 Board of Supervisors meeting and ask the clerk to call the roll. Good morning. Supervisor Leopold. Here. Friend. Here. Caput. McPherson. And chair Coonerty. Thank you, and I'm going to ask you to join me in a moment of silence and the Pledge of Allegiance. Pledge of Allegiance to the flag of the United States of America and to the Republic for which it stands, one nation, under God, indivisible, with liberty and justice. Mr. Palacios, do we have any late additions or deletions to the agenda? Yes, we have a couple. On the regular agenda, item 10, there's a revised attachment, page 151. On regular agenda, item 11, there's a revised attachment, A, packet, page 185. On the consent agenda, item 66, there's a correction, the item should read, approve amendments to two contracts for tenant-based rental assistance services, housing authority, to increase by $60,000 for a total of 181,875. On item 69, there's a revised attachment, packet, page 1159. Thank you. Great, thank you. And now I'm going to ask my fellow board members if they have any items they'd like to pull from today's consent agenda. Yeah, I'm going to pull 63. So that is for the public, that's the approve an allocation of $3.5 million in low and moderate income housing asset funds for the purchase of APN 04822109 by mid-pin housing and authorized the planning director to negotiate a final affordable housing agreement. Okay, so we will make that item looks like 20.1. It'll be heard this afternoon. If anyone is here for that item and would like to speak to that item, you're welcome to do so during public comment if you can't come back for that item. Does anyone else have anything they'd like to pull? Okay, seeing none, let's move on to public comment. This is an opportunity for members of the public to speak to us about a couple of different things. First, they can speak to us about items that are not on our agenda today but are within the purview of the Board of Supervisors. That's public comment. Second, they can speak to us about items that are on the consent agenda. Third, you can speak to us about items that are on our closed session agenda. Or four, if you can't stay because you have to get to work or you have another obligation and you want to speak to us about one of our regular item agendas, you can speak to us now but you won't be able to speak to us when that item comes up. I'd ask if you're interested in speaking to us during this part to please stand up and get in a line and we'll have you come forward and talk. I don't know whether I should say your honors or whatever but I just wanted to make a brief statement about plastic. The item before you today isn't the last item you'll see about plastic. I don't want to preach to you about information that's fairly widely available, the film Blue, there's many other sources. It's everywhere. It's not just at the surface. It's at 3,000 feet. We've already just proven that and it's all over. If we don't start asking grocery stores and other places to replace the plastic with other devices, we won't get anywhere. And it will still show up on our shores and it will be ugly and so forth. And the fish will die. I just don't want to go into all the information that's readily available. All I want to say is it's very important. You can do something about it. I've heard that there is a grocery chain for instance in England that's already done without plastic. Thank you very much. Thank you. My name is Tony Crane representing a group in Aptos, California in objection to the second story program. It has come to our attention that County Council has requested that you not speak to our community due to the threat of a lawsuit. We have not made any such explicit threats. If we had in the beginning of this debacle two years ago or you have misinterpreted anything we have said recently, you can disregard that thought. That burden of fixing a problem you created should not be put on the fixed income retirees and young families in our community. If we thought our best action was to file a civil lawsuit, we would have done that a long time ago. In fact, we believe it is not necessary. We have not been collecting evidence for a lawsuit. I'm just doing your job for you. You have sworn to uphold the law and I don't believe you are doing so. In lieu of a civil action, I have simply reported the crimes that we believe have occurred and that I have represented to you in the last several meetings and I've given that information to the district attorney. I've been presenting the evidence we've possessed in meetings to you two minutes at a time to remove any chance of plausible deniability. These are extremely serious issues that you have disregarded. I assume at the recommendation of County Council. In my estimation, they have made several errors along the way, including one email in which it appears that a member of County Council intentionally provided misleading information to the zoning department in the midst of a zoning violation investigation. So let me be clear. We have not and do not intend to file a lawsuit against the county at this time. I stand here before you simply as a witness to and have credible credible evidence of acts by County and encompass employees that I believe amount to crimes against the taxpayers of California and especially the citizens of Santa Cruz County. So any directive from County Council not to communicate with a witness to a reported crime would be unwarranted and possibly obstructive. Thank you. Good morning supervisors. Mr. Palacios. My name is Mike McConnell. I'm the division director for adult services for the Human Services Department. We wanted to thank you for your proclamation recognizing June as elder abuse awareness months. I have a couple of our key partners with me that will speak after me from the district attorney's office and sheriff's office. As the proclamation states, there are fewer than one in 24 reports of elder abuse and neglect that are actually brought to the attention of adult protective services or law enforcement. Last year in Santa Cruz County, about 1500 reports were made to adult protective services. I'm not stellar at math, but I think the actual numbers are probably much higher than that. And we just wanted to thank you for the proclamation and also for your consistent support of programs aimed at preventing and stopping elder abuse. Thank you. Thank you for your work. Good morning. Todd Loverty. I'm a lieutenant with the sheriff's office. Again, technical mic. We just wanted to thank you very much for your proclamation and the help that this does to raise community awareness for this very serious crime. Thank you very much. Jeff Rosell, district attorney. I just wanted to say that elder abuse is something that we deal with on a daily basis. Ed Brown, who you'll hear a few words from to my left, deals with it in our office along with several other attorneys. And we just want to thank you for the support that we feel and that the citizens of our community feel. And you have a commitment, as you always have, from the DA's office to provide education to assist in investigation and the prosecution of these cases. I just want to thank you very much. I'm Ed Brown and one of the prosecutors that prosecute these cases. I want to thank the board for the proclamation. Also thank the community for the information we get the banks, the neighbors, the stores that bring the information to us that let us prosecute these cases. Thank you. Thank you. Thank you for your important work. It's critically important that we have a great team that helps us protect seniors from abuse. And I appreciate all the different departments that provide that service. Good morning. Dagmar Leguillon, La Selva Beach. I'm here because I support the ban on the sale of plastic bottles. Mr. Leopold, I heard you last Friday on KZSC's Bushwackers. Thank you for taking my call or my text on the air. I understand you support the ban on the sale of plastic bottles. But that you needed more community conversation. So here we are. And just a few facts to set the stage. You may already, this might not be new information for any of you, but I find these facts particularly startling. 12 million tons of plastic is dumped in the ocean every year. Of the five top pieces that are found on beaches, plastic bottles exist in the top five. Every minute one million plastic bottles are sold throughout the world. And the most frightening of all statistics that I've come across recently is that by 2050, that isn't 30 years. If any of you have children in elementary school, they'll be 30 or 40 years old starting their family. And guess what? There's going to be more plastic in the ocean than fish. So I have a question, both for the board and for the audience. I'd like to see a show of hands who supports the ban on the sale of plastic bottles. And my second question for the board is what are the action items that the board is looking at? So start with a county wide ban. First of all in the county buildings and events and then for further on. Thank you. Thank you. Oh, and just to let you know, in my three minutes, that was three million plastic bottles that were sold. Thank you. It was two minutes. Yeah, they need to vote it. Normally it's three. Mr. Alexander, please. Thank you. Good morning. That was startling. My name is Bob Morgan and I'll just follow up what the lady said regarding plastics and looking forward to your August 6th plastic reductions proposals that have been proposed by the county to come to review. I also want to say thank you for offering the Association of Counties Challenge Awards, recognizing different departments in the county. And in particular, I want to recommend Zero Waste headed by Tim Gancharov as a very good recipient of that county challenge award. And I wish Zero Waste team good luck. I also want to comment on the approved contract for DUDEC to begin the EIR process for the sustainable plan. I'm representing Sustainable Soquel in thanking you for beginning that process, that contractual agreement with DUDEC. We believe in the sustainable plan. We think it is an excellent document and we want to thank the Board of Supervisors for beginning the EIR process to get this sustainable plan regulated on the books and law. Thank you very much, supervisors. Good morning supervisors. I'm Helen Ewan Story. I'm the Assistant Director for the Community Action Board and I definitely support a plastic bottle band, but I'm here this morning really to thank the Homeless Action Partnership, Continuum of Care for recommending and hopefully very soon your board for proving on your consent agenda this morning three homeless emergency aid program contracts with our agency. So building on CAB's successful existing programming, we're very excited and honored to be able to expand our rental assistance to avoid eviction and homelessness, programming to an additional 50 to 70 households throughout the county. In addition to serving additional 25 per year homeless and accompanied at risk youth and young adults in achieving their housing, employment and educational goals with our collaborative partner County Office of Education. And we're very excited to launch the Watsonville Works Experience Program in collaboration with our partner City of Watsonville Public Works to provide work experience for homeless residents of Watsonville and to provide that work experience, the housing and stability supports all at the same time as promoting the health safety and really the beautification of the City of Watsonville. So thank you so much for your confidence in CAB in delivering this impactful programming. And we want to thank you also for supporting effective solutions to homelessness equitably throughout the county. Thanks so much. If you could restart that, I'd appreciate it since you got it down to two minutes, Mr. Chairman. Please go ahead. That's outrageous. You've been building a parallel government and it's been attacked on local government for a long time and you know it. The founders of the country had studied various systems government throughout history and they found that the United States is not a democracy, never was, never was intended to be. We just pledge allegiance to the Republic. I can go through Alexander Hamilton and Thomas Jefferson who talks about turning into dictatorships. John Adams says remember democracy never lasts long. It soon wastes itself and murders itself. James Madison, it's been incompatible with personal security rights. It has been shortened its lives as it has been violent in its death. And of course we have programs throughout the county that Zach Friend and Sam Farr belong to as their hope for democracy. Any educated person in the United States knows democracy is evil. The same person that's a media consultant on there has various people at his broadcast. One of them includes Minnie Bendoka who is co-chairman of Leon Panetta's California Forward who wants to get rid of 80% of the governments and you know it. Sam Farr, the speaker on here, lied on KSEO. He lied before Democratic meetings and he lied before this lady here when she was a member of the Watsonville Council and he said he didn't know anything about Agenda 21. Yet he wrote the front page saying he would introduce Agenda 21 throughout the area. Agenda 21 is anti-American. It has to do with regionalism and you are guilty of that. You've been expanding regionalism which is no more than Soviets. And I'd like my extra five minutes, Mr. Coonerty. No, everyone's getting the same time. No, thanks. You're amazing. Next speaker please. Hi, my name is Alyssa DeKiewog and I have the privilege to be the clinical and program manager of the Gemma Transitional Housing Program. We decided to come here today because we know that reducing recidivism, gender responsive programming and addiction are really hot topics these days. And so I brought with me here a woman who can speak a little more closely to what her journey has been like with those three items. Jessica Postler. Hi, I'm Jessica Postler and I am a resident at Gemma approaching my graduation date. A year ago if you had seen me in this building it would have been for a very different reason. I was lost in my addiction and I was out committing crimes to support my drug habit. All of that has changed and although I put in the work the Gemma house gave me the structure support and a safe place to work on my recovery. I felt shame and guilt for the way I behaved in my addiction. The ladies at Gemma have helped me work through that and become a healthy member of our community. They have encouraged me to build my sober support network through NA, volunteer my time to help the less fortunate with the food not bombs program, and cheered me on when I interviewed for the position as a manager at a local spa. Gemma's helped me to completely turn my life around and I know there are hundreds of women like me in our community that need this program and I'm here to show you that the funding that you have offered has really changed my life and could change the life of others. Thank you. Thank you. Thank you. Great story. Good morning. Jim Helmer, San Lorenzo Valley resident. As you enter into your budget hearings next week, I wanted to make a first off, I would like to congratulate the board and the RTC for the Highway 9 Complete Streets study in SLV as well as the passage of Measure D. Highway 9 is often closed due to mudslides, trees down, car crashes, and we have essential streets that border Highway 9 that are your responsibility like Bear Creek Road, Jamieson Creek, Alba Road, Felton Empire, and others. And most of these roads are very steep. They've been carved into the sides of mountains. And in 2016, we had eight feet of rainfall on those roads. And in 2018, we had another six feet of rainfall. Essentially, it's critical. It's critical that our tow ditches are maintained every summer and our culverts and head walls are opened to provide for free flow of water. I commend our Public Works crews both locally as well as Caltrans for the good work they do. But as you enter your budget hearings, I would ask you, is there a possibility for new funding, dedicated funding, for summertime tow ditch cleaning, not only in the SLV area, but certainly in the Soquel Hills and the Coralitas Watsonville area? The last point I'd like to make is the San Lorenzo Valley or the Ben Lohman Park. For years, it was a great tourist attraction and swimming venue. And all I ask on these hot summer days, is there a way we could open up the river again for our feet and our dogs and for just generally cooling down? Thank you. Hi, my name is Mimi Snowden, and I'm here to talk to you just briefly about the cannabis ordinance. I spoke last week. I have been very negatively impacted by growing around me. And I would just hope, and so have my neighbors. So I would just hope that if you are planning on giving permits for cannabis growing, that you would allow people that border the agricultural properties that have residences or residential property. They need to be notified. Not being notified is really not okay. There are other issues that occur with cannabis growing that make life very difficult for a lot of us. The smell, the generators, the pesticides possibly, the lack of knowledge on some of the cannabis growers. We had to grow next to us illegal last year. We were told it was legal. They left their trash. They lived in trailers. It's really not the kind of environment if you purchased your very valuable home and someone set up all around you that you'd probably want. But if you were going to get it, you would probably want some kind of notification before they were granted a permit. So I would ask that you consider that when you decide to pass that amendment. Thank you. Thank you. Good morning supervisors. Catherine O'Day would save our shores. I have to imagine you saw the front page news yesterday regarding the study of the Monterey Bay Aquarium Research Institute published late last week about the extent of plastic pollution, really a crisis in our beloved Monterey Bay. It states among other stunning facts that in parts of the Bay there are more swirling microplastics than in the Great Pacific garbage patch. The study makes our local need to mitigate plastics very real. We are not talking about a non-visible, non-measurable, much-hyped, way-off shore phenomenon. This is, we are talking about the reality in our sanctuary. Santa Cruz and Save Our Shores has been at the forefront of the fight to stop offshore oil and gas exploration and drilling in the establishment of our National Marine Sanctuary. We therefore cannot sit back idly and allow the sanctuary, our community, work so hard to establish and protect from fossil fuel. Now be polluted by one of the most ubiquitous fossil fuel products, plastics. The irony is tragic. Don't let this community down when action is most urgent. You signaled interest in taking bold action back in February when you passed a director of requiring the DPW to bring you recommendations regarding plastic pollution mitigation upon which you could act. We know you received the recommendations and we know they were broad and reflected the input of your commission on the environment and other agencies and organizations with which you instructed DPW to consult. We also know action has been delayed from May to June and now until August. Please don't let these delays to act continue. Nothing less than our marine environment, our sea life, our human health and climate change mitigation is at stake. We continue to have faith in you. Please act. Thank you very much. Good morning. My name is Ali. I'm speaking on behalf of surfrider Santa Cruz but also on behalf of the Monterey Bay which doesn't have a voice, millions of sea creatures that cannot talk to you. I am also here in support of limiting our plastic production in Santa Cruz and what we allow to sell. I'm told that we're looking for more community support and I'm actually excited about that because I know this community and I know that we can pull people together and prove to you that this is what we want. We're a very tourism driven place and to me I see the excitement of people coming here and seeing a different city, a city that's ahead of everywhere else and a city that educates them on issues like this. I'm very confident that we're going to pull the community together so I'm really hopeful that you guys will also listen to us and make things happen because that's where the power is. We've always been really ahead of the rest of the country and the rest of the world and we're starting to kind of fall behind. The things that we want might seem radical but they're not. They're the way of the future. The world is heading toward limiting plastic production and we can be a really major part of that and we should be because of where we live. Thank you. Good morning Chair Coonerty and board members. My name is Ashley Blake O'Drager. I'm with Oceana. I'd first like to thank you again for your November action to prohibit single-use plastic toiletry bottles in exchange for reusable options as well as the progress that you're making towards eliminating single-use plastic bottles on county property. As expressed by others, hopefully that initiative will go county-wide. In light of the studies that were just shared conducted in Monterey Bay it's clearer than ever that microplastics are a pervasive problem. They're in the bellies of the tiniest plankton to the largest whales and they're literally contaminating our waterways, the air that we breathe and our own health. In recognizing that you had previously taxed the Department of Public Works with coming up with a range of recommendations for some priority single-use plastic products but that those recommendations have not yet been agendized for presentation and discussion at a public meeting yet respectfully request echoing the comments of others that those recommendations receive a presentation and the opportunity for your thoughts and comments from the public at your first available meeting in August. I also wanted to mention it's my understanding that you have already supported two pieces of legislation, SB 54 and AB 1080 that are making their way through the Capitol. So I want to thank you for supporting those bills. Oceana's belief that those pieces of legislation should they be signed into law will begin to set some high standards for single-use plastic policies in the state and hopefully that will inspire action nationwide but given that Santa Cruz County has a tremendous environmental legacy we believe that you shouldn't be holding off to see what happens with that legislation hopefully continue to support it but also continue to move forward with taking action on other single-use products here that are pervasive in our county for the benefit of wildlife, human health and our economies as well. So thank you very much. Good morning. My name is Becky Steinburner. I'm a resident of rural Aptos. I sent your board a communication light last night asking you to pull three items from the consent agenda. Number 43 you must pull because if you don't you'll be violating state law in the Brown Act by not publicly discussing Mr. Palacio's pay increase. Do any of you plan to pull this? All right, I see no action and I'm quite appalled that county council will allow this to occur but you will be violating the Brown Act by passing this and consent agenda. It is not public discussion. So I will move along. It is quite a good transition into what I'd like to talk with you about and that is your policy that you adopted almost a year ago wherein members of the public can no longer pull consent agenda items that they feel merit better public discussion. We are beholden to you to do it for us. I have written your board on many occasions. I have written individual supervisors on many occasions. The answer has always been no with one exception from Supervisor Caput. This began with recommendations from Mr. Palacio to reduce public comment and make board meetings run more efficiently. In March of last year, there was a subcommittee that included some of you, Supervisor Coonerty and Supervisor McPherson, along with County Council. That group met again in May and Mr. Palacio came up with recommendations. Your board adopted those recommendations. With the addition, thank you Supervisor Leopold for asking that there be a report back to your board six months on the effectiveness of them. That report has never come. I have filed five Public Records Act requests to get information and I just want to point out, reading from one in an email from Rachel Dan, Supervisor Coonerty's an analyst to Mr. Coonerty commenting, I guess if we're solely thinking of Becky, then sure it might save some time and maybe Zach will decline a request to pull items. I think we should think about the other fact that the frequent fliers that staff is trying to quell are women, Marilyn and Becky primarily, and this is an all-male board. The optics aren't great. I'm not just so sure that these changes will make much of a positive difference and may just generate a negative perception. Thank you. Thank you. So what I read was just this. So I'm going to start right here. Hi, my name is Rachel Spaulding and I'm just picking up from where Becky left off and I'm going to start at the beginning of the email from Rachel Dan to Ryan Coonerty. Recommended action number three makes it seem like staff can change the policies and procedures with regard to board meetings without board approval. This can't be right, but I would like to ask about it. If this is the case, then I think that recommendation should be removed. It's worded in a way that makes the direction difficult to understand. Number two recommendation says, approve attached policies and procedures changes, but we don't see the attachment. If it's adopting the Rosenberg rules, that's one thing and I don't see a big issue with that. But if there are additional recommended rules changes, then I think we should know what staff will be recommending before we put this out there. I'm a little uncomfortable that they are putting your name on this, though they are careful not to attribute the recommendations to you or Bruce. In general, I guess this is okay, depending on the specifics, but I wonder about unintended consequences that we aren't thinking of that maybe cause this change to be more trouble than it's worth. For example, they are pushing this issue of not letting the public pull items and instead making the public go through the board member. Board members are then in the position of having to triage consent item request and be the one to make people unhappy if we say no. I'm not sure board members will say no, so what is the benefit in the end, except making it look like we are less accessible to the public. Thank you. Good morning. My name is Edgar Ross. I'm from Scotts Valley. I'm a guy at Monterey Bay Aquarium, docent at Henry Cowell. I collected this and some more stuff that wouldn't fit on the tray. In the 20 minutes, it took me to walk from the end of Highway 17 to here on Ocean Boulevard. There's lots of stuff here. Lots of straws, as you probably guess. Paper cups are not actually paper. They include a plastic liner. That's how the coffee doesn't melt through and come into your lap when you're driving. These things were reworked maybe 40 years ago. They didn't like the pollution of these things and they thought that if they created a version that would break up into little pieces, it would be better. But what they realized is that the little pieces are still plastic. They're still non-digestible by anything. It's the little fishes that get eaten by bigger fishes that eat the little stuff, the stuff that we can't even see. I'll remove this because it looks like trash. Thank you. Good morning, members. It's heartbreaking for me to bring this back up again on 26 for the consent agenda, the abandoning of tobacco flavors. I am an ex-smoker at the same time, so I quit smoking myself. I think it's a choice we make. It breaks my heart as well to see all this business going to the internet sales and to other counties that other people benefit from. As of today, I might lose one of my businesses in Santa Cruz, which is I've been there for 10 years and I've always done the right things, followed all the rules, seen tobacco shop, not a smoke shop. So please reconsider this if you can. Pick and choose and ask the CHPs and the police departments on who runs the best clean shop in town. Please consider. Thank you. Marilyn Garrett. I've been coming here almost 20 years since I retired from teaching. And our purpose in speaking is to advocate for public health, the well-being, community quality of life here. How? Try to bring forth facts on adverse policies and impacts from big development and corporate policies. I've been focused on wireless technology. Your obligation, why we have government, is to protect the public and the community well-being. But what are you doing instead? Supporting big development, corporate interests, and you don't want to hear from the public. Why are you here? If you don't want to hear public input and take it into consideration and adjust your policies accordingly. Your censorship of the consent agenda items is outrageous. Outrageous. I watched a Nevada County Board of Supervisors meeting the other day. What a contrast of listening to the public. There was an appeal case of a cell tower. The appellant had 30 minutes, so did AT&T. You need to go back to the other policy. And Ryan, you did this when you were on the Santa Cruz City Council. Two minutes for everyone. There's a lot of assault, war, demeaning of women, demeaning of whistleblowers in this country. And we need more people to speak out and give you direction in the public interest. Thank you. Good morning, members of the board. My name is Andres Saria. I'm here representing thousands of families that are part of COPA from our 18 institutions from Scotts Valley all the way to Watsonville. I'm here to speak on item number 63 that was pulled for this afternoon. All across the county, I've been hearing numerous stories about congregations shrinking because of the affordable housing crisis. Families overcrowding up to four or five families in one household. Teachers that are not able to afford to live in this county because of the housing crisis. We're here to support this allocation of funding because we believe this is part of the solution to start addressing the affordable housing needs. We support this allocation of funding. That item number 63 allows and that we hope that this afternoon you do so as well. Thank you. Good morning, gentlemen. Stony Brook and I'm here on behalf of your veteran's liaison to our Human Services Commission. I want to mention that on Thursday, June 6, marked the 75th anniversary of D-Day, the Allied invasion of Europe to liberate world from Nazi domination. 