BOARD OF SUPERVISORS

STATEMENT OF PROCEEDINGS COUNTY OF SAN DIEGO BOARD OF SUPERVISORS REGULAR MEETING TUESDAY, JUNE 13, 2023, 9:00 AM COUNTY ADMINISTRATION CENTER, ROOM 310 1600 PACIFIC HIGHWAY, SAN DIEGO, CALIFORNIA Order Of Business A. REGULAR SESSION: Meeting was called to order at 9:02 a.m. PRESENT: Supervisors Nora Vargas, Chair; Terra Lawson-Remer, Vice-Chair; Joel Anderson; Jim Desmond; also, Andrew Potter, Clerk of the Board of Supervisors. ABSENT: (District 4 Seat Vacant) B. Statement (just cause) and/or Consideration of a Request to Participate Remotely (emergency circumstances) by a Supervisor, if applicable. C. Invocation was led by Bishop Susan Brown Snook of the Episcopal Diocese of San Diego. D. Pledge of Allegiance was led by the Girl Scouts of San Diego. E. Presentations or Announcement of Proclamations and Awards: Chair Nora Vargas and Supervisor Joel Anderson presented a proclamation declaring June 19, 2023, to be Juneteenth Day throughout the County of San Diego. Chair Nora Vargas and Vice-Chair Terra Lawson-Remer presented a proclamation declaring June 13, 2023, to be San Diego County Fair Day throughout the County of San Diego. Vice-Chair Terra Lawson-Remer presented a proclamation declaring June 13, 2023, to be Zainab Khan Day throughout the County of San Diego. Supervisor Joel Anderson and Supervisor Jim Desmond presented a proclamation declaring the Month of June 2023, to be National Great Outdoors Month throughout the County of San Diego. Supervisor Jim Desmond presented a proclamation declaring June 13, 2023, to be Best Father Anthony TJ Crossman Day throughout the County of San Diego. F. Non-Agenda Public Communication: Opportunity for members of the public to speak to the Board on any subject matter within the Board’s jurisdiction but not an item on today’s agenda. G. Approval of the Statement of Proceedings/Minutes for the Regular Board of Supervisors meeting of May 23, 2023; Flood Control District meeting of May 24, 2023; In-Home Supportive Services Public Authority meeting of April 4, 2023; and, the Redevelopment Successor Agency meeting of January 10, 2023. 1TUESDAY, JUNE 13, 2023

ACTION: ON MOTION of Supervisor Desmond, seconded by Supervisor Anderson, the Board of Supervisors approved the Statement of Proceedings/Minutes for the Regular Board of Supervisors meeting of May 23, 2023; Flood Control District meeting of May 24, 2023; In-Home Supportive Services Public Authority meeting of April 4, 2023; and the Redevelopment Successor Agency meeting of January 10, 2023. Vargas, Anderson, Lawson-Remer, DesmondAYES: H. Consent Calendar I. Discussion Items J. Board Member Committee Updates. This is an opportunity for Members of the Board to provide informational updates on their committee assignments. No action may be taken. NOTICE: THE BOARD OF SUPERVISORS MAY TAKE ANY ACTION WITH RESPECT TO THE ITEMS INCLUDED ON THIS AGENDA. RECOMMENDATIONS MADE BY COUNTY STAFF DO NOT LIMIT ACTIONS THAT THE BOARD OF SUPERVISORS MAY TAKE. MEMBERS OF THE PUBLIC SHOULD NOT RELY UPON THE RECOMMENDATIONS IN THE BOARD LETTER AS DETERMINATIVE OF THE ACTION THE BOARD OF SUPERVISORS MAY TAKE ON A PARTICULAR MATTER. Board of Supervisors' Agenda Items Category # Subject Financial and General Government 24. ENHANCING THE EFFICIENCY OF THE NEIGHBORHOOD REINVESTMENT PROGRAM (NRP) AND COMMUNITY ENHANCEMENT PROGRAM (CEP) GRANT APPROVAL PROCESS Public Safety 1. PROBATION - RATIFY SUBMISSION OF AN APPLICATION FOR, AND AUTHORIZE ACCEPTANCE OF, GRANT FUNDS FROM BOARD OF STATE AND COMMUNITY CORRECTIONS; ADOPT A RESOLUTION AUTHORIZING ACCEPTANCE OF MOBILE PROBATION SERVICE CENTERS GRANT FUNDS; AND COMPETITIVE SOLICITATION OF TWO MOBILE PROBATION SERVICE CENTER VEHICLES [FUNDING SOURCE: BOARD OF STATE AND COMMUNITY CORRECTIONS MOBILE PROBATION SERVICE CENTERS GRANT] 2. PROBATION - ENHANCING THE JUVENILE JUSTICE SYSTEM THROUGH THE CONTINUATION OF THE ACHIEVEMENT CENTERS THROUGH COMPETITIVE SOLICITATION(S) [FUNDING SOURCE: ENHANCING LAW ENFORCEMENT ACTIVITIES SUBACCOUNT-JUVENILE JUSTICE PROGRAM AND JUVENILE PROBATION ACTIVITIES FUNDS] 2TUESDAY, JUNE 13, 2023

3. MEDICAL EXAMINER - RATIFY THE SUBMISSION OF CALIFORNIA HIGHWAY PATROL CANNABIS TAX FUND GRANT PROGRAM, ACCEPTANCE OF FUNDS AND AUTHORIZE APPLICATION FOR FUTURE FUNDING OPPORTUNITIES Health and Human Services 4. ADMINISTRATIVE ITEM: SECOND CONSIDERATION AND ADOPTION OF ORDINANCE: APPROVE AN ORDINANCE AMENDING AND REPEALING PROVISIONS IN THE SAN DIEGO COUNTY ADMINISTRATIVE CODE RELATED TO THE CHILD AND FAMILY STRENGTHENING ADVISORY BOARD OF SAN DIEGO COUNTY, THE POLINSKY CHILDREN’S CENTER ADVISORY BOARD, AND THE SAN DIEGO COUNTY FOSTER CARE SERVICES COMMITTEE (MAY 23, 2023 - FIRST READING; JUNE 13, 2023 - SECOND READING UNLESS ORDINANCE IS MODIFIED ON SECOND READING) 5. AUTHORIZE ACTIONS RELATED TO THE 2024-2025 COMMUNITY ACTION PLAN [FUNDING SOURCE: COMMUNITY SERVICES BLOCK GRANT FROM THE CALIFORNIA DEPARTMENT OF COMMUNITY SERVICES AND DEVELOPMENT AND EXISTING GENERAL PURPOSE REVENUE] 6. AUTHORIZE A SINGLE SOURCE PROCUREMENT WITH SAN DIEGO HEALTH CONNECT FOR LOCAL IMPLEMENTATION OF THE MULTISTATE ELECTRONIC HEALTH RECORD-BASED NETWORK FOR DISEASE SURVEILLANCE [FUNDING SOURCE: CENTERS FOR DISEASE CONTROL AND PREVENTION COVID-19 HEALTH DISPARITIES GRANT AND REALIGNMENT] 7. AUTHORIZE A CONTRACT AMENDMENT FOR REFUGEE HEALTH ASSESSMENT PROGRAM SERVICES WITH FAMILY HEALTH CENTERS OF SAN DIEGO, AUTHORIZE A COMPETITIVE SOLICITATION FOR REFUGEE HEALTH ASSESSMENT PROGRAM SERVICES, AND AUTHORIZE APPLICATION FOR FUTURE FUNDING OPPORTUNITIES [FUNDING SOURCE: CALIFORNIA DEPARTMENT OF PUBLIC HEALTH, OFFICE OF REFUGEE HEALTH; REALIGNMENT] 8. ADOPT AMENDMENTS TO THE BY-LAWS OF THE COUNTY OF SAN DIEGO HIV PLANNING GROUP 9. APPROVE APPOINTMENTS OF BIANCCA BERRY AND NILSA HIGGINS AS HOUSING AUTHORITY OF THE COUNTY OF SAN DIEGO TENANT COMMISSIONERS AND APPROVE ANGELA ACOSTA AS AN ALTERNATE TENANT COMMISSIONER [FUNDING SOURCE: FEDERAL FUNDS PROVIDED FOR THE COUNTY HOUSING AUTHORITY'S PROGRAM ADMINISTRATION] 3TUESDAY, JUNE 13, 2023

