 Well, good evening, everybody, welcome to our 6.30pm session of the June 4, 2019 special meeting of the Santa Cruz City Council. I would like to ask our clerk to please call the roll. Thank you, Mayor, Council Member, it's Crone, is absent tonight. Glover? Here. Meyers? Here. Brown? Here. Matthews? Here. Vice Mayor Cummings? Here. And Mayor Watkins? Here. So I have a few announcements, and then we'll move on to our presentation. So tonight's meeting is being broadcast live on Community Television Channel 25 and is streaming on our city's website at cityofsantacruise.com. The City Council will hear information about the health and all policies concept, the framework, and the impacts on our greater community. Following our presentation, there will be an opportunity for public comment, and then we'll have an opportunity for council direction. And I'm sorry, discussion, there will be actually no council action taken this evening. So at this point, we'll go ahead and jump right in, and I know we have a number of guests here. I will allow our staff to help introduce those guests, but I just want to thank those who are in the audience who are able to attend from all parts of our community and region for being here this evening. So shall I jump right in, or are we going to have our folks come up? Introducing it. Sure, that'd be great. We have Casey, maybe if you want to introduce the folks, and then I'll go ahead and do the opening. Sure. We're very fortunate today to have some experts joining us, some from outside the city and some from within. We're going to start with Tina Yin from Change Labs. She'll be giving us an overview and background on health and all policies, helping you all to get an understanding of what they are. And then following that, we're going to hear about what it looks like from some of our neighboring jurisdictions, including Corinne Highland from the county, right here. And then some of our colleagues from Monterey County, Elsa Jimenez and Carmen Gil Hernandez, I think right here. And then we're joined also by the city manager of Gonzales, Renee Mendeth. And then from here within the city, talking about some of the efforts we're making that are already touching on the three pillars of health and all policies, sustainability, equity and public health. We'll have our climate action plan leader, Tiffany Wise-West, Beth Toby, our arts advisor from Economic Development, talking about equity. Laura Landry from the Planning Department talking about some of their work and how it touches on public health and also equity. And then I'll be talking about some of the work we've done on public health too. So, thank you. Thank you, Casey. Okay, so maybe we can go to the next slide. Do we have this slide? Oh, you have the clicker? Okay, perfect. Okay, so just briefly, we'll bring everybody up to speed on some of our goals this evening. So the first is to recognize the existing ways we are already working with the three tenants of community well-being. As mentioned by Casey, those include public health, those include sustainability and equity. We're going to gain the support and active participation of the community in advancing equitable community well-being. Look for what defining success looks like and the metrics necessary to track progress towards success. And ensure the ad hoc subcommittee process and recommendations add value to our organization and department directors. So the anticipated outcome, as you can see, is to report with recommendations for the health and all policies policy and implementation plan. This is just a real sort of short overview of the timeline in regards to where we are. If you can see on that sort of the timeline trajectory, March 26 is when our city council approved the health and all policies work plan. Fast forward to where we are today. First study session and intermittent, you'll see there are various opportunities where the subcommittee will meet. Provide updates to the council, as well as look at further defining our scope, how we plan to work with our community in outreach, looking at the implementation plan. And then next steps in terms of recommendations to the full council later in December. And so as Casey mentioned, we have a wonderful group of folks who came from the Bay Area and from Monterey County and everywhere in between to share with us more about how this is actually playing out in their community. And what some of the real experts sort of approaches have been in other jurisdictions. I am particularly just thrilled to be at this place to have an opportunity to learn about this. And I really feel personally that this aligns with a lot of our community's values. And allows for us as policy makers to look at some of the structural and social determinants of health and our approaches in policy decision making and all that we do. I also recognize there's so many things as Casey mentioned before that our city is already doing. So how do we enhance those, potentially just name them and incorporate them as we move forward. So with that, I'll go ahead and ask for our staff or whoever is going to take it from here to keep us moving. Now we're going to have Tina join us from Change Labs to talk about what health and all policies are. Thank you and good evening council members. I'm so excited to be here today and thank you so much for inviting me to speak in front of you. So hello, I'm Tina Yuen as Casey mentioned. I'm a senior planner at an organization called Change Labs Solutions. And I just want to let you know that I have a background in health and planning. And I lead our organization's transportation work and I also work with a lot of communities across the country, across a wide array of topics, including the topic that we're talking about this evening and that's health and all policies. So for this presentation this evening, I'm going to be covering these three topics. One is what is health and all policies? How does it work? What are the core components of health and all policies and why it's needed and what it can accomplish? And just to give you a little bit of background about the organization that I come from. Again, our organization is Change Labs Solutions. We're a national nonprofit based in Oakland, California. Our mission is healthier communities for all through equitable laws and policies. And we work at the intersection of a whole host of topic areas regarding law and policy, including health in the built environment, housing, transportation, tobacco prevention, and control health care, child care, schools, and education. And of course, how to improve how governments can work together to achieve community goals. And I just wanted to mention really quickly that at Change Lab Solutions, we have a number of resources that do touch on health and all policies. And I just wanted to point them to you if you ever are curious and want to check them out, you can get them all free and online from our website. So we have two guides from start to finish, how to permanently improve government through health and all policies, and then the roadmap for health and all policies collaborating to win the policy marathon. And we also have a number of model laws and policies that you can download and modify to fit your own local context or any government, local government can use to fit their own local context. Using the language that can be included in a general plan in a local ordinance or a local resolution. However, you see fit and see how that could apply to your local context. I also just want to quickly mention that there is a pretty awesome seminal guide to health and all policies that was written by one of our partners at the State Health and All Policies Task Force, and it's up there on the screen there. It's also something you can download and get for free if you're interested in delving in deeper. And it is specifically geared towards state and local governments as well. So just jumping in, what is health on all policies? I'm going to tell you a little bit about the why, the what, and the how. But before I go any further, I did want to talk to you all about what I mean when I say health. And when I talk about health, I use the World Health Organization's definition of health, which they define as the state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. And I think this is really important because it's a pretty broad definition of health. It's not just physical and mental health. It's also this aspect of thinking about our social and emotional well-being and encompasses aspects of equity and sustainability. And it's this idea of well-being that I think I really wanted to hammer home here. So that's what I really mean when I talk about health. It's about health and well-being and community cohesion. So what is health on all policies or high up? It is defined here as a collaborative approach to improving health of all people by incorporating health considerations into decision making across sectors and policy areas. So I just wanted to break this definition down a little bit for you all. I think first it's really important to talk about how this is really a collaborative approach to government and to problem solving overall. As you all know that the present day problems that communities face are really complex. They're difficult to kind of solve and they really require a multi-sector approach to addressing. And that no one sector can really solve these problems alone. It really is a hands-on all-deck kind of approach to really address some of these really difficult and entrenched problems. It's also about health and of course health is well-being and well-being of all people. The consideration of health as a desired outcome. And so why focus on health and why focus on community well-being? I think first and foremost health is something that everyone has, right? It's something that we all experience is all something we can relate to. It can also humanize the issue and it ultimately our health reflects our quality of life and the quality of our neighborhoods and of where we live, work, and play. And health and well-being outcomes as we'll talk about a little bit later can be measured and tracked over time. So it's something that we can monitor and evaluate and we can see if we're actually making progress. And it's also about decision-making and how government operates and how it works across sectors and policy areas. Ultimately this is about how government agencies work together and incorporate the consideration of health and well-being so that our government makes better decisions and can improve the lives and outcomes of all people. And I just wanted to add that health and all policies there isn't one way it can look. I think different communities approach what health and all policies look looks like. And so I don't I don't want to convey that there is a one-size-fits-all kind of approach to this. I think it can be it can be very much tailored and contextual depending on what you all want to achieve here and what you all think is best for this community. I did want to go over the five key elements of health and all policies and they're listed up here on the screen for you. I think one is that health and all policies fosters equity and sustainability in addition to health. It supports that collaboration, that cross-sector dialogue, especially among agencies and staff that have traditionally been siloed. A lot of our government processes are very much inside these siloed departments and offices so it's really about breaking down those silos in order to work together. It benefits multiple partners so in health and all policies there's this idea of co-benefits of win-wins that is not just about one person or one agency's agenda, it's about creating a collaborative opportunity where multiple partners can achieve their goals collectively. It's also about engaging different stakeholders that would be impacted by the decision at hand and ultimately it's about creating institutional changes to how decisions are made and how government operates by creating structural and process changes. So I wanted to go over as well as some core components of health and all policies. So there are three I would say basic core components of health and all policies that we've identified through some of our research that we've done across the country on health and all policies and how different jurisdictions have implemented health and all policies. I think it's about ongoing commitment to collaborate again across government. It's not just, it also requires a commitment of not just city agency and staff but also of government leadership and a willingness to put health and all policy on the agenda and resources behind it. It's also about advancing specific government projects, programs and policies that enhance public health which can also include community safety and security. And again it's about creating permanent changes and how agencies relate to each other and how government decisions are made, structures for intersectoral collaboration and mechanisms to ensure a health lens in decision making processes. And I also just want to add that a lot of health and all policy initiatives across the country do employ backbone staff to kind of operationalize health and all policies. And what I mean by that is that there's often a task force across government task force that's brought together and that there are usually staff members that staff the health and all policies task force that really help to drive the agenda and make sure that work moves forward. So that backbone piece is really important. I think that's where the staffing and resource needs can be thought about. I also did want to mention that there are, as I mentioned, models out there that are policies, governance policies that embed health and all policies in how government makes decisions and how it operates. These governance policies are the big P public policies and it's about using the tools, the policy tools that you all are familiar with to embed these types of practices. So the policies can include local ordinances, local resolutions, executive orders, and obviously, or it could include policy language into general plans. And we have it model policy examples, language that you can download from our website that can embed some of these ideas into these types of policies. And policies can do three things by using governance policies that institutionalize health and all policies into government practices. It can jump start a health and all policies initiative. So for example, the state of California, as I mentioned, Governor Schwarzenegger back in 2010 wrote an executive order that basically mandated the creation of the task force and supportive backbone staff to staff that agents or that task force. It can also accelerate a health and all policies initiative. And it can also codify and support the implementation of ongoing health and all policies initiative. So there could be an initiative that's gaining traction, gaining momentum and that adopting a policy can continue to support that initiative and help it expand and grow. And from our research, some preconditions or supportive factors that allow for governance policies to be more readily adopted include bold leadership and commitment to health and all policies, the cross sector relationships that are being built or have been built, work with community partners. So what relationships with community partners do you all, the government have? And funding and resources, are there funding and resource that can be utilized for this? And staff capacity, is there capacity to do this