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Segment 1

Hello everyone, good evening.
I am calling to order a special meeting of the Berkeley City Council.
Today is Tuesday, February 24, 2026.
Clerk, could you please take the roll? Okay.
Council member Kesarwani is absent.
Council member Taplin is absent.
Council member Bartlett is absent.
Council member Tregub? Present.
O'Keefe? I'm here.
Blackabee? Here.
Lunaparra? Here.
Humbert? Present.
And Mayor Ishii? Here.
Okay, quorum is present.
Okay, very good.
So today we have a very special work session.
Only one item on this agenda.
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 helped put this information together over the last year, and if they could just raise their hand, please.
We've got 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 work specifically on this project.
So with that, we'll start our 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.
We have a short video that we'd like to show you.
We have an exciting new dashboard 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.
It's okay, I got it.
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, etc.
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.
The first goal was to address disparities in life expectancy, and 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 is 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.
The steering committee worked 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 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 priority area.
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 6.5, and your pulse is 87.
So you want this one ideally to be under 120.
So you're in the normal range, which is great.
OK, I'm just going to register you, and then we're going to have you have a seat on that side.
I was fast, I didn't even 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 dialogue coincides with a mission, and we don't get this every time.
We do this more than once.
We have a mission, and we need your input.
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 on honestly.
And define 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, it kind of hinges on the strength of the partnership.
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 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 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've been able to kind of participate in before.
Here are the recipes.
The fresher, the better, and the healthier for our hearts.
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 that.
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 going to be even more important moving forward.
We are definitely going to need the support of council and city leadership, and we're definitely going to 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 their work.
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.
We need to center 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.
But 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 communities 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, it's sort of the essential thing.
I just think that it's really important that if you want to make that change, you've 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 in the next couple of 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.
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 we're demoing this as part of this demonstration is this will be where we'll 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.
It's really to give you an idea of what's coming.
And so with that, we're going to move to a community help.
We're logging in right now to the dashboard demo.
C-H-A-I-20.
Here we go.
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, an 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 in 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.
It 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.
Let's talk about racial disparities.
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 tracts in south or west Berkeley, that number drops to 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.
If 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 on our new dashboard because it highlights a growing fact that we cannot ignore.
Between 2022 and 2024, drug overdoses and self-harm suicide rose 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.
Go to the next slide.
So implementation is really where the rubber meets the road.
We're forming advisory groups for the four pillars, including housing, environmental health, behavioral health, community safety.
They'll help us shape 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 roadmap that the committee put together for us, lock ourselves 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 we'll 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 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 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, as I said, will involve community rolling up their sleeves and making things happen.
The journey towards a healthy, equitable, safer Berkeley requires more than just observation.
As we said, it requires partnerships.
We expect 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.
To quote James Baldwin, not everything that is faced can be changed, and nothing can be changed until it's faced.
We'll go to slide 11, please.
At this time, we really have two items left.
We'll take any questions, comments that you have at this point or discussion, and I'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 Draco 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 6 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.
I'm just not sure exactly what page you're referring to.
Sorry, page 6 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.
I also noticed an area in upper downtown below south side of campus that was comparatively 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 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.
Lastly, I wanted to see if you spoke to how many of these, 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, interdepartmental process around this, and how will you be keeping the council apprised at various inflection points? Thank you, Council Member Jacob.
Those are a lot of questions, so hopefully we can address all of them.
First, I'd like to address the question that you had around the community safety objective.
This is a high-level objective that our community steering committee identified that really rose to the surface from the data that was gathered.
The idea is to identify sub-objectives and strategies that will help address this.
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 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.
At this point, improving walkability and walking safety was something that really rose to the level of importance for them, but that could change when we revisit this area in the future.
Do you want to take the question about life expectancy? Yeah.
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.
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 youth.