Financial and General Government 10. SUPPORTING OUR FOSTER CARE YOUTH 11. COMMUNITY ENHANCEMENT AND NEIGHBORHOOD REINVESTMENT PROGRAM GRANTS (DISTRICT: 1) [FUNDING SOURCE: AMERICAN RESCUE PLAN ACT, TRANSIENT OCCUPANCY TAX REVENUE, AND GENERAL PURPOSE REVENUE] 12. COMMUNITY ENHANCEMENT PROGRAM GRANTS AND CEQA EXEMPTIONS (DISTRICT: 2) [FUNDING SOURCE: TRANSIENT OCCUPANCY TAX AND GENERAL PURPOSE REVENUE] 13. NEIGHBORHOOD REINVESTMENT AND COMMUNITY ENHANCEMENT PROGRAM GRANTS AND CEQA EXEMPTION FINDING (DISTRICT: 3) [FUNDING SOURCE: GENERAL PURPOSE REVENUE, ARPA FUNDS AND TRANSIENT OCCUPANCY TAX REVENUES] 14. SECOND CONSIDERATION AND ADOPTION OF ORDINANCE: ADOPT AN ORDINANCE TO ADD SECTION 125.25 TO ARTICLE VIII OF THE SAN DIEGO COUNTY ADMINISTRATIVE CODE TO ESTABLISH THE CREATION OF A WORKPLACE JUSTICE FUND (5/23/23 - First Reading; 6/13/23- Second Reading unless ordinance is modified on second reading) [FUNDING SOURCE: AVAILABLE GENERAL PURPOSE REVENUE CURRENTLY BUDGETED IN THE CHIEF ADMINISTRATIVE OFFICE] 15. AMENDMENTS TO THE ORDINANCE APPROVING A SALARY PREMIUM AND DCAO ALLOWANCE FOR THE CHIEF MEDICAL OFFICER POSITION WHILE SERVING IN THE ROLE OF INTERIM HHSA DCAO (6/13/2023 - First Reading; 6/27/2023 - Second Reading, unless the ordinance is modified on second reading) 16. ADMINISTRATIVE ITEM: SECOND CONSIDERATION AND ADOPTION OF ORDINANCE: AMENDMENTS TO THE COMPENSATION ORDINANCE RELATING TO THE RATIFIED TENTATIVE AGREEMENT FOR THE EMPLOYEE BARGAINING UNITS - DI AND DM REPRESENTED BY THE DISTRICT ATTORNEY INVESTIGATORS ASSOCIATION AND OTHER COMPENSATION ORDINANCE CHANGES (5/23/2023 - First Reading; 6/13/23 - Second Reading, unless the ordinance is modified on second reading) 17. SAN DIEGO COUNTY EMPLOYEES RETIREMENT ASSOCIATION (SDCERA) RETIREMENT BOARD ELECTION - SECOND MEMBER (GENERAL), EIGHTH MEMBER (RETIRED) AND ALTERNATE MEMBER (RETIRED) 4TUESDAY, JUNE 13, 2023

18. APPROVAL OF THE CONFLICT OF INTEREST CODE FOR SANTEE-LAKESIDE EMERGENCY MEDICAL SERVICES AUTHORITY 19. GENERAL SERVICES - CONTINUATION OF EMERGENCY REPAIRS AT THE COUNTY ADMINISTRATION CENTER [FUNDING SOURCE: CHARGES TO CLIENT DEPARTMENTS] (4 VOTES) Appointments 20. APPOINTMENTS: VARIOUS Communications Received 21. COMMUNICATIONS RECEIVED Health and Human Services 22. RECEIVE AND APPROVE THE MENTAL HEALTH SERVICES ACT THREE-YEAR PROGRAM AND EXPENDITURE PLAN FOR FISCAL YEARS 2023-24 THROUGH 2025-26 AND SUNSET TIME-CERTAIN REPORTING [FUNDING SOURCES: MENTAL HEALTH SERVICES ACT] 23. AUTHORIZE ACCEPTANCE OF STATE YOUTH SUICIDE REPORTING AND CRISIS RESPONSE PILOT PROGRAM FUNDING AND WAIVE BOARD POLICY B-29 [FUNDING SOURCE: PENDING AWARD BY THE STATE, WILL BE ONE-TIME CALIFORNIA DEPARTMENT OF PUBLIC HEALTH, INJURY AND VIOLENCE PREVENTION BRANCH YOUTH SUICIDE REPORTING AND CRISIS RESPONSE PILOT PROGRAM FUNDS; MENTAL HEALTH SERVICES ACT AND REALIGNMENT] Financial and General Government 24. ENHANCING THE EFFICIENCY OF THE NEIGHBORHOOD REINVESTMENT PROGRAM (NRP) AND COMMUNITY ENHANCEMENT PROGRAM (CEP) GRANT APPROVAL PROCESS Closed Session 25. CLOSED SESSION Public Communication 26. PUBLIC COMMUNICATION 5TUESDAY, JUNE 13, 2023