type of work? Is there interest to do health and all policies and to staff these initiatives? And also this understanding as Mayor Watkins mentioned, this understanding of the social and environmental determinants of health and equity, like having that strong sense I think really drives this work and how important it is. So I want to next go over why health and all policies is needed. And this is a rainbow of different factors that influence our health and well-being. And these are factors that work at different levels simultaneously that impact our individual and collective health, everything from individual factors like our age and genetics and our gender to things that we do in terms of like our diet and our physical activity. On up to the conditions and of our neighborhoods and what resources are available in our community, to larger issues around power, racism, geopolitical issues and inequities. So all of these are really important factors that are happening all at the same time that can impact our health. And based on a lot of research, people have started to figure out how much of these different factors really impact our overall health and well-being. And as you can see here, social and economic factors in the physical environment make up about half of what contributes to our overall health. And you can see that clinical care is important and it represents 20% of the puzzle. And a lot of people think about health. They think that health equals clinical care or that equals health care. And I think yes, clinical care, health care is important, but it's also important to focus on these other factors. And so focusing on these other factors can really drive and improve people's health. And so this is really where I think health and all policies comes in because it really focuses on looking at the social, economic and physical environmental conditions of our neighborhoods. And what we in local government and thinking about public policy and thinking about our communities and neighborhoods can really do to improve community health and well-being. So I just wanted to choose or draw attention to health and well-being here in Santa Cruz County. And this is data at the county level just to let you all know about this. And this is from your community health assessments here in the county. And this first statistic is on childhood poverty. So in the county it's been on the decline since 2014. However, if you break this up by race and ethnicity, you see that black and Hispanic children experience poverty at disproportionate rates to their white counterparts. And this is information regarding the county's housing and economic stability. Poverty levels in the county are lower than the state's average. About 23% stated in, I think, a survey that they went without one or more basic need over the past year. However, this is worse for Latinos in the county. In terms of housing stability here and across the Bay Area, we all know that we're experiencing a housing crisis. And we can see that many households are struggling in the county. About 16% of homes in the Santa Cruz Watson metro area were affordable to median income families. And this has been a sharp decrease recently. And about 60% of renter households in the county are deemed housing burden, which is defined as families that spend more than 30% of their income on housing costs. And we know that for some families and households that housing costs actually make up about 50 or even like 70% of income. So a lot of households are struggling. In terms of neighborhood and built environment, you can see here that access to affordable fresh foods is about 50%, which is above the state's average, which is great. But this trend has been on the decline here in the county. In terms of crime and violence and rates of homicide have been on the decline and less in terms of the state's average. However, juvenile arrest rates in the county have been on the increase for blacks and Hispanic juveniles. And I just wanted to mention in terms of sustainability goals that we can see that there have been an increase in the number of residential solar energy installations by jurisdiction. The pink area at the bottom is city of Santa Cruz. And you can see that there's been some significant gains over the recent past. And the goal is that by 2025% of homes in the county will have solar electricity. So I also just wanted to mention in terms of the growing need for health and all policies, I think we first must acknowledge that government decisions, especially with the passage of public policies, has done a lot for public health. Whether you're talking about sanitation and food handling, vaccinations, environmental quality regulations, seat belt laws, traffic safety laws, tobacco control. Laws over the past 100 years have really promoted and benefited community health and well-being. And I think this is really important to state. However, sometimes government does its work and makes its decisions without taking community well-being into account. And this can have consequences for the health of communities. Historically, this has been played out in policy tools. And some of you may be familiar with redlining and urban renewal. But this also extends to other policy areas and decisions that are seemingly facially neutral and that can have huge impacts on our health. And I think an example of that is transportation infrastructure improvements. We often want those to be done because we want to improve pedestrian and bicycle safety for people in our community. But sometimes that can also lead to gentrification and displacement of nearby residents. So just taking those types of considerations into account is really important and health and well policies can help you all do that. And making policy in this way has often led to isolated changes in our environment without ensuring that these changes are coordinated or consistently applied. And when you think of the big issues of today and when you recognize and acknowledge this failure to take health into account when creating and implementing decisions, it becomes clear that the old way of doing things has really limited our ability to tackle some of our biggest challenges. Those being community violence, poverty, our current housing crisis and climate change. So I just wanted to end again with why health and all policies is needed. We need an approach that allows everyone working government to work together to tackle some of our biggest challenges. HIEP is needed because no one sector or agency or office can do it alone. HIEP believes in the power of government to generate positive community change. HIEP is needed because it can be a vehicle for producing government efficiencies and generating co-benefits for multiple partners. And HIEP is needed because every aspect of our community affects our health and wellbeing. And last but not least, health and all policies is needed because it can help improve outcomes related to the things that we care about, community health, wellbeing and equity. So that's it for my prepared remarks and I'm happy to take any questions if you have any. Well, I just want to say thank you so much for being here and for such a wonderful overview of what the health and all policies framework is and all that it encompasses. At this point, we can go ahead and see if there's any council questions for your presentation or portion of presentation and then open it up to our next segment. So I'll look to my colleagues to see if there's any questions for Tina. We tell the end. Okay, any questions at this time? Okay, we may have, do you have a question? I just have one quick question. Could you speak a little bit to where the health and all policies framework sort of developed? Was it out of the state of California primarily? Or was there other states involved or just a little bit of the background about it? Are you talking about the framework that I presented? So just to give you a little bit of background, health and all policies actually was developed in other countries. So other countries like Thailand, for example, use health and all policies, Australia. So a lot of these kind of thinking and frameworks actually came from outside the United States and we learned about them and adopted them. The World Health Organization has also put out a lot of material and resources. In terms of like domestically, California has definitely been kind of the, has taken the charge on health and all policies and in the US context has really been the driver of a lot of this thinking. In early kind of conceptualization of health and all policies and that's translated to a lot of other communities outside of California that are now adopting and implementing health and all policies. Great, thanks. That's a great segue to the next portion and we may have more questions for you after, but thank you Tina. Great, thank you. Thank you. In case you want to come on up and introduce some of our peer agencies. So we will next be hearing from Corinne Hyland from the Santa Cruz County Health Services Agency. Good evening everyone. Let's see. It's waiting for the, do I just advance it? Oh, it's right here. All right, thank you. All right. Well thank you so much for letting me come here tonight and present you some of the examples that we have around our county that use our health and all policies framework. So when I first was tasked with putting this presentation together and was asked what does health and all policies look like? I came across this picture and this to me embodied what health and all policies looks like. This was in 2017. And in this picture we have public health. We have our Watsonville Police Department. We have community partners, Parle Valley Prevention and Student Assistance. We have Salute Parle Hente, one of our major healthcare providers in South County. And then we also have youth serving organizations such as Youth Now, Friday Night Live and then some parents. And what they're doing is they all went to the Watsonville City Council to amend the smoking definition to include electronic smoking devices. And what this did is had a huge impact because without making that amendment, smoking devices could be used in restaurants. They could be used in the workplace. All the places that cigarettes were previously banned. So this was a huge score for our health. Our next example is also with our tobacco education program. We are working with nontraditional partners to address tobacco waste in the environment. Our partners include ocean conservation organizations, waste management professionals, city beautification programs, and youth advocacy groups. And what I really love this is actually we also included our arts community. And in this particular instance in the picture with the on the beach during a first Friday here in Santa Cruz City, families went into the Museum of Art History and they created these large cigarettes and put all sorts of names like, but free, I can't remember all of them. My son and I went in and I had an octopus that was holding cigarettes that say butts don't belong on the beach, that sort of thing. And then those were taken for a save our shores cleanup day. And everywhere a cigarette was found on our beach, one of these poster boards was put. And so it gives us really the impact of cigarette butts on our beaches and our natural resources. And all involved in this were also our clean streets team, our downtown streets team, and we can see Mark Stone was there as well. And this is an all of an effort to increase awareness around cigarette butts in our storm drain systems that go out into the ocean. We also have an ongoing project with our downtown streets team to educate in those experiencing homelessness because cigarette smoking and waste is proportionately impacts our lower income communities and our communities of color. And so meanwhile, we're creating all this, we're creating all this, excuse me. We're trying to bring this out to our community to create a policy around tobacco waste and making it the tobacco company's obligation to deal with the waste that's being put out into our environment. Another area is creating policies that increase food access. And when we create a farmer's market, we have many different partners that come together to do that. We have city planning, environmental health, agriculture, but in using a health and all policies approach, we really wanna look at the equity issue there. So one of the things we have done within our county is make it so farmers markets can use, or families and people on EBT or CalFresh can use those benefits at our farmer's markets. But then we've also taken it even a step further at some of our farmer's markets and allowed for double market match. So if you have EBT dollars, you can get them doubled up to $10. So if you spend $10, you get an additional $10 to spend at the farmer's market, creating equity to those who are at lower income in our community. Another group that the county convenes are the community prevention partners. And you can see this by the slide, it has a lot of different partners that work. And what their focus is, is working with school districts, parents, youth serving organizations, healthcare workers, law enforcement agencies, the cannabis industry, and alcohol merchants and community members to reduce youth access, availability of alcohol, cannabis, and prescription drugs. And just last Tuesday in Watsonville, they went to city council and were able to amend the current alcohol ordinance. This was also another big win for health because it strengthens the local ordinance and allows for, I'm sorry. It strengthens our local health ordinances and it makes it mandatory for all sales and employees to receive training on responsible beverage and sales. It also requires a business plan to be submitted. And then the city panel reviews that business plan to see, is this a benefit to our community? Is it being placed in a proper area? And all the fees then that are received from this alcohol ordinance, then go back into education. It goes into law enforcement. And in our county, it is one of the most comprehensive and evidence-based prevention ordinances that we have. Next one I wanna talk about is a bicycle traffic school that we have in our county. Santa Cruz County has some of the highest injury, bicycle injury and fatality rates of counties of similar size. And so what we did to combat this is we worked with our law enforcement, our court system, to create a way in which those who receive a bicycle traffic violation can have a one-time option of in lieu of paying the fine, pay $35 and receive two hours of bicycle safety education. So this is another area where non-traditional partners are coming together to make sure the health and safety of our community is thought about and taken care of. And then this also again addresses the equity issue because a lot of people who are receiving these violations are bicycle is their only form of transportation. It really, the way we set it up was and chose the $35, it was often those who cannot pay their violation fee go to the court referral program and have to pay that $35 and then do community service. And so we set that up similarly. So this is just, it's a one-time option but it is a great way to take away a financial burden and replace it with education. Another thing that we're doing at the county is working on Vision Zero which aims to eliminate all traffic fatalities and severe injuries while increasing safe, healthy, equitable mobility for all. And to me, this really embodies the health and all policies framework. Was