Nice. Hello everyone. Good evening. I am calling to order a special meeting of the
Berkeley City Council. Today is Tuesday, February 24th, 2026. Clerk, could you please take the roll?
Okay. Council member Cusarwani is absent. Council member Taplin is absent.
Council member Bartlett is absent. Council member Tragem, present. O'Keefe?
It's the community health improvement plan so I'm going to pass it over to Director Scott Gilman
for our presentation. Thank you. Thank you mayor. Yes again to introduce myself I'm Scott Gilman
I'm the director of health housing and community services, and I'd like to introduce Tanya Bustamante who is our deputy director
We also have several staff in the room that have that have helped
Put this information together over the last year, and if they could just raise their hand, please
Get our crew there, and we have members of the community health commission
that are present and
Then at the end we'd like to recognize the members of the steering committee that actually works specifically on this project
So with that we'll start a slideshow
So the agenda that we have for you tonight is we're going to do an overview of the community health improvement plan better known
As the chip and we have a short video that we'd like to show you
We have an exciting new dashboard that that we plan to demonstrate with some data and then we'll talk about implementation
next steps and questions and recognition.
Tanya.
Okay, so the purpose of our Community Health Improvement Plan
is really to describe how the health department
and the community will work together
to improve the health of the citizens of Berkeley.
The Community Health Improvement Plan, or CHIP,
identifies health priorities
that came out of our Community Health Assessment
and strategies for how to address them.
In addition, the CHIP is required for National Public Health Accreditation, which is something
that our department, HHCS, is actively working towards.
It is also a requirement for local health jurisdictions to align their CHIP with behavioral
health strategies that the health jurisdiction will be focusing on as part of our Behavioral
Health Services Act Plan.
To guide this work, four guiding principles were used
to draft the high level goals and objectives
in developing the CHIP.
The first one is to balance ambition with feasibility.
So setting goals that are achievable and realistic.
The second one is to cultivate cross sector work.
As you know, at any given time,
there are various planning processes, commission meetings,
policy debates that are happening.
It's critical for us as city staff to be aware of
and collaborate with other city departments
and community members on the work that we're all doing
so that we're not operating in silos.
The third principle is to emphasize prevention.
So to really address the root causes
and not just the health outcomes.
And lastly, establishing a long-term cycle
of assessment, improvement planning, and implementation.
In fact, local health departments and health plans
are required to collaborate on assessment
and planning processes every three years.
So this cycle is an opportunity to build trust
and achieve long-term impact.
So I'd like to talk a little bit about how we got here.
Our approach was comprehensive and community-driven.
The first step, we took three main steps
and the first one was to do a landscape scan
where we took an initial snapshot
of the health of the Berkeley community.
We worked with a consulting firm, JSI,
to gather information, activities, and resources
through both qualitative and quantitative data synthesis.
JSI helped to conduct key informant interviews
with local leaders and community members.
They conducted a handful of focus groups,
and we also partnered with them
to develop a community survey that was distributed
throughout Berkeley, of which we collected
over 320 responses.
The qualitative data that we collected
focused on the community environment,
access to services, lived experiences, et cetera.
During this first phase, a community steering committee
of 10 community members with diverse backgrounds
and experiences was convened.
This committee was instrumental in analyzing the data
that was collected.
The second step was to develop our community health
assessment by taking a thorough look at health safety
and equity in the city.
The health assessment identified priority issues
and priority populations and enabled the community steering
committee to distill the information
into six key findings.
From the community health assessment,
Our steering committee, in collaboration with city staff,
developed the health improvement plan,
which lays out a realistic response
to the priorities that were identified
in the health assessment.
As part of the community health assessment process,
the steering committee identified two broad goals
for the CHIP for both their universality
and potential impact.
Well, the first goal was to address disparities
in life expectancy.
the second goal is to increase community power and partnership. While the health
assessment identified several key findings and health topics, it elevated
four priority areas under the umbrella of these two broad goals. Those are
housing, environmental health, behavioral health, and community safety. Housing was
defined as being able to live in a place that is safe, affordable, and stable.
Environmental health was defined as being safe from things like pollution and wildfires
and having clean resources and access to green spaces.
The behavioral health area highlighted that mental health problems are common in our community
and our members need access to care.
Community safety highlighted how often people get hurt and experience violence in our community.
The steering committee work closely with city staff to review the health assessment data as well as existing Berkeley policies
Resources and initiatives to establish a high level objective for each priority area, which you see here
Additionally these high level priorities are these high level objectives align with strategic priorities
across other local county and state agencies
I'd also like to mention that we held a World Cafe community meeting last month in December
where we brought together several community stakeholders to provide input on
possible strategies for each of these high-level objectives. Our participants included representatives from managed care plans, our county partners,
community-based organizations,
city staff, as well as both steering committee and community members.
We put together a video that hopefully conveys the depth and significance of this work, as
well as highlighting some of the experiences of our community steering committee members.
I'll play it for you now.
So you're at 104 over 65 and your pulse is 87.
Do you want this one ideally to be under 120 in the normal range, which is great.
pulse is 87. Do you want this one ideally to be under 120 here in the normal range which is great?
Okay I'm just gonna register you and then we're gonna have a seat on that side.
That was fast I didn't feel it.
I think we all want the same thing. We all want our communities to be healthy. We want to see
our children grow. We want to see our families happy and thriving. To have a community health
improvement plan that's based off of a community health assessment
really allows us to be grounded in what is most important
not just to the city but also to the community.
We all took that one and defined the intentions
of where we want to go together in the next three to five years.
If we want some of these objectives to be met
kind of hinges on the strength of the partnerships.
JSI was brought in basically to be facilitators in this space.
