 that in your names, honors, and demand those things. Morning, everybody, and thank you for your patience. We're going to now call the order of the January 9, 2024 meeting of the Board of Supervisors. We could begin, Madam Clerk, with a roll call, please. Certainly, Supervisor Koenig. Cummings. Yeah. Hernandez. McPherson. Here. And friend. Here. We could begin with the moment of sounds for the Pledge of Allegiance. Would any board member like to dedicate the moment of sounds today? I've seen none. We'll just begin with a moment of silence on the Pledge of Allegiance. Can you please join us in the pledge? I pledge allegiance to the flag of the United States of America and the Republic for which it stands. Mr. Palacios, are there any changes to today's agenda? Yes, Chair Friend and members of the Board, we do have a late addition. Item 9.1, consider addition of late closed personnel and litigation session. This is item 15.549 to be held at the conclusion of the Board's consent or regular agenda or at any time during the course of the meeting announced by the chairperson of the Board under government code section 5494.2. OK, that would be an item then that we would need to add to today's agenda to the closed session agenda. Are there any comments from board members before we open up for public comments specific to that item of adding? I see none. Is there anybody in chambers that wants to address us on adding an item to the closed session agenda? Please, no. Anybody online for the closed session agenda adding? Yes, Chair. Rachel, your microphone's now available. I'm sorry, it was not for that. That was an accident. OK, understood. Thank you. All right, then we'll close public comment. We just need a motion to add this to the agenda. Is there a motion? Still moved. Second. We have a motion from supervisor Koenig, a second from supervisor McPherson. If we get a roll call, please, to add this to the closed session agenda. Supervisor Koenig? Aye. Cummings? Aye. Hernandez? Aye. McPherson? Aye. And Friend? All right, and that passes unanimously. Are there any other changes to today's agenda? Mr. Palacios? None. Are there any board members that would like to remove an item from the consent agenda of the regular agenda? I see none. And so a movement for public comment is an opportunity for members of the community to address us on items that are either on the consent agenda or not on today's agenda within the purview. The board of supervisors are on the regular agenda or closed session agenda. If you're unable to say, good morning. Happy New Year. Back. Yeah, good morning. Happy New Year. And welcome back. My name is James Ewing Whitman. This seems like a little childhood toy, but this is how our universe actually works through magnets and electricity. Anything you can do with a chemical, you can do thousands to millions of times faster with a frequency. So I was recently reunited with a very interesting little skit that Rowan Atchison did over 10 years ago. He feels that free speech is more important than a roof over your head. He feels that only food and water is more important than free speech. So I'm not really quite sure where to start. I mean, I think that I try to stay up on current events as much as probably more than most people, but I wasn't aware that there was an election in March. So I'm kind of quite excited about that. I don't know who to promote, but I appreciate some people that are on this side of the Maritime Courtroom that are actually here that are running for office. I wish more candidates would. Seems like there's some individuals in this room that might wanna be governor someday. So I suppose that's enough for now. It's like, who knows what's gonna happen in 2024? I have joked that the city council in Santa Cruz will be flooded. Turns out it is on the 100-year flood plan, but I was not joking somewhat serious as to why the ocean would flood downtown Santa Cruz. There's many reasons, so I'd much rather be talking about that. So since there's so many other things to talk about today, I'll just leave it at that. Thank you. Thank you. Morning, welcome back. Good morning. My name is David Schwartz. I'm a candidate for Supervisor District Two. I wanna ask Zach, you're the head of my district. I'd like to ask you to remove item 39 from the consent agenda. And the reason I'm asking you to do that, I think the redevelopment money that has been spent needs to be brought to the attention of the public. I know our public has changed over quite a bit in the last few years and many people don't understand what this is all about. We have a $400 million debt that we're paying off that goes back many years. And it's taking up a lot of our budget, a lot of the property taxes are going to that quite a bit. And since the county is short on funds, I see that as an opportunity for a way that we maybe can get more money into our budget to do the things that we need to do. So I'd like to hear more about what is in that, where the properties are, who's managing the properties, why we haven't done something like condominiumize them to be able to sell them to people that live there and things like that. So I really appreciate your time and I hope you can do that for me. Thank you, Mayor. Good morning, welcome. Thank you. My name is Gloria Carroll. I come to you from HSD from the Family and Children Services Division. And I'm here along with my colleague, Kelly Kopeck, also from HSD. And I just came here today to thank you all for adopting the proclamation to make January in Santa Cruz County, the Human Trafficking Awareness Month. Human trafficking is a huge problem in our community and it's nationwide. It includes elements of not just sex trafficking but also labor trafficking. And again, I just really wanna thank you all for helping us raise awareness to this issue. Good morning, I'm Kelly Kopeck, a program manager with Family and Children Services here in Santa Cruz County. I just wanna encourage everyone to raise their own awareness about labor and sex trafficking of children in Santa Cruz County. We do currently work with multiple children in our division who are victims of both labor trafficking and sex trafficking. And to help encourage you to raise awareness, I wanted to let you know that Thursday is, this Thursday, January 11th is Wear Blue Day. If you have the opportunity to wear blue and do a selfie with the hashtag Wear Blue Day, that helps erase awareness in our community about the issue of labor trafficking and sex trafficking. We do have a problem with that in our community being an agricultural community. And if any of you have a suspicion of a child being trafficked, you can call our hotline at 831-454-2273, the Child Abuse Protection Hotline. Thank you so much. Thank you both for your work. Good morning and welcome. Thank you. My name is Louise Pierce and I live in Santa Cruz and work in healthcare in Watsonville. And I stand before you as a community member to ask for your support for measure N, which will help maintain Watsonville Community Hospital as a community asset. An ounce of prevention is worth a pound of cure and supporting measure N is that ounce. Having access to healthcare and treatment here in our community, especially for some of the most vulnerable in our community makes both fiscal and common sense. I hope that you will consider strong support for measure N in the upcoming election. And I thank you and this community for forward thinking investment in excellent local healthcare on this side of the hill. Thank you. Thank you. Morning, welcome back. Good morning, gentlemen. Gail McNulty, Bonnie Doon. Thank you to Supervisor Cummings for proposing the ceasefire resolution. And thank you to Supervisor Hernandez for voting in support of it. I'm here this morning to ask all of you to reconsider this resolution. I invite those of you who are parents to contemplate how what's happening in Gaza will impact our children's future and how it's impacting Palestinian families in our county right now. 2023 was by far the hottest year on record. Our planet is boiling. The political and economic systems we find ourselves trapped within are doomed. Hope for our children's future lives in radical paradigm shifts. We must compost the supremacist systems upon which this country and the United Nations were founded and sow seeds of unconditional universal love so that we can cultivate a just and joyful tomorrow. I'm currently reading Fugitive Dreams, a beautiful book published a year ago by Ramzi Hanhan, a friend my age who grew up in Palestine. This is a quote from his book from a year ago. The wall remains the knee of a policeman on the neck of a captive nation, crying to a world gone deaf. I can't breathe. In his Christmassy sermon delivered in Bethlehem, Christ in the Rubble, the Reverend Munther Isaac said, Gaza today has become the moral compass of the world. The genocide our government is supporting in Gaza is the George Floyd moment of global imperialism, the same profit at any cost system that is destroying our children's future. Perhaps you can, perhaps you think that a resolution in Santa Cruz County will have little influence over US policy. If so, I invite you to find empathy in your hearts for the Palestinian parents living in our county. Whether or not they've lost family among the 30,000 presumed dead in Gaza, they likely wake up each morning fearing for their own children's lives, praying that their child will not be the next Wadiah Al-Fahum, the six-year-old Palestinian American boy killed in Illinois or that they won't suffer a fate like the three college students shot in Vermont. Thank you, Ms. McNoll. Thank you. Good morning and welcome back. Thank you, Chair Friend and Board of Supervisors for proclaiming of January National Human Trafficking Awareness Month in Santa Cruz County. My name is Madikus Baldwin and I am the Resource Manager and Peer Counselor with Rising Worldwide. Rising was founded and is led by survivors of gender-based violence, many whom have lived experience with human trafficking. For over 20 years, we have walked alongside hundreds of survivors both locally and globally investing in their wellbeing and working to end cycles of intergenerational trauma and poverty through economic uplifting. Through these relationships, we have come to recognize the significant, that significant number of trafficking youth do not disclose what is happening to them. Often this is because they don't identify the type of abuse as them experiencing human trafficking. Other times the pain, shame, stigma, distrust or fear is too overwhelming. Survivors also feel humiliated, guilty, discredited or responsible for their own victimization, making it difficult to come forward. For this reason, most people don't think trafficking happens here. However, the FBI designated the Bay Area, which includes Santa Cruz County as one of the three highest intensity child sex trafficking regions in the nation. There is no miraculous tide that is shifting. The tide is made up of millions of people around the world choosing to pour their hearts, times and resources into preventing human trafficking from happening in the first place. We invite everybody to learn more about Ricin's work to prevent human trafficking here in Santa Cruz County. Please visit RicinWorldWide.org, thank you. Thank you, good morning