156,000 troops, 6,000 vessels, and 11,500 aircraft participated in the largest amphibious assault in history. Although the war in Europe continued for another 11 months, this marked the beginning of the end of World War II. On that single day, Santa Cruz County lost one of our sons on D-Day. Army Sergeant Carl N. Riggs, age 24, and a graduate of Watsonville High School. He was a paratrooper and easy company, 506 Parachute Regiment, 101st Airborne. His infantry squad company commander and first sergeant were aboard a twin engine C-47 en route to England from their drop zone. The plane was damaged by any aircraft fire over Normandy and crashed with the loss of all 22 soldiers and crew. Overall, Santa Cruz County lost 97 residents in World War II in combat and other causes and hundreds more were wounded or traumatized. We consider the county population at that time was approximately 47,000 people for the whole county. That loss must have had a tremendous impact on our community. Please remember and honor the sacrifices of these men and women of our nation. Thank you very much. Thank you. Real quick, Stoney, if I can get that name of the Watsonville High School graduate, make sure his name's on that memorial in front of the Watsonville High School. You can submit it here and then I'll get it. Thank you. Next speaker. Good morning, board. My name is Rafael Hernandez. I'm with the Monterey Bay Economic Partnership. I just wanted to make a couple of comments on the allocation to midpen. As you may know, Monterey Bay Economic Partnership works on different initiatives. I'm working the housing initiative, which supports housing at all different levels, close to transit, close to services and work to prevent sprawl. I don't need to elaborate on the housing context in which we all work and operate in which you make decisions in. I just wanted to say that given that we want to use every tool available and have every opportunity to work toward the issue that is central to almost all issues. When you think about healthcare, education, workforce development, housing impacts those. I used to be a teacher and I worked with housing because I realized whether I wanted to or not I had to deal with housing because before a student wakes up to go to school, she wakes up in the housing situation before an employee wakes up to go to work. Same thing, the housing situation is there and that impacts outcomes, impacts the economy, et cetera, et cetera. So I just wanted to say given that context and given what we know and hear all the time about the housing situation, I just wanted to say let's make sure we have every tool available, every opportunity to deal with this situation that impacts us on all levels whether we're aware of it or not. Thank you very much. Thank you. So we have a final speaker. I haven't even talked to you guys at that bottom. You know, it's very disrespectful. This is my victory hat from the threat from down below. People that are coming down from below right in the political system just a corruption. You're imposing an arbitrary rule. I want to be able to remind California residents, man we're good we're good Americans. It's a constitutional republic. You need to respect our brown rights, right and restore it. This is shameful. We might as well just get rid of the county who did the do nothing, right and let Carlos Palazzo exert him will save money because he's imposing all this arbitrary rule and you guys are following his guidance. You know the American public we, hey this unscripted reality that people are watching my activism I want to be able to share members of the public we had a victory today, the American public I took on the whole establishment in Santa Clara County on EBT being oppressed by the whole system the whole corruption and I prevailed. Election Code allows for members of the public to come up in here and to engage in vehement protests we have a right to bring our political props and to challenge the system and to keep it accountable. Listen I'm not embarrassed in my humanity you know I'm not embarrassed in my humanity because you guys want to sit here and pose this arbitrary rule and totally disrespect the American public I find it very shameful you know I had good things to say but you know it's very shameful man. I want to be able to share members of the public that we have a new heavyweight Mexican champion and I'm proud of that being American born Mexican and I won my victory as an American then respecting my constitutional rights and I want to be able to tell people that you know I'm trying to get back home because I'm in political exile right and I'm wearing this hat a member of the public bought this after one of my activist friends bought this so I can sport it and I appreciate that I appreciate the members of the public's prayers, emails the support and helping me out and I appreciate Gary Arnold looking out for me. He's a good man thank you. Thank you that concludes public comment I'm going to bring it back to the board unless there's anyone else who was waiting to speak okay I'll bring it back to the board for action on the consent agenda these are items 22 through 91 with the exception of 63 and I'll ask board members if they have any comments. Supervisor Friend thank you chair good morning just a couple of things I appreciated the work that the parks commission did in regarding to the parking lot work and that we're going to be seeing that item through on item 35 on item 65 it's nice to see the sustainable plan going forward hopefully this process will move in a more expedited fashion moving forward I know it's a priority of the board on item 77 on the Salva Beach library facility thank you for everybody both from the council and the county that worked on getting this lease agreement done we're very much looking forward to the construction of that new library the community down there is very excited about those possibilities on item 83 thank you to public works on continuing to stand top of the storm damage even with some of the changes at the federal level to know that we're moving forward to what we can do especially out on trial goals will mean a lot for the residents that live in the rural areas. Lastly on item 87 I know this is a deferral regarding the shared mobility of mobility as the service just to continue to express our concerns about scooters which I know are currently banned within county code but I think that it should maintain explicit that way I think that a lot of the communities that have these shared mobility services specifically the scooters have a lot of safety issues a lot of kids are getting hurt and I have concerns with other communities that have done it I don't think that that's something that we should allow here so when that comes back in August I'll be looking for that explicit on that regard. Thank you. Thank you chair and good morning there are a number of items here on the consent agenda I won't comment on all of them I'll comment on a few of them that I feel are important on item number 34 which is the report on the preliminary recommendations from the justice and gender task force I appreciate the work of our county administrative office with the task force I think as we heard from the testimony this morning during oral communication that providing safe housing for women who are coming out of jail can really make a difference and turn around people's lives and so we need to continue to work on this issue to have these options if we want to lower recidivism and be a safer community on item number 35 this is the issue of the parking lot and the parks commission I was glad to see that the park commission was able to weigh in on this I think they came up with a a reasoned set of recommendations I'm glad that it's something that we can do and it meets a lot of different needs which is providing more space for people here from previous testimony but also making sure that there is some ongoing support for our parks department which is always in need of resources and is very valued by members of the community on item number 41 I appreciate the work that my colleagues supervisor McPherson did to work with the city of Santa Cruz on our UC Santa Cruz growth plans response I think it's very important that when we look at impacts both on campus and off campus that those off campus impacts also include in the unincorporated area in Live Oak we have seen an increasing number of students who live there and you can always tell when the school year is over because the mattresses come out and everything else but the impact of university growth is not just a city issue it's a county issue and I just want to make sure in the work that goes on I like the idea of hiring someone to help do organizing around it I think that's critical and I appreciate the work by my colleagues on item number 58 which is a resolution approving a grant application to the state I want to thank the parks department the farm park is a park that was promised to the community over 20 years ago we've been working very hard to build all the pieces of that park I know the parks department is very committed to that and I think that with the investment that we've made with the community is made that it should be a very attractive grant application and I have high hopes for its success and given the recent success that the parks department has had in grants I'm cautiously optimistic on item number 62 and 63 I would just point out that these are two important items oh no not 62 and 63 62 and 65 these are two very important items items in which we know that there's going to be a lot of input from the public they both involve the planning department one is around our public safety and hazard management general plan amendments and one about the study session on what's going to be going into the EIR for the sustainability update if we're going to be successful in looking at both these issues it's going to be important for us to think about our agenda on the 24th to make sure that we have time to actually go over these issues sufficiently and I just want to put that out to the department that we need to be prepared for that because I think that what we heard from community members is they're ready for us to move forward with the EIR on the sustainability update and I don't want to push off having that discussion before we start that process on item number 72 I want to thank Public Works for their work on Main Street this has been some work that's been long time coming and I appreciate the efforts of the department to make sure that this safety improvements can be made for the school and the neighborhood it really makes a difference and then lastly on item number 87 this is another deferral this is our second deferral for the shared mobility and mobility as a service I look forward to a robust item on August 6 the community is very interested in looking at the shared mobility opportunities and we've seen the success of jump bikes and I hope that on August 6 we have a chance to really talk about that with that very good, yes I had some items that I'd like to comment on number one is the number 26 on flavored tobacco I've heard from so retailers in my district are concerned about losing revenue from the sale of menthol cigarettes as well as other non-tobacco products that customers buy when they come into their offices or their stores to buy cigarettes I agree that if we ban these products it would be ideal if nearby jurisdictions considered doing the same so that we don't really create an unfair competition I'd like to give additional direction on that issue to the health services agency to work with the other jurisdictions in the ban on county and possibly adopt having those other cities possibly adopt a similar ordinance and report back to us say in January of 2020 I think that would give them enough time to do that on item number 40 I want to thank U.S. Senator Dianne Feinstein for recommending additional federal funding to address the homelessness issue we need a greater investment to supplement the local and state funding for what is really a national program it's everywhere you go on item number 41 that's been mentioned I want to thank my colleague supervisor Coonerty for bringing this item to the board I'm happy to support it on UC SC growth we have an obligation in this community and throughout the state of California to educate Californians in our university system and UCSC is a big part to play in that work to really uphold the UC world class research institution that it is but we also are a small community and with finite resources and I think this gives us a voice with the university to help shape what the future looks like and how we mitigate the impacts whether they be in housing, water transportation and I'd like to say that as the university has grown and has had a substantial impact on our county no question about it that they have really come forward and done some really great work on reducing their use of water I mean they have thousands of more students and they're using less water than they did 20 years ago the metro service of which I'm a board member that's half of our ridership that goes to UCSC and they pay a portion of that to have that increased ridership so UCSC has tried and succeeded in being a good partner with this county and we just want to make sure that when they are looking at this growth that is going to be going up or going throughout the UC system that they have our voice and concerns about how they address particularly housing and its impact on this community on this county in the future but I think that they have done some positive things as they have grown so we shouldn't forget that it is with us and it's going to stay with us and it's going to grow so we just have to see how we can make that impact as less severe on the rest of the community as possible and number 44 who lives in my district and public works department she's been stellar, she's been fantastic and working on several items in the public works department and I just wish her well in her retirement I'd like to see her come back from time to time and give us some advice I'm sure she'd like to do that but in number 51 our new health officer Dr. Gale Newell we look forward to meeting with you and working with you in the future and congratulations there's some serious issues health related as we know and we're going to be discussing some of them today and later in the day I also like to mention on item 64 and 5 the sustainable Santa Cruz county I'm glad to see the environmental review coming forward that this has been a work in progress for 4 or 5 years and it's going to be a real critical element in how this county grows in the future and lastly on items 85 and 6 storm repairs I'm very glad to see the contracts awarded for storm repair in Bola Creek and near Scotts Valley as they have been throughout the county our public works department has been under the gun we've had some benefits of course with measure D and SB1 being upheld from the states to get additional revenue but Santa Cruz county has also been at the high of the storm and several of these storms that have happened in the last 4 or 5 years and some of them we have half of the road repair work that needs to be done in the state of California or in our county I know a lot of people are frustrated that there's damaged roads and potholes in front of their streets and so forth but we're trying to address what we can as quickly as we can with the most heavily traveled roads for the safety of the travelers in our county public works really everybody in that department from Matt Machado the director on down Steve Wiesner in charge of the deputy in charge of the road repairs I think they should have a real big thank you from all of us for directing what we can do with what we have in monetary resources as quickly as we can it's a huge job but we're getting it done road by road pothole by pothole thank you for your patience but thank you to the public works department for staying with this thank you thank you I'll just comment on number 62 that concerns the Watsonville regional airport and I don't know it's not clear and it will be brought up August 27th and September 24th but two mile radius around Watsonville airport we have the information on what change are we looking for Mary Carlos you got any idea I'm sorry I don't have information on that it is coming back it is scheduled for August 27th and we will be sure and get that information here you go these are changes to this is David Carlson from the planning department these are changes to bring our county code and general plan policies in compliance with the state of California airport land use planning handbook but we're changing the noise element it involves changes to the noise element and changes to the land use element and changes to one chapter of the county code to incorporate the requirements of the handbook into the county's policies and ordinances is that going to restrict the the airport from having flights it does not involve restrictions on the airport it involves restrictions on land use around the airport thank you is that your only comment okay and then I just have a couple comments on the items today on item number 35 on the AB 109 contracts I want to appreciate the probation department's real driven being driven by outcomes and adjusting contracts accordingly I'd like in the future I would like to I would like to I would like to I would like to I would like to I would like to I would like to I would like to I would like to count against the contracts I would like to stand the although it should include some data on the contract obviously we can see how they did not only not only how they plan to go forward but how they did coming into it really great impact on children and babies in our community. And I wanna, I'm becoming a model around the state and I really look forward to the report that we're gonna have in September around this. And actually, sorry, and item number 41, which is the UCSC growth and measure you. This is really a commitment that we made after the voters overwhelmingly approved measure you to say that when we look at the potential impact of 10,000 new students on campus, that we are going to advocate for reduced impacts and traffic water housing in all the ways and make sure that our voices heard among policy makers in Sacramento who are really driving these decisions. So now I'll look for a motion on item number, on the consent agenda with the exception of item number 63. I would move the consent agenda as amended. Okay, a motion by Leopold and a second by McPherson. All those in favor, please say aye. Aye. Opposed? That passes unanimously. We're moving on to item number seven, which is a public hearing to consider ordinances amending Santa Cruz County Code chapter 7.128 and 13.10, to relating to non-retail commercial cannabis regulations and making findings of exemption from CEQA schedule the ordinances for a second reading and final adoption on June 25th, 2019, and take related actions as outlined in the memorandum of the CAO. Mr. Fordy? Yeah, go for it. At the April 23rd Board of Supervisor meeting, staff stated that the last 10 months of code implementation have revealed the time consuming nature of the use permit process. And this process is taking much more time than it was expected, especially for our existing commercial agricultural operators. Staff identified various areas of county code which can be perceived as creating difficulty in the process and sought input on the board, or from the board on various recommendations. Our recommendations included the incorporation of a nursery and processor license type, aligning canopy and definitions with the state regulations, removal of general eligibility restrictions, increasing the cultivation area in the CA C4 and M zones and removal of cultivation size limits in the CA zone for indoor operations. These recommendations were incorporated into 7.128 and 1310 for the board to review at the May 14th reading. And these were provided to the Planning Commission for review at the May 29th meeting. While incorporating recommendations, staff identified a need for additional terms to make the modifications to code work. So we added several terms to the definition section and modified the canopy definition to mirror state regulations. We've proposed incorporating a nursery license type to allow for immature plant growth, genetic development and cloning so that growers don't have to pay state license fees based on mature plant canopy for nursery operations. These types of operations have to meet the eligibility restrictions in the TP and RA zones that the board has previously approved. Cannabis processing was previously included but the activity of processing was not defined. To process cannabis means to dry, trim, store and package. Processing is allowed as part of cultivation operations but we're proposing to allow processing to be done at an independent offsite facility. We're proposing to incorporate a processor license in the CA C4 and M zones as staff has identified this as a gap in the market. Currently we have multiple outdoor growers cultivating cannabis who are not processing cannabis on site due to financial costs associated with complying with fire code. They are shipping all their cannabis offsite and out of county, which is increasing stresses on our roadways and decreasing tax dollars for the county currently. Originally eligibility restrictions were put in place to protect the local market but we're proposing to remove the registration requirement based on only 2% of registrants applying for a use permit and just over 10% have completed the pre-application process at this point. We're proposing to increase the cultivation area in the CA zone by differentiating the cultivation area from the canopy. This increase does not apply to the coastal zone and the canopy is the mature plant area or the flowering area where the cultivation area is the immature and mature plant area. This additional space will provide cultivators an extra 1.2, an extra 1.25% of the land for a single operator or up to 2.5% of the parcel size for multiple tenants. We're proposing something similar for the C4 and M zones by providing additional space to cultivators to maintain sufficient immature plant stock to maintain continuous flower operations. This is in line with other jurisdictions and with state code. We're proposing to allow development in the CA zone of existing impervious areas as long as the area was permitted or legally non-conforming. This development would not have a cultivation area limit tied to the size of the parcel similar to how cultivation size is not limited by parcel size in the C4 and M zones. This would allow redevelopment of existing infrastructure and hardscape while restricting any takes of agricultural soil. The goal is to eliminate pressure on the C4 and M zones while preserving agricultural lands. We're proposing to change all use permits to level three for existing buildings in the CA, C4 and M zones and allow crop conversions in