the city of Watsonville just recently became the first Vision Zero city in the county of Santa Cruz. And what Vision Zero does is it brings again, very health and all policies, brings stakeholders together, city leaders to find solutions, to bring that sustainability. It changes the culture and the way we talk about traffic collisions. So we're trying to replace accidents because these aren't accidents, these are preventable collisions that we're looking at. It eliminates disparities by engaging and protecting our most vulnerable road users that are the most impacted are oftentimes are pedestrians. And it shifts the blame away from individuals and comes up with a system-wide solution. Again, that's sustainability. And so then in closing, what have we seen improved as a result of using health and all policies? We've seen less use and tobacco, less access to tobacco and alcohol products by policies that have been put in place. I didn't mention before, but kind of in working with the environmental, the tobacco environmental project, youth are coming forward saying, we care about the environment. It's actually being seen as a way to keep youth from starting to smoke because they're seeing what the end result of cigarettes and where they're ending up and how it's harming our environment, which they care about. We've seen increase in community leadership. So these youth organizations, the youth are getting up and talking to city councils and telling them, this is what we need for us to live healthy lives. And that is empowering also for our community members. We've seen it increase access to healthy foods by expanding the EBT program. And then just education over steep fines. What is the benefit? What are we trying to solve? So again, with that bicycle traffic school, there are other ways we can do things which educate and really improve the health of our community. And that's all I have. Thank you. Thank you. Thank you so much. And now we're gonna hear from, I understand tag teaming this, our colleagues in Monterey County, Elsa Jimenez, the health department director and Carmen Gil Hernandez, the HIAP coordinator and then also the city manager of Gonzales, Renee Mendez. Good evening, council members. I'm Elsa Jimenez, the director of Monterey County Health Department and I'll be starting us off today. So first and foremost, I wanna thank you for inviting us here tonight to be able to share with you our journey and the success of our partnership with the city of Gonzales as we move towards advancing health equity in our county. So the Monterey County Health Department supports working through a health and all policies approach because HIAP helps us address inequalities, injustices and disparities. Planners and public health professionals must study the variation in populations and neighborhoods and acknowledge that this variation leads to differences in health outcomes. The planning process must recognize disparities and structure processes to reach all segments of the community. HIAP helps us do just that. The framework helps us recognize and respond to community needs. Adding a public health lens to any city planning document, policy or program tells a much richer story. It broadens the stakeholders at the table and gives a deeper, more human meaning to the seemingly unhuman topics of zoning, land use, transportation and building. It helps humanize unhuman topics. It allows us to use data to prioritize non-health policies and it broadens stakeholders and partnerships. Public health and city planners have different types of tools available to them, political and social access and that data that when combined are exponentially more interesting and powerful at helping us understand exactly how healthy communities promote healthy minds and bodies and even help to answer the basic but fundamental question of what is a healthy community. HIAP is an equity strategy. Health equity refers to the study of and causes of differences in the quality of health and healthcare across different populations. This image depicts that we cannot give everyone the same thing or equality and expect them to respond in exactly the same way. Just like in this image, things need to be adapted to people's unique needs. When we take the time to do that, then we can say we are truly being equitable. In this slide, you see the age-adjusted diabetes mortality rates per 1,000 by race and ethnicity for Monterey County. We clearly see that there is a health disparity amongst the groups listed here. Why are individuals of a certain ethnicity, in this case black and Latinx, dying from this disease at a higher rate than other groups? And what are we doing to deter that disparity? Health in all policies helps us look at the factors that are influencing this disparities at a broader level. It allows us to work on the social determinants that affect this number and the disease's progression and then help us to impact this number through a collective effort addressing those things that influence the rates of diabetes. While clinical care is vitally important, you heard earlier today that it only affects or influences about 20% of our overall well-being and longevity. Social, physical and economic environments and conditions collectively referred to as the determinants of health have a far greater impact on how long and how well people in our community will live. Through HEAP, we can address the root causes or social determinants of poor health outcomes by addressing the opportunities available to our residents in their neighborhoods, ranging from their access to quality healthcare services, education, adequate housing, economic stability, community involvement to how communities that are designed or they built environment. Our well-being is directly correlated to the communities in which we live, learn, work, play and pray. HEAP efforts must be inclusive of all stakeholders as you heard earlier today. We know that HEAP works best when we collaborate across systems and when those individuals, neighborhoods and communities that are going to be directly impacted by the policies, services or programs, they're going to influence them, are involved in the planning and design from the beginning. Next, I'd like to introduce Carmen Gill, who is our Health and All Policies Manager at the Health Department. Good evening, so Health and All Policies in Monterey County was really brought about in 2010 with staff learned about it through the California Leadership Academy for Public Health and 2011, the framework was actually woven into our strategic plan and funding was actually allocated for the position that I'm currently sitting in. Since then, we have worked to develop champions and awareness of the Health and All Policies and its impact throughout our community. And really we have seen a great impact come about from the different collaborations that have emerged since we started. So some impact opportunities we want to share with you are under policy, we supported the City of Salinas' Economic Development element in which we were able to include a quality of life section to the plan, the City of Gonzales, which you will hear a little bit more about, but we supported the Health and Wellness element through a partnership there. And through community engagement, we supported the cannabis budget community-wide conversations where we included community voice into prioritizing of cannabis budget. For the City of Gonzales, we actually supported their community engagement to include community voice in the Health and Wellness element and you'll also hear a little bit more about that. Under systems change, we developed partnerships through our HIEP committees, we formed new collaborations that brought about new grant opportunities which have been very successful for us and we supported the connecting of systems to community for better results. We have really seen health and health policies work through effective collaboration and we have found that it is when systems and community work together that there is better sustainable results and a bigger impact. Some of the things we've learned by bringing those two groups together and really supporting their collaborative efforts, we have found that through that work, we're able to build more champions and advocates for the work, both at the community level as well as the city and county level, we're able to leverage experience and expertise, again, both through systems and the experience and expertise of those with lived experience, for example. We have also found that there is more support for implementation of projects and programs when community is at the table as well and that obviously supports sustainability and it really adds value and validity to the project if community is central and part of the decision-making process along with those that are creating the plan or leading the program projects, et cetera. We have found that having an engaged community from the start of the project and engaged throughout the project is really key. Communities cannot only be allies for the project but they can be key partners through the implementation phase and the sustainability as mentioned. One of the things we have found that's critical is though to keep them engaged throughout the entire time so can't come to community a year, for example, and then the project ends and then you expect them to come back a year later. You really have to make the effort to continuously keep them engaged through other projects so that when it's time to implement something like a plan, they're there still supporting you throughout the process so looking at creative ways to keep them coming along with you is really important. Renee Mendez from the City of Gonzalez is gonna share a little bit more about a specific project and a collaborative effort that we've worked on with them and what health and health policies has done for the City of Gonzalez. So good evening, Mayor, Council Member, Staff. Thank you for the invitation to be here. As you've seen, we partner with the Monterey County Health Department and other sector partners. We are obviously a small city in Monterey County. So, but part of the things that we learned early on is we don't have to be the experts in any of this. We have to invite, be open to ways, to different ways of looking at community issues, problems and potential solutions. Today, and what you've been doing is a great step in the leadership support. It really, we found has to come from the Council on down. It's a mindset, it's an approach and it's really educating kind of what it means and there's a lot of pieces to the HEAP model. And I think one of the things that's important that we found early on is not about the budget or how much it's gonna cost because when things start there, they quickly get derailed. I think it's looking at sort of the mindset and approaching what you really want for your community and exploring it and seeing how that develops. And so I think that's sort of a lesson learned as a picture of our Mayor and a couple of council members, our board president of our school, which is just one of our major partners here in our Monterey County Office of Education, superintendent at the time. Why did we choose this? Well, we kind of found that it really aligned to our vision and our mission for our community is quality of life issues, is bringing the community and engaging the community. Sometimes you gotta be careful what you wish for because you might get it. But it is really about having the ability to listen and not be so quick to respond. You know, sometimes we do actually do learn a lot from just listening to what folks are telling us. We did engage in a great partnership with the County Health Department and realized early on that to connect to our community it was really important to bring folks in that really understood this and we were certainly just as partners and supporters. We partnered with them and did hire a position. We jointly shared an health equity fellow, which he spent a year really going to our community events, having meetings with the community, just listening. What's their vision of the community? What we found is not surprising, but kind of how people tell the story and convey what they're looking for. Sometimes there's a lot of power in listening to what they're telling you. And then we collected a lot of data, community surveys, one-to-one interviews, focus groups. We also had partnered with the County Health Department a few years before and they did a health assessment, which we're actually working with them now to update the health assessment to see kind of where have we improved. But it's just kind of combining a lot of that data. We went to our school and got a lot of data from our school and a lot of other efforts. Like Carmen and others talked about, it's the partnership with your resident committee and I think one of the things we learned early on and it's sort of an anecdote. A few years ago, we were going through a project that maybe the community wasn't too supportive and we were going through the environmental, the CEQA processes, that could be kind of contentious. So we had this great thought to have this education on CEQA to our Hispanic-speaking community. So we brought in translators, we translated everything in Spanish and we started making a presentation. And within 10 minutes we realized that nobody had any clue what we were talking about. Even though it wasn't Spanish, because there was no foundation for them to understand the process. So that was really a good lesson to us as we now engage with our committees and our community. And we've tried the translating from English to Spanish, Spanish to English and that works in some settings but when you really wanna get into really listening to the community, sometimes that's not maybe the best model. It does obviously require a little bit more intentionality by city staff or the council and so forth to be willing to listen and go through that process. But I think the community responds well to that. At least it has responded well to in Gonzalez. The committee helped us develop the policy languages with the health department. Carmen kind of left that effort for us and made the presentations to the planning commission and also to the city council. So what Carmen talked about really finding ways engaging and continuing the engagement is I think really important. You want your community to feel sort of the buy-in and obviously there are prioritizations, decisions that are made when things occur, don't occur but I think the community we found really kind of understands when councils are engaging in some of those decisions you have to make on a regular basis about poverty and the resources and so forth. But it does help to engage the community. We've had joint meetings with the planning commission and city council to hear sort of some of the same presentations and our school board. We actually have joint meetings with all three bodies at the same time and what we found is at least they're hearing the presentation at the same time. And what we've also found is when you get different policy bodies together, the interchange of information and idea from the school board to the council and to the planning commission is just more robust. Because sometimes planning commission members might want to say something but don't feel it's kind of, it might be awkward in their meeting but when they're with the council or school board, so what we've realized is the interchange of information between the three different policy bodies, well at least the