cardiac emergency.3 One study found

1 Liu, Charles, Srebotnjak, T and Hsia, R (2014), California Emergency Department Closures Are Associated With Increased Inpatient Mortality At Nearby Hospitals. Health Affairs, vol. 33 no. 8 1323- 2 Distance Matters: What Losing Two Hospitals Would Mean for Brooklyn, July 2013. 3 Shen, Yu-Chu, Hsia, R. (2016), Circulation, Association Between Emergency Department Closure and Treatment, Access, and Health Outcomes Among Patients With Acute Myocardial Infarction,134:1595- 1597. 3

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that the increased odds ratio for increased inpatient mortality for stroke cases to increase by 3 to 22 percent, depending on the increased distance.4 Another study similarly found that on average, a minute increase in response times increases mortality by between 8 to 17 percent, depending on how long after the initial incident mortality is measured.5 A British study found an increased odds of mortality ratio of 2 percent per kilometer (.6 mi).6 Another study found a 6.5 percent increase in deaths from a 1 mile increase in travel distance in the Los Angeles area.7 Yet another study finds an association between ambulance diversion and survival.8 The Cardiac Catheterization and Stroke units were recently closed prior to review by the City of Berkeley. The HIA should review long-term projected impacts of the closure compared to the baseline of full-service operation of Alta Bates.

B. Pulmonary Emergencies

One California study found an “odds ratio” of increased inpatient mortality for asthma/chronic obstructive pulmonary disease (COPD) cases to increase by 9 percent for patients with just a 2 mile or less increase in travel distance, and a 4 percent increase for increases of 2 to 5 miles. A study reported an increase in mortality of 7 percent for each 10-minute increase in travel time for asthma/COPD cases.9 The Pulmonary Sub-Acute unit was recently closed prior to review by the City of Berkeley. The HIA should review long-term projected impacts of the closure compared to the baseline of full-service operation of the Alta Bates pulmonary medicine unit.

C. Obstetric Care

Alta Bates is an important site for birth deliveries. Transfer of maternity and NICU services could pose serious health risks, particularly for individuals without access to ambulatory care from West Contra Costa County. A study found a relationship between travel time increases greater than 20 minutes and total mortality (17%), neonatal mortality (51%), and adverse outcomes (27%).10

D. Psychiatric Emergencies

4 Hsia, Renee. (2012), Is Emergency Department Closure Resulting in Increased Distance to the Nearest Emergency Department Associated with Increased Inpatient Mortality? Ann Emerg Med. 2012;60:707-715. 5 Wilde, E. (2009) Do Emergency Medical System Response Times Matter for Health Outcomes. Columbia University. 6 Nicholl, J., West, J., Goodacre, S., & Turner, J. (2007). The relationship between distance to hospital and patient mortality in emergencies: an observational study. Emergency Medicine Journal : EMJ, 24(9), 665– 668. 7 Thomas C. Buchmueller, (2006) How far to the hospital? The effect of hospital closures on access to care. Journal of Health Economics 25:740–761 8 Shen, Yu-Chu, Hsia, R. (2011), Association Between Ambulance Diversion and Survival Among Patients With Acute Myocardial Infarction, Journal of the American Medical Association, 305(23):2440-2447. 9 Jones AP, Bentham G, Horwell C. Health service accessibility and deaths from asthma. Int J Epidemiol. 1999 Feb;28(1):101-5. 10 Ravelli A, Jager K, de Groot M, Erwich J, Rijninks-van Driel G, Tromp M, Eskes M, Abu-Hanna A, Mol B. Travel time from hometo hospital and adverse perinatal outcomes in women at term in the Netherlands. BJOG 2011;118:457–465. 4

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Hospital admissions may be medically necessary to address psychiatric emergencies. The HIA should consider whether geographic access could worsen patient outcomes, and analyze potential impacts on the County’s health care system.

E. Alcohol and Drug Poisoning

The HIA should consider the issues associated with timeliness of care and intervention in alcohol and drug poisoning cases. An important integrative issue is the risk of avoidance of accessing acute care services outside of Berkeley due to significantly longer travel distance, particularly for the U.C. Berkeley campus community.

F. Trauma

Most severe trauma cases are routed to highly specialized services at Alameda County Medical Center in Oakland. The HIA should evaluate what types of trauma cases are treated at Alta Bates, and how treatment at Summit may negatively impact patients.11 A surge in critical care is particularly expected in disaster events.