and welcome. You guys, good morning, my name's Caroline. I am a representative also from the Palestine Solidarity Central Coast Group and I'm a local, born and raised Jewish American from Santa Cruz. And yeah, I just kind of wanted to keep the kind of the conversation going about a ceasefire resolution. I think we're gonna be seeing some like really significant shifts in the coming weeks. We've got the genocide hearing at the Hague and just this morning, 36 rabbis were at the UN Security Council and had a peaceful demonstration. And there's 200 some odd Israelis that have signed on to support South Africa's case. And so yeah, I really just wanted to encourage as I heard last time a lot of concerns about division in our community. And I'd really like to just plant the seed to consider that the lack of a resolution might sell division that already exists. Maybe it, you know, expose division that we have but conversation between opposing views could be really powerful. And this has been, you know, bravely displayed by city council who took it upon themselves to work with different members of the community to try and craft something that felt really good, hopefully or as good as possible to everyone. And so yeah, I just wanna keep that conversation alive. And I hope that we can work together and try to find something that, you know, feels good for our community and is aligned with our values. Thank you. Thank you. Is there anybody else in chambers? Seeing none, is there anybody online? Yes, Chair. Rachel, your microphone is now available. Thank you. Hi, my name is Rachel Sodos. I've addressed you before. And previously I've suggested that it would be a good idea to, I'm sorry, it would be a good idea to have Truth and Reconciliation Commission to address the COVID era. In terms of the Palestinian Gaza-Israel issue, I mean, it occurs to me that one way to keep the conversation going as the last speaker suggested would to be to have some kind of public discussion parallel to international criminal courts in consideration of South Africa's against the State of Israel. But I only have a minute here and I would like to return to the possibility that it's a good idea for the county to establish something like Truth Commission, citizen-led ongoing Truth Commission. Since I addressed you last time, I've come across two things which I think are really noteworthy. One is that a Bay Area nurse has come forth as a whistleblower. She worked at Kaiser and at Sutter and has contacts throughout the Bay Area and California. She has a unique perspective for both sides before the rollout of the vaccine and afterwards. And I've emailed you that information. And her name is Gail McCrae. I recommend her to everyone. She's been widely interviewed. And the second thing that I came across is that I saw an ad for the county, the California Association of Counties. There was a job offer for Director of Public Relations or Public Affairs for proactive and message unity. And I'm very concerned that there's a top-down approach to this and to everything within the counties in California and a Truth and Reconciliation Commission would be the opposite. It would be bottom-up. Thank you. Colin, user 8204, your microphone's now available. Hi, my name is Diane Dutton. I'm Jim and I'm calling today to talk about the MPC and the pressure right now to improve what they claim regarding the safety of radio frequency radiation in this lagging. So I'm gonna read to you from this article that says, many Americans believe that if the federal communications system makes a statement that something technology related to disease may can be trusted as they are the foremost of some in the United States and appropriate use of radiation depending on the devices. The actual truth is that the MPC is under a lot of pressure, but let me explain regarding the safety of radio frequency radiation in the contrary, that the evidence is being asked in a happy way that they do. Within a court case and a lawsuit against the MPC that started almost four years ago that will have profound implications protecting the health of people, animals, and the environment from harmful and excessive wireless electromagnetic field exposure. The latest piece of big news was in August of 2021 when the US Court of Appeals ruled against the FCC determining that they have not adequately considered the health and environmental effects of radiation when reviewing and deciding not to update their official safety guidelines. The verdict of this case, but the ball back in SBC's court requiring that they acknowledge and respond to all current studies about RF harm to living organisms and to change their guidelines accordingly. Changing guidelines would be highly problematic to the telecommunications infrastructure making it very clear how much they side with the telecommunications and not the American people, providing truly adequate and thorough evidence supporting their previous guidelines established in 1996 when barely anyone had a cell phone is impossible and leaves them with their one remaining tactic avoidance and delay. Thank you for the comments. Are there any other speakers online? Sir Ridge, your microphone is now available. Good morning, boards and chair. Thank you for giving me a moment to talk. My name is Serge Cagno, stepping up Santa Cruz formerly Recovery Cafe Santa Cruz. I'm also on your Human Services Commission. And I also helped design the shelters at the vets halls during the COVID. I just wanted to speak and say thank you for staff and for you to support emergency shelter emergency shelter emergency weather shelters for the past couple of days it was at Depot Park and now it's at the vets hall and just heard that it's also gonna be going this week. I appreciate your compassion for looking out for people and trying to keep people safe. I would like to point out that the vets hall for some reason is only using in Santa Cruz is only using the first floor is limited to 40 people and people are not allowed in till 10 p.m. I would like I would ask for the board to ask the staff to try to use the second floor and the basement of the Santa Cruz vets hall which would allow a lot more people that are in need because in Santa Cruz the shelter has been full and to allow people in earlier than 10 p.m. It's not a way we would treat housed people during fires and things like that. So it's not really a compassionate way or a safe way to treat the homeless. Thank you. I hope you stay safe. Thank you. Well in user to your microphones now available. Well in Garrett thanks to the previous speakers if our money were going to kill people around the world like in Palestine we'd have money for food and housing for everyone. That those funds were redirected. Since the county has militarized the sheriff's department with much equipment on surveillance technology et cetera this book I have in front of me is very relevant. It's called the Palestine laboratory. How Israel explores the technology of occupation around the world by Anthony Moenstein. And the inside cover stage Israel's military uses the occupied Palestinian territories as a testing ground for the weaponry and surveillance technology. It then exports around the world to despots and democracies alike. For the more than 50 years occupation of the West Bank and Gaza has given the Israeli state invaluable experience in controlling an enclosed enemy, unquote population. It's here that they have perfected the architecture of control. Israel has become a global leader in developing the spine technology and defense hardware that fuels the globe the most brutal brutal conflict. And it goes on with the evidence. So I recommend the Palestine laboratory book and to revisit the resolution calling 4-H. These prior, how can anyone support the kind of... Elam, your microphone is now available. As a reminder, it's star six to mute or unmute yourself. Sorry, I started speaking without unmuting myself. Morning, board of supervisors. I would say good morning, but... Whoops. Elam, I'm so sorry. We had a slight difficulty and you dropped off. If you would please resume your comment. Hello. Hi there, thank you. So we can hear you now. Sorry. Terror has rained down on Gaza for 96 days now and counting. Calling for a ceasefire is the bare minimum we could be doing. I urge you to reconsider placing the ceasefire resolution back on your agenda and vote yes to saving humanity. I hope that we can all agree on hospitals, children, residents, civilian infrastructure, refugee camps, and also in Turkey is not only morally unacceptable, also violates international law. In terms of numbers, there are over 25,000 Palestinian civilians killed. In terms of humanity, that's more than 25,000 lives drained in goals brutally murdered while billions of us are much more horrified. I believe the county of Santa Cruz should support a ceasefire because Islamophobia, anti-Arab and anti-Palestinian hate has never been more prevalent and active than it is now. To try to get perspective about people of those that are feeling is beyond what we can imagine. To experience genocide is to experience death while still alive. You lose your life, your home, your friends, your education, your school, your jobs, all while still being alive. To experience ethnic cleansing is to lose all life assets. Imagine feeling this way about your own life. Reflect on what you would be doing if it was happening to you, your child, your parents, friends, and family. Palestinian is your basic human right to be peace. I want to thank Felipe Hernandez and Justin Cummings for supporting the ceasefire resolution previously put on the agenda. But I have suggestions that remove any language that dehumanizes Palestinians, control their women's humanitarian aid, or denounce this home asset tax on October 7th without denouncing what is the root of all the violence, which is 25 years of occupation and ethnic cleansing and state of violence by Israel against Palestinians. Finally, I ask to all, how many more civilians, including 11,000 children, need to die until Santa Cruz stands up against ethnic cleansing and genocide of a people and calls for ceasefire? Thank you. Thank you. We have no further speakers, Chair. Right, I see nobody in chambers will bring it back to the board for consent. I'll begin with Supervisor Hernandez. Supervisor Hernandez, any comments on the consent? Just a few comments on 2336 and 2436. I want to thank all my commissioners and people that are taking on this role of planning commission as well, and also the others. There it is. So yes, I just wanted to thank my commissioners and people that are taking on this role as well. We have Justice and Gender Commission Shelby Mason and we have our planning commissioners, Planned Commissioner Jacinha Jimenez and alternate Alicia Dana. And so I wanna thank them for all the work they do because it's really the foundation of all the goals that we have and all the work that we do. And the other one is I'm happy that we're getting awarded grants of almost 1.15 million for transitional housing and navigation services. And I hope that we can find a way to address the houselessness crisis in South County as well, given its 15% increase. And item number 40, 130 is going to PVUSD for intersession camps after school programming. And you know, it's always a good service