two of the school and the council and then the planning commission has led to a lot more robust conversation and our community is actually responding well to that because they get all three at one time. The policy implementation, we did adopt the health element in our general plan and what I've been telling folks is next year, now people are going to be asking, did we practice what we preached? Because we're in the midst of significant annexation for the city and we're actually meeting with developers and landowners and so forth on our next growth phase where we're going to try to put all these practices in place. So we will be engaging our community again in what that means, how we're going to bring to life some of these policies or elements. So it's a real intentional effort. We're also looking at things like our fee structures, impact fees, all the sort of things that go into building communities, whether it's in-field or you're growing out, businesses as businesses come in, we're starting to look at things like, daycare centers and so forth, as opposed to maybe the traditional models like parks or pools or community centers and so forth. So a lot of this is really, we're working with our community consultants to look at kind of what is it that we want our community to be. And this lens has allowed us to do that. Because of the effort, the city, we engaged our community and then the Robert Wood Johnson Foundation and I'll be real candid. I had no idea what this was. Folks brought it to us and said, hey, let's apply it. But as we've engaged the community, it's been real powerful to listen to sort of what the community is feeding back on this sort of competition. Things that have happened for us for city, from the city's perspective is the mindset. A couple of examples that I will give you is not something that we're particularly happy about, but our fire chief came to, all of us have management meetings and so forth and brought on an issue where we've seen sort of an uptick in attempted suicides. A year ago, maybe it's sort of a teenage population and then just recently in the adult population. But we quickly engaged in that and partnered with the health department and have began to sort of address community. If we brought our clergy into that conversation, at least in our community, which I'm sure it's very similar in others, places of worship or clergy tend to be sort of safe places for people. So we brought them in to sort of help us with the information. I'm not too sure, five years ago, our fire chief or police chief would have brought this to the conversation or discussion. Just when you respond, you're your first responder, you deal with whatever it is you're dealing with, but the mindset to step back and say, hey, what's going on? Why are we seeing an uptick in this? And it's not, you see that, and sometimes we're used to seeing that maybe during the holidays, people are under more stress and so forth, but we've seen it in other times during the year. So now my staff is coming forward and saying, what can we do about this? So that's what I mean about the mindset and now engaging with the different partners. And the other thing from a staff's perspective is the realization that no matter how great we think we are at our jobs, there's a lot we do not know. And the willingness to engage with the partners whether it's Santa Cruz Health Department or your nonprofits or the mental health professionals or whatever happens to be economic development professionals. And the willingness to be able to engage them into the conversation I think is something you start seeing. And you start seeing sort of that come before in projects, ideas, community engagements. So I mean, we can talk a lot about sort of different sectors but to me and I think the council is just a mindset. So with that, I think I'm gonna turn it over to Carmen and to finish out our presentation. Thank you. Thank you, Renee. As you can see, there's been a lot of exciting things that have happened for Monterey County since we started this initiative a few years back. Some of the lessons we've learned throughout the way is really look for collaborative opportunities. We know we're all restricted on funding. One person, one agency can't do it all. So we know that through collaboration and really attacking the work from different points of views and different levels, we'll be able to get more done. So we definitely encourage seeking out collaborative opportunities. We have also found it to be very successful in applying for grants, for example. Leverage expertise, not only from your system leaders but also from those who make up your communities. I spoke a little bit about those, engaging those with lived experience, for example, and Renee talked about the importance of getting their buy-in and support early on. Many times we come to them afterwards when the plan or project's already done and it's too late by then. They'll tell us themselves, well, we don't know about this. So bringing them on board from the get-go is really important because they could be your biggest champions and allies later on and really support the implementation process. And then with that, don't forget about the young people. So bring in the adults but also the youth. The youth have a lot of energy. A lot of them want something to do. They wanna get engaged. I think one of the things that we found in terms of the data collection for the health and wellness element that really stood out for me was the fact that communities said we want more volunteer opportunities. We wanna know how we can engage more with our city and really play a more supportive role. And I think that was something that we didn't really expect to come up. But I think if you ask the question, folks will tell you, open the door for us and we'll come. But do it in an authentic way that's gonna value everybody's time and bring us in from the beginning, not just at the end. So I think that's really important. And then the other thing is think outside the box. Don't let the answer just be no or we don't typically do that. Be open to new ideas and new ways of working because you never know what that's gonna bring about. Creativity brings a whole load of new projects but also new solutions as well. So be open and willing to try something different because you never know that might be the answer to the problem you're looking for. And then the other things to consider getting diverse stakeholders to understand their role in health is key. We all play a role in health. And I think that was one of the most impactful things to really talk to planners and say, hey, you're planning streets and roads but you play a role in the community's health. Developers, you guys have a role in community health. And so really getting everybody to understand what their role in health is is really important and you find that there's more alignment than not because ultimately everybody wants a good thriving community. So getting folks to kind of align in that sense is really important. Keeping people engaged, I talked about that, that if you bring them on in the beginning, make sure you're keeping them engaged throughout the full project. Don't expect them to be engaged at the beginning, not here for you for two, three years since we know plans take a long time to develop but then when you come back three or four years later and say, hey, remember, we worked on that, they're not gonna remember and they're gonna say, well, you never told us anything and now it's too late. So making sure that you're continuously keeping them involved and engaged is key. Ensuring that the diverse perspectives and experiences are respected and appreciated. So again, none of us know it all. So making sure that those perspectives, especially the ones that are most impacted by our decisions, our policies, our programs, our at the table and can reflect and tell us if what we're thinking is correct is really important. Identify priority areas since there are so many interests and there's a lot to do, right? So identifying those priority areas with folks that can help you implement those areas or address those areas is also really good strategy. It could be an idea that one of you all or somebody else may have but if it doesn't have support and support behind it, then it's really hard to make it happen. So really again, getting the buy-in early on is really helpful. Funding, obviously consider the funding to sustain the work and the long run. And then also consider partners time constraints. And that means folks from the public as well. They maybe have a job or two jobs are caring for a family. And so being really effective with time is really important, especially with most of us that are trying to do multiple jobs and handle multiple projects or whatnot, just making sure that meetings are efficient, that they're timely, but they're also at the time that works best for people as well. If you want the public to come, you guys already know this. You're not gonna invite them to a meeting at noon, right? Because they're probably not gonna be able to make it. So considering what time and in what language and the location where the meetings are held as well, depending on the group you're wanting to engage in at the given time, all really important things to consider. Also, it's gonna give us a few words and we'll wrap up. So as you've heard, an agency has to commit the resources and the funding to be able to advance health equity in your community. And what we've learned is that first we have to build our organizational capacity and understanding of what that is and what our role as public health professionals is in terms of advancing health equity in our community. We have to involve all stakeholders, including members of community-based organizations, elected officials across different bodies. And more importantly, we have to make sure that the community is at the center of it all, assuring that they know that they have a voice and then providing them the tools that they need to be able to advocate. Because of our journey and because of our work over the last few years, in 2017, our Monterey County Health Department won the California Endowment's Arnold X. Perkins Award for Excellence in Health Equity Practice, an award available to California Health Departments. And we're very proud of the work that we've done and the recognition of the work in terms of combining community with stakeholders, including community-based organizations, public health practitioners, elected officials, et cetera, to really help us move towards advancing equity in our community. So again, thank you, Mayor Watkins and council members for inviting us to share with you today what we are doing in Monterey County to advance equity. Thank you. Thank you. Thank you all so much. So we'll go ahead and now shift. We've had sort of the broader overview, some insights from our peer agencies and I want to thank you again for being here and making the presentation and highlighting some of the exceptional work you've been up to. And then kicking us off here is Tiffany Weis-West on our journey and how we're already doing aspects of health and health policies and our next steps here in Santa Cruz. Yes, thank you, Mayor. Good evening, Mayor and council members. I'm Tiffany Weis-West, Sustainability and Climate Action Manager and I work out of the city manager's office. I'm really happy to kick off what staff are going to share with you in terms of how we have operationalized these three pillars of health and all policy, equity, public health and sustainability. So I don't need to reread this. Tina kind of started with the definition of what health and all policies is and the five elements that surround it. Fortunately for the Climate Action Program and sustainability, we embody so many of these elements already, the necessity to do cross-sectoral work, the co-benefits that happen through our work in climate change and emissions reduction. The win-wins that happen from these projects, which I'll be sharing with you, obviously we can do better, but I do want to point out that sustainability is a really unique or climate action is really unique and that it does embody these three pillars and the work that we do. There we are. So just to start out with sustainability, the first pillar, I was just in front of you all a couple of weeks ago to talk about our climate action milestones and where we're at with those milestones. I did touch upon many of the projects, programs and policies that are in place, but I thought it might be helpful to instead focus on kind of these co-benefits, these equity benefits and public health benefits that many of our work that we're doing at the city, whether it's the Climate Action Program leading or other departments leading that are again carrying out these climate action milestones, but work that we're already doing that touches these other two pillars. So in terms of public health, our climate action plan actually calls out dozens of measures that align with public health and our adaptation plan calls out 10 specific concrete measures. Some of those that we actually have in place and that are happening right now is our anti-island campaign with city schools. Obviously the point here is to twofold, it is by reducing exhausts that exacerbates respiratory illness that's particularly emitted at kids' levels at the tailpipe that we can have an influence on public health and increasing better health outcomes with respect to exhaust. Of course, there is also really strong emissions reduction potential here through anti-idolings. So that's a new effort that we have going on. In terms of our Urban Tree Inventory and Planting Project as I told you previously, we've planted over 330 trees. And through that project, we are actually quantifying to the state what are the benefits from these trees? Using state models, not only are we identifying emission sequestration, but we're identifying other co-benefits such as particular matter reduction that is filtered through trees. There are many other benefits through planting trees. And eventually when we start to experience more high heat days, trees will provide shading that we're really going to need. In terms of active transportation, promoting active transportation through the jump bikes, investment in green lanes and the rail trail as well as a number of other things, we're really getting at public health benefits by increasing cardiovascular activity. Again, a really great win-win or co-benefit. And for the first time in 2018, we identified health impacts in addition to public safety in our climate adaptation plan, and I'll talk a little bit more about that. Right here, actually. So of course, we're projecting public safety issues from increased erosion, landslides and wildfires and storms. From the Santa Cruz County Climate Change and Health Profile we're expected to see an increase in temperature of four to five degrees Fahrenheit by year 2100 and that we should have four to eight more high heat wave events by year 2100. So this figure kind of shows the spectrum of impacts on human health from climate change. This combination of health related effects can affect public health through direct exposure, indirect exposure and socioeconomic disruption. Climate change also magnifies health disparities and disadvantaged populations such as those with low education opportunities, experiencing racial segregation, low social support poverty and income inequality face disproportionate climate related health burdens. Again, I've already mentioned the high heat