1. PROBATION - RATIFY SUBMISSION OF AN APPLICATION FOR, AND AUTHORIZE ACCEPTANCE OF, GRANT FUNDS FROM BOARD OF STATE AND COMMUNITY CORRECTIONS; ADOPT A RESOLUTION AUTHORIZING ACCEPTANCE OF MOBILE PROBATION SERVICE CENTERS GRANT FUNDS; AND COMPETITIVE SOLICITATION OF TWO MOBILE PROBATION SERVICE CENTER VEHICLES (DISTRICTS: ALL) SUBJECT: OVERVIEW The California Board of State and Community Corrections (BSCC) offers grant funding for counties to establish mobile probation service centers, as approved through the Budget Act of 2022 (Senate Bill 178). The funding is available through a competitive grant program from May 1, 2023 through September 30, 2027. These grants enable county probation departments to purchase vehicles, equipment, telecommunications, and other technology needed to operate mobile probation service centers to assist probationers, particularly those individuals who are unhoused and struggling to meet probation requirements. Today’s request is to ratify the submission of an application for, and acceptance of, $1,119,180 in grant funds from BSCC for the Mobile Probation Service Centers Grant program and to adopt a resolution authorizing the acceptance of grant funds. A waiver of Board Policy B-29, Fees, Grants, Revenue Contracts - Department Responsibility for Cost Recovery, which requires full-cost recovery is requested as the grant funds do not reimburse staffing or indirect costs. Additionally, today’s action requests the Board to authorize the Director, Department of Purchasing and Contracting with the Department of General Services, to issue competitive solicitations for two mobile probation service center vehicles. The two mobile probation service center vehicles will be used to reach Probation clients in all areas of the San Diego region and provide connections to programs and services, particularly for clients who are unhoused and/or residing in rural areas. The action will also authorize the Chief Probation Officer to apply for and accept BSCC funding for this program in subsequent years if there are no material changes to the grant terms and funding levels and authorize the Chief Probation Officer to review and execute all required grant and grant-related documents and any annual extensions, amendments, and/or revisions thereof that do not materially impact or alter the services or funding level, this year and in subsequent years. RECOMMENDATION(S) CHIEF ADMINISTRATIVE OFFICER 1. Waive Board Policy B-29, Fees, Grants, Revenue Contracts - Department Responsibility for Full Cost Recovery, which requires prior approval of grant applications and full-cost recovery for grants and revenue contracts. 2. Ratify the submission of an application for, and authorize the acceptance of, $1,119,180 in Mobile Probation Service Centers Grant from the Board of State and Community Corrections (BSCC) for the period of May 1, 2023 to September 30, 2027 and authorize the Chief Probation Officer to execute the BSCC-related grant documents, including any extensions or 1TUESDAY, JUNE 13, 2023

annual amendments and/or revisions that do not materially impact the services or funding. 3. Adopt a resolution entitled A RESOLUTION OF THE BOARD OF SUPERVISORS OF THE COUNTY OF SAN DIEGO AUTHORIZING ACCEPTANCE OF A GRANT FROM THE BOARD OF STATE AND COMMUNITY CORRECTIONS MOBILE PROBATION SERVICE CENTERS GRANT PROGRAM. 4. In accordance with Section 401, Article XXIII of the County Administrative Code, authorize the Director, Department of Purchasing and Contracting with the Department of General Services to issue competitive solicitations for two mobile probation service center vehicles and upon successful negotiations and determination of a fair and reasonable price, award a contract/s. EQUITY IMPACT STATEMENT Existing barriers continue to prevent many San Diego County Probation Department (Probation) clients from accessing the services and support needed to be successful on supervision. Many Probation clients live in rural areas of the county, experience housing insecurity, and/or lack transportation. These mobile probation service centers will help Probation provide services and resources to clients who would otherwise have difficulty accessing them. Today’s actions will provide the mechanisms to overcome these barriers and provide needed services and support. SUSTAINABILITY IMPACT STATEMENT Today’s actions support the social sustainability measures by providing just and equitable services to County of San Diego Probation Department (Probation) clients throughout the San Diego region, ensuring the capability to provide resources that help meet the individual needs of Probation’s most vulnerable clients where they live and work. FISCAL IMPACT Funds for this request are included in the Fiscal Years 2023-25 CAO Recommended Operational Plan Change Letter for the Probation Department. The funding source is the Board of State and Community Corrections Mobile Probation Service Centers Grant ($1,119,180). The grant does not reimburse costs for staffing and indirect costs, estimated at $210,000, which will be supported with existing General Purpose Revenue budgeted in the Fiscal Years 2023-25 CAO Recommended Operational Plan for the Probation Department. Future ongoing costs associated with vehicle maintenance and staffing to implement the program will be included in future Operational Plans. There will be no change in net General Fund costs and no additional staff years. BUSINESS IMPACT STATEMENT N/A 2TUESDAY, JUNE 13, 2023

ACTION: ON MOTION of Supervisor Desmond, seconded by Supervisor Vargas, the Board of Supervisors took action as recommended, on Consent, adopting Resolution No. 23-056, entitled: A RESOLUTION OF THE BOARD OF SUPERVISORS OF THE COUNTY OF SAN DIEGO AUTHORIZING ACCEPTANCE OF A GRANT FROM THE BOARD OF STATE AND COMMUNITY CORRECTIONS MOBILE PROBATION SERVICE CENTERS GRANT PROGRAM. Vargas, Anderson, Lawson-Remer, DesmondAYES: 2. SUBJECT: OVERVIEW Utilizing evidence informed practices based on the Positive Youth Development Model, the San Diego County Probation Department (Probation) and juvenile justice partners have identified a need for continuation of the Achievement Centers in our local juvenile justice system of care. Achievement Centers are locations that offer mentoring, tutoring, behavioral health support and social connections to Probation youth and youth in our community. The continued availability of Achievement Centers will assist youth with personal development, educational enrichment and positive community involvement while also promoting public safety. The existing three Achievement Centers provide community-based resources that help youth safely and successfully exit the juvenile justice system, while serving as an important prevention resource for others. Today’s action will authorize the Department of Purchasing and Contracting to issue a competitive solicitation(s) for continued services for Probation and community youth at three existing regional Achievement Centers. RECOMMENDATION(S) CHIEF ADMINSTRATIVE OFFICER 1. In accordance with Section 401, Article XXIII of the County Administrative Code, authorize the Director, Department of Purchasing and Contracting, to issue a competitive solicitation for the continuation of Achievement Centers services for Probation and community youth, and upon successful negotiation and determination of fair and reasonable price, award a contract to a qualified provider(s) for an initial term of four (4) one-year options with an additional six (6) month option period if needed, subject to the availability of funds and a need for the services, and to amend the contract as needed to reflect changes to services and funding, subject to the approval of the Chief Probation Officer. EQUITY IMPACT STATEMENT The County of San Diego Probation Department recognizes the systematic impact that inequitable policies may create for the youth in the County of San Diego. Serving both Probation youth and youth in the community, Achievement Centers provide ongoing academic support and 3TUESDAY, JUNE 13, 2023

