Health Committee recommends one‑year Measure A allocations, holds detailed reauthorization for later

County finance staff told the Health Committee on Dec. 9 that current Measure A base allocations exceed conservative revenue forecasts and recommended setting a one‑year base allocation of $49,660,000 for FY25‑26 while the county completes additional planning.

Crystal Acasio, Alameda County Health’s financial services director, and James Wynne, the agency’s administrative and financial services manager, told supervisors that Measure A (a half‑cent sales tax passed in 2004 and extended under Measure AA to 2034) historically directed 75% of revenue to Alameda Health System and 25% for board allocations. Their revenue forecast—based on HDL consultants’ statewide sales tax projections—showed only modest statewide sales tax growth, so current budgeted allocations exceed likely receipts, staff said.

“The current level of $52,160,000 is not sustainable,” Acasio said, explaining the recommended reduction to $49.66 million and a plan to backfill one‑time adjustments through the agency’s MOE budget process where possible.

On the Tobacco Master Settlement Fund (TMSF), staff recommended maintaining the current annual $8 million allocation and consolidating some school‑health program line items to increase flexibility for the Healthy Schools and Communities program.

Supervisors pressed staff on reserves and the implications of securitizing tobacco settlement revenues in the past. Wynne said the county securitized TMSF proceeds in the late 1990s, producing a consistent annual ($8 million) general‑fund benefit, and that staff can supply further analysis of whether securitization produced a net financial benefit compared with year‑to‑year receipts.

Committee members also asked for detail on the Measure A reserve balance and how excess receipts are handled. Staff said the county is preserving a target 10% operating reserve (about $5.2 million on the proposed base allocation) and that any receipts above the base allocation roll into the fund balance and reserves or are used for one‑time allocations; staff will return with confirmation of final fund balances.

Supervisors also raised program‑level questions: whether specific programs (notably Recipe for Health) could be partially supported from other county funds or braided across funding streams. Staff said CPAG and contract‑review processes will be used to investigate braided funding options and will follow up with program‑specific financial analysis.

The committee advanced staff’s one‑year allocation recommendation and the proposed TMSF approach to the full board. Staff said they plan to present a board letter in January requesting formal reauthorization for the first year and returning later with recommendations for years two and three after additional systemwide planning.

What’s next: Staff will provide audited fund balances and program‑specific gap analyses and return to the board in January for formal action on the one‑year Measure A allocations.