when we provide activities for young people. So thank you very much. It's my remark. Thank you, Supervisor Hernandez. Supervisor Cummings. Just a couple of comments. I want to want to thank Trina Barton for stepping up to serve on the planning commission and Sean Maxwell for stepping up to serve as alternate on the planning commission. Really just appreciate them being able to serve that role for our office. Item number 34, which is regarding mobile crisis response, I just want to thank the staff and the County for all their hard work with bringing these services forward. It's something that we heard a lot about over the years and just really look forward to seeing how it can be implemented and carried out. And then item number 41, just wanted to, this one is related to funding for affordable housing and just want to thank the County for putting those funds towards those projects. We know that that's oftentimes the hardest in the low and very low income housings often the hardest housing to build. And so it's just great to see that we're gonna be supporting some projects that'll really help members of our community. So thank you. Thank you, Supervisor Cummings. Supervisor Koenig. Thank you, Chair. I'm 21 nominating Sonia Leclerc to the Arts Commission. Just want to thank Sonia for all her enthusiasm and engagement over the years. And I think she'll make an excellent Arts Commissioner. Thanks for stepping forward, Sonia. On item 34, I also want to just express my enthusiasm for this rolling out of mobile crisis response services and approving this contract with the Family Services Agency to help do that. It is very much needed. And I think especially with the ability to access these services through 911 will make it just a lot more available to more people in our community. And I also wanted to comment on item 41, thanking our planning staff for so quickly organizing to help get some initial funds for pre-development and to continue development for these four affordable housing projects. I think this is really, we're starting to see our efforts bear fruit as far as sustainability update, the housing element and other work that we've done around transit. And the evidence is right here that we're seeing two brand new affordable housing developers expressed interest in some significant sized projects in our community. Thank you. Thank you for those comments. Senator McPherson. Yeah, one item I too would like to address item number 34, the mobile crisis response that behavioral staff has put together and agreement with what we have with Family Services Agency. I really appreciate this program because it's more of an effective tool for a crisis response to meet people where they are and a non-law enforcement personnel that are trained in getting into the discussions with these folks. And this approach is really safer for both the person experiencing the crisis as well as the officers in the field who would otherwise be required to respond. I think it's an excellent program. I think we're gonna see some real good benefits from it. Thank you. Thank you. And I'll just briefly comment on item 40, which is an expansion of services through our parks department for PVUSD, another significant investment in South County services. And I just appreciate the fact that the county is continuing to do increased investment in South County in particular for the most impacted youth coming out of post pandemic or out of PVUSD. And so these investments for additional services, I think continue to help equal the playing field. So appreciation of the parks department on that partnership. Is there a motion from a board member for consent? I'll move consent agenda. Second. We have a motion from supervisor Hernandez and a second from supervisor Koenig. If we could have a roll call, please. Supervisor Koenig. Aye. Cummings. Aye. Hernandez. Aye. McPherson. Aye. And Friend. Aye. And that passes unanimously. We'll now move on to the first item of the regular agenda, which is to consider the selection of the chairperson and vice chairperson for the calendar year. 2024 is outlined in my memo. I have a recommendation that we make vice chair supervisor Cummings as chair. And we make a fourth district supervisor, supervisor Hernandez as vice chair, just confirming that there are no counter proposals for any additional chair or vice chair on here. I'm seeing none. Are there any comments on this item from any board members? Survisor Koenig, no. Well, I just wanted to thank you, chair Friend for an excellent year leading our board. You consistently demonstrate just how to run a fantastic meeting, both being curious to everyone involved, staff, the public, and also moving us through some difficult topics very quickly and efficiently. Thank you for those kind words. Yeah, I'd like to second that comment. I think you've done a fantastic job under some real trying conditions of the emergencies that we've had. Hope we don't have another one and supervisor Cummings here as chair. But you've done a great job in pulling this through and some of the things that have happened in the South County, especially the Pajaro River issue that I think we're gonna correct and the hospital issue that we've overseen that really was really led by our CAO, Carlos Palacios. But some really fantastic things that we're gonna help the people of Santa Cruz County very much. And thank you for your very professional way of conducting the meeting. Appreciate it. Thank you, supervisor McPherson. Any additional comments? Yes, I'd also like to thank you for all your hard work and leadership as well. You worked really hard and tirelessly for the Pajaro River and also really took an additional work in this effort as well. And also thank you for guiding us, young new supervisors in our role as well. So thank you. Yeah, I'll just echo in the comments of my colleagues and thank you for all your leadership and demonstrating the differences in how certain boards run their meetings, having served on the city council, coming to the board of supervisors. It was interesting to see what those differences were gonna be and just really appreciate the collegial spirit that you bring and the respect that you give the folks who have come to speak before the board and will definitely be trying to carry out the level of efficiency moving forward into the coming year. I appreciate your kind words. I accept them very uncomfortably actually. I view it as a ceremonial role but also on the flip side this year, we had a significant number of challenges in particular with some of the storms and so to be able to be in the chair role and to help partner with our amazing county leadership on a state and national level has been a distinct honors. Everybody up here knows serving as county supervisors for a remarkable honor, being able to represent the board as chair is an even more distinguished honor and so it wasn't a responsibility I took lightly but it's something that I greatly appreciated. Is there any member of the community that would like to address us on this item? We do have, it is an action item to make Survisor Cummings chair and Survisor Hernandez vice chair. Good morning and welcome back. Yeah, hello, my name is still James Ewing Whitman. Seems like 2024 freedom of speech is really gonna be in question. We have so many Gerald Ford situations going on when the pedophilia was exposed with Watergate and Nixon was left. Ford just went into the presidency. What's gonna happen with our presidency when things happen, who's gonna walk in and who is going to replace the California state senator? So I actually wrote down that probably Justin Cummings and Felipe Hernandez would be the puppets on strings that are controlled by our county civilization and obliteration assistants. That's you, Mr. Carlos Palacios, because these members, they don't really have any powers. They just are kind of stick puppets. So I don't know Mr. Felipe Hernandez all that well but I have a pretty good record and can probably go on for about a hour and a half about Justin Cummings. We've got some really interesting things where Santa Cruz really states the stage for things that aren't really positive. So as far as the members and let's say the city, at least they're kind of redacting what they were as far as supporting the Palestinian ceasefire. I'm not for supporting a ceasefire. Apparently 60% of our Congress are dual citizenships with the government that controls Israel. We are facing so many different genocides going on and I'm glad that I wish more people were actually questioning things. So it's not so much about shooting the messenger but what is the message? I'm absolutely questioning the jurisprudence in this room and fiduciary trust because it's really fake. Thank you. Thank you. Is there anybody else that'd like to address this on the side of in chambers? I see none. Is there anybody online? Yes, Chair. Paul and user two, your microphone's now available. One year ago, this is Marilyn Garrett. I welcomed the two new board members with this comment and I would also like to request that you restore the three minutes comment time that we had for decades. Greetings to our two new board of supervisor members and now the new chair and vice chair. I've spoken many times before you as city council meetings and provided documentation on wireless microwave radiation harm from many exposures including cell phones for risons for G and pennies and towers everywhere, including in the public right of way on Freedom Boulevard in the Aptos where I reside. No thanks to the leadership of Zach Friend getting them in. No neighbors gave consent and informed consent. As our county is partnering with Crucio providing them with a half million dollars to install hazardous 5G radiation assault antennas and towers throughout our county. I now and again implore you to halt this 5G on the slot by Crucio and the telecommunications corporations. And I recommend you read a book by Dr. Thomas Cowan titled The Contagion Myth, in particular the chapter of electricity and disease from page 14. A particular concern is the fact that 5G transmitters broadcast. Is there anybody else like to comment and maybe make the item, the comments relevant to the fact that we're trying to choose a chair and vice chair on this item? Call and user 1192. Your microphone's now available and it's star six to mute or unmute yourself. Hey, this is Gail Mackey and I wanna comment on some of the possible. I wanna comment on some of the possible challenges coming up for the new chair that I am concerned about. And one of them is that Santa Cruz is a sanctuary city for people that have come to this country illegally. And my concern is that it's actually protecting sex traffickers and labor traffickers and contributing to an increase in crime in this area while ostensibly claiming that it's helping people. I think it's actually a great detriment to society. Also the high density that you're promoting like it's also ostensibly helping people is actually concentrating people in inhumane conditions and concentrating them for actually creating an open air concentration camp where people can be closely surveilled with 5G surveillance and controlled. In fact, 5G is the active denial system that was used in the Iraq war. It is a microwave based active denial system. And it tightly focuses