events, but the strain they place on our elderly, our ill or otherwise health compromised persons and people who work outdoors, not something that we would typically think about. Flooding of buildings can cause long-term mold and indoor air quality issues. And wildfire is not only threatened life safety, but smoke and fine particulates increase respiratory and cardiovascular risks. And we are following what other jurisdictions are doing in that regard, particularly those that experienced our massive fires last year and how can we prepare to deal with smoke, which we all had, we all smelled that smoke last year in our own region. And I'm really looking forward to initiating a dialogue with public health providers and some of the organizations that our speakers mentioned as a next step on this high up process with respect to climate change and climate action. Moving on then to equity. Equity really has become a central focus in the climate action program work in the past couple of years. We did integrate social vulnerability to climate change in our adaptation plan update last year. And now in our Brazilian coast Santa Cruz projects, we have a very clear equity focus and in fact have used an equity screening tool in developing our outreach plan and very much getting to what the last speakers were talking about, making sure that we're engaging with folks early, that we're engaging with the widest range of stakeholders that we can. Some other things with respect to equity, we have also operationalized property assessed clean energy. So enabling folks to finance things like water conservation, energy efficiency and renewable energy on their property taxes where credit worthiness is not one of the criteria. So folks that haven't been able to build their credit, this gives them an option to sustainability. Similarly, the recent CDBG funds that we've allocated for grid alternatives will fund six low income solar homes in addition to the 20 that Monterey Bay Community Power funding throughout our region. Speaking of Monterey Bay Community Power, we have also advocated for income qualified incentives which we saw materialized through our EV incentives that were out as of May 1st. And just today, equity was a central discussion on the regional electrification plan that is in development. We had a workshop today on that. And then last and most recent is through our climate action task force. We are exploring how could we green our rental market? Again, folks that may be priced out of housing but still wanna participate in emissions reduction, sustainability and benefit from energy efficiency and so forth in their homes. How can we do that with our rentals? We're just at the beginning of that work, however. So with that, I'm excited about the possibility of amplifying the positive impact on our community wellbeing through these three pillars and through the culmination of this process. I think we have a really unique opportunity at the end of this process. We're starting on our climate and energy action plan 2030 next year. What an opportunity to build in some of this work from high up into that process as well as continuing to do so in our adaptation work. So with that, I would like to pass the baton on to Beth Tobi, our arts program manager in economic development. And she's going to talk about the equity focus of the Arts Commission. Thank you. Thank you, Tiffany. Good evening, Mayor and City Council. I'm Beth Tobi. I'm the Arts Program Manager with the City of Santa Cruz. And I'm going to talk to you about the equity focus that we've had with the Arts Commission over the, about the last two years. So why are we focusing on equity with the Arts Commission and our city arts programs? Well, without addressing equity directly, system-wide inequities are replicated. This reality is often called structural racism or structural inequality. Acknowledging this reality, we've had a couple of what we've called retreats facilitated by a local cultural equity specialist. And out of that work, we've come up with a lot of things we're focusing on in this effort. We are currently working on a policy around what we're calling equity inclusivity and environmental justice. We're updating our mission vision values. We're really auditing, reviewing all of our programs and really brainstorming what are the equity opportunities in all of our arts programs. We're really focusing on expanding artist outreach. So we're not just reaching the same artists, but the artists that maybe are emerging or maybe don't speak English or maybe aren't the ones that we normally see applying for calls. Really formalizing partnerships and that's come up as a theme clearly throughout all of the speakers. That relationship building and that partnership building is really key. And then of course, creating projects specifically themed around equity. Working on increasing the diversity of our own arts commission members, which I'm so happy to say this last year has really been a shift. We've been talking about assembling what we're calling an ad hoc advisory group on equity, which is not the greatest like most interesting compelling name, but really bringing people together that can be our outside resource and say, hey, we've looked at what you're doing. Here's our input. Here's our input from our perspective as I'm part of this community or I'm part of this community. And these are the things that are concerning to us. Again, bringing that partnership element in. Focusing many of our projects in lower income areas. We've started collecting demographic data on our artist applicants and selected artists. So who are we attracting to apply for projects as well as who are we actually selecting for our projects? And then some of this might seem granular, but we added a pronouns field on our website. We're really being explicit about our equity goals in our recruitment. So when we put out a call or we have a project, we are developing a mission statement for that project and we're being really explicit about what we're trying to achieve around equity. So it's not, I think one of the aha moments that we had through our conversations with our cultural equity expert is, don't be obtuse, don't be opaque about what you're really doing. Say, hey, we would really love to have people of color or LGBTQ people apply for this project. Strongly encouraged to apply. So being really explicit about that. We're in the process of compiling a resource guide on equity, inclusivity, and environmental justice. That resource guide is local, statewide, and national resources on a broad range of topics. And that's something that we plan to share, freely to whoever wants it and to also take input from whoever wants to provide input. We're working on what we're calling a bootcamp for artists, which is giving artists tools on how to write a grant, how to potentially do that in both English and in Spanish, but how do you get those tools to artists that they might not have otherwise, especially artists that might be from communities where they don't have that social capital. And then, of course, this has also been phrased in a variety of ways through the evening, but staying humble and open-minded and continually learning. So this is just the beginning. And then a few resources I wanted to share if you're not aware of. The Government Alliance on Race and Equity is an amazing resource, Race Forward, which is sort of a subsidiary of that. And then the City of Salinas has done a huge amount of work around equity in the last couple of years, and so they'd be a great resource. And also I would be happy to be a resource on any of this going forward. And I'm now going to hand this off to Laura Landry from our Code Enforcement. Thank you, Beth. Good evening, Mayor Watkins, my apologies, and City Council members. My name is Laura Landry, the Code Compliance Manager with the Planning and Community Development Department. I've been given the privilege to present to you a Health in All policies for our department. I will give an overview of the department, but be more specific towards the Code Compliance Division. As is the case with many city departments, nearly everything we do in the Planning and Community Development Department can relate back to health in all policies. We plan for land uses and require site designs that promote biking, walking, and provide a range of housing and job opportunities. And that protect and provide access to parks, open spaces, and natural amenities in our community. You see this in our policies that call for development along the corridors, affordable housing, protection of our industrial lands, and preservation of our green belts. We ensure new construction meets health, safety, sustainability, and accessibility standards, including things like structural stability, indoor air quality, and access to those with varying abilities. Specifically, Code Compliance applies states and local ordinances designed to provide consistency and fairness, regardless of the social, economic, and legal residency status of the residents. That means the owners, tenants, students, and of varying abilities. We attend events such as the UCSC Housing Fair to provide education as well as answer questions for the students and also the faculty. We also coordinate the neighborhood cleanups in the Lower Ocean and also Beach Flats area, which helps with the aesthetics of the area, as well as bring in tons of garbage and recycled items. And some of those items that are recycled or that are provided by the community are electronics that later the nonprofit organization Gray Bears obtains and refirmishes and then again returns out to the community. Code Compliance helps with sustaining our natural resources for future generations to enjoy, such as the stream that you see here on the left-hand side. We received reports of the stream being altered and inspection of the stream revealed that there's the version of the stream as well as installation of a weir that was installed without permits. Currently, Code is working with state and local agencies to stop the impact of the natural resource and also to restore the natural habitat. On the right-hand side, you see numerous vehicles on this property and the concern is ground contamination due to the leakage of the automotive fluids. Currently, we're also working with the state, county and local agencies to address those issues and remediate this area. The Code and Rental programs protect and provide, protects and provides the health, improves the health of the residents and visitors in our community. On the left-hand side, you will see the residential program, through the residential program, the inspectors were able to identify several units in this condominium complex that had, that the balconies had failed due to the structural being unsafe, the structural stability of the balconies being unsafe. These balconies were posted unsafe to occupy but the residents were able to remain on the residents just not able to use the decks. On the bottom left-hand side, you see an uncapped gas line that was found to be free-flowing for an undetermined amount of time. If left unnoticed, it would have been a catastrophe to the health of the residents and to the surrounding areas. The middle picture that you see there is an unpermitted building that had a failing ceiling. The tenant of this unit had to relocate but was provided relocation assistance. Also, through the rental program, you see on the right-hand side a bed where a resident was sleeping in right next to a water heater which is also a potential for common monoxide poisoning. The bottom right-hand side, you will see an unattended refrigerator which is a hazard safety to the life of the children if caught inside or trapped inside of the refrigerator. Here on the left-hand side, you see construction without permit, a door with no landing, no stairs and no railing, as well as an improperly stalled vent that is touching the wood that is also a potential fire hazard. On the middle picture, you will see that there is an extension cord which is the sole source of electricity for this unpermitted shed and also a potential fire hazard. On the upper right-hand side, this multi-family unit, there were found to have several constructions where loft areas were enclosed, eliminating the egress, light and ventilation, and if a fire would occur, also eliminating the means of egress for the resident. On the bottom, we have another situation through the housing program that we see that this property has accumulation of items as well as humidity. The mold in the back, you see is from the floor to the ceiling. Here on the left-hand side, you have a outdoor compost toilet that was provided to a tenant that was in an unpermitted shed as well and with no plumbing and no electrical, which obviously it's substandard for living conditions. On the left-hand side, bottom left-hand side, you will see the before and after of these storage units, it's commercial building that was meant for storage and it was used as habitable space. They also had and plugged in a hot plate to be able to cook. There's no bathroom, no cooking facility, also very substandard conditions. And lastly, on the top right-hand side, you will see an unpermitted water heater that was installed where the venting was into the house. So the carbon monoxide was also being spread throughout the house in the attic area and into the rooms, which is also a potential hazard. It is a hazard for all the occupants in the residence. I would like to say that the pictures that you just viewed were pictures that were taken for the last couple of months through the rental and code enforcement program. The code enforcement purpose is the safety of the community, the well-being of the community. And as you can see, nearly everything that the planning and community development does relates back to health and all policies. I would like to now to present Casey Heemard to that we'll be talking about tobacco policies. Thank you, Laura. Council members, I'm Casey Heemard. I am an analyst in the city manager's office. And I have been supporting the work on health and all policies for the last couple of months. And when I first learned about the three pillars of health and all policies and her public health, somebody who's been working in the city for three years thought public health is a county concern. Why should we be concerned about public health? And someone wisely pointed out that the policies that the council enacts definitely have impacts on public health. And I had worked on one of those in November. So I'm gonna talk to you a little bit about the work that the council did with the adoption of the ordinance, banning the sale of flavored tobacco in the city. And that was in November 2018. So it's a recent. So let me start by saying, it's interesting to have change labs here because change labs helped us with the text on that ordinance. And we also partnered very closely with the health services agency from the county. And so they were both tremendous resources to us. Tina and Karen have both talked about the importance of collaboration. And that was key here. We had the health services agency, the police department, educators, and we even had youth involved in this. The tobacco industry has a long history of using flavored tobacco to target youth and communities of color. And survey data has shown that the number of high school age children reporting use of e-cigarettes rose by more than 75% between 2017 and 18. Teens who tried e-cigarettes are more than eight, more than eight times more likely to try traditional cigarettes. And that eventually leads to being four times more likely to use marijuana later. And in 2018, the CDC did some research and reported one in five high school students reported smoking an e-cigarette in the past 30 days. And that all told 3.6 million middle and high school students reported vaping that year. And what makes it so attractive for youth, these products come in a variety of candy-like flavors, including bubblegum, grape, menthol, and cotton candy. So we have some data from Santa Cruz County that was collected in 2016. It was a survey of, I believe it was 189 vendors in the county. And that data revealed that the availability of e-cigarettes had increased in the county from 34% of stores in 2013 to 57% in 2016. 