I think a lot of what we do is hear from all these different perspectives,
whether it's a community survey or a focus group or a community steering committee meeting,
talking with the staff at City of Berkeley, and then synthesizing it and thinking about,
okay, how do we talk about what happens next?
It was a learning process for the steering committee, understanding the data that was available,
what resources and programs were already in place.
What objective do we have within the workforce domain?
It's been amazing to see the really detailed underpinnings
of what it is to build and to develop a city,
but also how do you make change in a city?
How do you uproot the things that no longer work
and how do you plant the things that you hope will?
And that's a really, really meaningful process
and not one that I had been able to kind of participate
in before.
One of our core values for the city, this department and for the public health division
is that community voice, is that community drives the things that we develop, the programs
we develop to serve them.
We talk in public health about how health is connected to so many different things, but
being a part of this process we really saw what that connection looked like, where all
of the health priorities that rose to the top were behavioral health, community safety,
environmental health and housing,
and none of those are like directly physically health
related, but are all interconnected to how people,
what people feel like they need to be able to thrive here.
The focus areas this process identified
isn't something that just the health department
can work on in isolation.
It offers an opportunity to invite other departments
and other community-based organizations
to join us in this journey.
These relationships and these collaborations
are gonna be even more important moving forward.
We're definitely going to need the support of council
and city leadership.
And we're definitely gonna need the support
of our community members.
In working side-by-side with some of the folks
across departments in the city of Berkeley,
there is an extra level of passion and dedication
that I honestly will say to be totally open
wasn't really expecting.
What I saw was people continually inspired by,
by their work.
And how it kind of took a life of its own.
It's energizing to know that they're really receptive
to the ideas that we were bringing forward.
I just feel like my voice is heard as we've been discussing
like, you know, how are we going to integrate this?
What do we have to consider?
Is this going to affect a different demographic
that we didn't think about?
I love that.
I can see the tangible results coming through.
I think especially the way the world is right now,
you can feel really powerless.
And I would say yes and get involved locally.
These kinds of projects can help you build community
and have impact.
Whoo!
We need to center our community members
in order to understand the story.
And then the second part is actually to understand
what the right solutions are.
And that was really important for us in the centering, was that community members be at
the table to say, okay, so if we think the problem is displacement, for instance in Berkeley,
what are potential solutions?
We want to come up with ideas that are actually going to make a difference and move the needle
on some of these issues.
We want to do it in the realm of what's possible and not just say, this is what should happen
and demand that the city do something, but rather have this dialogue with people who
are really embedded in these systems so that they're more feasible. We really need to remain
attuned to what the community's needs are because they're going to be evolving, they're going to be
dynamic, and we need to be able to be dynamic with that. The only way to do that is to listen to them.
As health assessments and health improvement plans become more of a standard part of the
planning cycle in California communities. Creating that space for trusting problem-solving together
is sort of the essential thing. I just think that it's really important that if you want to make
that change you got to be a part of it. And that's why I love Berkeley so much where there is that
huge sense of community and commitment to one another. When a group of people fall down there's
another group who's trying to lift them up. Thank you, thank you. We'll go on to our next slide please.
There we go. If you've been in Berkeley for a while, you know we used to produce a health status
report every few years. The last one was back in 2018. I'm happy to report that we'll have a new
health status report coming in early 2027, and we'll be reporting back at that time. I mean,
while we will have a written report, we're moving away from the static reports. Our goal is no more
documents sitting on a shelf. The data changes and our community wants updates. And they also
want accountability through measurable outcomes. That means real-time access to
data on health, health equity, other related data that anyone including
policymakers, nonprofits that are writing grants, or residents can click on and
access data at any time. At this point we want to give you a sneak peek demo of a
public facing dashboard that will go live this fall. The reason that that
we're demoing this as part of this demonstration is this will be where
will be reporting out progress on the chip activities as well.
I'm going to show you some data that's, again, show you data that will be included in the
dashboard just to give you an idea of what will be available.
I'll talk a little bit about what we're presenting, but the purpose of tonight isn't really to
go into depth and have a detailed analysis for you on what this shows us, really to give
you an idea of what's coming.
So with that, we're going to move to the community help.
We're logging in right now to the dashboard demo.
CHA, there we go.
So once live, this is the first page
that residents will see when they log into the dashboard.
You'll see there's a table of contents and introduction,
and then the most significant part will be the key findings.
And again, this data is taken directly
out of our community health assessment.
For example, if we take a look at key finding number one,
we'll scroll down to the actual chart,
you'll see that Berkeley has a lot to be proud of.
Our physical environment, our diversity,
and our local partners are world class.
Generally, our health data is impressive,
but as you can see, Berkeley consistently outpaces
both Alameda County and the rest of the state
and life expectancy.
I want to just take a second and just show you.
If you hover over any part of this,
it'll drill down a little bit.
It'll tell you exactly where Berkeley is
compared to other communities,
or you'll see in future charts here other information.
Just makes it easier,
because some of the charts get kind of confusing.
If we can go on to finding number two.
So we'll scroll down here.
This one is about racial disparities.
And as you can see,
While our general life expectancy is good in Berkeley,
actually extremely good,
the data makes it abundantly clear
that there are disparities that we have to talk about
as we design interventions.
It's true, we are a vanguard of social movements,
yet our health data shows that historical
and structural identity issues
are still deeply baked into our outcomes.
So you can see here we have life expectancy by race.
If you live in Berkeley, I'm sorry, we'll go on to the,
let me just stop there for a second.
This particular one shows life expectancy by race.
If we go to the next one, we'll go on to finding number three.
We'll also show life expectancy by geographic location.