the CA zone to be completed via a level three review. This will decrease processing time for use permits by up to three months. Now, prior to the May 29th planning commission meeting, staff prepared a revised version of the use charts in 1310 based on board concerns expressed at the May 14th meeting. The revised use charts include a permit level of three or four for all cultivation sites in the CA, C4 and M zone parcels which are currently a level four, five or six review. A review level four includes a public comment period of 21 days to provide feedback. All cultivation sites which are adjacent to a park or a parcel with a different zoning and have a home will be subject to the level four review under the proposed version. Now the planning commission recommended this version and this is what has been provided to the board in the attachments. Questions? Any questions? Seeing none, let's open up for public comment. Is there anyone in the public who'd like to comment? Please line up if you're going to comment today. Good morning. A Darren story with Santa Cruz County Cannabis Alliance down in South County, a group of 20 farmers working on getting streamlined and getting these operations up and running. I hear I mentioned quite a bit about increasing tax revenues but it's not really about that. It's about increasing jobs and economic vitality. It helps to reduce crime, keeps kids off the streets and really just adds benefit to the community in general. I was down in Greenfield yesterday at a processing facility there. They built it from scratch. They provided 350 jobs to the local residents and it's going pretty well. At another facility similar to that up in Mendocino they were able to rehabilitate the Fetzer winery which had been in disarray for over a couple of decades. They now have 286 people on staff. They're continuing to make improvements. None of these are new buildings. They're just rehabilitating existing agricultural buildings and providing jobs, doing it right, doing it correct, working with the community, all the stakeholders, neighbors, you name it. Just trying to create a new business and a new industry and we'd like to do the same thing here in Santa Cruz County. We've been trying to do this for over three years. In the meantime, the people in Greenfield and Mendocino are already up and running and providing quite a bit of jobs. Right now we have about 50 people on staff. We'd like to create a processing facility that would be similar to these facilities, keep all those jobs and the economic vitality here in Santa Cruz County and hopefully some tax revenue as well. That's always nice but it's not the main point. Thanks. Thank you. Hi, Pat Malo. First, let me say thanks for going forward with these changes. It's really going to help at least the folks who are still struggling to make this work in the commercial ag zoning. But we've got a bigger problem. I think that all of you are aware at this point that we had hundreds and hundreds and hundreds of registrants, folks who were interested in going from what was legal medical businesses now into this new state system of regulation. And we've done absolutely terrible about getting those folks in. And some of them weren't community members. Some of them left. Most of them were community members and are still here. And my big problem with that is that we've actually pushed them into now not as criminalized but a criminal channel. And now we're spending all this money, which we should be spending on thrive by three children, unmet needs in the community on enforcement. So it's kind of just where did we go forward or backwards. And the main issue that it's not just these folks who now have to figure it out in this criminalized channel, it's that we took the whole Santa Cruz mountains. And what used to be by 7.126 legal gardens are now illegal. And we have no protections for the environment, no protections for the people who are going to use those products and no tax revenue at all off of any of those things. So we can sit here and celebrate the changes that are long overdue and necessary for a certain number of folks, but we really need to get moving on everything else. Or all we're going to have is illegal cannabis in Santa Cruz mountains. And that was not the goal. And Ryan in your district, Bonnie Dune, only has illegal cannabis at this point. It's not a success. So thank you. I'm really sorry. This is my hometown. I wish that all you guys knew what it was like to have this happen. Thank you. Good morning. I'm Marie Pasquale. I have over 35 years experience in the highly regulated food and agricultural industries for major companies on the East Coast and the West Coast. Over the past 21 years, I've served as the leader of many of these companies as either president or CEO. I'm honored to represent our company HQP Incorporated or High Quality Products. I'm extremely proud to serve as CEO of HQP in an exciting new legal industry. We are a highly respected and highly established license cannabis cultivator and license distributor located in Mossland in California in the county of Monterey. I am here in hopes the Board of Supervisors will favorably consider amendments to Santa Cruz County's cannabis regulations. Our company supports the amendment to increase allowable cannabis space in pervious areas based on the discretion of the cannabis licensing official. While HQP currently operates our business in Monterey County, our company has an asset purchase agreement for five acres in Santa Cruz County. In order to maximize the company's investment, our business plan calls for redevelopment of these impervious areas in the commercial agricultural zone. Currently cultivation in Santa Cruz County is limited based on parcel size, two and a half for parcel size for single occupants or 5% for parcel size for multiple occupants. The proposed amendment will change, will not only have a change in limit, but based on parcel size up to the discretion of the cannabis licensing official. High Quality Products has many young and energetic workforce that will provide a future foundation for our company. We currently employ a total of 67 employees, about 40 of those or 60% of workforce commute from Santa Cruz County to Monterey County. Our team members commute five days a week and because we are a cultivator, we have several team members who cultivate during the weekends. The amendment to increase allowable cannabis space in pervious areas would solidify our business decision and not restrict our investment on the built on the Santa Cruz County. The benefits of operating the Santa Cruz County for our current employees will allow for shorter commute, reducing the congestion on how he travels highway as well. So thank you very much. Hi, Robert Kidiyama, Kidiyama Brothers. And I just wanted to speak today. I did wanna thank the supervisors. I think since the last meetings in May, there has been a change in attitudes by the county towards trying to move the process forward as far as applicants. I wanna, I appreciate that. I also support the recommendations of the CLO. And I think the CLO is really working now to create a sustainable cannabis business in Santa Cruz County. The main message that I wanna talk about today is we're not concerned, if we can get through the process, we're not concerned about competing against Mendocino or Monterey or Carpentaria because I think they're all pretty much gonna be on a level playing field. But I've been going to a lot of different seminars where they're talking about the future. And in the future, when no one knows if it will be legally, federally legal, but there's a good chance. And we know very well about competition from offshore. So I've just heard that there's gonna be 50 to 100,000 hectares of cannabis not gonna be grown in the Savannah of Bogota. And I do know about competition from Bogota and from Columbia. And I just want you to know that, make sure that all this effort we're putting into to build a cannabis industry in Santa Cruz is in just a short-term blip with a lot of effort. But that five years from now, it doesn't exist because we over-regulated, we over-taxed, and we put too many restrictions that we could be competitive on a world market. I think Santa Cruz has the potential to have a very good, profitable cannabis industry if we grow a good quality, clean product for a local market. But I just want to make sure that we are able to have a business for a long term. Thank you very much. Okay, it's Mimi Snowden again. You already spoke to this issue, so... Can I have a question? Can I just know what a level four is? What the kind of level in order to get permits? Sure, we'll ask the planning department to ask that question. That's fine. Good morning, board. My name is Robert Singleton. I'm the executive director of the Santa Cruz County Business Council. Just want to say that our organization considered a lot of these changes, reviewed them, and just want to say we support the direction that your board is moving, and I'm making it easier for local business owners to bring their products to market, to make the process easier to conform to, and ultimately just to make it so that more people are helping to produce and provide community and economic vitality here in Santa Cruz County. Obviously, we think there should be a lot more done in terms of helping to facilitate these businesses and allowing for more legal access and more legal ability to start your business to get permits and get up and running, as that would cut down the black market and help generate more tax revenue, but this is a step in the right direction. So just saying support the changes. Thank you. Good morning. My name is Josie Roberto, and today I'm speaking to you as a member of Community Prevention Partners, and we do appreciate what the board has done, and the proposed changes, we do support that. And with that said, there is a strong need for local, non-retail cannabis businesses to be rapidly licensed and participating in the regulated market. Regulation benefits our whole community. It decreases youth access, supports responsible cannabis businesses, protects the environment, and brings in tax revenue. So we also support the proposed public notice hearing at a level four for adjacent properties that are residential to the CA zones. And we also support an annual review process that also gives the public a chance to bring any concerns in at that time as well. The current reviews process through planning, as you all know, had not been entirely effective and inadvertently promotes an illicit market. So even with the recommendations today, we still have barriers in the licensing program and the planning department in order to meet this goal of the 75 licensed businesses. We needed to continue to identify, clearly name, and address barriers to participation in the regulated market, or else we will continue to have the opposite of what we intended and want as a community. We urge you to use these accordingly reports from the Cannabis Licensing Office to assess incrementally if the shifts in this ordinance are working, and then be able to adjust accordingly in a timely manner and ensure that this system is working and that we're on track to meeting these licensing needs. We all stand for well-being of youth, of the environment, of neighborhoods, and of local individuals to be financially sound enough to meet their needs and stay in Santa Cruz. So policy is one of the best tools to achieve that impact, but it only works when the regulatory system is designed to protect the community it's working for. Thank you. All right, thank you so much. Mayor Longara, the last statement I wanna pick up on that it only works when the regulatory system protects the community. And as I'm looking here, that you're asked to make a determination of exemption from CEQA, California Environmental Quality Act would disclose if this is harmful to the environment or not. And I think CEQA is vitally important to any big projects or developments in here too. I've heard that some cannabis growing, they use rodentinsides or different pesticides on the crop. That's really environmentally damaging. Any way you look at it, the way it gets into the larger environment, the use of waters and other question, what's happening to the terrain. So I think this should be changed to say that you require CEQA, California Environmental Quality Act criteria to be met. That's, I think it's vitally important. That's my point, thank you. Thank you. This will be our final speaker, anyone else? So Chair Coonerty, members of the board, Kirk Schmidt appearing again addressing new only as to existing greenhouses on CA land. I support the changes that have been made, particularly the changes dealing with license registration to open it to a broader group instead of restricting it to preregisterance and also the changes as to zoning. There were some minor errors that were cleaned up by the Planning Commission two weeks ago. And I appreciate that. However, there was one remaining error that I, which not noticed until now and it deals with the definition of greenhouses, which is definition of age. This is in your proposed zone. And this is a new definition. And the word used is just incorrect. It says, constructed of glass or an opaque material which allows natural light to enter. Opaque does not allow natural light to enter. The correct word would be translucent or transparent, much like government should be transparent instead of opaque. So I request that you make this one minor change to definition age. And last May, 2018, when you approved this ordinance, the first time it came back for the second reading of the following month and it was bifurcated so that that portion of the ordinance that was not within the coastal zone could go into effect at that time. And I assume that this will be the same procedure at this occasion. Thank you very much. Thank you. That's our final speaker. I think I'll first turn to planning and ask you to quickly review the implications of a level four permit, as was asked. A level four permit is an administrative permit. There is however, public noticing on two different occasions. The planning director or the staff is the decision making body, but level four permits are appealable by anyone and they would be appealed to the zoning administrator. Great, thank you. Now, are there any other questions from my fellow board members? Maybe staff could just address the issue about the definition that was just brought up by our last speaker. Anybody want to give it a shot? I guess you drew the short straw. Yes. The term opaque was put in maybe incorrectly, but we thought it was correct because we used opaque to mean a material where light can come in, but you can't actually see directly through it because some greenhouses are made of a material that you can't see through, but it allows light to come in. So I will leave it at that. Okay. I don't know whether the council wants to weigh in. My impression was that it matches the definition in state law. I was just trying to find it. Perhaps we could move on and I'll see if I can find it. Okay, are there any other questions or comments? Two questions for Brown. I'll be just brief on the comments. I think that my position on this is pretty well known. I appreciate the fact that the planning commission attempted to or did come back with additional noticing adjacent to residences. I still don't actually think it goes far enough. I mean, I think that we should recognize just in general on the noticing that you'll now for overwhelmingly on cannabis related issues in Santa Cruz County, you'd have more notice if a vacation rental was in your neighborhood than if a cannabis grow was occurring. And I just think, I mean, that's a policy decision the board can make, but we should at least be honest about the fact that this noticing, especially at the administrative level, really rarely changes the outcome with conditions and probably doesn't make that much of a difference. But with that said, I mean, I think that it's an attempt to at least provide information to neighbors that weren't getting it before, immediately after the last vote, we did receive a lot of concerns from people that way. I also think that this is a larger expansion on cultivation policy than it's actually been presented. It's really been proposed as de minimis, but it's actually larger than that. I share Mr. Kitty Amos' concern about international competition, but I share it in a slightly different way, which is to say that one of the reasons that we have so many of these underused greenhouses is because of the issues that were brought up. My concern about allowing for the construction even on impervious locations is that it should the market collapse, as by the way has been predicted by a lot of people that come to before the board, then we'll be stuck with the exact same situation. We can't deregulate our way out of that situation on international competition because there's a lot of other elements on labor rates, which is the number one drive on that that the county has no impact on. So realistically speaking, if you don't want the entire Pajaro Valley to look functionally different in the next five years and then the next five years after that, which is to say that you'd have a lot of new structures that serve no value, then you would want to be pretty restrictive on what you can allow in these constructs, and this construct doesn't allow that. So I just can't support it. I understand why staff is going that way. I respect the concerns from the community about the black market. I think a lot of the comments have been self-fulfilling prophecies. I mean, asking for regulation allowing, then you create a regulatory framework, then asking for deregulation because you don't like what the regulation is, a difficult policy-making process, but it's a fluid process. Even if it's a bit opaque sometimes, it's a fluid process. But anyway, I'm not supporting it, and I think that there's more that can be done. I know that this issue is gonna continue to come back to us, and I think unfortunately the only thing that's gonna continue to come back to us is more and more loss of regulation and protections for neighborhoods in these agricultural areas. And I'm just concerned about what that'll mean for the Valley moving forward, but I guess time will tell how that pans out. Thank you. Supervisor Leopold. Thank you, Chair. Thank you for the comments from members of the public. As everyone knows, we've spent a lot of time talking about this business, this industry, the change in laws and trying to come up with something that actually worked. I respect my colleague's comment, although I don't agree because just this weekend, I went down to the Kitty Yama Brothers Farm for the Gerber-Daisy Festival and it was a great event and I recommend everybody attend that festival whenever it gets put on. But you could just see the acres of green houses that sit empty and thinking that that could be used in a successful way here in our county is a good thing. It helps a local business, a local farmer, people who've contributed to the community to continue doing what they know how to do, which is grow plants with flowers and contribute to the economic base of our county. We could live in fear of the future and say, let's not do anything because we might be challenged in the future with international trade and so therefore we shouldn't do it. I don't agree. I think that the balance that is struck here, which is not going into agricultural soil but using areas that have already been disturbed or which there might already be impervious surface is a good balance. That is gonna be a business decision by farmers and landowners about whether they wanna make investments in their property, whether we want them to redevelop their spots, whether they wanna invest in new technologies. And I think that's worthwhile. And I think that it will be no surprise to any of us here that over the next five years we're gonna be doing a lot of recalibration because a lot of our policy has been driven by the unknown, fear of the unknown. And as this state regulatory structure reveals itself and we try to fit in with that and it's clear what the market looks like, we're gonna need to recalibrate. That's not necessarily deregulations. I would argue that's effective policy because we shouldn't just stay the way we think in 2008 or 2018 if we know more in 2020 or 2028. We're gonna know a lot more about this industry. We're gonna know about its impact. We're gonna know a lot more about its economic contribution to the county. We're gonna know a lot more about what's happening nationally or even internationally. And we'll have to make changes to that. That's what we do, especially in an area which we don't have any previous regulatory experience and which there are so many differences county to county, state by state, country to country. So I think these are reasonable changes that don't open the door too wide but allow good commercial activity to go on. The addition at the Planning Commission to deal with those commercial ag properties that adjoin residential or park properties is a balance. And I think that's a good balance and notification is important. And there's a lot of vacation rentals in my neighborhood. They all get those same blue cards that people will get now if they adjoin a CA parcel that is gonna have cannabis. So I'm not exactly sure that they're gonna be less regulated than vacation rentals. It's pretty light. That's a couple hundred dollars. It's a form. For some people you fill it out once and that's it. The folks here have to go through a tremendous amount of investment. They have to clear a lot of regulatory hurdles. They have to be overseen by not only the local authorities but the state authorities and they have to pay a tremendous amount of taxes. And so I don't agree there but I understand the point that he's making. He just wants to make sure we have a well-regulated industry. I think this is well-regulated and commercial ag is a policy choice that we're making which makes sense that plants grown in the places where we've designated for plants to be grown. So I would move the staff recommendations. So we have a motion. Well, second. Second, was there any other comments? Yeah, I just would like to, this has been a work in progress for and we're still progressing. So to speak and we still have a long way to go maybe but I do appreciate working with the agriculture department, county agriculture department. I know that we have worked to try to stay independent and make our own rules as far as possible but there's also some, we have to recognize some state regulations too as we move along. But I do support the level four proposed sites near parks and residential areas. We have, we really, this has been an effort to strike a balance between lowering the barriers for the cannabis industry and also protecting public safety and providing some public notification. And I think this is this meet that, what we're proposing meets that balance. I do also support the loosening of restrictions around pre-registration because I think that's been a tremendous stumbling block that we've had. We set up a program really in a way that was designed to give our local growers an advantage but it doesn't seem to have worked out that way to achieve the result that we were seeking. So I do support what we're moving toward. I remain concerned about the medicinal marijuana aspect of this and us having that be available but we'll continue to work on that I believe. And I also, I know that there are some concerns about, especially in the mountain areas, which is a lot of my district in Santa Rosa Valley, they would like to have a commercial license but there's many, many concerns, public safety concerns regarding fire, roadways and so forth that is going to be very difficult for us to meet some of those requirements I think to make that happen in a general response. But in general, I do support what has been proposed and I thank everyone for their patience and working with this and I really do appreciate the office of our licensing officer too. Thank you very much. Senator Caput. I think everything's been mentioned here. Excuse me. I think all the arguments have been mentioned. I guess what bothers me is this never stops. We keep backing up and we keep saying we're going to get rid of another restriction and we're going to get rid of this, we're going to keep, we've written some rules and we finally have to enforce them and I do understand the state requirements exactly if you could just clarify it for me here. We're allowing, we're going with the state regulation on this, are we? We're aligning with various pieces of the state regulation specifically with the nursery license and with the processor license. We're not adopting other portions of the state regulations by any means, we're just aligning with them on those two aspects. So if we're not, anyway, let's go ahead and vote. Okay, well, before we vote, I wanna ask did we figure out this definitional question? I find that the state law uses the word greenhouse, I can't find a definition for it. I suggest that since we are trying where we can to be consistent with state law that you give us the authority to be consistent with state law. I would add that to my motion. Is that okay with the second? Okay. I'm supportive of the motion and I'm gonna call the vote. So just to be clear, the motion before us is the staff recommendation with the additional direction for County Council to make sure our greenhouse definition is compliant with state definitions or consistent with state definitions. Okay, all those in favor, please say aye. Aye. Opposed? No. Sorry. Okay, so that passed three to two and we will now move on to our 1030 scheduled item which is the Santa Cruz County Board of Directors flood control and water conservation district, zone five. And I'll ask the clerk to. Sorry, it was three to two with supervisor friend and capit voting no. Now we're moving to zone five and I'm gonna ask you to call the roll. Do you wanna call zone five roll? That's right. Director Leopold. Here. Friend, capit, McPherson, and Coonerty. Here. Are there any late additions to the agenda today? No, they're not. Okay. So any additions, deletions, or corrections? Okay, let's move on to item number one which is oral communications. This is an opportunity for members of the public to speak to us about items that are within the purview of zone five but not on today's agenda. Good morning, Becky Steinbrenner. I have a request. I try to attend these flood control meetings but it is always somewhat of an enigma to me what zones cover what areas. They are never described in your agenda and it would be very helpful to members of the public if they could understand what these areas, these specific zones are. I would like some clarification. I believe that zone five covers Capitola. Is that correct? Thank you. So to that end, I would