microwaves 95 gigahertz and can be projected at a long distance farther than the reach of standard military rifles. So this is not some benign communication system. And I just wanted to alert you to the dangers of that. Thank you very much. No further speakers chair. All right, we'll bring it back to the board for a motion. I'll move the recommended actions. We have a motion from supervisor Koenig a second from supervisor McPherson. We'll get a roll call please. Supervisor Koenig. Aye. Cummings. Aye. Hernandez. Aye. McPherson and friend. Aye. And that passes unanimously and congratulations. Name tags too. All right, here we go. I guess I'll just start by thanking my colleagues on the board for their support for becoming the new chair. And I can look forward to helping us, you know, continue putting efficient meetings and working in a spirit of collaboration. So with that, I guess we can move on unless Supervisor Hernandez, if you have any comments you'd like to make. I'm just, I want to thank everyone and I want to thank Justin and I hope that, you know, we're in good hands with Justin and his leadership as well. All right. That I guess we'll move on to the next item on our agenda which is item number eight. This is a presentation from Pajaro Valley Health Care District as outlined in the memorandum of the County Administrative Officer and I'd like to invite up Steve Gray, CEO of Watsonville Community Hospital and Marcus Pimentel to kick us off. Good afternoon. Good morning, Chair Cummings. Pleasure to present in front of you and Vice Chair Hernandez and our Board of Supervisors. I'm honored to be here today. Not in my role as County Budget Manager but in my role as an elected official for the Watsonville Community Hospitals Power Valley Health Care District. I'm here today with our CEO, Steven Steve Gray and in the audience is our Board Chair, John Freel, former CEO when the hospital was community owned and locally ran. We're honored here to have this opportunity to present in front of you. As you know, our board was formed and took, was formed and appointed in March of 2022 and in September of 2022, we took over the governance of the Watsonville Community Hospital. Unfortunately, shortly thereafter, 2022 finished for the hospital with nearly a $30 million annual loss in 2022. Since that time, our governing board has taken various initiatives, including adopting a new strategic plan with a new mission, a new vision and value statements that are gonna guide all of our action plans. This was all done with the partnership of this board, this community, our CEO, Carlos Palacios and all the staff and leadership of agencies and nonprofits and the state who put this all together. In those action plan, we developed a multi-year roadmap to bring our hospital to financial sustainability and long-term viability. We want another 128-year run in our hospital and then double that again. We've also received a clean audit for our first year. That's something we haven't taken a moment to celebrate. Our very first audit was a clean audit by independent auditors, so we're very proud of that. And on December 27th, just a couple of weeks ago, December 27th at 2023, our board adopted a balanced budget for the Watsonville Community Hospital, eliminating that loss from 2022. However, there's more work to be done. We still don't own the land or the buildings that are underneath the property that was sold out from our community in 2017. And this adds $3 million a year and annual costs that we like to bring back into our community and invest into our services and our providers. We know our hospital and healthcare campus with our devoted nurses, providers, executive team, leadership, staff, and community partners. We know we have incredible potential and the land around our property gives us a lot of opportunity for future success. We have already seen our patient safety ratings increase to that of Dominican Hospital and we're not stopping there. We plan to do even more and turn that campus into a health care, a campus of health care excellence for many new expanded services that our community deserves and needs. On behalf of our board and our entire community, again, we are internally thankful to this board and their leadership, the staff and their leadership, our community, our state partners, everybody who came together to save this hospital in 2022 and set it on a pathway towards local governance and the ultimate pathway to bring everything back under local control and operations. So I wanna turn over the rest of this to our CEO, Stephen Gray. Thank you, Marcus. Chair Cummings, congratulations and thank you for having us and members of the board. Before I start talking about our hospital and thank you for the opportunity to speak about our hospital and about our health care district, I do wanna thank County staff, in particular the County Public Health Department for investing in and participating in the Verily Wastewater Management, Wastewater Testing Program. So one of the best ways to find out how we're doing on our COVID and flu prevalence in the community is to test our wastewater because we don't get the good results from home tests and things like that. And so looking at our wastewater is the best way to do that and we are high right now. So we have a number of patients coming through our hospitals locally and across the state for various respiratory illnesses right now. About as high as we were at the peak of last winter and so for that, I'm gonna try to do my part to protect the high risk folks in our community and I'm gonna keep my mask on. If you do have any trouble understanding me or hearing me, please do let me know and I'll try to do better with that but I'm gonna try to play a little public health champion role as I speak about our hospital. Speaking of public health and important tools in our public health tool chest in Santa Cruz County, I wanna talk about Watsonville Community Hospital and our journey. So I'm gonna do a little bit of background on where we have come as a hospital and as a healthcare district. Mark has touched on that a little bit and I'm gonna go into a little bit more detail so that members of the public can have a better sense of where we have come. We'll talk a little bit about our strategic plan and where we are operationally and where we're going in the future and some of the things that we have planned and need support for as we move forward. We take care of thousands of members of our community at Watsonville Community Hospital. Over 33,000 people came to our emergency department in 2023. We had over 800 babies were delivered at our hospital and thousands of other patients came for lab tests, imaging scans, rehab, et cetera. We employ 650 people and that doesn't count the 300 physicians who have privileges to practice at our hospital and take care of patients. Mark has mentioned we've been in this community for over 125 years. That is pretty remarkable and something that I didn't realize until I met these wonderful folks who work for the hospital and work for the healthcare district. It was nonprofit for about 100 years, a little more than 100 years. The 89 earthquake damaged the hospital and made financial viability going forward very, very challenging. And so keeping up the financial sustainability at that point was it required somebody to come in and take over the facility. And so the for-profit ownership began in 1998 and there has been a number of other leaders in the for-profit healthcare world that have led and run Watsonville Community Hospital over the 20 years since then, culminating with Halston Healthcare from 2019 to 2021. They purchased the hospital in 2019 and sold the land and the buildings to Medical Properties Trust, which is a real estate investment trust based in Alabama in order to raise cash because they were cash challenged. The hospital was struggling financially. The COVID pandemic did not help and the way it had been invested in or not invested in over the years also did not help. There were a number of services that were in the hospital that had then gone away. And so the financial challenges were big in December of 2021, Halston declared bankruptcy and started sending warning notices to staff that the hospital might be closing. This community, people in this room, people in front of me, people to my left, people in Carlos Palacio's office, people at the state legislature and community leaders throughout the Pajaro Valley and Santa Cruz County and Monterey County came together and saved the hospital. They raised over $64 million to take it out of bankruptcy, to pay off debts and to purchase the operations of the hospital back from Halston healthcare and from bankruptcy. And the Pajaro Valley Healthcare District was born and officially began operating the hospital in September of 2022. And in January of 2023, we established a Watsonville Community Hospital Foundation, which is now our philanthropic arm that raises money for our now, again, non-profit hospital. The boundaries of the Pajaro Valley Healthcare District are, as you see on the screen, they go from Southern Aptos and Corolitos down through Watsonville and Pajaro and Los Lomas in Northern Monterey County. This is an overlap with the Pajaro Valley Unified School District, but not exactly the same boundaries, but it is similar. Why is this region important? The Healthy Places Index gives us a really good sense of why the boundaries of this healthcare district are important. The dark blue and the light blue represent areas of our communities that are underserved from a health standpoint, from an education standpoint. Healthy Places Index puts all of these, aggregates all of these data in every zip code and every census tract in California and puts it on a percentile ranking. And so the dark blue and the light blue are the most vulnerable of our parts of our community. And if you look at the actual numbers, there are 7,300 Santa Cruz County residents in the least healthy quartile in the Healthy Places Index, and all of those, 100% of those are inside the Pajaro Valley Healthcare District. And there are about 60,000 Santa Cruz County residents in the second least healthy quartile, and 92% of those are in the Pajaro Valley Healthcare District. So this healthcare district is not just about the hospital, but it's about what we can build around the hospital as we move forward. This hospital is the centerpiece of the healthcare district, but we have the opportunity going forward as we make the hospital more financially sustainable to then build the district around the hospital and to build and weave services throughout the community, throughout the Pajaro Valley Healthcare District, through these light blue and dark blue zones to wrap services, wrap healthcare services, preventative healthcare services around those communities to change these colors and make all of our community healthier in a less vulnerable place. The CDC Social Vulnerability Index is another example of all of the highest vulnerability areas in our community, in our county, are in the Pajaro Valley Healthcare District boundaries. These are the places that are most vulnerable, and we've seen this, and you've talked about it in your comments already this morning, the flooding that happened last winter made it obvious that these colors are