III. Safe Hospital Operations

A. Hospital Acquired Infections

The HIA should examine the effects of closure on patient safety and health. There is growing evidence that bed occupancy rates, overcrowding, and understaffing influence the spread of hospital-acquired infections.12

B. Inpatient Bed Capacity

The consolidation of staffed beds resulting from the closure should additionally be evaluated for adequacy of capacity in reference to standards for the amount of regular patient, ICU, and NICU beds required to serve our current and projected population’s medical needs. The HIA should also comment on the health risks of overcrowding in a consolidated facility.13

IV. Community Access to Primary and Specialty Care

Research has identified an association between patient travel distance and advancement of cancer disease stages,14 and a relationship between travel time and

11 Crandall M, Sharp D,Wei X,et al. (2016) Effects of closure of an urban level I hospitals and local injury mortality: a retrospective, observational study. BMJ Open. 12 Kaier, K., Mutters, N. T. and Frank, U. (2012), Bed occupancy rates and hospital-acquired infections— should beds be kept empty?. Clinical Microbiology and Infection, 18: 941–945. 13 George, F, Evridiki, K (2015), The Effect of Emergency Department Crowding on Patient Outcomes. Health Science Journal, Vol. 9 No. 1:6. 14 Massarweh NN, Chiang Y-J, Xing Y, et al. Association Between Travel Distance and Metastatic Disease at Diagnosis Among Patients With Colon Cancer. Journal of Clinical Oncology. 2014;32(9):942-948. 5

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mortality and quality of life for dialysis treatment.15 These examples may indicate similar relationships for other non-emergency care needs. Closure of the cancer unit should be evaluated from the perspective of pre-closure baseline operations. A survey of low-income people in urban areas found a connection between the struggle to access reliable transportation with missed appointments and poor illness management.16, 17 Hospital visits are an opportunity for a “teachable moment” to counsel patients on healthy behaviors, such as tobacco cessation, a nutritious diet and exercise, in order to lessen the risk of developing a chronic health condition. . The HIA should evaluate how removal of a hospital institution from a community could impact community health education for chronic disease prevention.

V. Safety-Net Services

Alta Bates is an important service provider of health services for populations without access to other options for care. Service delivery and coordination for mental health and homeless patients are of particular concern. The HIA should review how underserved populations depend on services at Alta Bates, and evaluate the impacts of the loss of these services.

VI. First-Responder Operations and Disaster Considerations

A 6.7 magnitude earthquake is more than 70 percent likely on the Hayward fault by 2042. Public health officials have warned of increasing pandemic risk. There is no burn unit in the East Bay. The Berkeley hills are susceptible to landslides and fires. A major attack could impact community infrastructure or limit travel between communities. These examples of disaster conditions would likely exacerbate travel time impacts, and hospital capacity concerns. The HIA should identify medical care surge needs, including critical care beds, and consider the implications of a major disaster. The HIA should consider plausible, but precautionary, disaster scenarios that model how acute care facilities would accommodate emergency needs during such a stress test. The HIA should identify and compare the stress on City of Berkeley first responders by comparing (A) baseline conditions, (B) baseline conditions in a disaster, (C) closure conditions, and (D) closure conditions in a disaster. The emergency impacts on first responder operations, mortality and disease risk projections could be evaluated through these disaster scenario models.

15 Moist, Louise, (2008) Travel Time to Dialysis as a Predictor of Health-Related Quality of Life, Adherence, and Mortality: The Dialysis Outcomes and Practice Patterns Study American Journal of Kidney Diseases 51(4):641-50. 16 Cronk, Imran, Transportation Barrier, The Atlantic, August 9, 2015; 17 Syed ST, Gerber BS, Sharp LK. Traveling Towards Disease: Transportation Barriers to Health Care Access. Journal of community health. 2013;38(5):976-993. 6

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To: The Berkeley City Council and Community Health Commission June 15, 2017 City Hall 2180 Milvia Berkeley, CA 94704

Dear Berkeley City Council,

Oakland, San Francisco, and Contra Costa County are considering restricting the sale of flavored tobacco products, and the City of Berkeley has an important opportunity to join them.

Flavored tobacco products are the main gateway for youth experimentation with addictive tobacco products as tobacco industry marketing makes clear. Carol McGruder, the co-chair of the African American Leadership Council, published this excellent open forum piece on the issue below, which I hope you will take the time to read.

Our city benefits from being among the cities showing leadership helping clear the air and saving the next generation from a lifetime of addition.