63% of stores were selling flavored non-cigarette products, which often have the kid-appealing flavors such as grape, watermelon, and gummy bear. 84% of stores sell menthol cigarettes. 60% were near schools and were selling, or 60% of the stores near schools were selling flavored non-cigarette tobacco products. And 16% of stores were placing tobacco ads in kid-friendly locations, such as at kid eye level, or near candy or toys. And as the mother of two young people, I can tell you, they see those things. So in November 2018, the council adopted an ordinance revising our tobacco ordinance. And effective June 11th, it's a violation to sell or offer for sale or to possess with intent to sell or offer for sale any flavored tobacco product. And because we involved the tobacco vendors in the discussions beforehand, the council opted to make it go into effect in June, allowing them an opportunity to get rid of the stock that they already had. And then PD is working to educate them starting in June so that they are aware of what they can and cannot sell. The council also eliminated restrictions on youth possession of e-cigarettes. And we heard from a number of health organizations that penalizing youth does not result in positive outcomes that it's more important to punish the vendors and the tobacco companies. So as I mentioned, PD is working with the health services agency at the county, collaborating, which is so key, and working on the education and outreach piece to vendors. What I have here is just one listing an example of some of the work that they're doing together to educate. These are some of the things that are no longer sellable in the city. And the county actually just adopted its own ordinance I think last week. So it's been a really great experience working together on this and with the police department as well and the Santa Cruz City Schools. So with that, I'm gonna close out and let you all have your discussion. Well, that's a great way to bring us to this place, Casey. I wanna thank you, Tiffany, Laura, Beth, all of our partners here from across our region for your time to be here, to share the examples that you did. Very inspiring to know other things that we can do, things that we're already doing. And I think the tobacco example, having participated in that is a great way of displaying a lot of the elements around health and all policies. And then also our unique lens in terms of how we're approaching it through sustainability and climate change. I think that's a fairly unique approach to it, very much so in line. They say climate change is the greatest threat to public health, so it's exciting to know and affirm our commitment there. So at this time, just sort of wanna remind those that are in our audience here, the city of Santa Cruz, the council today, we're not taking action on health and all policies. This is an educational opportunity. What we'll go ahead and do at this point is see if there are any questions for clarity amongst our council. We have a great group here who is an incredible resource for us if we do have questions. Then we'll go ahead and see if any community member wants to speak to us on this item. We'll turn back to the council just to sort of bring us back into closing in terms of reminding us of our timeline and next steps. So at this point, I'll go ahead and see if any of my colleagues here have any questions for some of our staff or some of our visitors in regards to the health and all policies presentation. Questions? Council Member Brown. And then Council Member Glover. Thank you all for being here and for providing us with some really helpful information on how to get started and then a review of some of the things we're already doing from our own staff. Really appreciate the opportunity to hear from you all and ask questions. My first question is, I think it may be for Renee, Mr. Mendez, but others who are part of that collaborative effort can also weigh in. So you mentioned the question of mindset change and working inside an institution that has particular culture, set of cultures and how we, our institutional culture is how we operate. We know that sometimes it's hard to make those kinds of shifts in mindset to be able to move forward. And so I'm wondering if you could talk a little more specifically about how you saw that happen in the work you're doing or how you see it happening. I know there's some element to that as the kind of, you know when you see it, but if you could try to help us understand what that looks like in your case. Yeah, Council Member, I'll try my best. I think part of it is the intentionality about bringing it, keeping it in the forefront kind of all the time. You know, we're very important in our, in our staff reports and agenda process, just trying to tie it to kind of some of the principles in our budget, in our youth engagement efforts. We, so we're really trying to point to efforts that we're doing and always keeping this lesson in place. We've gotten as far as even adopting some of our, I've had to replace, we've had to replace a few positions and be an intention about what you're recruiting, the mindset you're recruiting for, so you build it into your job descriptions. Maybe, you know, it took me a while to find a Pella Works Director with that kind of mindset. It's challenging enough as it is for some of the positions that we need, but so it's been part of that sort of journey. And so you were beginning to see it. And I think the other thing that we've found, I mean, you guys have some incredible youth efforts here, is if you really engage your youth, they start bringing it and expecting it. It's kind of like the seatbelt, right? Everybody talks about, you know, where your seatbelt is your kiss, that's how you put your seatbelt on, that's kind of how that culture kind of, or some of the reduction in the tobacco, people smoking. And I think we're seeing the same thing. We have a fairly robust youth effort and speaking to our youth about this, and they're bringing it back forward. They brought forward a social hosting ordinance. They're working on a few other things. So they're keeping it in the forefront. And so I think that's how you begin to see examples. It can, we went through a challenging, and again, it's not uncommon. We went through a challenging housing project where frankly, we were surprised at the level of community discourse, some force them against it, but just the way the conversation kind of evolved. And we ended up with a lot of the same folks now being our partners in kind of looking at this effort and realizing that maybe they, maybe some of the conversation was a little bit excessive or even maybe not civil. And I think that our youth had a lot to do with sort of bringing that reminder. So I don't know where we're gonna end up. I mean, I keep telling folks is what happens next that counts, but we're starting to see that. And sometimes you're gonna feel like we just took two steps back. We thought we were here, but I think it's, I mean, I really speak to, I mean, commend your effort. I mean, I really think it's the leadership at the top that's really gonna drive this mindset. And the questions you're asking, how you invite the presentation, the information. And you've heard a lot from our speakers about how you feed the community in kind of the respect. I think it's not easy. And I'm not too sure we're 100% there yet, but I think it's just a process. I have another question, which I think could potentially be for anybody who wants to address this. So with respect to, I think it was in the beginning of the presentation that you made, Ms. Yen related to, I don't think you used this term, but kind of unintended consequences of government policy and the ways in which we may, with all of our best intentions, either engage in policy and programmatic work that may exacerbate inequalities potentially through, you as the example of, I'm thinking about our active transportation plan and really promote the promotion of pedestrian and bicycle bikeways and kind of the new development and kind of downtown habitable. I can't remember what the term is, but kind of the sustainable cities, models that may actually lead to gentrification. So that's, I guess, one example. And I'm interested in hearing more about how we might, being mindful of that, try to avoid some of those unintended consequences as we move forward. And then anybody who wants to weigh? I can, that's a really tricky one, because obviously you have a lot of great intentions around your active transportation plans and your downtown corridor plans and wanting to revitalize areas and make it more accessible and friendly to folks of all kinds. But definitely there are trade-offs in a lot of decisions that you all make that are really tough to kind of think about all at the same time and make decisions that is comprehensive and fair and make sense. And I think with the health and all policies approach, really focused on social equity and thinking about the wellbeing of everyone, especially those who are most impacted, can really bring light and elevate some of considerations that aren't often taken into consideration and elevating those voices. And so I think that gives you an opportunity to see and hear from different sides of the story and people can present information in different ways. I think we heard from County of Monterey like sort of hearing more from stakeholders that would be impacted, hear from others about lived experiences and sort of like what they want out of their community and some of the important facets of things that are really important to them. So I think health and all policies really brings together a lot of different stakeholders and gives a greater opportunity for you to hear a lot more different sides to things and make a more informed decision when it comes to these policies. And I think it's, I bring the example of transportation improvements. I'm a transportation person, I'm a planner, I'm very much in the vein of I wanna make our streets safer but understanding the trade-offs so that you all could put into place policies and measures that ensure that these benefits are for everyone and that people can also stay in place in their residence if they do also wanna do that. Yeah, and I welcome other people to provide. I'll say Jimenez with Monterey County Health Department. I can give you a couple of examples of policies that were probably well-intended at the time they were adopted but has really helped to create crumbling neighborhoods in certain communities. So the County of Monterey's ordinance stipulates that in the unincorporated area, landowners are responsible for sidewalks, repairing sidewalks in front of their home. So in small communities, small rural communities where it's not necessarily owner-occupied but tenant-occupied, what we end up seeing over time is that sidewalks go in, disrepair, crumbling, and so then children, women with strollers, et cetera, are not able to safely commute from their home to their neighborhood school, for example. So a well-intended policy that was probably driven by finances at the county at that time but has really helped to kind of create these neighborhoods that are not conducive to safe walking. So at our health department, we have a staff that focus on conducting health impact assessments. So if there is a project that is being planned in the unincorporated area of Monterey County, we conduct a health impact assessment on that project to help identify if there could potentially be resulting any unintended public health concerns. A quick example, there was a solar farm planned between Monterey County and San Luis Obispo County. So the Monterey County Health Department worked with San Luis Obispo County's health department to help determine what potential negative health impacts could be resulting from that. Coxy is prevalent. It's a spore that becomes aerosolized when land and soil that hasn't been disturbed for long periods of time comes into the air and creates very harmful health conditions, particularly for men of color. And so we worked collaboratively across our two counties to work with developer to make sure that they had a plan in place that would protect their workers and other individuals that may come into near that. And sure enough, a few years later, we did start to see coxy rates increase in our county, particularly in that area. So by us being involved from inception, hopefully we helped to put in some preventative measures that the employer could take to assure that their employees were somewhat better protected and hopefully that helped to kind of reduce the number of individuals that unfortunately then developed the illness. Secondly, we are involved in the review of all of the permits that come through the county for cannabis operators in the unincorporated area. So we're kind of still exploring this. We're working with Dr. Lynn Silver from Public Health Institute to develop a checklist that we can quickly work with the planning department and helping to determine whether or not from a public health perspective. And our focus, of course, is trying to reduce access to youth, whether or not we support a recommendation of that permit moving forward or whether we do not support it and we state our reasons why. And our whole premise is just concentration and increased exposure and access to youth, people of color, pregnant women, et cetera. So those are a couple of examples that I can share with you in terms of how we hopefully start to look at potential impacts resulting from a policy decision and what are the plans that we can put in place to hopefully help reduce or mitigate some of the negative harmful effects. Thank you. Okay, Council Member Glover and then Vice Mayor Cummings and then Council Member Meyers. Thank you, Mayor. So I just want to start by saying that I love this. This is a fantastic framework, all of the stuff that was touched on by Tina in the original presentation was just exhilarating to hear about the focus and the different layers, the things that Health and All Policies is looking at and the way that it incorporates all of the different aspects of socioeconomic status in the conversation around equity, sustainability and public health. I wanted to have a couple questions and I also just, because I can mean this to me not knowing anything about Health and All Policies, I was like, what is this? So to hear this is just wonderful and I want to just share these packets, there's one for each of you and just some information that I want to share because I hope that this Health and All Policies and especially after hearing the framework as far as what it entails, I really hope that we're going to be looking at some very specific issues with regards to inequality, housing and homelessness and also the process of hiring in the city. So just