And so if you live in Berkeley Hills, for example,
you'll see that your life expectancy is 91 years.
If you also live in certain census tracks
in South or West Berkeley, that number drops
to 78, 78 years.
A 13-year-old difference based on zip code
is not just a statistic, it's a call to action.
If we can't measure it, we can't track it,
we can't change it.
Our biggest opportunity for progress lies
exactly where the outcomes are the worst.
And we'll exit our demo.
So again, just wanted to give you a quick snapshot
that that will be available
and we'll send you information as soon as it's live.
We can go on to our next slide.
I have another slide that will be built into the dashboard,
and this particular one is slide nine.
Slide nine is another example of data
that will be front and center in our new dashboard
because it highlights the growing fact,
a growing fact that we cannot ignore.
Between fiscal year, between 20 and 22 and 2024,
drug overdoses and self-harm suicide rose to,
into the top 10 leading causes of death for our neighbors.
And you'll see here it is number one, two, three, four,
number six.
That's going up from previous years
where it had been in the bottom of the top 10,
rose to number eight, and now it's up to number six.
We know why this is happening,
along with the deep emotional trauma caused
by the pandemic in our society,
social isolation, economic stress,
and everything going on in the world today
have created the perfect storm for many of our residents.
That's exactly why the community identified
behavioral health as a priority in the CHIP.
It's also why we must continue our efforts
to integrate behavioral health
and physical health at all levels.
We need a multi-pronged approach,
including wellness programs, easier access to care,
and tighter bonds with our community partners.
In a time of declining revenue,
it's more important than ever
to be good stewards of public resources.
Partnering with and empowering our community
is more important than ever.
Next slide.
So implementation is really where where the rubber meets the road
They're forming advisory groups for the four pillars including housing
Environmental health behavioral health community safety
They'll help us shape that the actions that we're going to take
You'll see right now and this is outlined in the chip document. We're in the preparation stage
And as I said, that's where we've been selecting
members of the community stakeholders as you see some of those
objective areas involve entirely different departments than the city, but we're all connected.
Environmental health, for example, having green spaces, having safe areas for the community,
all part of the public health strategy.
And finally, I want to make one important observation here.
I've worked in a variety of communities over the last 35 years, and there's really something
that's unique to Berkeley. And you all might know this, but being here for about a year
and a half now, it really jumps off the page at me. I'm hearing in multiple venues our
residents want to be involved, they want to help, they even want to roll up their sleeves,
and they demand to be part of the process. They demand that. And while it would be easy
for us to take this, very easy for us to take this road map that the committee put together
for us, lock ourself in a room for a nice lunch and strategic planning process and come
back and deliver you a strategic plan. That's not what the community demands of
us. What we're going to do at this point is we will be working with the focus
groups during implementation and will develop very specific actionable
measurable outcomes that we can implement in our community with their help that
have value to the community members and that they that they also perceive as
having value. Actually from December until July we're in that preparation
stage. The reason that we put action in July is we are going to be working on
this before July, believe me, but we also want to make sure that we get through
the budget process before we really, really formalize structures and bring
groups together because we are expecting, you know, there to be difficult
decisions and we want to make sure that, again, that we're good stewards of money.
We realize that some of this will, as I said, will involve community rolling up their sleeves
and making things happen.
All right. And so with that, I just want to go to my last page.
So the journey towards a healthy, equitable, safer Berkeley requires more than just observation.
As we said, it requires partnerships.
We invite the council to walk this path with us and we'll definitely keep you informed
and invite you to participate every step of the way.
We will be fueled by the courage to change the status quo and to quote James Baldwin,
not everything that is faced can be changed and nothing can be changed until it's faced.
So we'll go to slide 11 please.
So at this time we really have two items left.
We'll take any questions, comments that you have at this point or discussion and then
We'd like to conclude by recognizing members
of the steering committee.
Thank you, Mayor.
Thank you so much, Director.
And so I want to ask if my colleagues have any questions.
I'm not sure if our parliamentarian is working.
So I see that Council Member Drago is trying to select this.
So give me a second.
Let me reset it.
And you can start while I reset it.
Thank you so much.
Thank you, Scott and Tanya for your presentation.
I have a few questions I will, to save time,
ask them in rapid fire.
I think they go from more specific to kind of more meta.
My first question is on page six under objectives,
I see that you called out,
I assume these are just examples
and there are other sub-objectives,
say, under community safety, I imagine,
that would be more than just improving walkability
and walking safety that could be placed in that bucket.
Just not sure exactly what page you're referring to.
Sorry, page six of the presentation.
Sure.
On the life expectancy slide,
which I think is not in the slide deck,
but it was in the report.
I wanted to see, you may or may not be able
to talk about this, it may be too granular,
but I also noticed an area in up or downtown
below south side of campus
that was comfortively low in life expectancy as well.
I was wondering if you could talk about why.
I was curious how the focus group was selected
and what equity screens were incorporated
in the selection process,
as well as, well, you talked about how you would continue
to engage with the focus group,
but would it be the same focus group or a different one?
On page 19 of the report,
I was wondering how CHIP can target interventions
to communities that are most affected
and how will the root causes
of these health disparities be addressed.
And lastly, I wanted to see if,
And you spoke to how many of the challenge or the interventions
may not relate, may not be specific
within the community health bucket.
They may be informed by other disparities and barriers,
whether it's within housing or other departments.
what is your vision and plan
for a cross cutting process,
an interdepartmental process around this,
and how will you be keeping the council
apprised at various inflection points?
Thank you, Councilmember Trega.
Those are a lot of questions.
So hopefully we can address all of them.
So first, I'd like to address the question that you had
around the community safety objective.