like to discuss with you a recent appeal that I brought before your board regarding a cell facility that will because you didn't take action to stop it, it would be built in the flood zone. It will require a block of concrete, basically seven feet high. And I want to make clear that the building itself will not be flood proofed as is required by the 50% significant improvement rule because of changes that were made in the project description. That concerns me especially with the rise in flood levels as climate change models are being predicted. And I really think that your board and the planning director need to take a look at these policies and make sure that the public will be protected in the event of increasing flood in the riparian zone. Thank you very much. Thank you. That concludes public comment. I'll bring it back to the board to move on to item number two which is to approve zone five minutes. I'll make a motion to approve in a quick comment that to director Machado that we had talked about the possibility of coming back with consent items associated with zone five. I still haven't seen that happen. A number of these items appear to be things that could be on a consent calendar. So just I'll move the recommended action on the minutes with that additional comment. Second. So we have a motion and we have a second. All those in favor please say aye. Aye. That passes unanimously. Item number three is as the board of directors of the Santa Cruz County flood control water conservation district zone five accept and file the third quarter report for the fiscal year 2018 and 19 zone five expansion construction revenue as outlined in memorandum of the district engineer. Thank you chair and directors. Matt Machado the zone five district engineer. The item before you is the zone five expansion construction revenue for a third quarter. The recommended action is to accept and file this report and I can answer any questions you may have. Any questions from board members? Any public comment? Seeing none. I'll bring it back to the board. The recommended action. Motion by Leopold second by friend. All those in favor please say aye. Aye. That passes unanimously. Item number four is as board of directors of the Santa Cruz County flood control water conservation zone five consider a resolution accepting unanticipated unanticipated revenue of $56,000 into the Santa Cruz County zone five budget as outlined. Thank you. Thank you director. Thank you chairman and directors. The item before you is revenues that resulted from increased plan review and permit processing application fees for land development projects in zone five. The recommended action is to adopt the resolution accepting and appropriating unanticipated revenue of $56,000 into Santa Cruz County flood control and water conservation district zones five expansion construction budget. And with that I can answer any questions you may have. I'll move to approve. Well hold on is there any public comment? Seeing none I'll bring it back to the board. We got a motion by Caput. Second. Motion. Second by friend. All those in favor please say aye. Aye. That passes unanimously. On item number five which is as the board of directors of zone five consider accepting and approving the proposed budget for 2019 2020 zone five and its own five expansion construction budgets as outlined in the memorandum of the district engineer. Thank you chair and directors. I do want to highlight a few items in our budget and our proposed budget this year. Under our zone five master plan update we've shown a proposed budget of just $70,000. We are hoping to get a better number for you. And as part of our final budget we will be recommending that number to go to $670,000. We'll be pulling that additional $600,000 from our capital reserves. We believe that that's gonna be a budgetary number for the master planning effort. We hope to bring an item to you in the next three months to release an RFP for that effort. This is a critical effort for zone five so that we can better understand our deficiencies and look at a better streamlined process for development in the area. And so I just alert you to that. It's not shown here in your proposed which is okay, we'll bring it as part of the final but I think it's a critical item to share with you. With that the rest of the items are fairly consistent with prior year and I can answer any questions that you may have. The recommended action is to accept and approve the proposed 2019-2020 zone five and zone five expansion construction budgets. All right, are there any questions? Seeing none, is there any public comment? Seeing none, come back. Chair, I'll just say I look forward to this additional item being brought forward. I think it will help get some clarity for development projects. Because right now it's a one-off thing and we don't always know and it creates a lot of lack of clarity about what's going on. So I look forward to that item. I would move the budget though and the recommended actions as suggested here. Motion by Leopold. Second. Second by Friend. All those in favor, please say aye. Aye. Opposed? That passes unanimously. That adjourns our zone five meeting. We will now come back to our regular Board of Supervisors meeting and we will take up item number eight which is a public hearing to consider confirming the established benefit assessment service charge for County Service Area 12 wastewater management for fiscal years 2019-2020 as outlined in the Director of Health Services. Good morning, I'm John Ricker, Water Resources Division Director in the Health Services Agency. We're recommending that you adopt the service charge reports for the CSA-12 fees which support various activities for management of on-site sewage treatment systems, septic systems in the County. The fee levels are unchanged from previous years. We're recommending $6.90 for CSA-12, $18.54 for the San Lorenzo Valley CSA-12A and a range of $101 to $501 for the non-standard systems. We're recommending that your Board open the public hearing to hear any comments or protests, close the public hearing and adopt the attached resolution approving the assessment service charges for CSA-12 and I'd be happy to answer any questions. Great, are there any questions? Let's open the public hearing. Thank you, Becky Steinbruner. I live in the rural area. We have a septic tank and system and I really appreciate this service to the County's rural residents because it maintains good water quality in our system's water, in our County's waterways. This is especially critical in the San Lorenzo Valley where Santa Cruz City takes some of it, it's a good amount of its potable water supply and is looking to expand its place of use delivery of water to the mid County area in water transfers to come up with a regional solution for groundwater overdraft in the mid County area. So I'm very supportive of this service and I wanna thank the environmental health for making it happen. Thank you. Thank you. Seeing no other speakers, I'll close the public hearing. Bring it back to the board for action. Second. Motion by McPherson, second by Leopold. All those in favor, please say aye. Aye. Opposed, that passes unanimously. Moving on to item number nine, which is the public hearing to consider County Service Area 48 and County Service Area 4, fire protection assessment service charge reports for fiscal year 19 and 20, adopted resolution confirming the service charge reports for CSA 4 and CSA 48 as recommended by the Director of General Services. Let me ask, does anyone have any questions? Let's open the public hearing. Anyone like to speak? You know, I just want to one question on CSA 48. Just wanna point out that there's gonna be some real financial challenges coming for that and a measure that just barely lost several years ago, but that's something that I think is gonna need a good look at and maybe they would be commenting on that briefly as well, but County Service Area 48 in particular. Thank you. Now we'll open the public hearing. Thank you, Becky Steinbruner, resident of rural Aptos. I really support County Fire and I really want you to fund it. I understand what we're talking about today is just cost of living increase, but you've gotta fund it in a good way because this County residence, environment, tourism, all depends on good fire safety and good fire protection. 108 million, Proposition 172 brings in so much money, 18 million dollars every year. That was supposed to go to fund some of County Fire. Zero goes to County Fire. Measure G, the half-cent sales tax was sold to the voters last fall when we were all worried about fire as funding fire. I've submitted a Public Records Act request where that Measure G money will go, zero will go to County Fire. Now this has gotta stop and I understand that you're bringing something to the voters with a paper ballot to increase things, but I'm here to ask you as a rural resident, please fund County Fire in a sustainable way. There's plenty of money coming in. All you have to do is give a little piece of that Prop 172 and Measure G money to fund County Fire and not take it away. That's what I'm asking. Thank you. That closes the public hearing and I'll bring it back to the board for action. Move approval of the recommended action. Motion by Leopold. Second by McPherson. All those in favor, please say aye. Aye. Opposed, that passes unanimously. Moving on to item number 10, which is a public hearing to consider the 2019-2020 benefit assessment service charge reports for various County service areas, approve the engineering reports for CSA 9A, residential lighting and adopt a resolution confirming the benefit assessment service charge reports as outlined in the memorandum of the Deputy CAO, Director of Public Works. Thank you, Chairman, Board of Supervisors, Matt Machado, Director of Public Works and Deputy CAO. The item before you is a public hearing. This is with regard to CSA 9A. It's a residential lighting district. There is a bit of a change this year and it's a really good one, it's a positive one. The engineers report has increased the scope of services to include additional pedestrian safety improvements. And so the report here is for your approval. It does include a public hearing. And so the recommended action today is to approve the injures report for CSA 9A, residential lighting, to hold a public hearing to hear objections or protests, if any, to the proposed 2019-20 benefit assessment and service charge reports for various County service areas and following the public hearing, adopt resolution confirming the benefit assessment service charge reports for various County service areas. I will add that this report does not include an increase. There is no increase to the assessment. This is just a scope modification. I can answer any questions you may have. Any questions? I'll just say I wanna express my appreciation to Mr. Machado and the public work staff who have seen this through. This change will really help out in something that we hear about all the time, which is safety lighting for crosswalks, and which could be very expensive in which we have resources that we haven't been able to tap until an engineering report was done. So I know this was on your list when you came here and you've been dogged to make sure that it gets done and I'm glad we're at this day. And I have a number of constituents who will be, who I just spoke to on Friday night who was saying when's it gonna happen and are very excited that we're finally making, moving forward on this. So thank you for that. Good, thank you. Thank you. I'll open up the public hearing. Seeing none, I'll close the public hearing and bring it back to the board for action. I will move approval of the recommended action. It's got a motion by Leopold and a second by Friend. All in favor, please say aye. Aye. Opposed? That passes unanimously. Moving on to item number 11. It's a public hearing to consider the 2019-2020 benefit assessment charge reports for Sanitation County Service Areas 2, 5, 7, 10 and 20 and adopt a resolution confirming the 2019-2020 benefit assessment service charge reports as outlined in a memorandum of the Deputy CAO and the Director of Public Works. Thank you, Mr. Chairman and Board of Supervisors. Again, Matt Machado, thank you for the introduction. I will just add that for all of these various CSAs for these sewer districts, we are proposing a moderate increase. It's a CPI increase of four and a half percent to keep up with the cost of doing business in these sanitation districts. With that, the recommended action is to open the public hearing and hear objections or protests, if any, to the proposed 2019-2020 benefit assessment service charge reports for Sanitation County Service Areas 2, 5, 7, 10 and 20 to close the public hearing and to adopt resolutions confirming the 2019-2020 benefit assessment service charge reports for various Sanitation County Service Areas. And with that, I can answer any questions you may have. Any questions? Okay, I'll open the public hearing. Seeing none, I'll close the public hearing. Bring it back to the Board for Deliberation Action. I will move the recommended actions. Motion by Leopold, second by McPherson. All those in favor, please say aye. Aye. Opposed? That passes unanimously. Moving on to item number 12, it's the public hearing to hear objections or protests, if any, to the proposed 2019-2020 benefit assessment rates for County Service Areas 15, 18, 26, 42, 58 and 59. Consider submittal of all ballots for the proposed assessment and continue the public hearing to June 25th, 2019, to allow for tabulation and certification as outlined in the memorandum of the DPSCAO and the Director of Public Works. Thank you, Mr. Chairman, Board of Supervisors, again, Matt Machado. Thank you for the introduction. The increases as proposed in these CSAs are driven by the people. When the people request additional services, we support them in their request of increases. That is before you, and as you outlined, the recommended action is to open the public hearing to hear objections or protests, if any, to the proposed benefit assessments for those listed CSAs. To request a submittal of all ballots for the proposed 19-20 benefit assessments for those CSAs and to continue the public hearing to June 25th, 2019, to allow for tabulation and certification of the ballots. With that, I can answer any questions you may have. Any questions? I'll open the public hearing. Seeing none, I'll close the public hearing and bring it back to the Board of Deliberation Action. I will move the recommended actions. Motion by Leopold. Second. Second by Friend. All in favor, please say aye. Aye. Opposed? That passes unanimously. Item number 13, as Board of Directors of the Davenport County Sanitation District, a public hearing on proposed ordinances amending the district code to establish the 2019-2020 Water and Sewers Service Charges Schedule Public Hearing on August 6th, 2019, to consider the service charge reports and take related actions, as outlined in a memorandum of the district engineer, Mr. Adler. Good morning, Mr. Chair and Board of Supervisors. Kent Adler, Assistant Director of Special Services with the Department of Public Works. On April 23rd, 2019, the Board set today as the date of the public hearing to consider an ordinance which establishes the Water and Sewer Service Charges for Davenport County Sanitation District that will become effective on July 1st, 2019. The Water Service Charges are being proposed with an overall 4.4% increase with an individual maximum of 4.5%. The Sewer Service Charges are being proposed with an overall 4.2% increase with an individual maximum of 4.8%. The increase is necessary to adequately fund the maintenance and operations as well as capital improvements for the districts. For the district, we're recommending that the Board takes the following actions and there's a number of them. Number one, open the public hearing to consider the ordinance 8, number 89, amending district code Title III, Chapter 3.08, Article III, sections 3.08.160 through 3.08180 for Water Service Charges and ordinance number 90, amending district code Title IV, Chapter 4.08, Article III, sections 4.08.160 through 4.08180 for Sewer Service Charges and close the public hearing. Two, approve in concept ordinances number 89 and 90. Three, schedule the ordinances for final adoption on the next available agenda. Four, set Tuesday, August 6th, 2019 at 9 a.m. or thereafter as the date and time for a public hearing on the service charge reports on the service charge reports and five, direct the clerk of the board to publish the notice of public hearing once a week for two weeks prior to the hearing and the newspaper of general circulation and I'm available for any questions. Thank you. Are there any questions? Seeing none, I'll open the public hearing. Seeing no one to speak, I will close the public hearing. Quick note to folks who are waiting, we're gonna do item number 14. We're gonna take a 15 minute break and then come back and do the remainder of the items this morning. So if you wanna take a little bit longer break, feel free right now, but so on item number 13, I'm looking for a motion. I would move the recommended actions. All right, we got a motion by McPherson, a second by Leopold. All those in favor, please say aye. Aye. Opposed? That passes unanimously. On item number 14, this is the board of directors as the Freedom County Sanitation District, public hearing consider 2019-2020, Freedom County Sanitation District sewer charges reports and resolution confirming 2019-2020, sewer service charge report as outlined in the memorandum of the district engineer. Mr. Adler. Good morning again. On May 19th, 2019, the board approved the 2019-2020 service charges for the Freedom County Sanitation District and set today as the date of the public hearing on the 2019 service charge report. In order to complete the 2019-2020 sewer service charge proceedings, it will now be necessary for the board to open the public hearing, take testimony, consider objections and protests. If any, to the sewer service charge report and at the conclusion of the public hearing, adopt the resolution confirming the sewer service charge report for the Freedom County Sanitation District and I'm available for any questions. Any questions? We'll open the public hearing. Seeing no one, we'll close the public hearing and bring it back to the board for action. Recommended actions. Motion by Leopold. Seconded by Friend. All those in favor, please say aye. Aye. Opposed? That passes unanimously. We're now gonna recess to 1120 where we'll come back and continue our morning agenda. I think there's a couple people here. We're not gonna get to that to the end of this. Is that right? Unless we got lunch coming in. Yeah. I just wanted to say I want to, I think Joe all until he got it. Yeah. Good afternoon, everybody. I'm gonna call the meeting back to order. I do want to announce that the air conditioner is broken so it's hot in here. It's not just the potential debate we're about to have but it's actually a short of air conditioning so they're working on it and hopefully it'll improve in a few minutes. So we are gonna consider the only item on our agenda for this afternoon, which is consider the 2017 to 2019 biennial report and presentation of the Syringe Services Program, SSP, and direct the Health Services Agency to return in September and December 2019 with reports as outlined in a memorandum of the Director of Health Services. And we have Mimi Hall here to present. Thank you. I'm very pleased to be here and thank you Chair Coonerty and honorable members of the board. I'm here with our intro. Hold on. Do you have your... I'll go closer to the microphone. Is that better? Yes. Okay. Good afternoon. I'm here with our interim Health Officer, Dr. David Geller Ducci and also our Director of Nursing who also oversees the Syringe Services Program in our Public Health Division, Jen Herrera. And we will be, as the board may know, we have a requirement to come to the board biennially with a report on our Syringe Services Program. And I'd like to start off by telling the board that we've worked really hard as a Health Services Agency, particularly over the last year, to strengthen our program and our services, to capitalize and leverage all of the other services that we have expanded over the last couple of years, ranging from whole person care, integrated behavioral health, drug medical expansion, and our medication assisted treatment program to create a situation in which the Syringe Services Program is truly something that is a gateway to the other services that we provide. And we feel like we've made great strides in that. And the other thing that I wanted to mention is we find ourselves in a situation today where as a new director, I look back over the years and I see that the operations of our program has slowly been sort of limited and constrained year after year. And we hope that we can turn the tides for that and ensure the board that we have the capacity, the interest, and the ability to provide excellent oversight for this program and use it as, again, a lever to enter people into recovery and healthcare. So with that, today, you'll be hearing the general overview that you will receive today is the background of the County Syringe Services Program, the recent opportunities that I briefly spoke of just now. An overview of our program, Dr. Geller-Ducci will be going over the relevant programmatic data. And then finally, we will end with the recommendations that we have as an agency for your board to consider. And I'm gonna go ahead and turn it over to Jen Herrera. So as a reminder, there are four ways to lawfully provide syringe services in California. The California Department of Public Health may authorize syringe services programs anywhere in the state. City and county governments may authorize SSPs in their jurisdiction. Physicians and pharmacists may provide an unlimited number of syringes without a prescription to anyone over the age of 18 and syringes may be prescribed. HSA's Syringe Service Program received its authorization through the county. A Syringe Services Program provides clean syringes and safe disposal of used syringes. They have existed since the 1970s. In the 1980s, they became more widely available, playing a central role in dramatically reducing HIV infection among people who inject drugs. SSPs are one piece of the harm reduction paradigm for promoting health and safety with people who use drugs. And it's never just the syringes, it's always part of a system of care. The program is at the intersection of multiple epidemics. It is a well-known evidence-based intervention to prevent HIV and hepatitis C. Research indicates that it is also an effective strategy to prevent overdose and other infectious diseases, such as wound botulism, hepatitis A, endocarditis, and skin and soft tissue infections. The core purpose of the Syringe Services Programs is to create a safer and healthier community by reducing the risk of exposure to infection and disease and by acting as a gateway to integrated services. Accessible clean syringes and supplies allows person who inject drugs the option of using clean equipment with every use. This reduces the risk of sharing and reusing equipment, which reduces the prevalence of disease and infection in our community. By being accessible, the SSP is a gateway for services for a population that does not typically engage with health and social services. In this operational period, the landscape of our health systems has evolved on the federal, state, and local levels. The opioid crisis and the state's HIV getting to zero strategic plan has led to the following funding priorities across HSA and the community. Whole person care, drug, medical, organized delivery system, integrated behavioral health, and medication-assisted treatment. Since 2017, HSA has increased integration of these broad-reaching initiatives. This new capacity created an opportunity to optimize SSP as a venue to reach populations who are homeless, mentally ill, and struggling with addiction. Populations who otherwise would not access available health and social services. In February 2019, the SSP was reorganized from a standalone part-time program to operate within the Public Health Division's Communicable Disease Unit. Collaborative planning resulted in a new multidisciplinary staffing structure, which includes public health nurses, public health staff, and certified addiction counseling staff. With these changes, the program's metrics and performance indicators are being evaluated for sustainable, continuous quality improvement. The evolution of the SSP during this operational period supports an improved gateway to healthcare, treatment, services, and support. Even with HSA's expansion, there are many barriers for people who inject drugs to access services, some of which include the stigma-run substance use, personal trauma, being isolated, lack of trust in the system, not being ready for change, and the inaccessibility of health and social services. It is difficult to outreach to this population, since some have not accessed healthcare in years. The Syringe Services Program creates opportunities to connect persons who inject drugs with health and social services. People access SSP to reduce harm to themselves and the community. With this action, they have a shared responsibility to contribute to a safer environment. The SSP builds rapport with participants in a safe space, providing education, referrals, and warm handoffs to various services. It's not just the syringes. The SSP supports an effective system of care. Santa Cruz Program has three components with very specific goals. Distribution and collection has a goal of reducing the risk of exposure to infection and disease in Santa Cruz County through safer injection practices. Safe disposal has a goal of eliminating syringe litter in public spaces through proper syringe disposal, and enhanced referrals has a goal of linking participants to clinical, behavioral, and social services when they determine they are ready for change. For distribution and collection, the HSA divisions partner to provide one-for-one syringe distribution and collection services at the Emmeline and Watsonville Clinic locations. For safe disposal, HSA has partnered with the Department of Public Works to increase coordinated and ongoing syringe disposal in the community and maintains three sharps kiosks throughout the county for public use. The program also provides free personal sharps containers and safe disposal education for all SSP participants. For enhanced referrals, the program maintains a multidisciplinary staffing structure and coordinates with clinics, IBH, and other services for streamlined referrals. The program also provides on-site rapid HIV and hepatitis C testing, as well as on-site NARCAN training and distribution. Good afternoon, Mr. Chair, boards, board members. I'd