correct, that these areas within the Pajaro Valley Healthcare District are vulnerable to natural and man-made disasters. Equity is at the heart of everything that we do in Watsonville Community Hospital and the Pajaro Valley Healthcare District. This graphic shows that over a quarter of English-speaking people in the community who received care at a hospital in 2021 got that hospital care at Watsonville Community Hospital, but over 70% of people whose primary language is Spanish got their care at Watsonville Community Hospital. So these numbers represent what is at the heart of what we are trying to accomplish, our mission is to be the trusted, equitable healthcare partner for our communities. They're our communities deserve. We are the place where the vulnerable and the non-English-speaking and the non-white population of Santa Cruz County come for their healthcare, and we take a lot of pride in that. We take care of everybody who comes to us, and we know that that community is a big part of who we are and what we do and what we take care of. So when the Pajaro Valley Healthcare District was first created and birthed, the community and the district leadership came together and conducted a strategic planning process, and that strategic planning process led to the mission vision and values that you see on the screen here. Just read the mission, the vision is to be our community's champion advocate for health and wellness to improve the lives of our community for generations to come. As Marcus said, we wanna be here for another 128 years, and financial sustainability is gonna be a huge part of that. And our values, they're along the left of every single one of our slides, but they're about people, excellence, trust, and family. As I've been able to walk around the hospital my first few weeks working there, it's really clear that everybody who works there cares deeply about their community and is there because they get to take care of their family members, they get to take care of their community, they get to take care of their friends, and they wanna continue to be able to do that. The strategic planning process also gave us our strategic priorities. So two that are for the district as a whole, which is around community health and advocacy and recruiting providers, and the hospital focus ones are specific to clinical quality and patient excellence, our talent and our people, clinical services and access, and our financial sustainability. So everything that we're doing at the hospital to measure our success are built around these strategic priorities. And everything in that, as we drill down into every single one of those metrics, we'll be able to look at them from a health equity lens. Are we providing equal or better care to every single one of our populations, not just those who are better able to pay and not just those who have better access, but to all the parts of our population that are coming into greet us. Marcus talked a little bit about some of the financial history. Here's a lot more detail. And so you can see from 2012 to about 2016, the hospital was doing okay. We had a net operating income that was positive. When it started to go down in 2017 and 2018, that's when quorum health started to look for buyers and started to sell off some of their hospitals and including Watsonville Community Hospital in 2019 is when Halson came in. 2020 is obviously when the pandemic started, which was a challenge for hospitals and healthcare systems everywhere. And so you can see the losses in 2021, 22. And then late 2022 was when the healthcare district took over and the hospital became nonprofit again and a huge turnaround, more than a $20 million turnaround in 2023 alone from the 2022 losses to the 2023 losses. That $20 million turnaround was done without any layoffs. It was done without any service closures. It was done by looking at how we were collecting our revenue and doing a better job with that and renegotiating some of our payment structures with our insurance payers. And it was done by being really good stewards of our costs. And we are continuing to do that. And we have more plans to do that, such that the 2024 budget is effectively balanced. It's a very, very minor loss that we are budgeting for 2024. We feel really good about our ability to achieve that. And it's a big lift, right? That last mile to financial sustainability is a big lift. So we have a number of new services that will be coming online that I'll be able to talk about in a second. And we have additional cost savings measures that again will not cost jobs, but rather they're looking at how we can be better stewards of our costs around the supplies that we're buying. We have programs that through the government, through the federal government that we can apply for to save money on drug costs. And we're partnering with a group purchasing organization to get better prices on our supplies, things like that, things that the former ownership either wasn't able to do or didn't do. One of the big components of our continued turnaround plan is providing care to people where they live. Right now we transfer about 2 1⁄2 to 3% of patients who come into our emergency department get transferred out to another hospital. We wanna reduce that. We wanna be able to take care of as many of those patients in our hospital, in Watsonville, where they live as we possibly can. We're a community hospital, we're 106 beds. We're not gonna be able to take care of everybody, but we know that we can reduce the number of patients who are having to be transferred out to another facility. And so a couple of the ways that we're doing that, we have the Da Vinci robot assisted surgery. So this is a surgery device, a robot assist device that helps surgeons in general surgery and urology and gynecology to provide better, lower, smaller incisions, faster recovery for patients receiving certain types of surgery where it makes sense. Previously, these patients who needed that type of surgery were having to be transferred out to another facility. Now they can get that here at Watsonville Community Hospital. We had a cardiac cath lab at Watsonville Hospital up until 2017, and Quorum chose not to reinvest in that equipment, and so it has just sat dormant. We've been able to replace that equipment. We have the brand new equipment installed now. We are finalizing all of the construction around it, the flooring and all of that stuff over the next few weeks, and we'll have the state come in in February to bless it so that we can start doing pacemaker repairs and replacements and cardiac catheterization for patients who have heart attacks later in the summer and things like that. So this year we'll have additional cardiac services that again, patients have had to be transferred out. So patients will continue to get their care in their community and the revenues for those services will stay in the hospital. So what's next and what's important is we have a hospital improvement measure. It's called Measure N. It received unanimous board approval by our board, the Pajaro Valley Healthcare District to put it on the March 5th ballot. Residents inside the Pajaro Valley Healthcare District will be voting on it and it will require a two thirds majority vote to pass. The Healthcare District did a number of pieces of pre-research asking about the improvement measure overall and specific projects that are planned for the dollars raised. Overall support was over 74% with about a 4.88% margin of error. So we feel really good about that. We also know that it's close, right? We need to get to 66.67%. So we feel good and we feel like we know that it's important that we help people understand what it is and what it means. We will have independent citizen oversight if the bond passes on the dollars and how it's spent. $116 million would come to the district over six to nine year period. It would be paid for by property owners inside the district paying approximately $24 per year for $100,000 of assessed property value, not the market value. And the money can only be used for buildings and items that are attached to or part of the buildings. And so renovating and expanding our emergency department, I mentioned earlier that we have 33,000 people come through our emergency department last year. We know the demand for that is higher and the need for that is higher. And so the ability to be able to renovate the existing space and expand from 12 to 22 beds would be huge for our community. We'd be able to replace imaging equipment that is aging like MRI scanners and CT scanners. We would be able to repair and renovate our patient rooms, do all the things inside the building, inside the walls and the roofs of the building that you don't always see like the elevators and the heating and ventilation and air conditioning and the roofs. And we would be able to buy the property that Marcus mentioned as well to eliminate three million per year in rent. So again, the buildings and the property, the 27 acres that the hospital sits on are owned by medical properties trust which is based in Alabama. And we send them $3 million a year in rent so that we can be on that land. The right to buy it back was part of the negotiation as for during the bankruptcy proceedings. And so we have a right to buy it back but we have to do so by the end of 2025. So the bond measure dollars would allow us to be able to do that. Once the property is back in our ownership then the community owns it again, which is wonderful and we'll be able to use those $3 million a year to reinvest back in our people and our services. I'm gonna stop there and see if there's anything else you wanna add and see if anybody has any questions. Thank you very much for the opportunity to give you an update. Thank you for that presentation. Before we go to the board, I'm thinking maybe we should go out to the public and see if there's any questions or public comment on this item so if there's any member of the public who'd like to speak on this item, this is a non-action item but if folks have any questions or comments they'd like to make on the presentation now would be the time to line up in front of the podium and you'll have two minutes. Yes, David Schwartz. Just real quickly, I just have a question about the purchase of the building and the maintenance costs. Are you guys currently maintaining the building and is that going to be an additional cost over to above what the bond issues gonna bring in? Thank you. Sure. We are currently maintaining the building, all of the maintenance of the building whether it be the internal workings or the equipment, HVAC, all of those kinds of things are things that we are currently responsible for and will continue to be responsible for and part of the bond measure will be able to help us replace some of that aging equipment so that the maintenance is not as burdensome for our amazing facilities team. Thank you. You're welcome. Hello, my name is still James Ealing Whitman. There are many things that I can compliment about this presentation, such as increasing the hospital beds, fact that hopefully the county can buy this piece of property and save themselves three years in rent. Now as far as the auditing, there are some real experts in this county and doing audits and such. But you know, western medicine, a lot of problems with