in this packet, because I'm not one for normally printing things but I wanted to make sure that y'all had these to be able to read at your leisure and or check out and I'm not going to read all of them because there's probably like 60 pages of content here but just some things on the document that says the influence of inequality on health outcomes. I just want to highlight in the first paragraph there, it says the existence of inequality has important consequences for the health of individuals and groups and then goes on to say a high degree of inequality in any given location may itself be a health hazard. So especially here in Santa Cruz where we have such a vast gap of space between the haves and the have nots and so much inequality that's really running rampant and causing a problem, I really hope that we can bring this in. Also from inequality.org has a lot of great information about the impact of inequality on the overall health of communities and if you get a chance, I would really recommend this book, The Spirit Level, why greater equality makes stronger societies and it makes a data driven case as to the efficacy or the impact of making sure equity and equality are across societies both on health impacts but also on crime, people's participation in government, access to resources. The next one that I provided is from the American Public Health Association and this one specifically talking about homelessness and public health with regards to housing and just to highlight that the United Nations did declare that housing is human rights. There's a lot more that goes into that but something just pertinent on the second page around the fourth paragraph or so, it says ending homelessness is a public health issue and I look forward to diving into these documents or talking with all of you after you do dive into the documents at a future meeting so that we can really start talking, especially if we're gonna be looking at health and all policies, how we can apply this framework to things as crucial especially in Santa Cruz right now as homelessness and housing, especially the development of affordable, low, and section eight housing I think is something that will be really exciting to explore around health and all policies and figuring out how we'll move ahead in revenue generation so that we can do that. Something I was excited about too was the concept of wages and benefits because one of the main issues that we have in our city is that we are dealing with underpaid city workers and so especially wanting to keep them in the city and make sure that they're able to live where they work and be able to save and or pay off their college debts especially for our mid managers and the people that had to go to extra levels of education. I think this will be a great tool for looking at revenue policies on ways that we can generate additional money especially in offsetting and incorporating the concept of equity. And then the last one here from the, it's a peer-to-view study, really great talking about socioeconomic classes and how racial and ethnic stigmatized people experience higher rates of illness and I think we talked about that or heard it in a presentation which was great to see that incorporated as far as the access to health, the issues of stress that's associated with inequality, racism, sexism, discrimination for orientation. Also, socioeconomic status is a complex and multi-dimensional concept comprising a range of factors encompassing economic resources, power and or prestige and the influence that can influence health at different times in the life course. It's just wonderful because like I said, I came here not knowing what to expect and so I printed this as, but it's just so in line, it is beautiful. So my questions. First, you said this, I believe this was Tina, you said the old ways of doing things have limited the way we can deal with the issues. That's not verbatim, but could you expand on that just a little bit? Sure, yeah, I mean, I think, I was definitely generalizing and stereotyping. I mean, I think that definitely there are a lot of folks who believe that there are a lot of problems with the way in which policies and decisions and governments work currently that don't work for everyone. And I think that you mentioned a lot of the inequities and inequalities and how that shows up in people, in communities and how that impacts the life course. Definitely, government doesn't always work for everyone even though we have great intentions and we have great ideals. And so that's what I mean in terms of like kind of thinking about that in terms of like how we've made decisions. And I think there's an opportunity here that you all are learning about in terms of thinking about how do we change course so that we do include and think about different stakeholders, people who are often left out of the conversation and think about inequality and think about equity impact. So I think it's shifting the mind frame of some of that and the approaches that we take. I mean, there's definitely a history of at least in the planning realm which I come from in terms of like really terrible historic harm that has been generated in communities across the country. A lot of that is illegal now, thankfully, but certainly there are residual things that are remain in our communities that are left over impacts from that really terrible history and the things that are the legacies kind of is still present. And so just wanting to acknowledge that and just say there are ways and strategies and approaches that we can go forward that are embrace equity and embrace health and community well-being. I really appreciate you explaining that because I share that perspective, so thank you. The one thing that you also mentioned was incarceration, I think not only that be looked into but also education because even here at our local Santa Cruz High School we have such a small population of African-American and black heritage youth that we can't even calculate their rates of excellence or whether they're achieving their goals or how they correlate to the rest of their class. So these kinds of conversations are gonna be great moving forward, so thank you. A question for Laura Landry from the Code Enforcement. Thank you for that great presentation and for illustrating the dire situations of a lot of people with regards to housing. I was just curious, you mentioned one of the people that were dealing with the ceiling coming in, receiving relocation assistance. Did the other ones receive relocation assistance? No, actually all the members of that community were able to stay on their units. The only thing that they weren't able to utilize is the deck itself. They weren't able to utilize it at all. I was curious, more so about some of the other units that you showed, especially the person living in the commercial storage unit? Yes, the people that were living in the commercial storage unit, they were relocated. Also if the individual that was also sleeping in the area next to the water heater was relocated to a permitted area of the dwelling as well. So they didn't require relocation assistance but they were able to be removed to a permitted portion of the property. Great, because I of course feel the importance of public health, especially with regards to housing. I want to make sure though that we're not losing units and or displacing people and having them experience homelessness, which would then be a detriment to their public health or their personal health. Of course, and no, what happened in these instances is more of put them in a safe location and keeping them away from harm. That's what was done. Okay, thank you. Then just curious with anyone that was our guest speakers but maybe Tina has more information on this. What are some of the ways that communities have used this framework to address the issues of homelessness and housing? Oh. I actually don't, off the top of my head, I'm sure there are lots of examples and I'm just not able to pull them at the top of my head in terms of addressing housing and homelessness. No problem, I'll just be in touch with you then, I guess. Yeah, I mean I could certainly do some research and get back to you and certainly I can do that. I would love to see that. I should probably know this and I should have prepared, so I apologize. Hey, it's okay, some look forward to, right? And then. I'll just maybe if I can interject really quick because I know that you also kicked it off with showing some of those really great resources online and having done some research myself, a lot of those toolkits really do go into some specific examples, so I have a feeling if you did some of that, clicked on some of the links that brought those reports to the community or two that are free online, they might be able to answer some of those questions. Thank you. And then I see Carmen, yeah. That's your question. A few years back in Monterey County we actually put together a housing infographic that really detailed the differences in the issues of overburden, et cetera, for all of our local cities, that then the community actually used that data to go to their each respective communities and say, here's what we're dealing with, here's our income level, here's the housing affordability level, and really advocated for themselves. As the County Health Department, our task is not to push one way or another, although we do believe that housing is obviously critical to overall health, but that was a tool that was created for them that community can use in numerous ways and so that's an example of how we actually supported the community with the data, the facts, and then they were able to use it for a lot of different, in a lot of different ways to kind of press the issue of how housing is an issue for all of us. Great, thank you. Last question. So representation and equity is important to me. Something that I noticed though when looking at the 2018 report from the city's Equal Employment Opportunity Committee that we only employ 0.7% of our staff are black women, 0.4% are Native American and black men are 1.2%. Hispanic women at 3.4%, Asian men at 4.2%, Asian women at 1.4%, white women at 24.1%, and white men at 47.6%. So I'm just curious, on the city level, what are we doing to remedy that? I know that it's somewhat reminiscent of our population breakdown, but the numbers are off in some of them, so I'm just curious what we're doing to. And I don't know if I see, I know Lisa's addressed us in regards of some of the employment kind of work that she does in terms of recruitment and equal opportunities, but I know that she's not here, so I don't know if we wanna get back on that. Yes, I mean our HR director has a lot more information on it, but we do have an Equal Employment Opportunity Committee comprised of employees as well as members of the public, and they do focus on the various efforts and have a plan, which are specific efforts and initiatives to, and they also monitor, collect data and review the data to assess where we have gaps and then provide recommendations and efforts in that regard. Great, and just with that, I mentioned that it's representative of our population, but that in itself is something that needs to be addressed as to why we've seen such a mass exodus, especially of our black families that used to live on the west side, which is ironic because we're talking about gentrification, transportation, and then someone mentioned the west side, which is a place of massive gentrification that has displaced many black families. So definitely wanna make sure that we can figure out how we're retaining our communities of color and having them represented in our health and law policies. Thank you. Vice Mayor, come in. Well, I'll just say that I appreciate the presentations that we received this evening. Most of the questions I had were actually asked by council member Glover, so I don't have any more questions at this point in time, but I do wanna say how much I appreciate that this is moving forward, and really I'm looking forward to seeing how we can incorporate this into a lot of the policy that we're gonna be making, especially as it pertains to maintaining diversity, equity, and inclusion within our community, and also how we're gonna use these policies to address our impacts on climate change, which is something that our community has expressed that we really wanna start addressing so that we can start mitigating some of the negative impacts from climate change. Councilor Myers. I think in the interest of time, and so that we can hear from the public because it looks like there's quite a few people here tonight. I think I'll wait and kinda cook on this. It's a great concept, and I really appreciate everyone from Monterey County coming up and talking with us. And just, I think this is a really compelling way to think about how we work for our community into the future, so thank you, everyone, for your presentations. I just have one quick question, and then we'll move very briefly. I think we've moved from questions to comments, so here. So I'll toss mine in very quickly. Again, I wanna thank all those presenters who came. I'll be interested to hear from the public. Basically, I think we have already a very strong record in Santa Cruz, the city of Santa Cruz, on the whole spectrum of health policies and collaborations of interdepartmental cooperation between departments, commitments to active lifestyle, environment, infrastructure, again, reiterating partnerships. That's where so much of the work is done. And I do wanna harken back to one of the first comments that was made was every community's plan is a bit different. And we did get earlier, I think, in some material that the mayor passed out to committee, city of Richmond's plan, quite different from probably one that we'll deliver. And I did notice it has a whole section on residential and built environment, which has everything from fixing up older properties and reducing displacement. It's in one community's plan, and that will be, I think, a good challenge for us is to figure what are the categories and how do we wanna organize them. I think we have a supreme basis to operate from, and this will help us pull it together and look forward. Thank you. And before maybe we move to the public comment portion, I just have a quick question. I'm wondering, and maybe this would be for you, Tina, and I know that you've been kind of called out a bit, so I don't wanna overcall you out again here, but in terms of your work at the kind of the state level, have you seen this intersection between looking at climate change and health and all policies as sort of the forefront, and in what ways has that shown up in terms of the examples or potential direction you can point us in, for examples? So I was a mosquito. Definitely, climate and equity and health are very much interrelated, I think as a previous, I think Tiffany presented on, and at the state level, there are lots of conversations that sort of interweave all of those concepts. There is a person, Linda Rudolph, who leads the Center for Climate and Health, and she is also one of the preeminent leaders in thinking about health and all policies, really says you can't think about and talk about health and all policies without also talking about climate and equity, so these are all concepts that are very much embedded in each other. And so I think climate affects health. A lot of things affect health, so in thinking about the potential impacts of health, of climate impacts, you have to also think about potential impacts on the health and