tutoring, case management, and career exploration and preparation. It is anticipated these actions have a positive impact on all communities served by the Achievement Centers by providing just and equitable access to services and resources. SUSTAINABILITY IMPACT STATEMENT The proposed action contributes to the County of San Diego's Sustainability Goals of engaging the community and providing just and equitable access to services and resources. The Achievement Centers are a resource linking community and justice involved youth to services with the goal of meeting the underlying needs of individuals and diverting them away from the justice system. The Achievement Center model includes diverse stakeholders and partnerships; subsequently, strengthening community collaboration to sustain an individual’s supportive networks and relationships after program completion. FISCAL IMPACT STATEMENT Funds for this request are included in the Fiscal Years 2023-2025 CAO Recommended Operational Plan in the Probation Department. If approved, this request will result in estimated costs and revenue of $1,683,786.59 in Fiscal Year 2023-2024. Funds for subsequent years will be included in future operational plans for the Probation Department. The funding sources are the Enhancing Law Enforcement Activities Subaccount-Juvenile Justice Program and Juvenile Probation Activities funds. There will be no change in net General Fund cost and no additional staff years. BUSINESS IMPACT STATEMENT N/A ADVISORY BOARD STATEMENT N/A ACTION: ON MOTION of Supervisor Desmond, seconded by Supervisor Vargas, the Board of Supervisors took action as recommended, on Consent. Vargas, Anderson, Lawson-Remer, DesmondAYES: 3. MEDICAL EXAMINER - RATIFY THE SUBMISSION OF CALIFORNIA HIGHWAY PATROL CANNABIS TAX FUND GRANT PROGRAM, ACCEPTANCE OF FUNDS AND AUTHORIZE APPLICATION FOR FUTURE FUNDING OPPORTUNITIES (DISTRICTS: ALL) SUBJECT: OVERVIEW The California Highway Patrol (CHP) has funding available under the Cannabis Tax Fund Grant Program for Fiscal Years 2023-25 to address impacts of impaired driving. The number of drivers under the influence of drugs, or a combination of drugs and alcohol is rising. As illicit drug use 4TUESDAY, JUNE 13, 2023

continues to increase, it is expected that the number of motor vehicle deaths will also continue to rise. Funding from this program will be used to purchase additional toxicology instrumentation that detects substances in lower concentrations, which meet specific accreditation requirements for identification of various substances. This will enable the Department of the Medical Examiner’s Toxicology Laboratory to expand its scope of testing and provide data on emerging drugs and drug trends. Today’s request is to ratify the submission of the CHP Fiscal Years 2023-25 Cannabis Tax Fund Grant Program application and if awarded, the acceptance of up to $2,000,000 in grant funds. This is also a request to authorize the Chief Medical Examiner to apply for and accept grant funding from the California Highway Patrol Cannabis Tax Fund Grant Program and execute all required or related grant documents in subsequent years, provided there are no material changes to the grant terms and funding levels and future funding opportunities that would support the department’s work related to the drug overdose epidemic. RECOMMENDATION(S) CHIEF ADMINISTRATIVE OFFICER 1. Waive Board Policy B-29, Fees, Grants, and Revenue Contracts - Department Responsibility for Cost Recovery, which requires docketing at least fifteen days in advance of date on which the grant request must be received by the granting agency. 2. Ratify the Medical Examiner’s grant application to the CHP for the Fiscal Years 2023-25 Cannabis Tax Fund Grant Program with a performance period of July 1, 2023, through June 30, 2025, in the amount of up to $2,000,000 and authorize the Chief Medical Examiner to accept the funds if awarded. 3. Authorize the Chief Medical Examiner to apply for and accept funding from the California Highway Patrol Cannabis Tax Fund Grant Program in subsequent years provided there are no material changes to the grant terms and funding level. 4. Authorize the Chief Medical Examiner, and/or designee, in this year and subsequent years, to review and execute all required grant documents, including any annual extensions, amendments and/or revisions thereto that do not materially impact or alter the services or funding level. 5. Authorize the Chief Medical Examiner, and/or designee, through June 30, 2028, to apply for future funding opportunities for the purpose of supporting the department’s work related to the drug overdose epidemic. EQUITY IMPACT STATEMENT The Department of the Medical Examiner’s mission is to contribute to safe communities and to justice and equity for the residents of San Diego County by certifying the cause and manner of death for all homicides, suicides, accidents and sudden and/or unexpected deaths in the county. Improving the scope of toxicology testing for the Medical Examiner’s Toxicology Laboratory benefits the residents in San Diego County, especially those who have been victims of crimes where there is suspected use of, or presence of, drugs. Necessary and timely toxicology testing ensures that victims receive justice, and the safety of affected communities is increased, by aiding in the prosecution of those who sell illicit drugs. Successful prosecution is a step in bringing healing for the victims of crimes, many of whom may have been impacted by community inequities and inequalities. SUSTAINABILITY IMPACT STATEMENT 5TUESDAY, JUNE 13, 2023

The proposed action to pursue grant funds to improve the scope of toxicology testing for the Medical Examiner’s Toxicology Laboratory contributes to the County’s sustainability goal of protecting the health and wellbeing of justice-involved individuals and the broader community. By providing the latest data on emerging drugs and drug trends, the Medical Examiner contributes to the county’s efforts at harm reduction and other public health and criminal efforts to those who have experienced the acute effects of substance use disorder. FISCAL IMPACT There is no fiscal impact associated with today’s requested actions. If awarded, staff will return to the Board to appropriate funds if necessary. There will be no change in net General Fund cost and no additional staff years. BUSINESS IMPACT STATEMENT N/A ACTION: ON MOTION of Supervisor Desmond, seconded by Supervisor Vargas, the Board of Supervisors took action as recommended, on Consent. Vargas, Anderson, Lawson-Remer, DesmondAYES: 4. ADMINISTRATIVE ITEM: SECOND CONSIDERATION AND ADOPTION OF ORDINANCE: APPROVE AN ORDINANCE AMENDING AND REPEALING PROVISIONS IN THE SAN DIEGO COUNTY ADMINISTRATIVE CODE RELATED TO THE CHILD AND FAMILY STRENGTHENING ADVISORY BOARD OF SAN DIEGO COUNTY, THE POLINSKY CHILDREN’S CENTER ADVISORY BOARD, AND THE SAN DIEGO COUNTY FOSTER CARE SERVICES COMMITTEE (MAY 23, 2023 - FIRST READING; JUNE 13, 2023 - SECOND READING UNLESS ORDINANCE IS MODIFIED ON SECOND READING) (DISTRICTS: ALL) SUBJECT: OVERVIEW On May 23, 2023 (27), the Board of Supervisors took action to further consider and adopt the Ordinance on June 13, 2023. On March 26, 2019 (11) the San Diego County Board of Supervisors (Board) established the Child and Family Strengthening Advisory Board of San Diego County (CFSAB) to enhance the ability of the County of San Diego (County) to prevent and respond to child abuse and neglect and to ensure the well-being of children and families. Since its inception, the CFSAB has served as a platform for cross-sector collaboration and transparent monitoring of the San Diego County child welfare system. The CFSAB has allowed for streamlined collaboration and expanded transparent communication and oversight between stakeholders and the newly formed Child and Family Well-Being Department, ensuring foster care community feedback is received by all partners who collectively impact the intertwined elements of the foster care and prevention systems. The holistic approach of the CFSAB has acted as a conduit for reducing siloes amongst child and family serving stakeholders from various areas of the foster care and prevention 6TUESDAY, JUNE 13, 2023