So this is a high level objective
that our community steering committee identified
that really rose to the surface
from the data that was gathered.
And the idea is to identify sub-objectives and strategies
that will help address this.
And also since we are going to undergo a process
of revisiting our planning and priorities every three years,
my assumption would be that the high level objectives
would, under each of these areas, would evolve over time.
And even the priority areas themselves
may evolve over time,
depending on how the community's needs and priorities change.
So at this point, improving walkability
And walking safety was something that really rose
to the level of importance for them,
but it could be, that could change
when we revisit this area of the future.
Do you wanna take the question about life expectancy?
Yeah, so drilling down into those specific things
are what the next steps will be.
I don't have the answer for how the focus groups
were selected if you're referring to the community cafe,
that was open to everybody for that one.
I will add that when the consulting firm
conducted the focus groups that were part
of the health assessment process,
they did identify priority populations
to conduct those focus groups.
And again, I think they conducted a total of four.
I think one of them was with transitional age youth.
I think one of them might have been
with African-American and Latino.
And I can't recall the other two.
But we can get back to you on that.
Yeah, and to your question about how we will ensure
other departments, other stakeholders,
that's the process that we'd be going through
from now until July, is looking at each of these areas.
And I want to also mention that the steering committee gave us
a bunch of ideas for specific solutions or interventions,
but they didn't dictate it to us.
So our challenge now will be is pulling together
the different stakeholders, going through the data,
and then figuring out actionable objectives, solutions,
as they refer to in the video, that we
can implement within the financial restraints
that we have. Um, because this process is going to be so transparent, we're
planning at a minimum of annual updates to council. The first one being, um,
January, February, ish of 2027. The selfish me wants to make sure that
whatever we commit to doing, we're gonna get done and we're gonna deliver for
you. Again, this is different for most health departments around the state
where they do plop down a plan on the table
and that's the end of it.
So because we are gonna be developing those community,
we're gonna be very transparent,
we're gonna be very measurable
so that we can demonstrate our value.
We absolutely have to be very, very focused on what we do,
make sure we can accomplish that.
I think that was the last question,
but let us know if there's more.
Yeah, just wanted to see if he can,
drilling down, I, certainly south and west Berkeley,
were called out as communities of concern,
but I did notice also a reduced lifespan
in upper downtown.
I wanted to see, at least within other parts of Berkeley,
I wanted to see if you can speak to why that may be.
Yeah, I don't think I don't think we're to the Y yet. We're to the we're to the this is this is the data and what it is I think there's a there's an infinite number of wise, you know, some of them, for example, we have data on different health conditions asthma was a big one that that we've looked at that that comes out in the community health assessment.
And so as we look at asthma,
we can also look at asthma rates in different areas.
And then we can also start to match that up
with the outcomes that we want.
We're fortunate that we have epidemiologists on our staff,
you know, that will work with us on that.
But that sort of deep analysis
and what does it really mean to the community,
we need to talk with the community about that,
you know, and involve them in that process.
Thank you.
Moving on to Council Member Bartlett.
Thank you. And thank you for your work here.
I recall the chip was conceived of a few years ago when we funded the health equity innovation
zone.
I think the same manager was here then before he went to Emoryville.
I think I remember that.
So it's wonderful to see an action.
Wonderful.
Amazing.
Question.
Looking at the leading causes of death, so I guess diabetes is not on here, right?
But is that not a cause of death?
Or is it just a cause of cost?
Diabetes number three?
Is that what you're asking about?
I said heart disease.
Oh, I'm sorry.
Am I missing it?
Not in the chop chop.
It's not there.
Well, that's amazing.
That is amazing.
Well, very healthy city.
You know, the work is incredible that we do here in Berkeley.
We are the healthiest city.
And of course, as you mentioned, the disparities
are super entrenched.
And we've taken many steps to address them.
And this is part of a long running effort
by your team in my office to get at some new ways
of approaching the equity elements here.
And so a couple of things I wanted to ask you about.
More just pegs for your memory, I guess.
Will there be, is it possible to have a dashboard
assigned to this stuff, related to the budget?
I know Council Member Black would be working
on something like this.
some sort of dashboard that's readily available
for people to see, our progress.
And does another element I was curious about
was alignment with Medi-Cal, Medicaid.
Right, despite the cuts of those programs recently, right?
However that works.
And then I guess with the,
it seems that we put a lot of,
rightfully so, we leverage our local talent,
which is immense here in Berkeley for their ideas.
So I guess, is there a strong decision-making structure?
So are they making recommendations to your office?
Do you have something in place to?
Yeah, in terms of the decision-making structure
for how the specific solutions will be identified,
that will be through the community.
There'll be an oversight, and we've
approach the community health commission to be part of that process with us and
at this point there's also calling for another steering committee to be
established as we get further down the road. In terms of the Medi-Cal
implications or how this fits, it absolutely fits because when I said
integration with primary care and behavioral health, that's really the huge change that
we're seeing right now in the Medi-Cal world, where they're actually requiring that.
So this is the first year that there's been a requirement on both sides, in both silos,
to work together with the, you're probably familiar with the three-year action plan that
we have to submit and get approved from the Mental Health Commission that has a ton of
data a ton of information before this this cycle that process never touched
this process they were done in complete isolation the state's now requiring as
Tonya mentioned they're requiring us to work together and that's all around our
ability to build and be reimbursed for Medi-Cal and do that so so yeah we
absolutely see this and as we look at whole person care you know working
together around Medi-Cal also the health plans are very much involved in this
process and they're required to be and which is great because they're
responsible for paying for you know for a lot of this and so this state I think
was very forward-thinking when they put the requirements together for this
requiring the health plans to be at the table with us requiring behavioral
health to be part of the process and then actually a small pot of money out
of the behavioral fund will come to public health to help convene and
coordinate all of this work. That's wonderful, that's so great and let's just leave you with
a couple points just to keep in mind. Since Alzheimer's dwarfs so many of the other cause
of death here, it'd be great to align with the senior centers and because there have been some
ideas about ramping up the senior centers into more than just meeting places for Zumba before,
you know, real health care delivery, community health delivery vehicles to the community.