like to go over some of the data that we've collected through the SSP, and I obviously won't read this entire chart to you, but some of the key takeaways I believe are, we've seen about 7,500 visits across the county for SSP services. This encompasses about 870 individuals. We think, we know that the majority of these patients go to the Emmeline Clinic, although the Watsonville Clinic also sees quite a few. Most of these patients are male, most of them inject heroin, although 50% of this group also use methamphetamine, which is a significant issue as well. Our kiosks actually have been quite successful in terms of collecting syringes, and as you can see, there's been a 300% increase over the last two years, or three years rather, and so that continues to be a significant source of return needles, but when you look at what happens at our SSP sites, the two sites, you see that there's a pretty close match between the number of syringes collected and the number of syringes dispensed. In fact, in 2018, we actually collected more syringes than we dispensed, and so I think what that shows between the two slides is about 900,000 needles. Obviously, since we've only distributed 600,000, that there is a significant source of other needles out there in the community. Over the years, we've seen a gradual decline in the number of clients that come to our services, but the number of syringes distributed has actually increased, and this might seem to be a curious relationship. The reason for this, we believe, is something called secondary exchange, and this is a phenomena where one person may go on behalf of many other people, bring their syringes in on their behalf, and collect syringes back, sterile syringes back on their behalf, and so we may find more of this kind of proxy relationship happening. We believe that this continues to be an important thing to do, because these are people that would otherwise not necessarily come themselves to the site to get clean syringes, so we believe, from a safety perspective, in terms of preventing disease, that it's important. However, we do lose the opportunity to actually interact with the individuals and the social services that we wanna hook them into, the mental health, the clinical services, vaccinations, and testing, so there's a little bit of a double-edged sword. We do believe that secondary exchange is important, but also need to find ways to increase access to patients that otherwise would not come to us directly at the two clinic sites. Looking at HIV, fortunately the numbers are relatively low, but these are newly diagnosed cases over the years, and as you can see, there's been a gradual decline. A significant proportion continue to be persons who inject drugs, the PWID. That is probably an artifact of not only new infections, which we believe continue to happen despite our efforts, but also our improved detection techniques. Now that we have more access to the folks that inject drugs, we're able to test them and identify infections that otherwise would not be identified, so part of what you're seeing here is that artifact. There we go, hepatitis C, kind of a similar situation here, and it would appear on the face as though the program itself is not working because it looks like infections are going up, but I again wanna stress that what we're actually seeing here is increased detection and not necessarily new infections. So it's important that we identify people with hepatitis C so that we can make sure that they get the appropriate treatment. In some cases, there's actually a cure for this, but that can't happen unless we know that they're infected. For hepatitis B, we are seeing again a similar trend to downward trend. There are relatively low numbers. As you may know, back in the late 90s, hepatitis B vaccinations became routinely available to adolescents, so I think in the blue bar, what we're seeing mostly here are patients that did not get vaccinated for one reason or another, and as the older age groups, of course, probably acquired their infections and never did have an opportunity for vaccination, so that is a service that we offer. And then finally, you may remember back in 2017, we had a significant hepatitis A outbreak, and you can see that hepatitis A would happen every once in a while in the years prior to 2017, but in 2017, this outbreak was clearly amongst the group of people who inject drugs, and I think what's important here is that in the orange bar or the yellow bar, rather, is that this is actually a disease process that is so communicable that it broke outside of this kind of traditional risk group, and so when we think about vaccination, we obviously are concerned about the health of people who inject drugs, but this is also an issue that affects people who are outside that community and the general public, and my last slide here is what we call an epidemic curve that shows, again, the sort of smoldering infection rate for hepatitis A, and then this rapid increase that happened in June and July of 2017, and again, mostly in the PWID group, but as you can see, that's the orange bar. The blue bar shows infections in people who are not PWID or persons who inject drugs, so you can see how it transferred from one group to the next, right? And then the blue bar, the blue line that you see there actually represents the vaccinations that we performed at the SSP, and this is, I think, a good demonstration of how the SSP is kind of the tip of the spear in terms of managing these kinds of outbreaks because as we increased our vaccinations, the PWID group went down, as did the people in the non-PWID group, so I think it's an important public health avenue to reach people that otherwise are very difficult to reach. During this operational period, we received feedback on the SSP from the Civil Grand Jury and the SSP Advisory Group. We've used this feedback to develop our recommendations for the program. In 2017, the Civil Grand Jury published the following findings and recommendations in its report on the SSP titled Sharper Solutions. The findings include that the SSP currently operates without a budget or permanent staff, which hinders the success of program goals. Limited hours, space, and staff hamper referrals to counseling, treatment, and support programs reducing the number of people receiving assistance. Some injection drug users don't travel to SSP sites, thus preventing them from receiving assistance from other health programs. The recommendations from this report include that HSA should devote more time and resources to community outreach to promote rehabilitation and counseling of SSP clients. HSA should implement a mobile needle exchange unit to increase access to SSP services. And HSA should post hazardous waste signs with a single contact number for advice or reporting available 24-7 in areas where syringes are commonly found. On April 30th, 2019, the SSP's advisory group provided the following recommendations, which align with best practices noted by the California Department of Public Health. This includes increase accessibility of the SSP, maintain secondary exchange, ensure dedicated resources for the SSP, improve awareness of current law that prevents criminal prosecution for possession of syringes and associated materials, transition to a needs-based distribution of syringes, increase accessibility of syringe disposal kiosks, utilize the Citizen Connect application to report syringe litter, and formalize the advisory board membership. Given this feedback, we recommend that your board direct the HSA to implement the following recommendations to the Syringe Services Program. Expand SSP hours at the MLINE campus in Watsonville Health Center up to 20 hours per week as staffing resources become available from collaborating programs. Incorporate SSP into the Homeless Person's Health Project Clinical Field Services. Collaborate with the California Department of Public Health to complete a study of syringe litter to be conducted in Santa Cruz County and return to the board by September 24th, 2019 to report on the findings and provide recommendations. And use the results of this syringe litter study to develop a pilot program to reduce public syringe litter using the Citizen Connect application and return to the board by December 31st, 2019 with a proposed plan, implementation, and evaluation for the pilot program. Thank you, Jen, and Dr. Gilarducci. With that, I would like to end our presentation by summarizing that the focus of our Syringe Services Program is, as Jennifer Herrera mentioned, three-pronged. The primary focus is to ensure that we reduce the risk of exposure to diseases that can be experienced by persons who inject drugs. The second goal or the second prong of our program is to focus on syringe litter, regardless of the source of syringe litter, and it's clear to us that much of the source of syringe litter comes from outside HSA's program. We feel like public safety is an important and we see ourselves playing a role in overall syringe litter, regardless of where it comes from. And then thirdly, we really do focus on engaging the community and its stakeholders. We've had a lot of discussions internally among staff about methods where we can more efficiently communicate to the public, to our stakeholders, and also to those who utilize our services. We recognize that we can learn a lot about how to improve our services and how to reduce the community impacts of those services by talking to the people who avail themselves of the services that we provide because they provide the most information on how we can best both meet their needs as well as serve the needs of the community. So with that, we have these recommendations before the board and I will say that these recommendations do fall short of best practices and we do recognize that. We make these recommendations based on the funding, the capacity, and the staffing that we have at this moment. I would like to add that in the governor's budget that's been proposed, there is funding specifically for HIV, STDs, and Hep C and it's an ongoing allocation to local health jurisdictions and there's also $40 million earmarked for communicable disease control and we haven't put those into our budget request for this year because it's not finalized. The budget will be finalized on June 15th. The governor has 12 days to respond but there is a potential source of funding for us to expand services if the board would so allow and three of those funding streams for HIV, STDs, and Hep C will be ongoing allocations. Thank you. Thank you. I want to open it up now for board member questions. I mean, I have a lot of questions and comments so I mean, I think I could, maybe let's tell what, let's wait and hear from the public. So if you are interested in speaking today, I ask you to please line up if you can and we'll have, we'll take testimony. Please do, yeah. Dear supervisors, my name is Richard Schellberg. I live in the Soquel. I'm a member of John Leopold's district. Lived here in Santa Cruz since 2002 and love living here and I'm really concerned about where we are today. We have the numbers on number of homeless people here varies. I think the count is up for debate but roughly the number of chronically homeless people here has gone from 54 to 62%, just a data point. There's roughly 40% who have mental issues, 40% who have persistent drug issues and these numbers don't change. 30% of these people visit jail at least once a year as well. So I mean, I'm bringing this up because in context of the program here, it matters because these are the customers for this program largely. Now, I have a question on the objectives for the syringe program. In the mission statement that's available online, there are really just two objectives, not three. So I was a little bit surprised today. Maybe the documentation needs to be updated but it's about to avoid the spread of disease and to address the concerns around syringe litter. That's it. So I don't know where the additional objective comes from. I would strongly recommend that you add an objective though about rehabilitation and providing a way out of drug use. To do that, you need to close a massive loophole that you have in this program. The thing that you guys call the secondary exchange, it's not working. The only way for that to work is to have professionals who are trained, who are out there and can provide services that cover all three objectives. Assuming that we have those. Having someone, I can, okay, I'm sorry, I. I appreciate it, thank you. And we got your emails earlier. Thank you, my name is Jennifer Hastings, Jen Hastings and I'm a family practice physician practicing for over 20 years in this community. I'm currently at Encompass Community Services providing MAT and I work at the Health Improvement Partnership. I just wanna state my support for the syringe program that the county is proposing. I would love to see it move closer to best practices. The comment that was made about treatment is incredibly important and one can never force treatment. That needs the principles of harm reduction and engagement which was the third piece. And so with engagement of both users and our community I think we could move towards success but I encourage our community to work together and that the principles of harm reduction are incredibly important. They follow principles that are working towards evidence-based practices, decreasing the spread of disease, increasing healthy behaviors but we can't do that with force. Thank you. Hi, good afternoon, my name is Gabrielle. I am a constituent of John Leopold's. I'm also a member of Take Back Santa Cruz's Needle Solutions team and I also happen to be an attorney. So the team asked me to take a look at a practice that's been happening recently and that is a third party non-profit group going to the syringe services program and signing up as clients and getting hundreds of needles under the open secondary exchange provisions. So the question was, is that permissible under the health and safety code? I determined no. Is that permissible under the SSP's own policies and procedures? No. There's only two ways that a syringe program like that can be authorized. One is by the state and one in a county such as this is by the county board of suit providers and there has been no authorization by this board for a third party group to be passing out needles. And the code makes it very clear that it has to be both the board and the health officer not just the health officer unilaterally. It's also not permissible by the SSP's own policy. Clients and SSP participants is not defined but obviously that would mean IV drug users or close friends and family. So some suggestions to close this loophole so it doesn't happen again. The policies and procedures could be amended to add a cap on the number of syringes given out of secondary because we recognize there will be situations where there needs to be a secondary exchange so limit that number or explicitly state that syringes can't be picked up and distributed by a whole unauthorized group. And then also on page 12 of the syringe policy there's a list of reasons for termination of participants. So that could be amended as well. Thank you. Thank you. Hey, my name's Sharon. I'm a 43 year resident of Santa Cruz County and I'm a constituent of Supervisor McPherson. First I want to thank you all for this presentation. I know that was a lot of hard work and I fully support the county in expanding its syringe services program, increasing the hours. If you can get more staff, I'm happy to hear there's possibly more money allocated for that. I think it's extremely important that clients that come in here get the wraparound services that are available. The window of opportunity, when an addict wants to get clean is so small. I'm in long-term recovery from addiction. I was blessed to have somebody to talk to to hold my hand through that time. And she was a long string of people that helped save my life. And when I was in treatment, I read something alcohol and drugs gave me wings and then they took away the sky. That might not resonate with everybody but I finally saw that somebody knew how I felt. And addiction is complicated and can't be summed up in one sentence but it gave it words. And I've been graced with over 27 years clean now. I'm comforted in knowing that if a client came here for syringes that that little window of opportunity opened up that someone could say, here, come on, let's get you in treatment. Secondary syringe services run by volunteers cannot offer that. And I took a look at the Santa Cruz County Harm Reduction Coalition Facebook page and saw a post that said, addict is hate speech to oppress drug users. Those are not the people you want handing out syringes that are to people that are suffering out there. That narrative and delivering needles is assisting them in suicide on the installment plan. And I don't talk about this from judgment. I talk about it from experience. That's it, thank you. Hello, board members, my name is Gus Guzman and I've been a heroin addict for 15 years and lived here all my life. I was part of the, well, I'm part now of the MAP program. And also, you know, the syringe program, you know, it worked for me. I was part of that. And the accountability part, you give one needle, you get one needle back. You know, you give five, you get one back. I hear that, you know, and I don't know where this comes from, but that the needle exchange promotes drug use. And 15 years of me using, I never once heard anybody say, well, I saw a needle program, I'm gonna go use some heroin. You know, it doesn't work that way, you know. But it worked. Before I was involved in that needle exchange program, I got diagnosed with hepatitis C, you know, and I wish I had that long time ago. Maybe I wouldn't have gotten it. But, you know, it's time that the county that you get involved in this addiction, the potential for spreading diseases is really big, you know, I believe in the program and, you know, I hope for the best for this county. Thank you. Good afternoon. My observation of the SSP is that in order for it to be successful in its primary mission, which is to stop the spread of disease, two things must happen. The program must be as transparent as possible, and addiction must be taken seriously. To date, neither has happened. The program policies last published revision was five years ago, despite their own requirements that they'd be updated annually. You guys said nothing. The SSP claims that they are unable to physically count collected syringes. I dislike those who say they can't do something. One for one is a non-starter for me. Figure out how to do it. You're all college graduates. Should be easy for you. I've got a GED, and I can think of half a dozen ways to do it safely. Include the public at every opportunity before making changes to the program. Has anyone reached out to the neighborhood surrounding the Emeline Clinic regarding expanded hours? If an opioid addiction is a health crisis and treated as such, secondary exchange must be eliminated from the program's services. I would cite that the recent example of the Coalition Roadshow and the death, misery, and destruction they were allowed to create, addicts need to be seen in a clinical setting by healthcare professionals who are subject to local oversight. Period. Hello, my name's Carol Paul Hamas. Thank you for listening to my comments. I'm a retired teacher and high school principal. I ran two environmentally focused high school programs in Santa Cruz County. And in the course of our study, we would take kids, high school students out to the beach to do beach cleanups routinely. 10 years ago it was extremely rare to find a needle on the beach. Now it's extremely rare not to find one. I understand the whole concept of harm reduction and I believe in it. I also don't think it should come at the cost of public safety. We need to have accountable programs. We need to have programs with expanded hours if necessary, run by professional people who again can offer counseling to people at that golden moment when they might be open to suggestion. To allow volunteers who are untrained even though eager to distribute hypodermic needles is irresponsible. Please think about that. Hi, my name is Mai Dow and I have been a resident of Mount Hermann for 20 years. And I'm here today to offer my strong support for the needle exchange program and for the harm reduction coalition as an active part of Santa Cruz initiative for the health of its city. Today, June 11th, would have been my older sister's birthday. She died a couple of years ago at the young age of 62 of early onset Alzheimer's that was no doubt due to the chronic use of opioids and prescription drugs. I've asked this question over and over and all this time. Why my older sister? Why not me or my older brother? We came from the same privileged background growing up in Cupertino attending one of the best high schools. What I do know is that this is a very complicated question to which there are no simple answers. I've racked and searched for it and that I'm still searching for years later. What was already an epidemic years ago when my sister became a chronic user has only worsened by several waves since then. And it's been hitting our community especially hard since the introduction of chronic use of pharmaceuticals. The long-term effects are only starting to be felt by this way. The bottom line is no one in this room will be unaffected by chronic drug use either their own or by a family member. They are all your family members, the chronic users in this city. They may be in another city but we shouldn't be othering them anymore than those people we seek to hopefully help our own family members in another city. Pretty much my entire family abandoned my sister when she was struggling with her opioid use. So we do we wanna abandon our citizens in this, I don't have a problem with people not caring or bearing their heads in the sand about it but I do have a problem with them throwing wrenches and intimidating and harassing anyone willing to help. Please I implore you bring these vital services to our county. Hi board members, my name is Jennifer Landford Brown and I'm here in support of the county's syringe access program. I am part of the harm reduction coalition and I have been out for every single outreach. I'm an employee right now of Beckin and Dickerson and I'm a biomed tech. I also work for the public authority here in Santa Cruz. I have a degree in political science I'm masters in criminal law from the College of William and Mary in Virginia. I have been part of harm reduction for a while. I have a son who has a substance use disorder. He's 25, he's in Virginia. He's OD three times. He has now contracted hepatitis and he is in and out of rehabilitation because they actually have beds there. So they, I am here because the county allows what the state allows and the health and safety codes. One, two, one, three, four, nine, point one through three allows secondary exchange. If we didn't do that, things like my neighbor who just contracted HIV because she didn't know she was having sexual intercourse with a man who had HIV or was HIV or AIDS. And now she is 49 years old and she never used a drug in her life. I'm asking you guys to just go by what the state recommends. In Roanoke, Virginia, they went by what best practices here in California and they almost eliminated syringe litter. It was horrible and open up the beds, open up the hours, just allow us to refer people, more people to services. Please. Good afternoon. My name is Erin McLaughlin. I'm a senior manager of residential services for Encompass Community Services. And two of our programs are Cece Puede and Santa Cruz Recovery Services which are substance use disorder treatment plans. I am speaking in support of the county syringe services program and here's why. To decrease the rates of HIV and hepatitis in our community and to increase treatment opportunities for people in this county who struggle with opioid addiction. A study by the CDC in 2018 found that syringe distribution programs decrease the frequency of syringe sharing and reuse. And this has significant impacts on decreasing the rates of infectious diseases like HIV and hepatitis which is often spread through sharing needles. The study also found that people who participate in programs like the syringe services program are more likely to seek treatment for substance use disorders. This program is an important part of the continuum of care and Santa Cruz that leads clients to participate in the treatment programs like SCR and Cece Puede. So in closing, I'd like to urge your support for this very important program which helps people in Santa Cruz County find their way to treatment and ultimately a path towards health and recovery. Thank you very much. Good afternoon. I'm a constituent of Zach Friend. My name is Katrina Lisma. I'm a nurse and associate marriage and family therapist working at the medication assisted program at Encompass Community Services. Math services are not directly involved with the syringe services program but I serve the same clients and we are a part of the substance use disorder treatment services for this county. Harm reduction is much more than needle exchange. It is a practical approach to help people change with safety front and center. What I see by working daily with this population is that meeting with people exactly where they are leads to trusting relationships where people are more likely to ask for help, make safer choices, seek and receive medical and behavioral healthcare and keep coming back. Because of the syringe services and other outreach programs, many of my clients and our community members have been linked to our services which help them recover and stop using. I support an expansion of the SSP services. Santa Cruz County needs to adopt a harm reduction model of care for providing these services. Thank you. Ma'am, can I ask you a question? Yes. So please come forward to back to the microphone. Which is where I think everyone here is interested in getting more people connected to treatment and aligning the syringe services. We constantly ask how many people from syringe services are getting, Matt are getting enrolled and the answer is we don't know because it's anonymous. But if you just made a claim that you get a lot, can you tell me what percentage of your new clients are SSP users? Were they monthly users? Like how do we know this? That's a really good question. I don't have specific numbers. I can tell you that this population tends to be rather chaotic. They can't remember things. Their day-to-day living is really chaotic so they don't necessarily track these kind of things. I can't give you numbers but I'm sure we can probably find some at some point but I know that the continuation of care as other people have spoke of, the connection to all these services happens as a partnership, a community