systems by bringing together individuals and groups that were historically fragmented from each another. If approved, the amendments to the CFSAB ordinance will similarly incorporate the work of the Polinsky Children’s Center Advisory Board and the San Diego County Foster Care Services Committee into the work of the CFSAB. In accordance with the Board’s Sunset Review Process, Policy A-76, the County Health and Human Services Agency periodically reviews Board Policies, County Administrative Codes, and Regulatory Codes to ensure policies and codes reflect current Board standards and practices. Today’s actions seek Board approval to amend and repeal provisions of the San Diego County Administrative Code relating to: · The Child and Family Strengthening Advisory Board of San Diego County; · The Polinsky Children’s Center Advisory Board; and · The San Diego County Foster Care Services Committee The ordinance will be introduced to the Board on May 23, 2023, and if approved, will be scheduled for adoption on June 13, 2023. If the proposed ordinance is altered on June 13, 2023, a subsequent meeting date will be selected for the ordinance’s adoption. This item supports the County’s vision of a just, sustainable, and resilient future for all, specifically those communities and populations in San Diego County that have been historically underserved as well as our ongoing commitment to the regional Live Well San Diego vision of healthy, safe, and thriving communities. This will be accomplished as these County Administrative Codes provide a framework for a county that is healthy, safe, and thriving, specifically for one of our most vulnerable populations, families involved with the foster care system. RECOMMENDATION(S) CHIEF ADMINISTRATIVE OFFICER Consider and adopt (second reading): AN ORDINANCE AMENDING AND REPEALING PROVISIONS IN THE SAN DIEGO COUNTY ADMINISTRATIVE CODE RELATED TO THE CHILD AND FAMILY STRENGTHENING ADVISORY BOARD OF SAN DIEGO COUNTY, THE POLINSKY CHILDREN’S CENTER ADVISORY BOARD, AND THE SAN DIEGO COUNTY FOSTER CARE SERVICES COMMITTEE EQUITY IMPACT STATEMENT The recommended changes support the San Diego County Board of Supervisors’ framework for achieving better outcomes for the community. The recommended changes to San Diego County Administrative Code 84.500, Child and Family Strengthening Advisory Board of San Diego County (CFSAB), ensures the CFSAB receives feedback from stakeholders and community members regarding the implementation, progress, and resources of the Office of Child Safety’s programs and services designed to serve families in a consistent and equitable manner. The integration of the Polinsky Children’s Center (PCC) and Foster Care Services communities into the larger CFSAB continues to promote transparency for all involved, as the same information is shared among stakeholders and streamlined feedback is provided for consideration by the CFSAB. 7TUESDAY, JUNE 13, 2023

Merging the PCC Advisory Board and the Foster Care Services Committee into the CFSAB ensures all areas of the prevention and child welfare systems are included. The composition changes of CFSAB members to include adding a member from child abuse and juvenile justice prevention, supports the newly formed Child and Family Well-Being Department’s commitment to engaging in prevention work with children and families. The addition of prevention to the CFSAB will provide feedback and a lens set to reduce disproportionality in the foster care system by partnering with the community to prevent increased child abuse reporting in overrepresented communities and working with families to support efforts at keeping children safe from abuse or neglect and intervention by the Office of Child Safety. SUSTAINABILITY IMPACT STATEMENT Today’s actions strive for programs and operations that reflect the County of San Diego’s (County) values and priorities. By aligning with the County’s Sustainability Goals, the changes reflect more equitable, sustainable, and impactful practices. Specifically, the consolidation of advisory boards as recommended, aligns with Sustainability Goal #1 to engage the community in meaningful ways by streamlining information to and from the public to ensure that it does not get siloed into one committee or advisory board, when the areas of child welfare supports, services, resources, and staffing are intertwined. Today’s actions also align with Sustainability Goal #2 providing just and equitable access to county services, resource allocation, and decision-making by facilitating review of all components of the child well-being system in one setting, ensuring stakeholders’ input and feedback is received and considered by all appropriate parties. This consolidation provides increased transparency with all child and family serving stakeholders collaborating with the County to move forward towards the goals of community engagement and equitable access that will have lasting impacts on the assessment, evaluation, and continuous quality improvement processes of child welfare activities. FISCAL IMPACT There is no fiscal impact associated with the recommendations. There will be no change in net general fund costs and no additional staff years. BUSINESS IMPACT STATEMENT N/A ACTION: ON MOTION of Supervisor Desmond, seconded by Supervisor Vargas, the Board of Supervisors took action as recommended, on Consent, adopting Ordinance No. 10851 (N.S.), entitled: APPROVE AN ORDINANCE AMENDING AND REPEALING PROVISIONS IN THE SAN DIEGO COUNTY ADMINISTRATIVE CODE RELATED TO THE CHILD AND FAMILY STRENGTHENING ADVISORY BOARD OF SAN DIEGO COUNTY, THE POLINSKY CHILDREN’S CENTER ADVISORY BOARD, AND THE SAN DIEGO COUNTY FOSTER CARE SERVICES ADVISORY COMMITTEE. Vargas, Anderson, Lawson-Remer, DesmondAYES: 5. AUTHORIZE ACTIONS RELATED TO THE 2024-2025 COMMUNITYSUBJECT: 8TUESDAY, JUNE 13, 2023

ACTION PLAN (DISTRICTS: ALL) OVERVIEW As the region’s designated Community Action Agency, the County of San Diego is eligible to receive an annual allocation of federal Community Services Block Grant (CSBG) revenue. CSBG funds local programs that increase economic security for individuals and families, as well as supports civic engagement in low-income communities across all of San Diego County, particularly around addressing barriers to economic inclusion. CSBG revenue is available to California Community Action Agencies each year through a revenue agreement with the California Department of Community Services and Development (CSD), pending the submission of a two-year Community Action Plan. On December 7, 2021 (10), the San Diego County Board of Supervisors (Board) authorized the Clerk of the Board to execute the latest CSBG revenue agreements and any amendments associated with the Community Action Plan for those same years. Today’s actions requests authorization to submit the Community Action Plan for calendar years 2024 and 2025; acceptance of approximately $3,540,000 annually in CSBG funding from CSD for the periods of January 1, 2024, through December 31, 2024, and January 1, 2025, through December 31, 2025; and authorization to execute CSBG revenue agreements and any amendments. Additionally, today’s actions requests authorization to issue competitive procurements for Communities In Action programs and authorization to pursue additional funding opportunities to address barriers to economic inclusion and promote civic engagement in the region’s low-income communities. The programs outlined in the Community Action Plan support the County of San Diego’s vision of a just, sustainable, and resilient future for all, specifically those communities and populations in San Diego County that have been historically left behind, as well as our ongoing commitment to the regional Live Well San Diego vision of healthy, safe, and thriving communities. Allowing the continuation of CSBG funded programs helps improve lives by strengthening economic inclusion and civic engagement in low-income communities throughout the region. RECOMMENDATION(S) CHIEF ADMINISTRATIVE OFFICER 1. Authorize submission of the calendar years 2024 and 2025 Community Action Plan and acceptance of approximately $3,540,000 annually of Community Services Block Grant funding from the State of California Department of Community Services and Development, for the periods of January 1, 2024, through December 31, 2024, and January 1, 2025, through December 31, 2025. 2. Authorize the Clerk of the Board, upon receipt, to execute all required revenue agreement documents, including any annual extensions, amendments, and/or revisions thereto that do not materially impact or alter the services or funding level. 3. In accordance with Section 401, Article XXIII of the County Administrative Code authorize the Director, Department of Purchasing and Contracting to issue competitive solicitations for Communities In Action programs, and upon successful negotiations and determination of a fair and reasonable price, award contracts for an initial term of one year, with four one-year options and up to an additional six months if needed, and to amend the contracts as needed to reflect changes to services and funding, subject to the approval of the Agency Director, Health and Human Services Agency. 4. Authorize the Agency Director, Health and Human Services Agency, to apply for future 9TUESDAY, JUNE 13, 2023