western medicine. I mean, there was an author in Canada that after being a physician for over 25 years, she wrote a book called Medical Mafia. She describes western medicine as petrochemical finance, sickness over health, profits over cures. You know, here I see people who seem so uninformed about what's really going on in positions of leadership where you know, the biggest organ on the body is their skin. People are concerned about wearing a mask. How does that help the rest of your body? How does that help your eyes? You know, there was an award given at the ACLU about a month ago. There were four awards, but Gail Newell was given award. You know, she concentrated the contact tracing and reaching out to the Brown to make sure that they got tested and they got vaccinated. And there's a lot of problems with these vaccines. So I have a lot of questions. I was able to say a couple positive things, but you know, I live in very close proximity to the life flight helicopter that is flying in and out all the time. You know, advanced first aid really isn't that difficult. I mean, I have an advanced first aid that's really not much larger than my wallet. You know, I really appreciate some of the activities like the Boy Scouts and becoming an Eagle Scout and being interested in helping people. So, you know, I did appreciate a great deal of what was said, but I do have some questions and I heard them. Thank you. Thank you. Is there anybody else in chambers who'd like to comment on this item? Seeing none, are there any members of the public online who'd like to comment on this item? Yes, Chair. We have speakers online. Colin, user two, your microphone is now available. Colin, Garrett, seems like corporations are taking over everything that should belong to the communities and be supported by our tax dollars. I often think of the contrast of when I visited the former Soviet Union in 1966. And my husband at the time got sick. The doctors came to the room. Everything was free, free medical care. This is not a system that helps people. I want to get this quote again, James Ewing gave about profit over health and petrochemical, I got to get that written down. But I want to give an account of a friend of mine in a Monterey County brokerhood. And she is made ill like me by the wireless microwave technology and the Wi-Fi antennas on the roof of all these buildings. And there's a whole documentation on adverse health effects. So anyway, we need places that do not have this kind of microwave radiation assault which causes heart palpitation, DNA strand breaks, headaches, nausea, increased cancer incidence on and on. And I request that any hospital should have facilities that are free of this kind of exposure. And again, read the book, The Contagion Myth by Dr. Thomas Cowan. And the subtitle is why viruses, including coronavirus are not the cause of the disease. Are there any other speakers online? Call in user 1192, your microphone's now available. We're unmuted. Thank you, this is Gail. And I am concerned about this COVID vaccine rollout again. The hospital is a pivotal promoter of whatever strategies we use. And I'm appreciating so much of the hardworking doctors there. So I know it's a hard job, but this vaccine was promoted to be safe and effective and that there would be minimal side effects. But actually this is proving to be false. There's a Midwestern doctor who is reporting that actually this came out of the New American Journal that people 25 years old, 50 years old, 40 years old, experienced an 84% increase in mortality, which has never been in history. There's a serious, serious problem here. Another estimate is that the United States is experiencing 2.5 million excess deaths a month that we are facing possible population collapse. The deadly side effects observed by this Midwestern doctor that reported these are strokes, blood clots, hemorrhages, heart conditions like myocarditis, heart attack, sudden death from an unknown cause, anaphylaxis and allergies, seizures, other neurological conditions, psychiatric conditions, body immune disorders and chronic fatigue, turbo cancers and immune suppression and miscarriages. So unfortunately, we cannot trust the CDC anymore. We cannot trust them to guide our policies. And I suggest people think for themselves that the hospital staff think for themselves and not blindly follow corporate protocols by giving remdesivir, which is... We have no further speakers, Chair. All right, thank you. So I'll bring it back to the board to see if there's any questions or comments on this item. To the President. Thank you, Chair. Thank you for the presentation. Mr. Gray, thank you, Mr. Permitello. Also for your service on the board. Thank you all for your service on the board and for your continued service on behalf of South County. Unquestionably, it's been a system that's been destabilized by private owners over the, at least the last decade, but realistically even longer than that. And a lot of what the public ownership has been able to do is just create a sense of stability and normalcy to the system, both from a financial standpoint, but also from a staff standpoint for the providers and finally from a service standpoint. But I did have a couple of questions that sort of longitudinally, for you, Mr. Gray, that I thought you'd be able to address. It was a very informative presentation and the data was remarkable in the sense that it shows how integral to the overall healthcare system the success and survival of Watsonville Hospital is. The data not just on the number of babies that are delivered or seniors that receive care from strokes or cardiac related issues are significant, but what would happen if that were gone on a system with Dominican going code red and multiple days a week on different weeks, for example, and how somebody would even receive care for most much of our districts, but also for the other districts that rely on Dominican Hospital to have that sort of overwhelming. But with that said, given that a number of hospitals across the state are struggling financially in particular with this payer mix, do you know of any other hospitals across the state with this kind of payer mix that are successful? And how do you see sort of longitudinally, not just measure end, but moving forward, whether under this structure, Watsonville Hospital can continue to be successful? Yeah, Supervisor Friend, thanks for that question. So there are other hospitals that have similar profiles to ours that have been successful. So we are a 106 bed hospital and 80% of our patients who come through our doors have either Medicare or MediCal. And so a profile like that with around 100 beds and around an 80% government payer mix, there are 34 of them in the state of California and 11 of them had positive operating incomes in 2022. So it's about a third, right? So it's possible and it's hard, right? So I think that's sort of the message of everything that we're doing, the way our system is set up, the way that Medicare reimbursement works, it's challenging, but it's doable. And so I think we will continue to look to those other hospitals that have been successful. We immediately, when we became a healthcare district, became part of the Association of California Healthcare Districts. And so we have great relationships there and have the ability to learn from other healthcare districts that have hospitals that are in communities like ours and the Pajaro Valley to learn about what their success stories have been. And so we are doing that. And again, a lot of it is being able to take care of patients where they live and being able to show that stability and have physicians want to practice where we are. And so we've been able to have a number of conversations with physicians who haven't come to our hospital in many years but are hearing that things are different. And so that's a wonderful thing that more people can get taken care of at our place. Thank you for that. And I had the honor of speaking at the Health District Social Services annual event a few months ago and they looked to this district as the beacon of possibility of what can be done when something moves back into public ownership, community based ownership. And they really are looking for this district to lead to show how it can be successful across the state and to that end, one last question, that's okay, Chair. I serve on the Alliance Board complicated government or public financing vis-a-vis the way that Watsonville Hospital works. So maybe if you could speak a little bit about how those government reimbursements work, how reliant the hospital is on that and how you see that moving forward. Yeah, absolutely, thank you. So the Alliance or the Central California Alliance for Health, which is our MediCal managed care partner has been an amazing partner throughout this whole process. They provided us a large significantly large grant during the bankruptcy proceedings to help save the hospital. And they have been wonderful partners as we've been moving through these transitions to a public not-for-profit entity as we've been moving forward. So I do wanna take the opportunity to thank them for their great partnership. And they are working in a system and they have the resources available to them that our state government and our federal government choose. And so the choices that state and federal governments have made is that in California, across all of California, as a state average for 2022, if you spend a dollar to take care of a Medicare or a Medicaid patient, the hospitals get reimbursed 70 cents. So we lose 30 cents on every dollar that we spend to take care of a Medicare or MediCal in Santa Cruz County and in Northern California, it's worse than that. And in fact, at Watsonville Hospital, it was 54 cents we got paid in 2022 to spend a dollar to take care of a Medicare or MediCal member. And so that presents a challenge, right? We have if 80% of our patients are giving us 50 to 70% of our costs on the dollar, then that presents a challenge and it presents something that we get to talk with our legislative leaders about and I've already had some of those conversations and it makes it so that we have to rely on the other 20%, right? And that's what all hospitals in the state and the nation do is they rely on the payments that they get from their commercial payers. And just makes it all that more important that we're very good stewards of our costs and that we have good processes for collecting every dollar that we are owed based on the services that we provide, which frankly was a challenge and that 54% is probably a challenge of some of the lack of systems and processes that the former owners had for collecting some of those dollars. So we're probably closer to the statewide Northern California averages. Thank you. And moving forward, I think that the board should take a look at Measure N and see the ways that we can be supportive of it. I'm sure that we can take a more formal discussion about that moving forward, but I appreciate you providing this opportunity for us to learn more about the system. Yeah, thank you. Thank you, Mr. Chair. Other comments? Yes. Thank you as well for your presentation on such a valuable asset in our community. You know, I'm supportive of the district that's goals and objectives that you guys presented today. And