partnership. It's a porous, a non-porous system and I see people that come in and out of all these different services, outpatient, inpatient, cross-camp treatment, the whole thing, right? So I think going forward, it would be very good to get this information. Right now it's anecdotal. Right, thank you. Thank you. Hi, I can just add there is also lots of documented research if you wanted us to share that with you outside of Santa Cruz. Yes, I'm interested in Santa Cruz, but yeah. Great, good afternoon. My name's Savannah O'Neill and I'm a manager at the National Harm Reduction Coalition, which is a national capacity building and advocacy agency. I have 12 years of providing volunteer syringe service programs. I'm an addiction treatment counselor and social worker and I first worked in syringe exchange programs here in Santa Cruz in 2008 for five years. In my current role, I work statewide to strengthen community-based harm reduction programs, link people to care and build safer communities. I support county-run, organization-run and volunteer-run programs across the state, all who provide essential lifesaving services. I support expanding services in Santa Cruz County, currently only 20% of Santa Cruz residents live within five miles of a syringe exchange program, making it really difficult for people to access. So with the addition on mobile services, we know we would reach more people. When we look at HIV rates, hepatitis C rates and overdose across all California counties and we compare to Santa Cruz, Santa Cruz is at a high comparative rate of a potential HIV outbreak and Santa Cruz has far more restrictive and less services than most counties in California, reducing people's chances to connect and the most marginalized people. In 2017, Harm Reduction Coalition, the national organization conducted a needs assessment where we talked to 70 people who use drugs and providers in the county and we heard that they were mostly only having contact with outreach workers and those outreach workers were essential links to healthcare and treatment, offering people support in the field. For these reasons, I support the expansion of services that we know are based in evidence, save lives, reduce infections and treat people with humanity. I also support because people in the county want these services and they wanna be a county that stands in support of public health. Thank you. Hi, good afternoon. My name is Jenna Haywood. I'm also with the National Harm Reduction Coalition. That was my colleague Savannah. I won't repeat some of what she said about the statistics we know in Santa Cruz, but I will share that I'm also someone who is an IV drug user for over a decade and I now do consider myself to be in recovery. And I wanna talk about the fact that we need more, not less tools for people who use drugs, people seeking recovery or people just seeking to stay alive in whatever state they happen to be in in that day. So when I hear a lot of people talk about the fact that secondary syringe programs are not equipped to actually serve the needs of people who use drugs, I wanna talk about my own experience with peer-based support. That yes, I have used medical providers and I have gone to the doctor for support, but when I struggle with my recovery, I go to peers because I know that is what works for me. And so why wouldn't that model of peer-based services and harm reduction also be effective? And in fact, we know that it is. There is ample evidence to show that peer-based support is what works for people. I also wanna mention that we have advocated at the National Harm Reduction Coalition for money in the state budget this year for peer navigators to link people to treatment who access services at syringe services programs. So it is at the governor's desk right now. There'll be $15 million. Every authorized syringe program, syringe services program can have a peer navigator. Why did we do this? Because we talked to people who use drugs that said we wanna get into treatment. We don't necessarily trust mainstream medical providers all the time for different reasons because of oppression, because of trauma. And so there actually are going to these programs and that's what's helping to link them to care, but programs don't have enough money to do that warm handoff, to actually help somebody get to the treatment provider. And so with this funds, hopefully it will pass and this will allow Santa Cruz some more resources to meet that unmet need. But we have to support all of the different kinds of ways of reaching these people and that's why I encourage you to expand these services but also to really rethink the secondary syringe. It's legal and it works. Thank you. Hello, my name is Patricia Olson-Reiman and I am a 40 plus year resident of Santa Cruz County and my children have gone to public school here. My husband has his own business here and I've been working in the nonprofit world for over 20 years here. Right now I am the program manager of the Santa Cruz AIDS Project at Encompass Community Services as well as I work with the Encompass MAT program. I'm only here to just say a couple things and mostly is that it's highly imperative that we support the SSP. If not the best practices. Watching the presentation was really wonderful to watch but the 20 hours a week was kind of a little bit of a discrepancy for me. Working in the nonprofit world we are working in the frontline. Very rarely do you come to a situation such as this and see reports such as the presentation today. We're working with the people every day and we are seeing their suffering. We're seeing their disease and how it's progressing and we're seeing their isolation and depression and anxiety. And so I think what I just want to say is I just really want to support the county's program. And I want the county to work with us. I think that's the other key thing. I think there's a missing link and really working together with Encompass Community Services the MAT program and the Santa Cruz AIDS Project. We're seeing the people at our offices and we need to be able to have that relationship with the county to work with them closely so that we can have them over and have them do the hand warm off to the medical services there. Thank you. Good afternoon board. My name is Damon Bruder. I'm an addict and recovery. I'm here with my personal experiences. I'm here with my family, my grandchildren. Nobody that I've heard speak so far today is against the Surin Services program. Everybody is for harm reduction. Everybody believes that harm reduction does good for our community whether it be the addicts or just your average citizen. Nobody wants to step on a needle. That's part of harm reduction. Keeping the citizen safe as well as the clients. That being said, as an addict, I needed to have wraparound services to help me get clean and sober. I needed to be able to walk into a place and get told, hey, there's an option for you. Hey, there's a place you can go, hey, are you okay? We're here to help you. That doesn't happen in the field. Any expansion of the SSP should be done under the umbrella of the county and our health services agency. Ms. Hall and Ms. Herrera have both shown a great interest in being more transparent and fixing and tweaking the things that are wrong with the program and trying to make it better for everybody. We're working hard for that. I'm part of their advisory panel at the moment, hoping to be of more help to them in the future. What we need, we need more hours of accessibility for the SSP. We need more beds for the people that need help. There has to be a bed available when people want help. And we need to close the loophole of the secondary exchange. We need to put a cap on that of approximately 50 needles per secondary exchange. The secondary exchange that was going on by the Harm Reduction Coalition dropped the client numbers seen at the SSP by over 40% in a three month time. 40% of the people that used to go and get their supplies from the SSP stopped going, stopped having access to medical, mental health and recovery possibilities because the secondary exchange took needles to them. It was room service. Please do something about that loophole. I'm available anytime. Anytime anybody wants to talk one-on-one. I'm easy to find. Hi, my name is Savannah Carlson. I graduated from Cabrillo and I work as a caregiver with adults with developmental disabilities in Santa Cruz. I'm here today to support every expansion of services around harm reduction. I hope that the Board of Supervisors today can vote to allow the program to begin to move towards the advisory groups recommendations, which are backed by both local and national data on how to best support public health. The program has been stopped from enacting best practices for a long time and it's time to move towards science-backed policies, which all forms of harm reduction are. Also to make it personal, my mom has been addicted to heroin for a long time and I am honestly grateful that she doesn't live here. She lives in a county where services are much more expanded, including peer-based support and those policies have saved her life multiple times. I wouldn't have a mom without them, so thank you. My name is Olympia. I'm a recent graduate from the community studies program at the UCSC. I've lived in Santa Cruz for almost four years and in the past year, I spent six months doing a participatory observation at the Homeless Persons Health Project and also volunteering at the county syringe services program. During my time at HPHP and SSP, I met people who were current and past drug users, some of whom access county services regularly, visiting the exchange on a weekly basis. Many clients I built relationships with, however, were not accessing SSP for a variety of reasons. The data presented on SSP demonstrates a clear need for programs like this in our community. However, after six months of outreach, it became clear that SSP sees only a fraction of drug users in our community. While the lack of hours at SSP was one of the barriers to accessing services, trepidation about entering county buildings guarded by security officers, as well as mobility issues preventing people from actually getting to the Emeline campus to exchange needles seemed to be an even larger barrier. In order to fulfill its goal of acting as a gateway to integrated services, the syringe service program should be complemented with mobile exchanges and street outreach in order to engage with folks who aren't able to access the Emeline campus or the Watsonville location. As has been stated in previous comments today, harm reduction means meeting people where they're at and that means symbolically, but also physically, which is what mobile exchanges do. Thank you. Good afternoon. My name is Josie Roberto, and I'm speaking to you today as a concerned mother. I have four adult children, two teens, and two, three young children, including my grandchildren. They're all being raised in Santa Cruz County. I am here in support of the syringe services program and best practices. I'm not as versed in what that is, but I can tell you my experience in the community and my concern about prevention and about holding compassion for all our community members and what I've seen. We spend a lot of time downtown and local beaches and on West Cliff and we do participate in beach cleanups and we have found needles. We have interacted with people on the streets and I think it's important that the board remember they are human beings and I teach my kids and raise them to treat people with respect, even if they seem, you know, doesn't mean I want them to know them, but treat people with respect. We don't know where they've come from and what they've seen and what they've been through. And you know, I'm gonna remind the board what we've been doing in our cannabis industry for the last four years. The board encouraged us to instead of attacking other members in our community or other programs or other neighbors, you encourage us to listen to their side with respect, you encourage us to make the compromises necessary to come to agreements and I thought that was a really important lesson. I actually bonded with the people that were absolutely opposite side of the scale as what I believed in and by finding that common bond and respect, I think that the county can find a way to not demonize these people and to not attack these other programs because they're coming from a place of compassion and they wanna help. Thank you very much. Thank you. Hello, my name is Danny Drysdale. I'm a constituent of Zach Friend and a lifelong resident of Aptos. I was born and raised here. I'm speaking with strong and unequivocal support for all possible strengthening of the county SSP and I have that same level of support for our secondary exchange program. I am a proud and active volunteer with the local harm reduction coalition's secondary outreach efforts. I go out there every week. I believe that my support to other addicts as their peer is deeply important to the health of our community. I went to Aptos Junior High and Aptos High School. It was there when I was 13 years old that I started using drugs very heavily. When I was 14, I became a daily user of cocaine. That same year, I found out that my mom also had the same addiction when she was my age and I spent my entire teenage years struggling with that. Because of the common beliefs around addiction that are especially prevalent in Santa Cruz, I came to believe that I was broken. I was racked with shame and I almost took my own life on multiple occasions and kids here should not be growing up with that shame imposed on them. A community that believes itself to be progressive should not be flooded with these narratives that I learned as a teenager and it should definitely not have some of the most restrictive programs in the state. But as I'm learning now, Santa Cruz is a massive aberration. It is a specifically regressive community on the question of drugs. I blame that fact directly for my traumatic teenage years. There is no data to support the claims of opponents of harm reduction, the SSP, or the secondary exchange. The arguments against secondary are in complete contradiction with public health research. But as a queer person and as a trans person, I can't help but remember the AIDS crisis. When public health data and the stories of victims were completely ignored, leading directly to the loss of many thousands of lives. There was a point in the AIDS crisis early on where half the country believed that all AIDS victims should be quarantined and forced into that kind of care. And we have the same kind of messed up, misinformed public opinion here in Santa Cruz and I don't think that should trump public health opinion. I don't think it should trump the need for care that me and my fellow volunteers provide every week in this county. Good afternoon, Board of Supervisors. My name is Melissa Freebarron. I'm a registered nurse. I'm a former Matt nurse. I'm a nurse who've worked at your local jail and I currently am a supervisor at a state prison in Soledad. I come here to advocate for vulnerable populations like I have since the beginning of this campaign. Drug addicts deserve the same level of medical care and outreach that every citizen in this county deserves and what that means is that we don't leave this population in the hand of unqualified. While they mean well, it is misguided. Untrained volunteers going and handing out needles and Narcan and not being able to offer somebody HIV, Hep C testing on site. Not really understanding what that means when they hand the Narcan. I understand that. I am that nurse who runs to a man down of an inmate who is blue, who is dead. I pump on that chest. I administer five doses of Narcan in a correctional setting where yeah, I work around a lot of people who don't think and feel the same way that these people are still human beings even after they've committed a crime and they're incarcerated because what's missing from this conversation with all these people is that the end result of a heavy duty drug addiction is that you will end up dead, you will end up incarcerated or you will recover. There is nothing else. There is nothing else unless you are extremely wealthy and you can maintain a heroin or meth addiction over the course of your lifetime and that is paid for by someone else. So I am in full support of the county taking this program back and stopping secondary exchange by people who are not trained. They cannot link people to services. They have zero data to support that they can help anybody and until they come under the umbrella of the county, you have to stop this. Hi, my name is Dane Enderton. I work for the HIV Education and Prevention Project of Alameda County. I'm here because I originally moved to Santa Cruz when I was four and I lived here until I was 27 and I really feel like I call this place home because it was the place that raised me and it's the place that I really feel like is special in California. I'm also here because I wholeheartedly support the Syringe Service Program and all of its best practices and harm reduction. I have lived in this county. I've been homeless in this county. I spent a primary portion of the time that I lived here in the mountain area of Santa Cruz. I first moved up to Long Pico and then I lived in Boulder Creek and then Lomond and Felton all over that area. I can tell you because it is a more removed area, it is very difficult to get access to the program in Santa Cruz and throughout my entire time growing up, I knew people who suffered from addiction who really needed the help that the Syringe Services Program offered in Santa Cruz and it was very difficult for any of them to get down there. I work in data so I can tell you from a data perspective, from a science perspective, secondary syringe services work, all of these programs, all these best practices actually work, they help save the county money, they help reduce syringe litter. If we really wanna see reduced syringe litter, if we really wanna see more people in recovery, if we really wanna see this county get more help, expanding the syringe services program in every way possible is the best way to do that and there's lots of data that shows why. So please, if you could do that. Good afternoon, I'm Scott Graham and I'd like to refer to this item 20. You got it as 20.i, exhibit nine. It's in your folders and it's from the office of AIDS, the California Office of AIDS and it says the Department of Public Health advises syringe exchange programs to needle-based distribution policies with the goal of ensuring that participants have a new sterile needle each time they use. Under the program that you currently have at Emeline, you're doing a one-for-one exchange which is not needs-based. No, there's different levels of exchanges. There's like the one plus where people can get more than one needle and what is the best practice according to this document is the needs-based where the person comes in and they might not even have needles. They might have put all their needles into a bin somewhere. So having the ability to get the number of needles they need is what's gonna be the healthiest thing. I had friends that died of AIDS and it's possible that that epidemic could come back if you let it. So I would urge you to work with the Harm Reduction Coalition to work out a way that that program can exist in this county and help them work with the different areas where they wanna do distributions and go into those areas and do public relations with you and the health department to ensure that these things happen. Thank you. My name is Danny Contreras. I'm the Health Service Manager over the Medication Assisted Treatment Program for the County of Santa Cruz. I would urge you to accept or approve the county's recommendations. I say this because I started at the county in 2016 and I worked in the Syringe Service Program for about a year and a half and through that I was able to connect with people that probably nobody else can connect to and through those services I was able to get people into IVH to specialty mental health, to medication assisted treatment and sometimes that is just building a relationship with people every single time they come in. Yeah, they might not be looking good but hey, you got an abscess. Let me get you to the nurse. Are you ready for treatment yet? Here's my phone number. Every single time. Here's my phone number. Here's the brochure. Here's some other services. You might not want it but here keep it just in case you want it later or you change your mind. All of our drug and alcohol counselors we have five drug and alcohol counselors underneath me who all are doing shifts in the Syringe Service Program and all of them are providing those services or connecting people to services throughout the county whether that's whole person care, IVH, drug Medi-Cal, connecting to Encompass, C-Suppoy, the Santa Cruz residential, Alto, whatever drug program that is but it's basically just working with people where they're at and providing the services and we're just laying it out for them. You know, we're showing them love when sometimes somebody else won't show them love. And we're being a voice or advocate for them when sometimes nobody can hear their pain or what's going on with them. Some of these people have severe trauma, severe stuff that you don't know or that nobody knows, that they've never shared with people. I have watched people come from the bushes and have nothing. When we didn't have the MAT program in Watsonville Health Center yet and we were still rolling it out, they would get homeless, try to find a bus or a ride to HPHP to get MAT and continually strive and struggle. And that came through the Syringe Service Program. One of those persons, a couple of those persons wanted to come here today but they were not able to because of work and they're getting housing some of the other persons but they got full-time jobs now, they're going to college, they're working on becoming drug and alcohol counselors and they're doing a lot of awesome, amazing work and they're helping people else recover too. Thank you. Good afternoon. My name is Matt Nathanson. I have been a resident of Santa Cruz City in the county for 25 years. I'm a constituent of Supervisor Coonerty's. I also am a public health nurse. I've worked for 21 years in homeless services for this county and I'm here to speak in support of the recommendations. I actually think there is more that we could be doing but I think they represent a political compromise of where sort of the community is at. I don't think they necessarily represent the best science but the good things in it, I guess what I would want to say is first of all, Santa Cruz used to be a leader in syringe exchange back in the 90s when I started working here. We were a model for other places and I think that was largely in response to the HIV epidemic at the time. I think part of the problem has been over the last several years. We've lacked leadership in the health department to move forward on this issue and I'm really excited today to see the health department leadership bringing forward these proposals. So I think that's great. I think what I want people to, there's a lot of focus on this syringe and as a nurse my view of this is I want some, if somebody is gonna be injecting drugs, I want them to be injecting drugs with a clean needle every time because every time they use a dirty needle they're at risk of contracting as we've heard HIV, hepatitis. There's lots of people with endocarditis in the hospital with really severe abscesses. There's a huge economic cost as well as personal costs. So you from a medical, from a nursing perspective, it's just like somebody who shoots insulin for their diabetes. I want them to not reuse their needles. I want them to use clean needles. There's no moral judgment there. It's just about people's safety. I also think that I'm glad that there is the study about syringe litter. I think that that issue causes a lot of fear for people and I understand that but you can ask your epidemiologist how many people in the county have contracted HIV or hepatitis from an accidental needle stick in the environment stepping on it versus how many people have gotten it from sharing needles. You'll find the numbers are dramatically different. Anyway, I'm out of time. Thank you. You can pull it down. No, no, not that one. The other one. What's going on? Don't start, reset my time. Okay. Hi, my name is Annalisia and everyone I came here with today lives in Santa Cruz County. Okay, let's make that clear off the bat. We've been talking about this for a long time and I'm proud to say that everyone, at least that I've heard that it stood up is not against the SSP. That's not what this is about. We're for harm reduction. We believe that that is absolutely part of the answer. I do sit on the sheriff's advisory team and the harm reduction coalition did come in and I did get a chance to hear them out. I was really alarmed and I hopefully all of you have read all the holes that have been put into this harm reduction coalition state application that went through but things like questions about data. So how many people did you refer to rehabilitation or any kind of services? This person has hit rock bottom. They have said, I need help right now. What, okay, what do you do now? Are you ready? Let's grab that person, throw him in the back of your car and get him where they need to be. The answer was I have no information about that. Did you follow up? Did you call, like find that guy? Hey, you know, what happened with that? No, this is secondary services problems. This idea of getting needles from the SSP and calling ourselves a client, this is shady. This is shady things. And I want you to look through all this shadiness that all of us have been seeing on this state application which I see Swiss cheese that doesn't have this many holes in it. And I want you to think about what we're doing and who we want to be as a county. I want every single person who wants help to find it. And I know you guys read the grand jury findings and those weren't all their findings. It's things like that, little bits of information that are kept out of the conversation when they're brought to you and when they're brought to the community. Thank you. Hi, I'm Denise Ellarick and I'm the supervisor of Friends Constituent. And I was at a different meeting that Annie Alicia is speaking about because I explained the data that we do collect. We have collaborated with Mimi Hall and Jessica Altman's. We collect data on male, female, age, do you use the SSP? Naloxone distribution, all that. And we turn it over to Jessica. So the county data includes our secondary data. And you need to know that excessive data collection is not best practices for any syringe program be it the public health department or all volunteer. And what I'd also like to highlight, I know everybody wants to see