funding, including grants, supplemental funding and other funding opportunities for programs or projects that address barriers to economic inclusion and promote civic engagement in the region’s low-income communities. EQUITY IMPACT STATEMENT The County of San Diego’s Health and Human Services Agency (HHSA), Department of Homeless Solutions and Equitable Communities, Office of Equitable Communities (HSEC-OEqC), strives to enhance community engagement and collaboration, and devote efforts to meet the needs of underserved communities. HSEC-OEqC's Community Action Partnership (CAP), as the locally designated Community Action Agency, is responsible for administering programs that address locally identified issues of poverty through Community Services Block Grant (CSBG) funding. CSBG funded programs advance equity and opportunity for economically disadvantaged communities through HSEC-OEqC’s mission of focusing on embracing diversity, health equity, economic inclusion, and poverty reduction. CSBG funding requires community input through a Community Needs Assessment every two years, which utilizes data and information collected to be incorporated into program design and service delivery to reflect the needs and priorities of the community. Strategies for expanding input during this process included utilizing existing meetings, such as the Resident Leadership Academy Council meeting, and a series of needs assessment presentations to gather feedback. CAP and CSBG funding advances equitable opportunities as information collected through the Community Needs Assessment is made available to community stakeholders for their own use in developing and enhancing programs and services addressing similar needs. SUSTAINABILITY IMPACT STATEMENT Today’s actions support the County of San Diego’s Sustainability Goal #1 of engaging the community, Sustainability Goal # 2 of providing just and equitable access, and Sustainability Goal #4 to protect the health and well-being of everyone in the region. This will be accomplished by engaging the public and providing residents with opportunities for self-sufficiency through Community Advisory Board meetings, which facilitate discussion regarding program development and oversight of the biennial Community Needs Assessment. These programs serve to remove barriers from low-income families seeking crisis stabilization services, provides opportunities for equitable access to health resources, and reduces the demand on other services. FISCAL IMPACT Recommendations 1 and 2: Authorize Submission of the Calendar Years 2024-2025 Community Action Plan and Acceptance of Funding; Authorize the Execution of the CSBG Revenue Agreement for 2024-2025 Funds for this request are included in the Fiscal Year (FY) 2023-24 CAO Recommended Operational Plan in the Health and Human Services Agency. If approved, this request will result in costs and revenue of approximately $1,770,000 in FY 2023-24, and costs and revenue of approximately $3,540,000 in FY 2024-25. The funding source is the Community Services Block Grant from the California Department of Community Services and Development. There will be 10TUESDAY, JUNE 13, 2023

no change in net General Fund cost and no additional staff years. Recommendation #3: Authorize Competitive Procurements for Communities In Action Services Funds for this request are included in the FY 2023-24 CAO Recommended Operational Plan in the Health and Human Services Agency. If approved, this request will result in costs and revenue of approximately $1,200,000 in FY 2023-24 and costs and revenue of approximately $2,400,000 in FY 2024-25. The funding source is the Community Services Block Grant from the California Department of Community Services and Development and existing General Purpose Revenue. There will be no change in net General Fund cost and no additional staff years. Recommendation #4: Authorization to Pursue Future Funding Opportunities There is no fiscal impact associated with this recommendation. There will be no change in net General Fund costs and no additional staff years. BUSINESS IMPACT STATEMENT N/A ACTION: ON MOTION of Supervisor Desmond, seconded by Supervisor Vargas, the Board of Supervisors took action as recommended, on Consent. Vargas, Anderson, Lawson-Remer, DesmondAYES: 6. AUTHORIZE A SINGLE SOURCE PROCUREMENT WITH SAN DIEGO HEALTH CONNECT FOR LOCAL IMPLEMENTATION OF THE MULTISTATE ELECTRONIC HEALTH RECORD-BASED NETWORK FOR DISEASE SURVEILLANCE (DISTRICTS: ALL) SUBJECT: OVERVIEW Detailed and accurate data are critical for planning and implementation of programs, policies, and environmental change through evidence-based approaches, which promote healthy behaviors in San Diego County communities. Program evaluation benefits from detailed information to help assess program outcomes and determine program effectiveness. Traditional large-scale health surveys are designed to provide State and county-level data, but surveys can be lengthy and expensive, and data can be delayed for more than a year after collection for processing and reporting. Emerging methods utilizing de-identified electronic health record data collected at medical visits, hold promise to provide data at the neighborhood level. On November 2, 2021 (8), the San Diego County Board of Supervisors authorized the extension of contract No. 549622 with the San Diego Regional Healthcare Information Exchange, Inc. doing business as San Diego Health Connect for healthcare information exchange services. Extending this contract enabled the County to continue participation in the regional health information exchange, which brings together various stakeholders in the geographic area, including healthcare providers, hospitals, clinics, payers, and government agencies to safely and securely share health-related information electronically for the purpose of improving health and care. 11TUESDAY, JUNE 13, 2023

Today’s action, if approved, would authorize the Director, Department of Purchasing and Contracting to enter into negotiations with the San Diego Regional Healthcare Information Exchange, Inc., doing business as San Diego Health Connect and subject to successful negotiations and a determination of a fair and reasonable price, award a contract for local implementation of the Multistate Electronic Health Record-Based Network for Disease Surveillance (MENDS) system and to host, maintain, and update the MENDS system. Additionally, today’s action would authorize the Agency Director, Health and Human Services Agency to apply for additional funding opportunity announcements, if available, to support future enhancements and continued maintenance of the MENDS system. This item supports the County’s vision of a just, sustainable, and resilient future for all, specifically those communities and populations in San Diego County that have been historically left behind by utilizing non-traditional data sources to improve data-driven services, as well as our ongoing commitment to the regional Live Well San Diego vision of healthy, safe, and thriving communities. RECOMMENDATION(S) CHIEF ADMINISTRATIVE OFFICER 1. In accordance with Board Policy A-87, Competitive Procurement, approve and authorize the Director, Department of Purchasing and Contracting to enter into negotiations with the San Diego Regional Healthcare Information Exchange, Inc., doing business as San Diego Health Connect and subject to successful negotiations and a determination of a fair and reasonable price, award a contract for local implementation of the Multistate Electronic Health Record-Based Network for Disease Surveillance system and to host, maintain, and update the system; for an initial contract period of one year with four option years, and up to an additional six months, if needed, subject to the availability of funds; and to amend the contract as needed to reflect changes in services and funding allocation, subject to the approval of the Agency Director, Health and Human Services Agency. 2. Authorize the Agency Director, Health and Human Services Agency, or designee, to apply for additional funding opportunity announcements, if available, that would support future enhancements and continued maintenance of the Multi-state Electronic Health Record-Based Network for Disease Surveillance. EQUITY IMPACT STATEMENT Communities of color in San Diego County (county) are disproportionately affected by chronic diseases. California Health Interview Survey data for 2021 indicates, rates of diabetes for African Americans and Latinos in the county are almost 30% higher than rates of diabetes for Caucasians. These disparities are reflected in the social determinants of health and result in dramatic differences in life expectancy. Additionally, the differential impacts from the COVID-19 pandemic are still being felt through increased rates of chronic disease from neglected preventive care as well as diseases resulting from long COVID. Existing data sources lack the specificity to accurately direct resources to historically disadvantaged populations and neighborhoods. The Multistate Electronic Health Record-Based Network for Disease Surveillance (MENDS) system includes a suite of modern data dashboards to display data by demographics and geography for more granular assessments of the most disproportionately impacted communities and populations. The data and information from MENDS will ensure the focus of public health programs are on the communities most in need, including historically 12TUESDAY, JUNE 13, 2023