And then, the heart disease and hypertension,
which factors really greatly in my district,
as well as two other persons in the district
that's on the body here.
Someone on your body should be, I guess,
aware of the city council's measures that exist,
like healthy checkout, right?
And so, that program is sub from lack of funds.
But we know that the stores in the communities
where the heart disease is the highest,
has the highest concentration of heart disease
making food, right, all over the place, right,
not to mention vapes and et cetera.
So it'd be great to align some of these resources
to help implement those health making items that we already
have that are just suffering from lack of funding, right?
And then, that's all I can think of.
Thanks very much.
Thank you.
Thank you. Moving on to Council Member Blackby.
Thanks, Madam Mayor.
Thank you, Director Gilman,
and Deputy Director Bustamante for the great report,
and thanks to all the team for putting this together.
It comes from Raul and the part I were commenting
about how great the video was,
but everything is just really,
I mean, we really appreciate the effort and the care
that went into this.
I just had a couple of questions,
or comments than questions.
One is, and Council Member Bartlett mentioned,
I really love the focus here on measurable outcomes
in your comment.
Again, if you can't measure it,
you can't manage it, you can't track it,
and so that's so important.
And so having that on the dashboard,
and having that basis of information
that we can then say, are we improving or not,
it's really important, I appreciate that.
Also, your focus on, this is sort of the first step,
this is the plan, but so much of this
is about the implementation.
And what are we gonna actually do
in each of these buckets to sort of move the needle?
I'm really excited to see what comes back
as you move into that phase,
So that really becomes an action plan.
And there's really things and initiatives
that you're tracking back and seeing what happens.
And then last, as other people have commented,
how sobering some of those deltas are
on the neighborhood outcomes, especially life expectancy.
I think we all kind of knew that.
But to see that so clearly and understand
how big the deltas are, that's obviously something
we have to really focus on and improve.
So first question is, community health, big topic,
very broad, some of which we can have an impact on here
locally, some of which are factors
that are far beyond our control.
I'm wondering as you put together
sort of these goals and the objectives,
how did you think about that?
Were there sort of, did you intentionally
look at some things that were like,
oh that would really be great,
but we actually just don't think we can do it.
Are there categories of disease
or you'd mentioned drug addiction things before.
So when you came up with those goals,
I'm wondering if you also looked at other things
and sort of said, well, you know what,
we're not gonna put this in the plan
because this isn't something we can do at the community level.
Just curious about that process.
Yeah, I mean, as I mentioned before,
I think the four priority areas really rose to the surface
and they were the areas that the steering committee
identified as ones that we wanna focus on,
at least for the next three years.
And, you know, there were a myriad of other findings
and data that was identified in the health assessment,
but we wanted to keep things again, reasonable and feasible.
And so the steering committee,
along with some guidance from city staff,
identified those areas as ones to tackle first.
And I think as we move forward in the action phase,
that will be, that will be, it will be critical
to really kind of hone down actions
that are feasible and realistic
and things that are within the span of control
and be able to relay that to the community.
Like this is what the city has control over
and this is something that we can move forward on
in collaboration with the county or with the state
or with other community-based organizations
and also be transparent about what's outside of our control.
Just to follow up on that, you're right.
There's pretty much anything anymore
is called public health.
Some communities are declaring gun violence
a public health crisis.
So it's huge.
It's huge.
And what I love about what this process accomplished
is that the community told us what the top four are.
And they had quite a detailed process.
And they said, this is where we want
you to focus, you know, to get started. And so, the ball's in our court.
Great. You referenced kind of the sneak peek, I think, page 18 in the actual
blueprint where it's sort of the first look at, you know, one strategy in each
category to advance and then, you know, so resources, workforce belonging across
all four of those different subjects and it, again, it's kind of exciting to see
some of those first, you know, first looks at maybe what some of the actions
might be. When do you think, you know, in the timeline might be the point where we
might see what the first kind of next version of that implementation plan is?
You know, the next, because again, to me that's where the rubber hits the road,
it's the part that's really exciting, it's like what are we actually doing? When
do you think that we might just see that? You know, our goal was just was to start
much sooner on that part than July,
but because of budget discussions,
that's why we're pausing just a little bit.
That said, we're still gonna keep working on this.
So I would hope that by the time we come back
in January of 2027, that we'll have some initial,
initial, I'm gonna keep calling them solutions
instead of specific measurable objectives,
solutions that we can share with you.
Okay, and last question is, given all that is,
again, these are big, bold, some of these are big, bold goals.
How confident are you that we're gonna be able
to move the needle on at least some of these,
if not all these?
This is Berkeley.
Seriously, I've never been in a community,
and I've said this when the federal budget cuts
were raining down upon us, and I'm like, oh my gosh,
how am I even gonna run a public health department?
I said, I know if public health puts a call out
to our community for help, that they will step up.
And so I'm confident if we do this right
and we let the community roll up their sleeves
and get involved and help figure out what it's going to be
that we will move the needle.
Well, thank you so much.
Really great work.
Thank you.
Thank you.
Other questions from my council colleagues?
I have a few questions as well.