how many people are cured but curative substance use goes a spectrum of it can be decades. And so if somebody doesn't use for one day and they're on Suboxone, but then the next day they use that's still a win. And it's gonna be very hard to ask for measurable outcomes on substance use curing when you're not using an evidence-based practice program. The real measurement of effective program is when you get that client into medication assisted treatment, are they HIV negative and do they have hepatitis C? And do they have endocarditis? Are they dying in the hospital of pneumonia from an unsafe, unclean injection? Those are measurable outcomes that we all have control over. And I value the syringe program incredibly. I don't have a fake account. I go in there, we talk by name. I'm a Sherpa. I met people that asked for this program because it was raining cats and dogs. The programs closed on Mondays. The holidays, they were closed on Fridays after Thanksgiving. And people were incredibly needy. They are in wheelchairs and walkers. Mud, it was an insane winter. And I look forward to connecting with our community. I have driven people to the SSP. I have driven people to the Emeland Clinic for wound care. I drove a gentleman. I have driven two men to the emergency room. Long story, not gonna waste my time on that. But there is a way to connect people to services. And it's done every day all over the state of California. We're not here to talk about any supplemental program. We're here to say thank you to Mimi. Thank you to Jen. Go with expansion of your program. Thank you very much. Good afternoon, Supervisor Coonerty and Board of Supervisors. My name is Erika Padilla Chavez and I'm the CEO of Pajaro Valley Prevention and Student Assistance, located in the heart of the Pajaro Valley in Watsonville. We provide counseling and outpatient substance abuse services to youth living in the greater Pajaro Valley. And that of course includes our beautiful community and APTAS. We are very proud to be a partner in the county's behavioral health continuum of care. And when I say behavioral health, I'm talking about mental health and substance abuse services. Well, at PVPSA, we work really diligently to prevent youth from swimming deeper into the continuum of need. We recognize that there are people along that entire continuum. And so it is therefore imperative that we provide services no matter where people are at in that swimming pool, whether they're at the shallow end or at the deep end. And therefore, I'm here today to say that the SSP proposal before you is a very sound and very public health-minded approach to addressing the needs of the people on the deeper end of the pool. It articulates a very comprehensive and systematic approach to increasing the opportunity for wellness for those individuals while ensuring the public's health. I want to thank the county team for being so diligent with conducting all the research and gathering the information needed to present to you a very articulate and a very research-based proposal. I am very excited to be a partner knowing that I have partners around me that do have expertise in working with folks that are in that deeper end of the pool. And I stand ready to work with them in whatever way possible to expand whatever service needs to be done. But I will continue to try to prevent our youth swimming deeper into the pool. Thank you. Chairman Coonerty, members of the board. I'm Arnold Leff. I'm a resident of Boulder Creek. And former currently a retired health officer. All I can say to all of you is do what needs to be done to decrease the amount of substance use in this community. By increasing the availability of the Syringe Services Program, you will in fact do that. By increasing the Syringe Services Program, you ultimately will decrease the amount of syringe waste in the community, not increase it. By allowing the county to increase their hours, give them as much flexibility as you can. By doing that, you will decrease the substance use in this community and you will decrease the amount of syringe waste in this community. All the evidence shows that. All the science shows that. Please follow the evidence, follow the science. Don't do what some people in Washington do and reject the evidence and the science that supports these programs because they do in fact prevent disease. They do in fact decrease the amount of syringe waste in the community and as importantly, they save a lot of illness and a lot of resources that have to be used to correct serious disease. Thank you. Hi, my name's Eric. So at the beginning of the presentation, the director said that SSP is not just about needles but the third party is about needles. When you've got two people handing out 600 needles a day, they're not sitting down, they're not doing testing, they're not having peer counseling. They're handing out needles and I just, I think one to one is the way to go. So the numbers show that there are fewer visits but more needles being handed out. So again, that's not consistent with it being not just about the needles. And finally, I'm not a health service worker, I'm a finance guy, I know money, I know numbers. So they say that they collected more needles than they distributed by weight. So I have to ask you, if I came and paid my property taxes by weight, would you accept the container and trust me? Thank you. Hello, my name is Craig Reinerman. I'm a 30 year resident of Santa Cruz, retired professor at UCSC and a member of the Syringe Services Program Advisory Group. I was around in the early 90s when we did an evaluation of the Santa Cruz AIDS project, the Santa Cruz Needle Exchange project under Santa Cruz AIDS project. And I was struck by how many people we learned, that was the first step. Showing up and exchanging needles was the first step they had ever taken in their lives to take responsibility for their own health. Nothing has convinced me otherwise since then. Syringe services do not cause drug problems by themselves. And I'm here just to add my voice to support the expansion of the hours and the services, the connection to HPHP, and particularly the distribution of fentanyl strips, which will help prevent overdose deaths. Thank you. Thank you. Speaker. Good afternoon. Hold on just one second. Is this our final speaker? Is there anyone else who'd like to speak to us? This will be our final speaker. Good afternoon, everyone. My name is David Junini, and I'm a recovered alcoholic and drug addict. 29 years clean and sober. What, it's emotional for me because what I see before me is so much possibility. So much can be done when we have an opportunity to interact with someone who's in the throes of addiction. Being able to garner the trust of that person when they make that rare decision to do something about the situation that they're in, that is a golden moment. And however you decide to structure this program, I would advise you to keep in the back of your mind the possibility of having trained professional addiction counselors available when a person has that golden moment where they wake up and they decide that maybe I can do something about my life. Maybe I don't have to continue to live this way. Whatever, however you structure this program, please keep that in mind. Thank you. Thank you. Thank you. So that concludes the public comment. I'll bring it back to board for deliberation discussion. First I wanna begin by thanking everyone who came out today. This is the most thoughtful and respectful conversation I've heard around this issue in 15 years in politics. And I think we're all much closer than often, not least on social media, we appear. And I wanna thank everybody for the thoughtfulness and for taking the time and sitting in a warm room as well to make sure your comments are heard. I'm gonna call myself first. I have some broad comments. And then I supervise it with Ferrisen and I have some motion that we'd like to bring forward and then have discussion and changes. So the first thing I wanna say is I very much support SSP and I think and I wanna congratulate them for the good work they do and the public health staff at the county are absolutely amazing. I've seen them from early childhood and babies all the way through disease prevention and Dr. Les' heroic efforts around hepatitis A last year saved many lives. It was stated that there were three goals for the SSP program and I believe that there are three goals, but I believe that we've overemphasized one at the exclusion of the other. And when we talk about reducing needle litter, the goal has to be there is no needles in our parks, beaches, neighborhoods or other public spaces. Once a week, a parent comes up to me and says I no longer or a grandparent, I no longer take my child to a park, to the parks or to the beaches or to the library because we went once and there was a needle or I heard about a needle. Now I can tell them what the epidemiologists say but that is not a conversation that they want to have or will believe. And so father of a young children there is no conversation that I can have where my child steps on needle, it's okay because the relative chances of disease are small. It has to be a zero possibility and when you have whole sections of our public no longer engaging in our public spaces out of fear that's a public health crisis and it needs to be treated as seriously as the spread of disease. Similarly, the efforts to expand access to treatment and I commend the HSA staff who's expanded treatment and hopefully will continue to expand it going forward and the work from people like Danny at HSA, I mean that is exactly what the kind of outreach and compassion and passion that we need to help people get treatment. So the short answer is we have an obligation to serve the needs of the entire community and I'm not sure the answer to too many needles is more needles. Santa Clara has seven times our population and gives out one third of the needles that we give out in just 12 hours of clinic time. Monterey has 12, two times the population and gives out 20% of the needles and their disease data is not different than ours. In fact, Santa Clara is better than ours. And in fact, we followed science and we are now giving out three times the needles that we're giving out in 2014. We haven't seen a statistically big difference in the amount of disease and yet there's far more needle waste than I ever remember there being. So I think we need when we look at this to figure out how we approach this in a way that will work in this community. The slide about the reduction in the number of clients served from September 2017 of 385 clients to 167 clients last month or in April means that we're not having any of those conversations. Means that we're not connecting people to services and we don't have people like Danny who's half the conversations he gets to have with people and that means that we both are getting fewer people referred to treatment but we also when we talk about and rightfully celebrate our HEPA response which wasn't spread through dirty needles but was because we had a relationship we have half the relationships that we had in September of 2017 to be able to deal with the HEPA outbreak. For litters, the downtown streets claim has cleaned up so far and it's not even a year yet, 6,000 needles. It was not the purpose of the downtown streets team to be a needle abatement strategy. They just happened to be out cleaning trash and it's job training program but for that program which had nothing to do with needles we would have 6,000 needles in our community. We have 217 reported by Save Our Shore, thousands by the city parks environment, thousands by community members. We have to figure out a way to drive that to zero so when I look at some of the solutions I'm absolutely supportive of kiosks. I've gone to city council members and asked them to put up kiosks but we had a kiosk at the gateway camp that was 20 feet away. We had HPHP that was a stone throw away and there were hundreds of needles on the ground in our waterway when that camp disbanded with a kiosk, with services there. When I look at the Citizen Connect I in general like the idea but San Francisco spends $700,000 a year to have a 24-7 needle program and San Francisco is an unmitigated disaster for needle waste so it's trying to figure out how we address that without spending $700,000 a year. Because once we have a Citizen Connect app when somebody reports that I'm gonna expect as a homeowner if I find a needle in front of my house that somebody will be there within the hour to clean it up. That is an expensive proposition and I'll tell you talking to City of Santa Cruz they're not gonna send people they expect us to send people we're distributing needles so the county is gonna be running a county wide program trying to connect people. And then when we look at expansion whether it's and I do believe I am supportive of some expansion but if you look at HPHP Coral Street is a complete public health and public policy failure right now. You have every child that's trying to participate in a summer program driving through an open-air drug market it's a totally unacceptable situation and to add yet another service into that area without talking to the neighbors and without having a strategy for what's going on we cannot have Coral Street look the way it is and ask to expand programs. Similarly I am supportive of expanding it but if you look at but if the third prong is really about community outreach how many conversations have we had with the neighborhoods before we advocate for expansions? So I think I wanna support and I will support SSP I will support the very good public health people who are trying an expansion of treatment but we just can't keep saying we have these goals of litter abatement and then I mean but for the fortune of bringing in the downtown association connecting with streets team there's 6,000 needles that would have been picked up by citizens, parks workers or somebody else and that's 6,000 needles that shouldn't have to be picked up in the first place and so I think I appreciate the efforts but it's not working right now and so it's very, very challenging to advocate for expansions when it's very much not working and in other counties that have much, much smaller programs even though they're dramatically larger their programs are working so it's hard to figure out what exactly is going on here when you wanna look at the data and you wanna look at best practices. Thank you for indulging me and I'm gonna ask Supervisor Fierce and then we'll work our way around the board everyone can have comments. Thank you, I agree with that. I, you know syringe exchange, excuse me, syringe exchange has been an important element in reducing our communicable but disease nobody disagrees with that and it's a proven positive outcome here and elsewhere and I'm really grateful for it and I wanna thank the Health Services Department and the agency too having brought this report to us and having to air this out as we should do probably more than each every two years but I think that we have, the county does have an obligation to find out what our program may be contributing to or against or for the program. A needle exchange has been in my district and Supervisor Caput's district up to now. I'm also troubled as stated that according to SSP we've seen the number of unique ID clients fault 40% in the past four years but then we also have syringes that we're giving out have nearly tripled. We're seeing fewer clients and we're giving out more needles. That's troubling to me. That doesn't seem to fit right. Doesn't make good math to me. We must help more people treat their addiction rather than just manage it and I do agree with much of what Supervisor Coonerty said. I would, if it's proper to like to move a motion it's a pretty lengthy one of one I've thought about and would like to move a motion to approve the recommended action and to accept the HSA biennial report for SSP and that we give this additional direction and there's seven points that I've been down. Direct the HSA to reduce the maximum number of clean syringes exchanged per person per visit at SSP sites from 100 to 50. Syringes returned to the county should be in clear containers as to be visible to staff receiving the syringes. And be weighed. This step will more closely align our procedures with our board approved one to one exchange policy. Second, in order to encourage more people to use primary exchange as a six month pilot that we direct Health Services Agency to increase the hours at the M-Lan and Watsonville clinics to 15 hours per week and to conduct a community meeting to address any concerns. I would ask for a report back in six months to determine whether the increased hours and fewer needles per visit serve the purpose of encouraging greater use of our exchange. Number three, direct the county administrative officer to manage a 90 day waste stream assessment using marked syringes to determine the extent to which syringes exchanged by the county, this county are contributing to the needle litter. That's an unanswered question now. The assessment should be conducted by an independent provider that is near the county or state department of health. The assessment will be confidential and conducted for a period of time with specific markings not made known to the SSP clients and the results were reported back to the board within six months of completion. Four, direct the Health Services Agency to return to the board by September 24th, 2019 with an ordinance to change the SSP advisory group to a seven member SSP advisory commission subject to the Brown Act with one seat appointed per district and two seats appointed at large. Five, direct Health Services Agency to work with the local jurisdictions to explore additional options for installing safe sharps disposal containers at HSA's expense if jurisdictions agree to the placement of the containers. Six, direct the HSA to start tracking the number of SSP clients successfully referred to medically assisted treatment. And lastly, number seven on mobile services and the homeless persons health project. While there may be benefits to the county providing additional services by public health in the future, now it's not the time given our concerns about the current exchange. And mobile exchange should involve community input about appropriate sighting and timing if that decision is to be made. That's the motion I have. And I'll second that. Supervisor Caput. I think we're pretty much ready for a vote. I wanna thank everybody for coming here and it's an honor to be a part of the board and actually showing everybody we're ahead of what it looked like was coming down from the state. It was very disorganized and we've always, we've been on top of this for quite a while and we're trying to improve it. So we're ready to go. I think this is good for South County and it's good for the rest of the county. So I think it's a slam dunk on the phone. Supervisor Leopold. Thank you, Chair. Thank you for everyone's testimony today. I really appreciate it and I continually learn from the public as I engage in conversations about this. I've had the place of watching needle exchange or syringe services over the past 25 years when the county passed its first ordinance about this in 1995. I was the executive director of the AIDS project. And so over that period of times I've seen the ups and downs of this program. And there's a couple of things that stand out to me. One is that when there has not been a strong institutional program, volunteers have filled the gap because we are a compassionate community. And so it was that way when it started back in 94 is the first time I became aware that there was a needle exchange program in Santa Cruz. Eventually the Santa Cruz AIDS project took it over and then as that organization was suffering great difficulties, volunteers then showed up again as street outreach supporters. Their actions caused the county to take the program over but we have consistently shrunk our program and that has resulted in volunteers stepping up to fill the gap because regardless of how you compare us to other counties we have people who inject drugs in Santa Cruz County. The other thing that is kind of clear to me is that when you have a well run program that's actually following best practices it can do good things. And for 15 or 17 or maybe more of those years that there was some kind of needle exchange or syringe services program we didn't hear and did not see needle litter in the same way that we have in the recent past. We should not feel comfortable with the level of needle waste in our community. It's unacceptable, it's unhealthy and we shouldn't just look at it as an HSA problem because it's a waste problem. And as a waste problem that HSA is connected to it because there's a public health strategy that involves needles and then there are needles out in the community. It doesn't mean that HSA is the one that's responsible for that and there was a needle litter problem before HSA was involved. So this idea that somehow that our program is the cause of this is just not borne out and it was not borne out by looking at other communities that also have needle litter program problems. Santa Cruz is not the only community that has a needle litter problem. And that is also a recent vintage in other communities as the state laws have changed about the accessibility of needles there are other places to get needles. And as a result, there are more needles in our community and other communities. We should not sit still or assume that it will just take care of itself. We need to be aggressive in that. And that's aggressive in terms of having places where people can place needles, having people to clean up needles working with other jurisdictions to also do the same. We have tried to get other communities that have that where their residents have complained about needles to take kiosk and we have been rejected consistently with a few exceptions. So as I look at this motion, I think that we're just, that is a failed strategy to just say, let's try to work with them. If Grant Street Park or Cow's Beach or another park or Coral Street has needles, we should work to place kiosk there, not wait. We should also use good science that we do care about that. We had a science march here in Santa Cruz County. We said that we cared about good science. We criticize legislators for not following good science. And so we shouldn't accept something that I understand the perfect, I understand the motivation for people wanting to do things, but it's not backed up by the research. It's not backed up by the science. And so it's hard for me to support an arbitrary cut from 100 to 50. Why should it be 75? Should it be 25? Should it be cut at all? When I see, I understand the concerns about the number of needles giving out and the reduction in the number of individuals coming into the SSP program. We could look at that as saying, you have the hours so little, under 10 hours a week, that you have to increase secondary exchange because we're just not available to people. And so people who are in need find someone to take their needles in because nine hours isn't enough. So maybe we should increase the number of hours and look at that impact in six months and assess whether that actually gets more people through the door and into the program, into the things we say we care about. Because I think HSA has worked very hard to tie in their syringe services program with trying to connect people to clinics and services. And it takes really good staff to be able to do that. We need dedicated staff, people who are used to doing it because say what you will about the harm reduction road show. And I understand the concerns that were raised there. But the idea that someone's out there trying to help people and that a secondary exchange is a bad thing if they don't include hep C testing or HIV testing. When I was at the AIDS project, we had health outreach workers who regularly met with people. They didn't give out needles. That wasn't something that the AIDS project did. But they gave out condoms, they gave out supplies for people to inject carefully. And they worked to get them into testing. And we actually at that time had a much more robust testing program and community testing spots that we don't have today or the same kind today. To link our successful and recognized program of homeless person's health project with the problems down at Coral Street. They aren't the reason that there are problems down at Coral Street. We place the program because that's where the people were, right? And so, I believe in community outreach and community meetings. I think that that's critical. But let's not say that our effectiveness in placing programs where the problems are the reasons why we shouldn't have, we shouldn't do something for that population. That was the whole strategy to begin with. I take everybody at their word. I didn't hear people speak about us against the syringe service program. I heard a lot of support for it. And I'm grateful that we're past that part of the discussion. And I think we should try to use science wherever possible because it's a very loaded issue. And there's a lot of emotion in it. And sometimes emotion doesn't make the best policy. Science helps makes it the best policy. And we can't let the perfect get away with the good, right? I understand that. And so I see that the staff has come with something that's not perfect. It's good, not perfect. And we should be aspiring to following the best practices. The State Office of AIDS, the National Association of Counties, the National League of Cities, the Republican Congress that funded Needle Exchange last year. These aren't crazy left-wing anarchist organizations, right? I mean, these are reputable organizations, organizations that we are part of, we choose to be part of. And they support this activity. And we know public health works too because if you look at our SafeRx campaign as provided in the data, we can see that the opioid prescriptions have gone down because of the interaction and the public education that's gone on. When I look at this motion, I can't support it. It's far too broad. Reducing it for 150 to me does not seem like anything that's backed by science. And it feels completely arbitrary. A six-month pilot, about extra hours. All right, that might be something that will work. The waystream assessment, again, I don't even know whether it's possible to do this. I don't know what it would cost to do this. It's hard to support something that is so amorphous that you can't figure out exactly what it is you're buying into. And to try to figure out what the, I think I've came back with a suggestion about how that would be done and what would be cost. We can make an assessment of it. But just given today what's written here, I don't feel like I could sign on to it. When I look at the SSP advisory commission, you know, I