Watson Community Hospital is vital. It's a vital asset in our community in South County, but also Mid County as well. And I think it helps decrease the patient overload in Santa Cruz as well. So it's really valuable to entire County. You know, I was born in Watson Community Hospital and in high school, I got to volunteer there at the front desk many years ago. And now, you know, I'm really proud to be just a small part of the formation of this district because, you know, it really puts the community back in Watson Community Hospital, big drastic difference from the past owners. And so, you know, our County has been really supportive of the Watson Community Hospital, the district. And I hope we continue to support it and help it with the expansion of services you guys talked about and further its relationships with local healthcare providers like Salupa La Gente, Clinica del Valle. And if there's anything that we could do, whether it's a letter of support or a resolution to endorse their goals and objectives and the measure, I would like to see that happen. Thank you. Thank you so much. We really appreciate that. I will make sure Marcus will be in touch. Any other questions or comments? Supervisor Koenig. Yes, thank you, Chair. Thank you, Director Pimentel. Thank you, CEO Gray, for the great presentation. And in particular, CEO Gray, I just want to thank you for taking on this role and really helping to stick the landing of this amazing turnaround. And I heard that you were taking on the position. I was so excited. I don't think there's anyone who knows our community better and the healthcare system in our community and there just couldn't be a better fit for leadership at the hospital. So thank you. And does your presentation really explain how Measure N is an important last piece of the puzzle to really putting back together the community hospital after it's basically pulled apart by vulture capitalists. You can see how they're like, well, we'll just sell off this piece and take the money. And so I do hope our community will support that. And it really does seem like that, at least in the short term, puts us back in the black from that with an additional $3 million a year that we can use, as you said, towards operating the hospital. So that's really exciting. Certainly some sobering numbers, as far as what you're getting reimbursed by the government insurance to take care of patients at Watsonville Hospital. And so my question is, what's the goal? Is do we have to get to 75% government payers, 25% private insurer mix? Is it just providing more services for folks on private insurance in order to ensure financial health in the long run? What's the goal for the payer mix in the future and how do you get there? Sure, yeah, thanks for that. First, thanks for the vote of confidence. I really appreciate that. I'm gonna try to do my best to live up to those words. In terms of a goal for the payer mix, I don't have a goal for the payer mix. I'm gonna, we're gonna take care of the patients who come to us. We do have a goal for financial sustainability and we're gonna have to work with whatever payer mix that we have to achieve that. And that goal is really gonna be, we're gonna wanna have like a 2% operating margin each year in order to be able to have some money to reinvest back in our services, to be able to replace aging equipment, to be able to add new services that our community health needs assessment tells us that our community needs and that we, is not a service that's provided in our local area. So about a 2% operating margin is usually around what my past experience tells us that you kind of need. You saw on my slide, we've been significantly negative for a while and this year calls for like a negative 0.2. So that's getting there, but we need to be positive a little bit positive each year in order to be able to reinvest back in the services. And so that's gonna take, is it gonna take better reimbursement from any of our payers? Yeah, that might be part of it. And it's gonna take us being really good about making sure we're charging for everything. We're not missing charges. We're getting credit for every piece of care that our doctors and nurses and techs are providing and that we're saving money on our expenses where we need to. We have a new, we're joining the 340B program with the federal government to be able to save money on medication expenses. And we're with a group purchasing organization to get better prices on our supplies. So we gotta keep doing things like that and then keep providing the services that the community needs and that can help pay those bills. Great, thank you for the explanation. And of course, if there is anything that our board can do to continue to help, whether it's get better reimbursement rates or other ways to help just financial health and of course the physical health of all the patients who depend on the hospital. I'll add lots of hospitals, my parents' hospital. So I'm very interested in making sure that you guys are around. Thank you. Appreciate it. Yeah, thank you for your presentation. Very, very interesting. And once again, I want to thank the people of Santa Cruz County. Our county staff team led by Carlos Palacios, our CAO, Mr. Pimentel is on the board now for everything you have done to rescue the hospital in the first place, raising $64 million was no easy task. It's nothing like that has ever been done in this county. So I know the people of Santa Cruz County realize the importance of keeping this hospital running. And it's a Herculean effort that needs to be recognized. I want to just say too, thank you to the 650 staff that you have. Would you please tell them that we really appreciate their being there and providing the services that they need, the people that Santa Cruz County need. And as I said, it's just not the South County in this district that's going to benefit from this. There are plenty of measures on the March ballot. And there's none more important than measure end for literally the health of Santa Cruz County. So I hope we can get people behind it. It looks like it's good, but don't give up. Keep going, I know you will. I just urge the people of that district to support measure end. And I'm sure the county board will be taking some action on that regard in the near future. Thank you. Thank you for that. And thank you for the words to our staff. I will pass that along. I appreciate it. Now, if there's no other questions or comments, I'll just thank you all for your presentation today. And I think the board is very supportive of the hospital and just really want to appreciate all the efforts that have been made to not only save the hospital itself, but to really bring the hospital back up into a position of financial stability. And it really just goes to show that if you get the right people in there, then we can make this hospital work. And I think that's going to be really important for members of the public to see when they can be deciding on whether they should support this measure. And I think that by demonstrating that, we're able to actually make this a sustainable hospital will really be encouraging for voters to want to continue to support it, especially because in the absence of that hospital, we know that we would have a very weakened medical system here in Santa Cruz County. And so to the extent that we can, whether it's putting a resolution on the next agenda to support measure end and whatever efforts we can do on our side to be supportive of measure end of the hospital. And I think we'd be more than happy to support that. So I just want to thank you all for your hard work. Thank you for being here today. Thank you so much. And thank you for having us appreciate it. All right. With that, we're going to close out on that item. We're going to move on to the next item on our agenda, which is item number nine. Item number nine is for the board to consider resolution ratifying the proclamation of a local emergency with the summer 2023 coastal storms as proclaimed by the county administrative officer as the director of emergency services on January 3rd, 2024 and take related actions as outlined the memorandum of the director of the office of response, resiliency, or recovery and resiliency. And so with that, I will turn this item over to Dave Reed, director of OR3. Good morning, board. Good morning, chair. Just want to give you a short update and report on the agenda item and some context for where we've been and where we're going. This represents the third consecutive year where I've come before the board to ratify a local emergency proclamation. So there's no question as CAO Palacios mentioned at our last meeting in 2023, the struggles that we're facing today, over 40 million Americans are actually facing extreme weather conditions. So for us in this event and what's before your board, I just want to give you some context for what we were observing, what we did in preparation response and early stages of recovery. So what we were really interested in focusing on heading into this storm was recognizing what we experienced on January 5th and the conditions of January 5th on the coastline and seeing how the forecasted high tides and high wave action was going to impact the community. So as a comparison, just for context, we had a six foot tide in January with a storm surge that put us over 7.2 feet and then we had 30 to 40 foot waves hitting our coastline. In December 28th, we had a five and a half foot tide storm surge over 6.7 feet and we had waves in that 20 to 30 range. So we still saw significant impacts in December, not as big as January, but we're trying to collect data sets of the conditions that yield this kind of damage so that we can better prepare our community ahead of these types of events. So from a preparedness standpoint, we were preparing for what we thought would be similar to January 5th, that ended up being slightly less, but we sent out two county-wide emails through the cruise aware system on the 23rd and the 27th to alert community. We deployed cert volunteers into the coastal zone to go door to door to let folks know ahead of the storm. We were concerned that there would be vacation rental folks because it was a holiday week. The County Emergency Management Organization, we notified all of our TSW-1 staff the week before Christmas to prepare them. We notified all county staff ahead of that holiday week in preparation because we knew how difficult it is, so many people being on vacation. We communicated directly with the city of Santa Cruz and the city of Capitola to ensure that they were preparing themselves and their community and their businesses and property owners, and we held operational area calls to make sure everybody was informed with the best available data from a preparedness standpoint. On the response side of things, we activated at a level two, our EOC on the 28th and again on the 30th. We opened a temporary evacuation point on the 28th, just not knowing kind of what people were gonna do. Our Human Services Department leadership in the Karen Shelter branch of the EOC coordinated that and we opened that at one of the elementary schools in Capitola. It was not used, so we did not open it again on the 30th, but it was just again good practice and exercise in how we wanna respond during disasters. From