So thank you all very much.
really appreciate just this report and everyone that did work. I know that these these reports
can take a very long time and involve a lot a lot of work so um thank you and I especially
appreciate the community engagement that that you have intertwined throughout this process. I think
that's really essential and you're right our community does demand that of us. So um so I
have some questions. I'm curious about what is the difference between the community health assessment
in 2025, the health status report,
which I think you mentioned was 2018,
I just, there's a lot of different reports
and plans and things, so.
So the last health status report
that our department put out in 2018
really focused on quantitative data
and data that's collected both locally
and from other state and regional reporting sources
and some of them also nationwide.
And the previous practice was that
we put out a health status report,
I think about every four or five years,
that again really focused on the quantitative aspects
of the community's health.
The health assessment is more focused,
well, it does take into account the quantitative data,
but it also engages the qualitative aspect.
So the informant interviews from community leaders,
focus groups, the community survey, all of that helped to really build a more
comprehensive story and picture of of our health. Thank you, yeah that's
helpful to understand. And then I was also curious, in the past the city
prioritized addressing chronic diseases like high blood pressure and heart
disease due to the serious racial and geographic disparities within
and communities of color in south and west Berkeley versus the hills, is there a reason
that this data and the strategies are not included in this plan?
When you say that, are you referring to the four priority areas or?
No, I think that in the past, they would show like disparities by these different diseases
by sort of the racial breakdown and also geographic breakdown.
I think it's in here for cancer maybe, but.
Yeah, I'd have to go back and look.
Where that would be located is in the Community Health
Assessment.
And so that will be populating, we'll be bringing that forward.
But in terms of the priority areas,
it doesn't mean we're not going to work on that,
but it just wasn't one of the main areas that they identified.
I see.
But having that, if you're referring
having that data available, that data will be available. It will be available on the
on this on this dashboard that you're showing us. Okay, great. Okay, I have some
more comments but I'll save them for later. Thank you. What I want to do now
is open it up for public comment. Is there any public comment on this item? Thank you.
Hi, good evening. Mary Sheehan Council. I'm Andy Katz. I'm chair of the Community
Health Commission and speaking as an individual because our Commission has
has not had a chance to meet since this went live.
But I would like to share that the,
you know, we've received some interim presentations
and we've all seen that the pillars of housing,
community safety, behavioral health,
and environmental health, they bring new insights
and we should all take note and reimagine
what kinds of solutions in the spirit
of community prevention and empowerment we can have
as a result of this work.
But let's think about what CHIP is
and what it isn't in this format.
Health in all policies is really exciting approach to take
and I think that's what this is doing,
is looking at really big issues that affect all of us
and highlighting how they affect our health.
There's a big value to aligning
with the Future of Public Health program.
We can access funding through the plans.
There's a lot of benefits to the way the city's engaged with this, but
the CHIP is so high level here, moreover it falls short of addressing
the strategic plan needs for the public health division.
So this leaves me with a deep concern that if CHIP would be intended to
address prevention of chronic disease, prevention of infectious disease,
it's clearly not doing that as many of you have noted in your questions.
It's critical for the city of Berkeley to improve
and maintain programs that promote public health
through peer-to-peer education,
closing gaps in access to care,
direct services like public health nursing,
and an iterative assessment
with a new kind of results-based accountability.
The city needs to move forward with that as well.
So how will CHIP implementation be positioned
to be successful across these pillars
that are not traditionally implemented by HHGS?
I'll wrap up.
I'll wrap up with one more. You can actually, if you have additional comments, you're welcome
to send them to us too. Thank you. Okay. Thank you. Thanks. Good afternoon, Council,
Torres Baptiste Community Health Commissioner. I'd like to firstly second what my commission
colleague just said, and also to say that the city has been given a mandate on this JIP report.
I think it fairly, concisely spells out what my fellow community members have want around
community health.
I mean, these four pillars that we've been given perfectly emblemize what our city is
facing right now.
So also the City of Berkeley now has both the data and the mandate to act.
The Berkeley Wellness Blueprint makes clear that life expectancy in our city differs by
by as much as 13 years, depending on neighborhood.
91 years in the Berkeley Hills
and just 78 in South and West Berkeley.
That disparity is not accidental.
It is a predictable result of housing instability,
environmental justice, behavioral health gaps
and unequal neighborhood investment identified
in the CHA, the community health assessment
and elevated in this community health improvement plan.
At the same time, California's future
public health framework warns that fragmented categorical
and historically underfunded systems
cannot meet modern health challenges
without stable investment in workforce,
data infrastructure, emergency preparedness,
communications and community partnership.
Berkeley cannot adopt the language of equity
without committing to the structural investments
that make equity real.
This community health improvement plan
explicitly states that words and reports alone
do not create change without accountability
or dedicated funding.
Therefore, I urge the City Council and City Manager
to formally align budget, interdepartmental work plans
and performance metrics with the CHIP's two central goals.
Closing the life expectancy gaps
and increasing community power.
That means targeting resources to the neighborhoods
with the worst outcomes,
as we've seen in South and West Berkeley through the CHIP.
Investing in...
Investing in...
Thank you.
Thank you.
Oh, the rest of my comments.
Thank you, I know there's lots of talk about here.
It's challenging. Do we have any other public comment? Okay, is there any public comment online for the community health improvement plan? There's 1 hand raised that's Matt Matt.
You should be able to unmute Uber. Hi, everybody. My name's Matt. I was part of the community steering committee that was on this trip.