the well-being of the community, and especially because we know that climate affects everyone but not everyone equally, so we need to think about the most vulnerable parts of our community and making sure that they have the resources they need to adapt and be resilient. I think sort of a health and all policies is a very broad approach to thinking about all the different pieces that would need to be considered when making decisions and moving forward and thinking with that equity lens sort of like helps you think about like how, where do you prioritize your commitments and where do you invest your resources first? And I think that it sounds like the work that you all are doing really encapsulates and tries to think about health and sustainability in this broad way and thinking about how a health on a policies approach can be applied and thinking about climate change. Thank you. All right, we'll go ahead and see if there's any member of the community who would like to address the council on this item. If you could just please line up to my left and you'll have up to two minutes. Thank you so much. I really appreciate this tonight. Health and all policies, the first time I heard about it, I absolutely loved it. So some of the words that's called out to me were collaboration, the importance of safe and accessible spaces, equity and community well-being. Often feeling, I feel the greatest threat to the well-being of the community is the growing exposure to EMF feel and the great proliferation of wireless radiation in the community, especially as 5G is coming in. Often feeling left out of the conversation. I'd like to bring this to the discussion of health and all policies because I think it's included and there's a way to include it relating to how this affects all of us, especially someone like myself who is EMF sensitive in the public right of way. As we're, our access, this becomes an access barrier, our access to spaces such as this, parks, all public spaces, buildings, it becomes more and more difficult the more cell towers there are, the more technology there is. I've sent some suggestions to you of ways that these spaces can be made safer, that are easy, that means some change. I also, although it's not been addressed often, ADA, California law, public utility code, access board recognizes EMS, electromagnetic sensitivity as a protected class and that applies to all public right of ways, all public buildings. So we haven't really talked about that much. We're like the forgotten ones. So thank you. Thank you. Thank you for this evening's presentation. It was extremely interesting and very hopeful. It happens to fall in line with something we were trying to do in terms of taking a look at the city manager's office got two year work plans because it seemed to us that in the 2015, 17 document there were clear goals for community involvement, environmental, et cetera. And these were essentially sidelined by the 2017 work plan although the text at the top said they would simply put new goals in. When you read further down, it's like, yeah, those are the ones we don't really have time for. And in any case, the environmental goals needed a really major upgrade in view of the environmental crisis or climate change. So this has been emailed essentially, a few highlights. All new construction must be zero carbon. Remodels must phase out gas appliances and include solar installation. Development must be transit oriented. Climate action plan is to be continually upgraded based on the most current scientific knowledge and full engagement of the community. So there's a few ideas here that totally fit in with HIAP. Thank you. Thank you. Hi, I'm Gil Necunam. And I'm very encouraged by the resolution that you passed to join in a lawsuit or sue the FCC yourself. I have sent some articles to you with links to which cities are already in process with that. I would like to keep that momentum going because we're sort of in a race to save our lives. Because once that infrastructure goes in, it isn't coming out. So this is a great unifying factor because we are all universally affected by this microwave radiation. And I think we are trying to save lives and that could very well be our own lives. So right here I have something. Well, I just wanna say there's a little bit of a conflict between the telecom industry policies and the green policy and the health and all policies policies. Because this is a major health hazard and needs to be addressed in the health considerations of all our policies. But we aren't allowed to talk about it, but we're gonna talk about it tonight. Here I have the Naval Medical Research Institute manual from 1971 where all these studies have been done on microwave radiation. There are many other military manuals this big. This is over 2,300 studies. And without saying the conclusion of the studies, this is just indexing them. This is some of the things they've studied. This is well known. This is not iffy, heating of organs, whole body, skin, bone and bone marrow, brain, sinuses, metal implants, burns near hips and hip pins. Changes in physiologic function. Thank you, your time is up, but you're welcome to contact the council and email or individually as well. Okay. All right, Phillip, this will probably be a little different. I'm just gonna read it really fast. I regard the growing ill-conceived anti-American value and principle warping agenda of the trash political theory and economics of what is known as leftism as the greatest internal threat to the welfare and rights of the people of the United States. It is not easy to define all of leftism's tenants as it is not a fully rational or cohesive theory, but as a new amalgamation of attacks really that seek to redefine words, values, rights, liberty and principles of the American bedrock good versions of those. The result is leftism destroys everything it touches and replaces with nothing or a worse known historically proven defective poor imitation. It is advocated by those who want to destroy what America is good because they believe in an unattainable utopia. Health in all policies is that simple form, in that simple form is unarguably desirable. Without health we have little, but a simple policy requiring a factor of consideration of the health effects of all policies is really quite sufficient. No 20,000, no committee, just consideration is needed. Wise and just consideration is all that is ever needed and really not an outline, especially one defined by leftists that defines in their way what is wise and just. I see similarities of this so-called health policy which was invented by and in the globalist EU, not America to the core nonprofit policy in which some measure attempts to filter approval of nonprofit grants through leftist agenda filters with their own un-American definitions of the unholy trinity of diversity, inclusiveness, inequity, the acronym of which is die. Block acceptance of Trojan horse leftism into policy is doom and very hard to remove by the people as our unelected commissions, agencies and unelected government bureaucrats. I would like to see and hear your precise definitions of all three pillars of community well-being equity, health and sustainability and you should receive public comment and modification. Good evening, I'm Brett Garrett. I like that so many of us are named Garrett tonight. I don't think any of us are related, but who knows? I just, so I really appreciate this concept. I think it's wonderful. I appreciate council member Glover for saying so many of the things I wanted to say about homelessness and affordable housing and inequality, all pillars of health and backing it up with documentation. I think that's wonderful. I love the emphasis on climate and thank you for bringing in Dr. Tiffany Wise West to speak about climate. I support the other speakers who are talking about issues of 5G and radiation. I think it's something we should be concerned about and incorporate into our health and all policies. One thing I haven't heard mentioned explicitly is mental health is very important as a component of health and all policies. I also do advocate to include vision zero as part of, you know, whether it's, I guess it would have to be integrated. I mean, just to also approve vision zero in addition or as part of this effort. Thank you very much. I really appreciate these speakers who came a long way to be here tonight. Thank you. Thank you, council. This is a wonderful presentation tonight. Thank you, speakers from Monterey. I'm here to share a letter which you've received in submission from the campaign from Sustainable Transportation. My name is Bob Morgan. Thank you mayor and council members for your health and all policies initiative with focus on equity, public health and sustainability. CFST wants to take a moment to appreciate the council's support of public transit by using parking funds to issue bus passes to all workers downtown. The eco pass will promote public health as studies have shown transit riders get three times the amount of daily physical activity when compared to non-riders. CFST also appreciates the city's ongoing commitment to infrastructure improvements for bicyclists and pedestrians. The California Department of Public Health reports that meeting the state's goals for increasing bicycling and walking will produce profound reductions in deaths due to chronic disease. Unfortunately, the study estimates that increase in bicycling and walking will also result in an additional 250 deaths per year from traffic collisions. We in Santa Cruz understand that deadly trade-off only too well. The city has among the worst rates of injuries to bicyclists and pedestrians of any California city of similar size. The campaign for sustainable transportation anticipates that the city council will accept the unanimous recommendation of its Transportation and Public Works Commission and adopts Vision Zero, making public safety the top priority for transportation investments. In order to prioritize safety, we need to reverse some policies that are still represented in our city budget, such as expanding intersections to speed up traffic flow. Speeding traffic makes streets more dangerous. Widening intersections makes streets more intimidating to bicyclists and pedestrians. In a negative feedback loop, people don't feel safe riding bikes, and then they make more car trips. Excuse me. In turn, they make streets less safe. Thank you. Good evening. I wanted to thank all of you for the presentations and for the city council for looking at health and all policies. I just wanna quickly mention that I believe environmental wellbeing should be included in this policy because a healthy ecosystem is necessary both for human health and existence. Thank you. Marilyn Garrett, two minutes. We've been sitting here two hours. Seems like it should be at least three minutes. Without our health, we don't have anything. This microwave radiation assault from the intensification of wireless radiation that's been going on since 1996 and will be even worse with 5G really needs to stop. When you talk about these various aspects of health, which are well and good, not talking about the elephant in the room, we're getting one quintillion, a new word for me, times the radiation in the environment than it's natural from all these satellites, 3G, 4G, mobile communications. And this detector of radiation is just one indication. It's up to the red. This is an acoustometer. There's a sound component. You could hear these frequencies. It's a major factor in killing the bees. I'm gonna leave you with this public health warning and also a DVD for each of you called 5G Apocalypse, The Extinction Event, and many health professionals and researchers very definitive on the horrific harm from this radiation. This needs to be incorporated in your policy. It's affecting us negatively everywhere. And so I will leave you with this and two of my friends who are going to speak. One for each person. Thank you. Thank you. Wait that long. Thank you. Good evening, Mayor and Council. It's a great presentation. You guys have a lot of things to understand. And what I noticed is, or what it seemed to me was that the health and all policy had climate changes, kind of like, and climate change. So I'd like to take us down a little walk down memory lane. A number of years ago, the city of the county and the university came together in a climate action compact. Their goal was to do an assessment of all their emissions and create climate action plans. When they accomplished that, they decided to expand it to include the three counties and all of the cities with that goal in mind of having each of the city and the counties do exactly the same thing, do a climate assessment and goals, climate action plans. That organization, the Monterey Bay Climate Action, Regional Climate Action Compact has sort of disintegrated and not exactly doing that. Right now, the best thing that came out of that was the Monterey Bay Community Power. Jenny Johnson spearheaded it and with her now employer, the supervisor, whose name is escaping me at the moment. What's happened, and so that became the Monterey Bay Community Power became the main plan for reducing emissions by counties and cities. However, what's happening right now in the legislature is there's an absolute assault on the climate, on the community choice programs. There are 20 in the state and they will all virtually become crippled by these laws that are going through right now. And I ask for your input to stop it. Any other member of the community who's interested in addressing the council at this time, so we'll go ahead and return back to the council. Just again, reminding you, we're not taking any action tonight. Very informational, helping our colleagues understand the concept, helping our community understand the concept. I just want to, if I can, draw your attention for the timeline and just also really acknowledge somebody who was not mentioned as one of our speakers here, but has been instrumental in bringing this all together. And that is Shebra, who's sitting here in the front. Shebra Kalantari-Johnson, who does a lot of consulting work in regards to a lot of community issues, but many that touch health and community, health and well-being. And just thank you for bringing this and organizing this for our council and our community. So just in closing, I just will go ahead and just reorient us to our timeline. As you can see, there's gonna be a lot of really great work happening in the next several months in regards to some of the data, some of the community outreach strategies, check-in points with the council and the community, how we hope to move forward in prioritization and testing, and ultimately concluding with a recommendation for the council to consider. There's so much potential. There's so many things that we're already doing and really look forward to working with my colleagues, working with our community to forge the path ahead. And we're in really great hands with some really stellar staff. So I wanna thank you all for your work as well on this. Again, thanks to everyone who is here from Monterey County, from the city of Gonzales, from Change Labs, and locally here at our Health Services Agency. Wonderful presentation, great examples to highlight for us to look at and make our own in Santa Cruz and the city of Santa Cruz. So with that, unless there's any final burning questions or insights, we'll go ahead and close the meeting and conclude our study session. All right, okay, we'll go ahead and adjourn. Thank you all very much.