an emergency communication standpoint, this board gave direction to OR3 to develop the cruise aware platform. It's been tremendously successful in terms of being able to outreach to community. We implemented the first WIA, Wireless Emergency Alert, that the county has issued on the morning of the 28th. So that went to all cell phones within the coastal zone to alert them to stay away from the coast. Obviously we know through social media that was not entirely effective, but at least we felt it was important to send that message to the community. We also issued in collaboration with the Sheriff's Office evacuation warnings for most of the unincorporated coastline road closures by our public works department along East Cliff in Rio del Mar Beach Drive. And our biggest challenge from a response standpoint was really as folks on social media securing those high risk areas. So anytime we see a large wave breaking over small children on West Cliff, that is not where we want people to be standing. So fortunately they were not injured in that circumstance, but we had similar circumstances in the city of Capitola, along Rio del Mar in the Beach Drive area. So we wanna work more effectively with our city partners to try and secure those high risk areas because those large waves can carry logs, boulders, all kinds of things that if you're hit by the wave, it might not just be water. On the recovery side of things right now, just in the reason this action is before you, we're gathering public damage estimates, initial damage estimates. Right now we have numbers north of $4 million in damage between unincorporated county and the cities of Santa Cruz and Capitola. The California Disaster Assistance Act threshold for public damage is about $1.2 million. So we have exceeded that threshold. We don't anticipate the scope and scale of this event to warrant a federal declaration, but the state does offer cost share for damages. So we're gonna make that attempt through the action before you today. As a context, the county parks department received the highest amount of damage in the $2.5 million range to our coastal parks. Yesterday, OR3 did a tour with the Small Business Administration. The attempt of that tour was to try and meet their independent thresholds for disaster declaration. They can declare a disaster independently of the state or the federal government. It does not appear unfortunately right now that the scope of damages in the city of Santa Cruz, the city of Capitola and the unincorporated county meets those minimum SBA thresholds to support individual damage. If more information comes out of the woodwork in the impacted community members or businesses, we can always revisit that. But right now, our best available data from our city partners and from unincorporated residents and businesses is that we don't meet that threshold. So that's unfortunate, but we will still proceed with asking for public assistance funding if your board ratifies the local emergency proclamation. The last thing I wanted to share is that in the last week or so, we have also worked in collaboration with HSD on opening the extreme weather shelters in the city of Santa Cruz and the city of Watsonville. So those have been operating since Friday in two locations at the Depot Park in Watsonville Vetshall. And then on Sunday and last night, they were open at Depot Park in Watsonville and at the Santa Cruz Vetshall. And we will be extending, get based on weather forecast that operations of those shelters through Friday morning. That I'll stop and see if there's any questions for. Great, thank you for that presentation. Why don't we open up to the public and we'll invite, if there's any member of the public who'd like to comment on this item, if they have questions on this item, now's the time to approach the podium and you'll be given two minutes and then we'll move to online and bring it back to the board for questions and discussion. Yeah, my name is still James Ewing Whitman. That was actually an excellent report. Glad that you included some information about what else is going on in the nation with some cold. 2024 is gonna be a spectacular year. What many people describe, the ocean's really going to experience some very high tides. Bible talks about it and such. We're having some planetary alignments that haven't happened since 79 AD. So it just seems quite fascinating how the different groups pulled together. I think it would be wonderful if the different response groups could get more citizens to actually help them because when something really serious does happen and there are a lot of really serious things going on, we all need to actually work together. I don't mean to seem like I'm so much your foe but I'm using my free speech and I'm asking questions. Don't shoot the messenger. What's the message? So thank you. Thank you. Is there anybody else in chambers who'd like to speak to us on this item? Seeing none, we'll move on line to see if there's anyone on line who'd like to speak to us on this item. Yes, Chair. Call in user two. Your microphone's now available. As a reminder, it's star six to mute or unmute yourself. I appreciate the hard work of people who are out there dealing with the emergencies. And I think wider questions, wider questions, some of the causes of these emergencies, I've referred the board before to geoengineeringwatch.org with Dane Wiggington who talks about covert weather operations that are documented to be causing floods and droughts. And he signs patents by Locking, Martin and Ray Dion. So one of the policies the board could do is to call for a halt to these geoengineering operations. That's a big thing. I also think of a larger context of emergencies. I consider the military industrial corporate takeover damage to be an emergency. And I just heard that 886 billion on the military is the proposed national budget with only 773 billion for everything else, that was on NPR news. So our money is being misappropriated. I want to commend people. There was an emergency right where I live, Redwood-Hydro and Freedom Boulevard in the Aptos, but it was caused by a high speed chase, I think. Is there anybody else online? We have no further speakers, Chair. Okay, I'll bring it back to the board then for any questions or comments from board members. Mr. Chair, yeah, this is just another reminder about Santa Cruz County being so vulnerable to natural disasters, whether it be flood or fire or whatever the case may be. And that we're gonna need to receive predictable state and federal assistance in our efforts. It's also a reminder of how important it is that we've been investing in our climate adaptation and resiliency measures that we've had. There's been several of them. We cannot prevent these disasters, but we can make our community more resilient. And I just want to commend you, Mr. Reed, our Public Works Department and others, emergency responders that we have for what they've done for the tragedies and the experiences we've had in the last several years. It's been phenomenal and we just gotta do our best to get ready for the next one. It's gonna happen and I think we're doing that and I appreciate your work in doing that as well as the other departments in Santa Cruz County. Supervisor Koenig. Thank you, Chair. Yeah, Director Reed, I also want to thank you for just the great communications around this extreme of weather event. And it seems that with all the practice, improving every time, more focused group, receiving the message, and a more focused message overall. So I thought it was great. It was a little concerning that I did go out and watch some of the flooding firsthand and that here the storms did not hit us directly. And yet even so, it seemed like just the overall amount of water hitting our coastline was actually greater in some ways than last year. I know a lot of the low-lying spots throughout District 1, just saw a huge tidal surge. And it's concerning, it's concerning to see some of the, as you mentioned, the damaged parks around Moron Lake, fence lines that had just been repaired after last year's storms are once again knocked down. So we are gonna have to do some serious thinking about how we actually adapt the infrastructure. I know that started, including looking at some bridges and some of these low-lying spots. So a lot of work ahead, but reason to be optimistic. And of course, this disaster declaration will be helpful, not just to the county and the damage we've received, but also to the various cities, as you mentioned, and to businesses and private property owners. Thank you. All right, well, I just wanna thank you for that presentation as well and for the update and report on the storms from this year. We're still not out of our winter yet either. So, and I know there's a couple predictions of king tides that if a couple with storm surge could also prove to be, prove to be issues for the county. And I, just thinking about how this is the frequency of this and how it's happening over and over, I do wonder if there will be a point where, we're gonna have to start having serious conversations around managed retreat in certain areas, depending on what infrastructure is there. Because going out and like putting all this money towards repairs, only to see them get damaged again and again over and over, I can just see certain agencies maybe not wanting us to continue to invest in something that we know is just gonna get destroyed over and over again. And so it's a conversation I think that we'll have to have at some point with our community, but just wanna acknowledge the work that you did and appreciate the efforts of your office and all the other responders out there who've been trying to at least keep people informed as to how they can be safe, make sure that people can get out of harm's way and I'm looking forward to continuing to working with your office to make sure that these services are in good shape for our community. And so with that, this is an action item and the recommended action is to adopt resolution ratifying the proclamation of a local emergency for the December 2023 coastal storms as proclaimed by the County Administrative Officer as the Director of Emergency Services on January 3rd, 2024. Upon adoption, direct staff to forward the resolution to the Governor of California with the request that he proclaim the County of Santa Cruz to be in a state of emergency and further that the Governor requests both the state and federal funding assistance and inform the applicable state legislatures of the Board's action. So I'm looking for a motion. I'll move the recommended actions. Second. So we have a motion by Supervisor Friend, seconded by Supervisor Hernandez and with that I'll turn it over to the clerk for a vote. Supervisor Koenig. Aye. Hernandez. Aye. Friend. Aye. McPherson. Aye. So that item passes unanimously. With that, I believe that that closes our open session agenda for today. We do have an item that was added and that was voted on by the Board to go into closed session for item number 9.1. And so at this time, the Board will go into closed session and that will, and before that, I'd like to ask if there's anything that will be reported out on. Nothing reportable. Thank you. Thank you very much. And with that, we'll close our regular agenda and we'll move into closed session.