I just wanted to point out just a couple of things that may be helpful for our council members or
those that are not as involved with public health to begin with. I know that there was a lot of
interest in talking about how to improve mortality from Alzheimer's disease and there are a lot of
things that are in this report that I think push towards having better primordial prevention,
for example, diabetes is a high risk factor of stroke. Diabetes is causal of ischemic heart
disease, diabetes is causal of hypertensive heart disease, like all of these different things that
are pushed at the very top of the city of Berkeley's mortality. And you know, all of those things are
associated or causal themselves of Alzheimer's disease. And other pieces of this are very,
very interwoven within all of these things. And I can say as somebody that works at the
Department of Medicine at San Francisco General Hospital, that if somebody is unable to have
housing, their diabetes outcomes are going to be far, far worse. And so I think a lot of these are
addressing what are called primordial prevention levels. So not only should the implementation of
that look really, really strong at that, but also at the public health programming that is kind of
working on, you know, mitigating those risks. So just kind of wanted to put that out there
for folks that aren't as familiar with the way that a lot of public health diseases sort of implement.
Thank you. Okay. All right. Well, I will move us on to comments then. We have a comment from
Councilmember Humbert. Thank you, Madam Mayor. I want to begin by expressing my immense gratitude
to you Director Gilman, to you Deputy Director Bustamante, and other members of the HHCS team,
Janice Chin, Kelly Knox, Patricia Zialcita, and Katherine Roseman. You know, I apologize,
There are too many other people to name, but I also want to thank our partners at JSI and especially members of the Community Steering Committee.
The Berkeley Wellness Blueprint is a very candid document and that's a great strength.
The 13 year life expectancy gap between the Berkeley Hills, my part of the town, or at least part of the Berkeley Hills,
And South and West Berkeley is a stark and necessary finding that should anchor every health and equity conversation we have going forward, and I've heard other people say that in different words.
The four priority areas, housing, environmental health, behavioral health, and community safety, those make all the sense in the world to me.
Housing being number one.
Reflect what residents actually told us, and the goals of closing that gap and
genuine community partnership I think are the right ones. I'm particularly glad
that the plan emphasizes prevention and cross-sector collaboration because
health is made in neighborhoods not just in cities. But we've got to be
clear-eyed about the constraints ahead. The budget environment is severe. That's
an understatement. Federal funding that our most vulnerable residents depend on
is under threat, that's also an understatement, and the community
organizations this plan relies on are absorbing those same shocks. We'll not be
able to act on everything or maybe even most things in this document in the near
term. And I think saying that we can is potentially a disservice to the
community members who invested their trust in this process. What we can and I
think we have to do is use this framework actively where we have key
decision points such as in budget decisions. That's probably number one.
Departmental work plans, grant applications, equally important, and perhaps
more importantly public safety and roadway safety and I'm glad that that
showed up in the report and I think it's more than just pedestrian safety and
bike safety. It's public safety in general. I'm a little uncertain how
how we're going to build out the accountability framework in the context of our limited constrained resources.
But to the extent we actualize this plan, I think that needs to be a top priority.
I'd ask Director Gilman and HHCS to come back to council.
We're the city manager with a concrete accountability framework, even a minimal one that reflects our current resource reality.
To the CSC members here today, I hope you will stay engaged and
hold us to the maximum extent, hold us to this, to the maximum extent feasible.
So again, a huge thank you, this is a really important document.
I look forward to this plan being another guiding light in our decision.
Decision making as we work to overcome these health challenges and disparities that just should be,
are absolutely a prime priority of mine.
disparities or just continue to be shocking every time I see them. I, you
know, it makes me very sad. Thank you. Thank you, Council Member. Council Member
Traca. Thank you, Madam Mayor. Thank you again, Director Gilman and Deputy
Director Bustamante for your presentation and to all who made this
report possible to many people to list, so I'm not going to. I'm so glad that you emphasized
the importance of the report being actionable. I look forward to, along with my colleagues
on the council, to engaging with it more deeply in the coming months and collaborating with
you and your team and my colleagues, particularly my role as chair of the Health and Life Enrichment
and Equity Committee to look at how existing policies do
or do not bring the report's recommendations
into meaningful effect, and where they do not,
what is needed within our community
through meaningful policy and legislative direction.
I will note also, was that it?
That wasn't five minutes.
You're gifted some time from Councilmember Tatlin.
Oh, thank you.
That could not have possibly been five minutes.
But I am almost complete.
I will note and I want to echo Councilmember Hambert's
comments.
Of course, one of the guiding principles
is to balance ambition with feasibility.
and we have a tough situation on our hands.
I will note, for instance, just around environmental factors
which was, or environmental solutions such as tree planting.
I know that we have lost some needed grant funding for that.
How do we backfill or are we able to?
And so within establishing a long-term cycle,
the final guiding principle laid out.
Even though this is not intended to be an advocacy document,
and I recognize it's not,
to the extent that this is a requirement by the state,
I think we would be remiss not to also tell the state
this is what needs to be funded
in order for us to effectuate these goals.
So I know we have another agenda item tonight
around legislative priorities and some of this may come up,
but I really, given that every jurisdiction
and ours is no different,
is thrust into this very challenging environment,
especially right now where we have to do a lot more
with a lot less, I think we need to be able to use
any and every lever of power and opportunity
to tell the state what we need
in order to pursue the goals of this plan.
Thank you so much.
Thank you.
Other comments from my colleagues?
Yes, Council Member or Vice Mayor Lenapara.
Thank you.
I just wanted to thank staff
and thank the community members
who have been involved in this process.
This was a great presentation.
Thanks.
Thank you.
Anyone else?
Okay.
Oh, I have a couple other questions
came up for me as we were talking about Alzheimer's and dementia something that
I was wondering about is is it perhaps a very high cause partially because people
are living longer so they're more likely to have Alzheimer's and dementia
because unless it's early onset then typically folks would be later on in
their years. Can you speak to that at all? I'm sorry we can get back to you on
but I would need to consult with our public health officer.