disadvantaged communities. SUSTAINABILITY IMPACT STATEMENT Today’s proposed action supports Sustainability Goal #2 to focus investment in chronically underserved communities, and Sustainability Goal #4 to protect the health and well-being of everyone in the region by developing systems and tools to provide information to help focus public health investments in chronically underserved communities. The Multistate Electronic Health Record-Based Network for Disease Surveillance (MENDS) is based on technology developed and vetted by nationally recognized experts and relies on secondary utilization of existing data, providing useful information at a fraction of the cost of a large health survey. The data provided by MENDS will improve access to County of San Diego (County) services through more accurate assessments of neighborhoods and populations with higher disease rates and enable County staff to track program outcomes to determine the effectiveness of programs. FISCAL IMPACT Funds for this request are included in the Fiscal Year (FY) 2023-2024 CAO Recommended Operational Plan in the Health and Human Services Agency. If approved, this request will result in estimated costs and revenue of $450,000 in FY 2023-24, and estimated costs and revenue of approximately $125,000 annually in FY 2024-25 through FY 2027-28. The funding sources are the Centers for Disease Control and Prevention COVID-19 Health Disparities Grant and Realignment. There will be no change in net General Fund cost and no additional staff years. BUSINESS IMPACT STATEMENT N/A ACTION: ON MOTION of Supervisor Desmond, seconded by Supervisor Vargas, the Board of Supervisors took action as recommended, on Consent. Vargas, Anderson, Lawson-Remer, DesmondAYES: 7. AUTHORIZE A CONTRACT AMENDMENT FOR REFUGEE HEALTH ASSESSMENT PROGRAM SERVICES WITH FAMILY HEALTH CENTERS OF SAN DIEGO, AUTHORIZE A COMPETITIVE SOLICITATION FOR REFUGEE HEALTH ASSESSMENT PROGRAM SERVICES, AND AUTHORIZE APPLICATION FOR FUTURE FUNDING OPPORTUNITIES (DISTRICTS: ALL) SUBJECT: OVERVIEW The United States Refugee Act of 1980, as amended, provided for permanent and systematic procedures for admitting refugees of national interest through uniform provisions and authorizing federal assistance to resettle refugees and promote their self-sufficiency. Since 1983, the federal government has designated San Diego County as an area highly impacted by refugees, therefore qualifying the region for funding. The California Department of Public Health (CDPH), Office of Refugee Health supports the County of San Diego (County) Health and Human Services Agency, Public Health Services, Refugee Health Assessment Program (RHAP) in providing culturally and linguistically appropriate comprehensive health assessments to incoming refugees and other eligible individuals. 13TUESDAY, JUNE 13, 2023

On June 28, 2022 (3), the San Diego County Board of Supervisors approved acceptance of funding from CDPH for tuberculosis control and treatment and refugee health assessment services. The County has a contract with Family Health Centers of San Diego to administer care and provide comprehensive medical and mental health assessments for eligible individuals resettled in San Diego County. Health screenings of newly arrived refugees and asylees minimize communicable disease exposure, identifies serious medical and mental health conditions for intervention, and evaluates health barriers. Today’s request, if approved, would authorize the Director, Department of Purchasing and Contracting to amend contract #563397 with Family Health Centers of San Diego for refugee health medical services, to increase the contract amount, and to issue a Competitive Solicitation This item supports the County’s vision of a just, sustainable, and resilient future for all, specifically those communities and populations in San Diego County that have been historically left behind, as well as our ongoing commitment to the regional Live Well San Diego vision of healthy, safe, and thriving communities by building better access to high quality medical care that leads to improved physical and behavioral health. RECOMMENDATION(S) CHIEF ADMINISTRATIVE OFFICER 1. In accordance with Board Policy A-87, Competitive Procurement, and Administrative Code Section 401, authorize the Director, Department of Purchasing and Contracting, to amend contract No. 563397 with Family Health Centers of San Diego for refugee health assessment medical services, to increase the contract amount for the projected increase in number of refugee health assessments, subject to the availability of funds; and to amend the contract as required to reflect changes to services and funding allocations, subject to the approval of the Agency Director, Health and Human Services Agency. 2. In accordance with Section 401, Article XXIII of the County Administrative Code authorize the Director, Department of Purchasing and Contracting to issue a competitive solicitation for Refugee Health Assessment Program services, and upon successful negotiations and determination of a fair and reasonable price, award contract/s for an initial term of one year with four option years and up to an additional six months if needed, and to amend the contracts as needed to reflect changes to services and funding. 3. Authorize the Agency Director, or designee, Health and Human Services Agency, to apply for future funding opportunities to support refugee health assessment services. EQUITY IMPACT STATEMENT Achieving health equity requires addressing societal inequalities, historical and contemporary injustices, and healthcare disparities. This will be done by ensuring newly arriving refugees are given access to resources, through the County of San Diego (County) Health and Human Services Agency, Public Health Services, Refugee Health Assessment Program (RHAP), which promotes the overall health and well-being of those disproportionately impacted. To support self-sustainability in terms of health and well-being among the newly arriving refugee population, refugees are provided with a comprehensive medical assessment within the first 90 days of arrival through the RHAP. The initial assessment, based on the Centers for Disease Control and Prevention guidelines for arriving refugees, includes a medical history, physical exam, mental health screening, and laboratory screening for infectious conditions such as intestinal parasites, tuberculosis, syphilis, HIV, and hepatitis B and C. Depending on age, 14TUESDAY, JUNE 13, 2023

