Alameda County staff outline Measure C plan to direct $6M a year to pediatric safety net, supervisors press for details

Alameda County health staff presented a recommended spending plan July 28 for the pediatric portion of Measure Cs safety-net fund, proposing to program an annual base of about $6 million and to draw on roughly $31 million in accrued revenues to support juvenile justice health services, school-based vaccination and school health center programs, violence-prevention work and a one-time $4 million renovation at Saint Rose Birthing Center.

The presenter, a county health official, said the Measure C half-cent sales tax (approved by voters in March 2020) is estimated to generate roughly $150 million a year across its accounts; the pediatric health account is projected at about $30 million annually, of which the countys safety-net share equals approximately $6 million per year. Staff recommended a three-year funding cycle, a prudent reserve (roughly 10 percent, leaving an estimated reserve of about $13.7 million under the current plan) and that most strategies leverage existing county programs and contracts with community-based organizations.

Why it matters: Staff and public commenters warned that pending state and federal changes to Medi-Cal eligibility and reimbursement could raise uncompensated-care costs and increase demand on county clinics and federally qualified health centers (FQHCs). County and community speakers said predictable county funding is critical to sustain school-based clinics and CBOs that serve priority populations such as immigrant youth, LGBTQIA youth, foster youth and youth experiencing homelessness.

What staff proposed and questioned from supervisors: The plan packages several priority strategies over three years: a mandated expansion of health services at the Juvenile Justice Center ($11.4 million over three years funded from the base allocation); school-based vaccine programs ($4.38 million over three years); a $1 million annual allocation to school health centers ($3 million total over three years); a $4.44 million three-year violence-prevention allocation; a competitive adolescent health grant program to fund CBOs; family supports including Help Me Grow; and a one-time $4 million capital allocation to remodel the Saint Rose birthing center to preserve local obstetric capacity.

Supervisors pressed staff on implementation details. One committee member asked whether the school health center funds (28 county sites) would be divided equally or by service level and whether local CBOs such as REACH and Youth Uprising would be eligible for direct allocations. Staff said distribution rules are not finalized and that some funds would flow through the countys Healthy Schools and Communities division and competitive RFPs, and agreed to return with more granular implementation plans.

Community health center warnings and county response: Mia Cooper Khan of the Alameda Health Consortium told the committee, “Of the 28 school based health centers in Alameda County, 23 are provided by FQHCs,” and urged the county to consider federal and state policy impacts in the spending plan. Tu Quach of Asian Health Services and Estefanie Urbina of Augusto Vasquez Health Center similarly warned that proposed Medi-Cal eligibility and reimbursement changes could force clinics to absorb millions in uncompensated care.

County staff acknowledged those risks. A county official summarized a social-services estimate that "up to 250,000 Alameda County residents could lose Medicaid coverage" with proposed work requirements, and said staff were attempting to design the safety-net investments to anticipate systemwide disruptions.

Requests for follow-up: Committee members asked for detailed metrics and breakdownson how funds would be allocated across sites and programs, the list of CBOs expected to receive grants or contracts, the violence-prevention interventions to be supported (staff noted roughly 60 percent staffing and 40 percent direct services in the violence-prevention budget), and how RFP timing would align with program sunsets. One supervisor said the 40 percent allocation to direct services in the violence-prevention bucket "seems very low" and asked for a committee-level follow-up.

Next steps: Staff said the presentation was informational and proposed returning to the Health Committee on Sept. 8 with more implementation detail and, if appropriate, a recommendation to place the plan before the full Board on Sept. 9. The committee agreed to request an expanded follow-up with specific program budgets, metrics, and a clearer explanation of distribution rules.

No formal committee vote occurred on July 28; staff will return with a more detailed implementation plan for committee review before any board action.