Yeah, no, that makes sense.
Thank you.
And I think similarly, as I was looking
at the geographic information, one of the things
that I was thinking about is, yes, of course,
those disparities are quite stark.
And I think that that is something that's really
concerning to all of us.
Many of us have commented on it.
And I also think that typically houses that are up in the hills
cost more, houses that are in the flats cost less,
Meaning most likely that people who have more funding
would live up in the hills.
They would therefore have access to better health care,
gym memberships, better just care generally
for themselves, healthier produce.
And so, of course, there are structural things,
systemic things that we need to be looking at our city
that might be impacting the geographic age,
life expectancy disparities.
And some of those things are gonna be sort of embedded
and just based on who can afford to live
in these different places.
So I just want us to think about that
as we're thinking about those discrepancies.
OK, and then also, I know many of these challenges
that we've had are challenges that we've had for many,
many years and are not unique, of course, to our city,
but are all around the country and the world.
And I'm wondering, are there strategies
that we've deployed that have had an impact on these numbers
on improving them?
Are there things that have helped us kind of see a jump?
or is this sort of like a steady progress situation?
I think the way that I would look at it is more it's,
some of these are lagging indicators
that you might not see for a few years,
as we look at those.
I think the thing that's new
that we've seen better results on
is breaking down the silos.
And one of the examples that I use is,
we may at times, and I've seen this in my department,
where we'll have three different city departments
interacting with a family, mental health side,
environmental health side,
and we're not coordinating care.
So breaking down the silos as we try to move
these interventions forward is a big part
of what we need to do.
It's also being better fiscal stewards.
So the magic happens is when you can get primary care,
mental health, behavioral health, the social net system,
all working together.
that's where you can start to see the real movement.
I love that, I think that's really important
because it's really about being more efficient
with the resources and the systems
and the people we have in place already.
And I think that that's important
across all levels of our government.
So I'm really glad to hear about breaking down those silos
and especially given as everyone has commented on already,
but just our concerns about our budget deficit,
$32 million is really significant.
And, you know, I don't want us to,
I think Paul has said this to me before, our city manager,
you shouldn't be doing more with less.
It's kind of really like we need to be adjusting
and right sizing and making sure that we're being realistic
so that we also don't have burnout
because I'm particularly concerned about the people
who do the work in our communities and serve these families
and see like year after year, you know,
I want them to feel like they're seeing results
and that we're actually able to serve people
and help them get better health outcomes.
So I think when I see this information,
what I worry about is just not having enough resources
and not being able to kind of wrap our arms
around these massive problems
because they are really big problems.
So I appreciate knowing also that there's kind of a process
moving forward that you all have to continue
to engage the community and figure out
what are these areas that we can be better collaborating,
connecting with the community
and breaking down those silos.
And that was one of the other comments
that I was gonna make,
highlighting the insight that more transparency
and collaboration are needed to increase trust
and effectiveness of health improvement efforts.
Transparency, building trust, community engagement
are all really important to me.
And I think that, again, is something important
throughout our city.
It's something we've been trying to do on council,
even with each other, just connecting with each other
and building relationships.
And the focus on housing, environmental health,
behavioral health, community safety make a lot of sense.
And housing in particular stands out to me.
When I saw last year's community health assessment
that approximately 60% of African Americans
and 60% of Latinx households in Berkeley
pay more than 30% of their income for rent,
it's really clear that addressing housing instability
and affordability remains a high priority.
And that is a huge priority for me.
And I know my council, many of my council members as well,
stable, safe housing that's free of environmental risks
like mold, pollution have a direct impact on health outcomes.
I really also am concerned about people not understanding
their legal rights around this in particular.
I think so many people that I speak with,
especially young people are afraid to call out
when there are these concerns
about living in an unsafe housing situation.
And so I do also want us to keep in mind
making sure people understand their rights
and their ability to get health inspections,
you know, inspections on their apartments
if they have things like mold.
I've even talked to my own staff about that,
advocating for themselves in that way.
And then I'm really glad to see
the plan focus on prevention,
especially when it comes to mental health.
And I'm also really concerned about the shift
in mental health and behavioral health funding
away from prevention and early intervention.
It is concerning to me that some of these shifts
that we're seeing, especially from the federal government,
I don't want that to impact how we're doing things here.
And that's really essential.
So just some thoughts that I have on your report
and just really, again, thank you all so much
for taking the time to come and present this to us
and also to keep us updated
because I think that's really important.
I think this really helps ground us in, you know,
really what's happening with people's everyday lives
and how our different policies are potentially impacting
their wellness and stability, so thank you all.
I believe that is our final item on here
and we don't need to do anything to receive it,
but I do want to make sure that we acknowledge
the city of Toronto. I'm going
to pass it back over to you.
Thank you mayor and Council.
So at this time we wanted to
recognize and appreciate the 10
members of our community
steering committee who were so
critical to the chon the chip
development process. And I'm
going to read off names. But
essentially the certificate is
appreciating these members for
and for their service in creating healthier Berkeley communities.
As Tanya reads off names of individual members, if you wouldn't mind stepping up to the front,
and then we'll be ready to take a picture.
So I'd like to call up Mackay Freeman, if they're here, Michael Rodriguez, Kaitlyn Cole,
Penelope Collins, Matt N. I know he's not here because he spoke earlier via Zoom.
Thank you Matt. Clarice Rios, Israel Nikodimos, Rocio Amigar Andrade, Isabella Ledesma, and JW Fry.
thank you everyone thank you everyone and with that is there a motion to
adjourn so moved second second there we go a second all right and as long as
there's no opposition I will have us all marked as eyes and we will be adjourned
all right meeting adjourned thanks everyone