medical history, and other risk factors, the refugees are also assessed for non-infectious conditions such as diabetes, hypertension, hyperlipidemia, anemia, and lead poisoning. Medical assessments of arriving refugee populations, with timely collection and review of health data, enables early detection, treatment, and follow-up on conditions and can help the County develop and set priorities for population-specific health interventions and guidelines. In Fiscal Year 2021-22, RHAP services were provided to 1,649 newly arriving refugees in San Diego County. Patients who were diagnosed with a serious medical condition and/or mental health condition were referred to a specialty provider for follow-up care as part of the Refugee Health Prevention Promotion Program which is a component of RHAP. SUSTAINABILITY IMPACT STATEMENT The proposed actions support the County of San Diego’s (County) Sustainability Goal #2 to provide just and equitable access and Sustainability Goal #4 to protect the health and wellbeing of the region. This will be accomplished through a continuous investment in chronically underserved communities and building resilience in vulnerable populations. The services provided by the County Health and Human Services Agency, Public Health Services, Refugee Health Assessment Program, via the current contract, focus on protecting health and wellbeing, in partnership with community partners. Refugee health assessments serve to provide early detection and identification of infectious and chronic diseases. If patients are given timely proper care and treatment, this will improve the overall health of communities, reduce the demand of associated care services, while increasing effectiveness of care providers and lowering operating costs of facilities. FISCAL IMPACT Recommendation #1: Authorize Contract Amendment with Family Health Centers of San Diego for Refugee Health Assessment Program Services Funds for this request are included in the Fiscal Year (FY) 2023-2024 CAO Recommended Operational Plan in the Health and Human Services Agency. If approved, this request will result in estimated costs of $242,021 and revenue of $237,281. The funding source is the California Department of Public Health, Office of Refugee Health. On June 28, 2022 (3), the San Diego County Board of Supervisors approved a waiver of Board Policy B-29 since this funding does not offset all costs. These costs which will not be recovered are estimated at $4,740 and the funding source is Realignment. There will be no change in net General Fund costs and no additional staff years. Recommendation #2: Authorize Competitive Solicitation for Refugee Health Assessment Program Services Funds for this request are included in the FY 2023-2024 CAO Recommended Operational Plan in the Health and Human Services Agency. If approved, this request will result in estimated costs of $652,006 and revenue of $637,784 for FY 2023-24, and estimated costs of $869,342 and revenue of $850,378 for FY 2024-25. The funding source is the California Department of Public Health, Office of Refugee Health. On June 28, 2022 (3), the San Diego County Board of Supervisors approved a waiver of Board Policy B-29 since this funding does not offset all costs. These costs which will not be recovered are estimated at $14,223 in FY 2023-24 and estimated at $18,964 for FY 2024-25, and the funding source is Realignment. There will be no change in net General Fund costs and no additional staff years. 15TUESDAY, JUNE 13, 2023

Recommendation #3: Authorize Apply for Future Funding Opportunities to Support Refugee Health Assessment Services There is no fiscal impact related to this recommendation. There will be no change in net General Fund costs and no additional staff years. BUSINESS IMPACT STATEMENT N/A ACTION: ON MOTION of Supervisor Desmond, seconded by Supervisor Vargas, the Board of Supervisors took action as recommended, on Consent. Vargas, Anderson, Lawson-Remer, DesmondAYES: 8. ADOPT AMENDMENTS TO THE BY-LAWS OF THE COUNTY OF SAN DIEGO HIV PLANNING GROUP (DISTRICTS: ALL) SUBJECT: OVERVIEW On December 15, 2015 (8), the San Diego County Board of Supervisors (Board) adopted a resolution establishing the County of San Diego (County) HIV Planning Group (HPG). The HPG was established with the goal of unifying the HIV Health Services Planning Council and the HIV Prevention Group into a single planning body in order to better coordinate HIV services. The HPG serves as an official advisory board to the Board and meets statutory requirements related to receipt of federal funds under the Ryan White Treatment Extension Act of 2009 (RWTEA). RWTEA funds are allocated by the HPG and used to provide health care and supportive services to San Diego residents living with HIV. By-Laws for the HPG were last amended on November 13, 2018 (16). The amendments adopted in 2018 addressed governance and operational items, added additional seats to ensure the HPG reflects those living with or at risk for HIV infection, established term limits for all HPG members, and added conflict of interest language and standards of conduct. Today’s action requests adoption of additional amendments to HPG By-Laws. The proposed amendments and clarifications address governance and operational items including the nomination and renomination process, membership composition, term of office, duties, and committee requirements. Today’s action supports the County’s vision of a just, sustainable, and resilient future for all, specifically those communities and populations in San Diego County that have been historically left behind, as well as our ongoing commitment to the regional Live Well San Diego vision of healthy, safe, and thriving communities. This will be accomplished through education, prevention, and intervention to interrupt transmission of disease and improve the health of San Diego County residents. Additionally, this item supports the County’s Getting to Zero initiative, a 10-year plan to halt the local HIV epidemic, by planning and allocating resources dedicated to services for residents who are living with or vulnerable to HIV. RECOMMENDATION(S) CHIEF ADMINISTRATIVE OFFICER 16TUESDAY, JUNE 13, 2023

1. Adopt the amended By-Laws entitled HIV PLANNING GROUP BY-LAWS. EQUITY IMPACT STATEMENT Since the beginning of the epidemic, HIV has disproportionately impacted the most vulnerable residents. According to Gallup, Gay, bisexual, and other men who have sex with men, for instance, are currently estimated to comprise less than 2% of the adult population in the United States, and yet they comprise 62% of recent HIV diagnoses and 71% of persons living with HIV. In San Diego County, much like the rest of the United States, HIV has disproportionately impacted Black and Hispanic communities. In San Diego County, Black individuals make up less than 5% of the county’s population, yet comprised 12% of HIV diagnoses from 2017 through 2021. Additionally, Hispanic individuals make up 34% of the population of the county, yet comprised 48% of HIV diagnoses over the same time period. The County of San Diego continuously explores funding resources to further address these disparities. Since its inception in 1990, the Ryan White Treatment Extension Act of 2009 has focused on ensuring access to treatment and support services for the most vulnerable residents. During the Fiscal Year 2021-22 grant period, a total of 3,313 clients received services funded by Ryan White Part A in San Diego County. Of those clients, 54% were Hispanic and 13% were Black. The success in reaching residents and communities most disproportionately impacted by HIV through the use of this funding is due in large part to HIV Planning Group’s legislative authority to allocate Ryan White Part A funding to respond to local needs as determined by review of epidemiologic data and extensive engagement with affected communities. SUSTAINABILITY IMPACT STATEMENT The proposed actions align with the County of San Diego’s (County) Sustainability Goal #2 to provide just and equitable access and Sustainability Goal #4 to protect health and well-being of San Diego County residents. The priorities and allocations developed by the HIV Planning Group will provide support to the HIV, STD and Hepatitis Branch within the County Health and Human Services Agency, Public Health Services and in turn to HIV service providers throughout San Diego County by increasing capacity and services aimed to prevent, identify, and treat HIV. Timely testing, identification, and treatment of HIV will improve the overall health of communities, reduce the demand of associated care services, while increasing effectiveness of care providers and lowering operating costs of facilities, thus further advancing Sustainability Goal #3, by reducing greenhouse gas emissions and waste generated within the care sector. FISCAL IMPACT There is no fiscal impact associated with this recommendation. There will be no change in net General Fund co