remember when we set this up and we have a bunch of professionals on there and law enforcement was invited to participate. And a couple of the members spoke today, Damon and Dr. Reinerman both spoke. I think you're both on it. And we have a bunch of health professionals. And it seems like those people who actually know something about disease prevention are useful. And whether there should be other people as part of that, okay, that's a good idea too. But I want us to be directed by good public health data and science, not just emotion. When it comes to working with local jurisdictions, I think we should have something a little bit stronger. For instance, I think we should direct the chair to write a letter to the mayor of the city of Santa Cruz and ask them to respond back to us. So there's something in writing because I've had those conversations and every council member I talked to say, well, yeah, sure, that sounds like a good idea. But we never get it to the place where there's one actually placed unless there's a crisis as there was with the Ross encampment. So I think that we should have something stronger and ask them to tell us that they don't want these things. So their citizens can understand that they don't want to participate, that it's in writing because the county has kiosks in the warehouse ready to deploy, but we don't have support from cities to place them. It's not the magic bullet. It won't make the problem go away, but we should at least attempt to place these because we've seen that where we place them, at least it collects some of the needle waste that's in our community. I don't know the answer about SSP clients successfully referred because again, you might make the referral, but if they never show up, it's hard to, I don't know what the appropriate measure for that. It's an admirable goal. And if we want to hold off on the mobile services until we see what's happening with the expanded hours, great. But for all I can tell from the discussion that's gone on about the harm reduction road show is that there appears to be people using drugs outside the city of Santa Cruz. And we should think about how we get those services available to people outside the city of Santa Cruz. And if mobile services were once part of the array of services that we had for exchange, and it stopped for various reasons, and maybe we need to think about that again. We don't have to do that right away. I don't think the staff was suggesting right away, but I'd be happy to come back and take a look at that. We should not accept needle waste and we should do everything we can, and we're gonna have to spend money in order to help clean up the community. We should use the best science to make decisions about how to practice public health because we've seen that when public health does those best practices, we have good results. And we should operate not about trying to limit this, but trying to make it successful so it actually meets the need. And the research tells us if you have a program that does a better job of meeting the needs, you can actually see less litter. That is, there is national research on that. We got information in our packet about state research on that, that's clear. And so if we're committed to that, we have to take in all those pieces. We can't just pick and choose from that. So I don't support the motion and I hope that we can talk about making some amendments to it in the hopes to make it stronger. Thank you, Chair. Before we're using our health professionals for heat stroke treatment, I'll try and make this a much faster here. I think that we can actually get to a motion that can be supported by the majority of the board. I have two brief questions of the health staff. The first one is just on the point here of reduction from 100 to 50. Do you have a number of a sense of what the average giveaway per person would be? What the reduction would mean as far as access components? I agree with Supervisor Leopold that this is an arbitrary cut. The question is, what does that cut actually mean as far as delivery services would be concerned? I think the overall- And I'm sorry, but just there's a difference, right, between 50 for primary and 50 in a secondary exchange. We're saying that essentially you treat all exchanges as primary exchanges. So for people who are primary exchanges, it obviously caused a reduction of people who are operating secondary exchanges with the idea that we're trying to drive, I'd like to see 100% increase the number of people that use the clinic. So we're trying to drive that up. So there's a lot of people who are using secondary exchange who aren't coming there and this would obviously drive, that we're trying to get those people there. So I got that, but then you would do something that regulate the secondary exchange. I mean, so meaning that you might be going out at the wrong way, if what you're trying to do is eliminate an independent or non-transparent or whatever adjective you want to use third-party exchange and everything would be under the controls of the county, then make that statement. I mean, just ban them. But then what you would do then is then not regulate what the county says is the best practice in the distribution under that regulated model, because those are mutually exclusive things. So what I'm asking then is, is what the reduction from 100 to 50 would mean? I did actually hear, by the way, remarkable amount of common ground, even though people were approaching it differently, which was interesting. So I think that there's a way to actually get there that would, even if people didn't actually recognize it, actually make this motion something that could be done. So if we went from 150, how detrimental in essence would that be? To me, I would be willing to keep it at 100 unless I could be shown that there's a reason that the reduction would actually do something that would meet the public health interests that are being expressed, or concerns that are being expressed by my colleagues. Ms. Hall. So that's actually moving in the wrong direction. We were very conservative in our request to the board because we recognized that we're not close to best practice. What we're trying to do is balance what capacity and resources that we have and expand it slowly. I truly believe, and I believe that Dr. Gilarducci and Jen, you may also chime in. But I think the first thing that we need to do is expand access and availability. The primary reason I believe that we're seeing this large reduction in folks physically coming in is because we don't have access. Being open 10 hours a week, or five hours a week in Watsonville does not. But Ms. Hall, you were open 10 hours a week in 2014 and you had 40% more people. So the hours haven't changed and you're seeing your access fall. What has changed is that someone in the community or a few someones in the community recognized the gap and decided to step in. So my understanding of how the secondary exchange started was last a year ago Memorial Day. I wasn't around, but from what I understand of the history, the county was closed on a Monday on a county holiday. And it started kind of informally to provide the service to folks because we only provide it three days a week. So if we have a county holiday on a Monday and or a Friday, that three days a week turns into two or one days a week. And what we have heard in terms of feedback from our clients is that they'll carry around 100 needles waiting for the exchange because they're not exactly sure that they can actually access us every time we're open. And so I think it would be more prudent to allow us to expand our hours, see how those hours change because now we have different items at play now than we may have had a couple of years ago. The other thing that I wanna say is our program has changed dramatically. When I first got here, I've been director for seven months. When I first got here, our exchange was located in, I will call it a hole, like a 100 square foot hole in the back end of our building. Our clients didn't have a proper waiting room. We have changed that so that there is a dedicated space. It's bright, it's open, it has privacy. It has the ability to conduct multiples of exchanges at one time. Everyone at Danny's, Matt staff, they staff a shift. Every one of those shifts are staffed by public health nurses. Every one of those shifts. So I would say that the changes that we've made have just happened very recently and it's only been since February that I asked Jen to transition this under the Communicable Disease Unit and we've made these changes. So I ask that the board allow us to test the changes that we've had to continue to document the successes that we have, grant us what we're requesting so that we can come back and show if it makes a difference. What I really fear from a scientific standpoint is that we pick some kind of arbitrary marker or information and make an assumption that that means some certain kind of outcome. Our program is staffed by an epidemiologist, a physician, public health nurses, myself as a public health professional, certified addiction counselors. I feel like we have the best brains on staff and we have a great community advisory group as well and so I feel. But come at this from different angle, which is I believe all that and I want more people to go to return who were using Amaline, who stopped using Amaline to return to Amaline to do all the things that you want. But in a world of secondary exchanges, they won't return because, and there may be lots of public health reasons for, but if we want to eliminate secondary, as a policy matter, if we want to eliminate secondary exchanges and in an anonymous system, somebody comes in with 100 needles, how do you know it's their needles and they're not getting some from somebody else? There doesn't seem to be a way to eliminate a secondary exchange without reducing this number. Well, may I make a suggestion? I think a better way would be to ask staff to examine what that way could be. So I admit we have a lot of work to do. There was a constituent that said we hadn't updated our policies and procedures. Again, we've been really busy revamping this program and we're happy to address our shortfalls. But one of the things that we can do is examine our secondary exchange practices. We have talked about things like having training standards, protocols, policies, having certain kinds of entities enter into agreements to conduct exchange on our behalf. There are all kinds of possibilities for us to provide that I think the accountability that the board and some of the public is looking for and we're happy to pursue that. We could come back to the board in September after putting some thought into that and provide some recommendations for the board. I think that that's a better path than to choose, reduce the number that we exchange than to kind of take a stab at different strategies. And then we can test that and see if it really works. Okay, may I continue on this? So that answered the question and for me, I'm comfortable with it being, so we all received, you know, over a thousand emails and contacts associated with the harm reduction road showing a lot of suggestions. Overwhelmingly what people said, except for the outliers, was that they wanted this to be run by the county, that they wanted it to be under the county's control. I think one of the things that's important then is you have to accept the fact that that means an expansion of county services, what that actually means. I mean, I don't know that everybody's necessarily internalized what that really means, but that actually means that you'll see more hours. What I would like to see before we move into a world of mobile that may have externalities that we can't account for yet is to at least expand the fixed point location to a point that we can at least say that it is or is not meeting the need of the community after a certain period of time. What I'm seeing here is a movement toward that on number two, but I think that we should move toward what's being requested, which is a 20 hour a week on that with the same six month return. I think that some of these other recommendations are actually okay. I mean, I'm maybe in slight disagreement with my colleague on item four, which is in creation of this group, the SSP advisory group, because I think there should be community buy-in too, and I think that one of the ways that you do that is actually by having community members that aren't necessarily from the field sometimes have say an input into the system, because as you can see, most of the people that are showing up are from the community and feel a sense of powerlessness in regards to a program that they don't really understand, that they don't feel like they can control, and feel like is being thrust on them in a way that they aren't having any kind of input in, and I don't think that's reasonable. I think that there should be that element. I agree with my colleague as well that the chair should write the letter on number five. I think number six is what it is, and for number seven, I just think that you adhere it to the same timeline of a six month return. So I mean, I think that there's a way to do this, which is I'm gonna make a proposed an amendment to the motion and we'll see whether we can get there. I think that we eliminate number one. I think we change number two to 20 hours. I think we can try number three because we'll see whether it works. I think that we may find out that it actually doesn't. I'm fine with keeping number four. Number five, I say we reword it to say direct the chair to write local jurisdictions and request a response. Number six, we'll see whether tracking SSP clients as possible. And number seven, that should be a six month as well. I'll make that as an amendment to the motion. I would second it. It would just be helpful on number three if we could get some report next week about what this might cost. I mean, we're doing budgets hearings. I have no idea whether this is a $5,000 thing or a $50,000 item. And it would just be good to know as to whether that's it's actual possible. And so if I would, I want to second your motion and I hope that you see that as a friendly amendment. With a comeback during budget to explain what number three would mean financially. I guess, well, I would say this, which is on the number one, okay, but we're not going to expand hours until we know what their plan is to reduce secondary exchange. Because if you're just expanding hours and it's just more needles out the door, like bringing forward a plan that matches the hours that makes me feel comfortable, but just expanding hours and then maybe having a secondary plan that we don't know yet is okay. Yeah, I just the secondary, I mean, somebody can come in and get hundreds of needles and we don't have any idea where they're going. All right, yeah, I get it. That's just nuts. I think the board's unanimous in that, Bruce. The question is whether or not what you're proposing gets you there and we're trying to get the board's trying to get there. And I think that it may not be just, if you can cut it down to 25 needles, 50 needles and I saw 10 people, 15 people show up from a road show that are ready to get another 50 people that'll now just be 50 people with 50 needles. So I mean, if you're trying to get rid of the secondary exchange, there is going to get more people to show up with less needles to each person. That's not accomplishing your goal. Your goal is accountability on a contract. Well, at least we have a contract though. If those people show up, they're violating that code. Maybe Ms. Hall, you have an idea of what it would take to come back to us with a plan for increased hours and managing the secondary exchange in a more meaningful way. I mean, is that something that could be done in by August or September? I mean, I think the interest here and the chair can correct me if I'm wrong. I think we do have an interest that we want as many people as possible going into this county program that we feel like has all the elements that we want, right? And so the question is, how do we best get there? And if the concern is secondary exchange and we want to try to find a way to do hours and have some limits on secretary, let's talk about what that plan would look like. And it wouldn't stop us from doing the advisory commission if this waste thing is, you know, whatever that is. But before we expand hours, we get information about what that program might look like with expanded hours and costs. You know, I think that's a win for everybody. So I will say that the current program that we have, we dramatically changed our program from what it looked like six to nine months ago to what it looks like today without expending more dollars. What we did was we took advantage of leveraging the additional staff that we had that we were able to acquire through Drugmatic Cal, through our MAT grants, through whole person care. And we layered the staff that we already have to ensure that their expertise was lent to the Syringe Services program. So it's not so siloed as if, oh, we need X number of new dollars in order to expand these hours. It will mean us going to the drawing board, taking a look at how we schedule people's shifts. How, you know, so I think that there's a possibility that increasing to 20 hours could cost no extra dollars. There's a possibility that we find a way that we feel is better that would cost extra dollars. And I think that we would have an idea of what those extra dollars might be after the governor's budget passes. Regarding the kiosks, we do have kiosks sitting in a warehouse ready to be rolled out. I'm absolutely, actually, I had talked with staff about rolling out those kiosks in some of our other jurisdictions or maybe other areas of the county. And in the case where it was in other jurisdictions, I agree with you, Supervisor Leopold. I believe that we, if we didn't have a Syringe Services program at all, we would still have a syringe litter problem. I was able to order a box of 100 syringes from Amazon for less than $18, and they were delivered to my doorstep. Nobody asked me if I was over 18 or where I lived. So I know that there is an ability to access syringes through other methodologies. We- But people who have homes aren't ordering from Amazon and then leaving syringes in the street. No, I understand that. What I was gonna say about the kiosks is we had actually talked about internally with staff that we would be willing to fund the cost of servicing the kiosks for the first year. And if it showed that they were well utilized in other municipalities, have an agreement with that municipality to take over the cost, because it is for the benefit of that municipality. So there are lots of different options that we could. So let me just say, so my, our motion is that we would maintain the, we were maintaining those in perpetuity. We're the ones disturbing the needles. We will pay for the kiosks. We're gonna pay for the cleansing. So my expectation of what I was going to send to the cities was that HSA would maintain that on an ongoing basis. And I would say that there are about just over 2,000 tons of needles a year we collect in the kiosks over and above what we distribute and collect in our personal services. They're coming from somewhere outside of our program. Yeah. So just to address this issue though, we were asking something very specific. And so Chair, I hear what you're saying, what Supervisor McPherson is saying is that you don't want to extend hours until you know that the secondary exchanges, there's a plan for that, correct? Okay. Could a plan come back on September 24th for addressing the secondary exchange issue that I think the Board unanimously has a concern with? Yes? I believe so. Okay. Then why don't we just... You're saying yes. Okay. Then why don't we, if this is true then, then we would get rid of number one. In essence, we would get rid of number two contingent upon this coming back. So number two would come back on September 24th with a plan for how to manage the secondary exchanges. We would keep number three. We would keep number four. But come back during budget hearing so we know what we were buying. Excuse me. On number three, the budget hearing component, sorry, Mr. Palacios. Number five would be to direct the Chair. Number six would say, and number seven would also, well, we had a six month after that we actually increased the hours. So it would be six months past the time when those hours were increased. So that's all fine, although I would expect that you would hold a community meeting in advance in the affected neighborhoods before expanding hours. Yeah, we're happy to do that. Yeah, and I hope that when we hold meetings that it involves both supervisors who represent that area. You know, I represent the Emeline area, the vast majority of it, and a lot of surrounding neighborhoods as well. So I would hope that in the future when we do that, that we have meetings that both our offices are aware of. Sure, yeah, I mean. So those are, I pose those as an amendment. And there is a second to the amendment. So I think we're accepting them as friendly. I'll accept those as friendly amendments. So we're gonna come back at budget hearings on number three, is that right? Correct. That's correct, with the cost estimate and feasibility analysis. This is something that people just wanna get an assessment. You're right. There's nothing we can do about these orders, you know, through Amazon or wherever. That's out of our hands. We just have to try to do, manage our situation better than we're managing it now. And I wanna say that my hands off to the Health Services Agency and everybody's been working on this. This is not easy. This is not always friendly, so to speak. But I think there's a vast room for improvement and it's not your fault for why we need to improve it. We just need to improve it because it's not working well right now and there's two parts. As we go to stop the expansion of communicable diseases and reduce the number of improperly discarded syringes. That's the key point probably that we wanna get to as much as anything right here. We just have to earn the trust of the general public and they don't have it in our syringe exchange program right now. Thank you. And so I think we're all close to it. Let me just say, I think a waste stream study is science and that waste stream studies are done all the time and we have a lot of talk about it's our needles, it's not our needles, it's from Amazon. Like we should know where the needles are from and also the Citizens Connect proposal in this thing, as I pointed out, is a several hundred thousand dollar a year running a 24 seven county wide cleanup operation. I agree. Is a major, major cost. If we're gonna do it in a way that the community expects which is I see a needle in front of my house, I expect to be cleaned up within an hour or two. That is no small task. So let's be clear that if we're serious about addressing needle litter, we're looking at a huge expenditure. And that is why we're suggesting that we attempt to pilot, gather information, do a process evaluation and report back to the board because it allows us a chance to evaluate the success or lack of success and what the resources may be needed. And I do wanna say I appreciate the board working together. I know that there are members with different points of view and I appreciate the public and as well as our staff. I think we have an amazing staff that has worked really hard, especially in the last year to take this program from what it is and what it has been, which is harm reduction, but grow it into something that brings so much hope to our community and the ability to really meet people where they're at, get them into any kind of service, whether it's healthcare services, medication assisted treatment. And I do believe that with all of the expansion of the services that we've had on the behavioral health and the healthcare side that this is our way to reach our most at risk clients. And so I wanted to thank the board for their work and also our staff. Great. Are we clear on the motion? I do have a question. Thank you, chair. Does your recommendations and amendments, Supervisor McPherson circumvent the recommendations that the HSA has made on their report? Thank you. Okay, so we have them, except we are accepting the HSA report. All right. Yes. Okay, so we have a motion. One last thing, the syringe litter study. Don't we want that also to move forward? I did. I mean, so the question is superseding. That's what, to be clear, what? The number three supersedes what the recommendation from. We reviewed health. From us, we reviewed the Orange County study and it wasn't what we were trying. It just doesn't provide the information that we were trying to get at. So we thought this would be a better use of time. So the waste streams assessment is you're saying in place of or can it be in addition to? I mean, is there a reason? Maybe I look to staff on this. I don't know whether the California Department of Public Health is paying for that study. So there's no cost to us. And so I like the belt and suspenders method, right? I mean, if we can do this waste assessment and do this study and have a couple points, because our goal is to reduce needle litter in our community and the best ways to do that and to figure out where it's coming from, right? I mean, that's what we're interested in. So that's why I'm asking the question and if someone else is paying for the study and the staff could still work on it, I don't see the downside. I feel like we're asking a lot of staff between now and September on a small program. I'd like to, you know, I'd like to do this and then come back. And if we don't get the answers we need, we can go to and we can engage in the state. But it- Is it too much? Let me just ask. No, it's, well, it was our recommendation and to answer your question, yes, the state is financing it. They have federal dollars as well as state dollars and they use a consultant that has been doing this type of work. So it's part of the reason we made the recommendation is because we can have an outside entity that runs the office of aides do this on our behalf and then use that data to develop our litter program. So I just- Sure. I think we accept the report, we do the study, we do the change, the amended motion, that's what we're voting on. And you're fine with the maker? Sure. Let's find the second one, okay. Okay, I'm sorry, so one quick. Sure, sure. So the recommendations with the friendly amendments and then Mimi, including seven of your recommended, or C of your recommended actions. Correct, it is seen, yes. Okay, thank you, Carl. Great, okay, thank you. We got a motion and we have a second. All those in favor, please say aye. Aye. Opposed? That passes unanimously. We are going to adjourn to our budget hearings which will be available next week starting at 9 a.m. here on Monday.