Thank you,

Carol Denney 1970 San Pablo Avenue #4 Berkeley, CA 94702 510-548-1512 Attachment 8

Subcommittees Enhancing Acute Public Healthy Chronic Immigrant LGBT Services for Health Outreach & Food Policy Disease Health Health District Last First Berkeley Equity Education Security Tracking Prevention Access Equity 1 Engelman Alina X X 1 Rashi Kesarwani X 2 Morales Mary Lynn X X X X 2 Speich Pamela X X X 3 Stein Antoinette X X X X 3 Carter Donna X 4 Smart Karma X X 4 Wong Marilyn X X 5 Teunis Niels X X X 5 Wertman Holly X X X 6 Franklin Linda X X X 6 Lingas Elena X 7 Nathan Neal X Chi Wen 7 Chin (Athena) X X X 8 Chen Leona X 8 Brosgart Carol L X M Wang L. Victoria X X M Katz Andy X X X 9 6 4 6 4 4 4 3 Attachmetn 9 Community Health Commission 2017 Meeting Dates

Community Health Commission (CHC)

Month Meeting Day and Date Time January 2017 Thursday, January 26, 2017 6:30 pm

February 2017 Thursday, February 23, 2017 6:30 pm

March 2017 Thursday, March 23, 2017 6:30 pm

April 2017 Thursday, April 27, 2017 6:30 pm

May 2017 Thursday, May 25, 2017 6:30 pm

June 2017 Thursday, June 22, 2017 6:30 pm

July 2017 Thursday, July 27, 2017 6:30 pm

August 2017 The CHC does not meet in August

September 2017 Thursday, September 28, 2017 6:30 pm

October 2017 Thursday, October 26, 2017 6:30 pm

November 2017 Thursday, November 16, 2017 6:30 pm Meeting in November is scheduled on the 3rd Thursday due to the Thanksgiving Holiday

December 2017 The CHC does not meet in December

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/ Attachment 10

Community Health Commission

CHC AGENDA ITEM SUBMISSION TIMELINE FOR 2017

Agenda Items Secretary Secretary due to Reviews Final submits agenda CHC Meeting Date Commission Agenda with for posting - (Thursdays) Secretary – Health Officer - Friday Wednesday Thursday Wed 1/18 Thurs 1/19 Fri 1/20 January 26, 2017 by Noon by 4 pm by 10am Wed 2/15 Thurs 2/16 Fri 2/17 February 23, 2017 by Noon by 4 pm by 10am Wed 3/15 Thurs 3/16 Fri 3/17 March 23, 2017 by Noon by 4 pm by 10am Wed 4/19 Thurs 4/20 Fri 4/21 April 27, 2017 by Noon by 4 pm by 10am Wed 5/17 Thurs 5/18 Fri 5/19 May 25, 2017 by Noon by 4 pm by 10am Wed 6/14 Thurs 6/15 Fri 6/16 June 22, 2017 by Noon by 4 pm by 10am Wed 7/19 Thurs 7/18 Fri 7/17 July 27, 2017 by Noon by 4 pm by 10am Wed 9/20 Thurs 9/21 Fri 9/22 September 28, 2017 by Noon by 4 pm by 10am Wed 10/18 Thurs 10/19 Fri 10/20 October 26, 2017 by Noon by 4 pm by 10am Wed 11/8 Thurs 11/9 Fri 11/10 *November 16, 2017 by Noon by 4 pm by 10am

*Meeting in November is scheduled on the 3rd Thursday due to the Thanksgiving Holiday

Attachment 10

Community Health Commission

COUNCIL ITEM SUBMISSION TIMELINE FOR 2017

Council Commission needs Reports Due to Commission Items Meeting Date to take action by Dept. Director City Council Winter Recess (December 14, 2016 to January 23, 2017 24-Jan 11/24 12/1 31-Jan 12/1 12/8 14-Feb 12/15 12/22 28-Feb 12/29 1/5 14-Mar 1/12 1/19 28-Mar 1/26 2/2 4-Apr 2/2 2/9 City Council Spring Recess (April 4 to April 24, 2017 25-Apr 2/24 3/2 2-May 3/2 3/9 16-May 3/16 3/23 30-May 3/30 4/6 13-Jun 4/13 4/20 27-Jun 4/27 5/4 11-Jul 5/11 5/18 25-Jul 5/25 6/1 City Council Summer Recess (July 26 to September 11, 2017 12-Sep 7/13 7/20 26-Sep 7/27 8/3 3-Oct 8/3 8/10 17-Oct 8/17 8/24 31-Oct 8/31 9/7 14-Nov 9/14 9/21 28-Nov 9/28 10/5 5-Dec 10/5 10/12 12-Dec 10/12 10/19

6/14/2017 More than 75 percent of some Berkeley High School demographic groups report mental health needs | The Daily Californian Attachment 11

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OPEDS MONDAY, JUNE 12, 2017 More than 75 percent of some Berkeley High School demographic groups report mental health needs HIDE

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