Segment 2

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'll 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 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.
Because this process is going to be so transparent, we're planning at a minimum of annual updates to council, the first one being January, February-ish of 2027.
The selfish me wants to make sure that whatever we commit to doing, we're going to get done and we're going to 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 going to be developing this community, we're going to be very transparent, we're going to 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 Mitch, let us know if there's more.
Yeah, just wanted to see if you can, drilling down, 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 we're to the why yet.
We're to the this is the data and what it is.
I think there's an infinite number of whys.
Some of them, for example, we have data on different health conditions.
Asthma was a big one that we've looked at that comes out in the community health assessment.
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 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 and involve them in that process.
Thank you.
Moving on to Council Member Bartlett.
Thank you, and thank you for your work here.
The CHIP was conceived a few years ago when we funded the Health Equity Innovation Zone.
I think the same manager was here then before he went to Emeryville.
I think I remember that.
So it's wonderful to see it in 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 top ten.
It's not there.
Wow, that's amazing.
That is amazing.
Wow.
We're a 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 and my office to get at some new ways of approaching the equity elements here.
And so I was curious.
A couple of things I wanted to ask you about, more just pegs for your memory, I guess.
Is it possible to have a dashboard assigned to this stuff related to the budget? I know Council Member Blackaby has been working on something like this, some sort of dashboard that's readily available for people to see our progress.
And another element I was curious about was alignment with Medi-Cal, Medicaid, despite the cuts to those programs recently, however that works.
And then, I guess, it seems that we put a lot of, and 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 they would make recommendations to your office or, you know, 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 will be an oversight, and we've approached the Community Health Commission to be part of that process with us.
And at this point, there's also a 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, we'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 cycle, that process never touched this process.
They were done in complete isolation.
The state's now requiring, as Tanya mentioned, they're requiring us to work together, and that's all around our ability to bill and be reimbursed for Medi-Cal and do that.
So yeah, we absolutely see this, and as we look at whole person care, working together around Medi-Cal.
Also, the health plans are very much involved in this process, and they're required to be, which is great because they're responsible for paying for a lot of this.
So the 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 health 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 of points just to keep in mind.
Since Alzheimer's dwarfs so much of the other cause of death here, it would be great to align with the senior centers because there have been some ideas about ramping up the senior centers into more than just meeting places for Zumba, but for 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' districts in the body here.
Someone on your body should be, I guess, aware of the city council's measures that exist, like healthy checkout.
That program is subbed 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 all over the place, not to mention vapes and et cetera.
So it would 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.
And then that's all I can think of.
Thanks very much.
Thank you.
Thank you.
Moving on to Council Member Blackbee.
Thanks, Madam Mayor, and thank you, Director Gilman and Deputy Director Bustamante for the great report, and thanks to all the team for putting this together.
Council Member Lindepaar and I were commenting about how great the video was, but we really appreciate the effort and the care that went into this.
I just had a couple of comments and then questions.
One is, and Council Member Bartlett mentioned, I really love the focus here on measurable outcomes in your comment.
You can't measure it, you can't manage it, you can't track it, and 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 is 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 going to 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 it really becomes an action plan, and there's really initiatives that you're tracking back and seeing what happens.
And then last is other people 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? 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? You had 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 going to 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 want to focus on, at least for the next three years.
And 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 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.
Yeah.
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 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 one strategy in each category to advance.
And then, you know, so resources, workforce, belonging, across all four of those different subjects.
And, again, it's kind of exciting to see some of those first looks and maybe what some of the actions might be.
When do you think in the timeline might be the point where we might see what the first kind of next version of that implementation plan is? 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 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 going to 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, I'm going to keep calling them solutions instead of specific measurable objectives, but 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 going to 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 going to run a public health department? 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.
Okay.
Well, thank you so much.
It's 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.
I really appreciate just this report and everyone that did work.
I know that these reports can take a very long time and involve a lot, a lot of work.
So thank you.
And I especially appreciate the community engagement 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 I have some questions.
I'm curious about what is the difference between the community health assessment in 2025 and the health status report, which I think you mentioned was the 2018.
There's a lot of different reports and plans and things.
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 informal interviews from community leaders, the focus groups, the community survey, all of that helped to really build a more comprehensive story and picture 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 between 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? No.
I think that in the past they would show disparities by these different diseases, by the racial breakdown and also geographic breakdown.
I think it's in here for cancer maybe.
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 if you're referring to having that data available, that data will be available.
It will be available 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.
She and council I'm Andy cats.
I'm chair of the community health commission and speaking as an individual because our commission has not had a chance to meet since this went live.
But I would like to share that 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 a 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 is 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 HHES? 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.
Taj Batiste, 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 CHIP report.
I think it fairly concisely spells out what my fellow community members have want around community health, these four pillars that we've been given perfectly emblemize what our city is facing right now.
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 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 CHOP, 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 CHOP'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 CHOP.
Investing in...investing in..
Thank you.
Thank you.
I'll send the rest of my comments.
Thank you.
I know there's lots to 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 one hand raised.
That's Matt.
Matt, you should be able to unmute.
Super.
Hi, everybody.
My name's Matt.
I was part of the community steering committee that was on this trip, and 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 a lot of..
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 Council Member 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 HHS team, Janice Chin or Janice Chin, Kelly Knox, Patricia Zelsita, and Catherine Roseman.
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, 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 building 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 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 with a 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 making as we work to overcome these health challenges and disparities that just should be, you know, are absolutely a prime priority of mine.
The disparities are 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 Trakop.
Thank you, Madam Mayor.
Thank you again, Director Gilman and Deputy Director Bustamante for your presentation.
And to all who made this report possible, too 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 in 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.

Segment 3

Through Meaningful Policy and Legislative Direction.
I will note also..
Was that it? You're gifted some time from Councilmember Taplin.
Thank you.
That was..
that could not have possibly been five minutes.
But I am almost complete.
So, I will note and I want to echo Councilmember Humbert'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 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, Vice Mayor Lunapara.
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 that 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 that.
Sure.
I would need to consult with a 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 going to 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.
Okay, 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 just, you know, some of these are lagging indicators that, you know, you might not see for a few years, you know, 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, you know, 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 when 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, that 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, you know, what I worry about is just not having enough resources and not being able to like 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 like 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 I was going to 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, you know, 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's just, 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 in 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 Steering Committee.
So I'll pass it back over to you all.
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 CHAW and the CHIP development process.
And I'm going to read off names, but essentially the certificate is appreciating these members for their dedication in creating the Community Health Assessment and the Improvement Plan 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 Mekhi 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.
Claritza Rios.
Israel Nicodemus.
Rocio Almaguer Andrade.
Isabella Ledesma.
And J.W.
Frye.
Thank you, everyone.
We've got to get more people in.
Okay, thank you, everyone.
And with that, is there a motion to adjourn? So moved.
Second.
Second.
There we go.
Second.
All right.
And as long as there's no opposition, I will have us all marked as ayes, and we will be adjourned.
All right.
Meeting adjourned.
Thanks, everyone.
Thank you.