Review the County Executive's Fiscal Year 2026-2027 Recommended Budget for departments reporting to the Health and Hospital Committee.

County of Santa Clara Office of the County Executive 128755 DATE: May 11, 2026 TO: Board of Supervisors FROM: James R. Williams, County Executive SUBJECT: FY 2026-2027 Recommended Budget for the Health and Hospital Committee Departments RECOMMENDED ACTION Review the County Executive's Fiscal Year 2026-2027 Recommended Budget for departments reporting to the Health and Hospital Committee. a. Valley Health Plan b. Public Health Department c. Emergency Medical Services d. Santa Clara Valley Healthcare, including Custody Health Services e. Behavioral Health Services Department Board of Supervisors: Sylvia Arenas, Betty Duong, Otto Lee, Susan Ellenberg, Margaret Abe-Koga County Executive: James R. Williams Page 1 of 1

May 8, 2026 Dear Board Of Supervisors, We are writing in strong support of keeping intact the critical suicide prevention efforts of the Santa Clara County Behavioral Health Suicide Prevention Oversight Committee (SPOC) staff. Our team at the Stanford Center for Youth Mental Health and Wellbeing has worked closely with these highly skilled colleagues on innovative suicide prevention efforts for over a decade, including the successful development and implementation of the evidence-based TEMPOS tool and safe messaging trainings across the County and beyond. TEMPOS is an internationally recognized innovation in safe messaging that the SPOC team co-created with us based on their deep expertise in suicide prevention and postvention. Such expertise is highly specialized and comes with years of on the ground experience that is difficult to substitute. We are currently working with this team to bring safe messaging trainings to students and families through school and community presentations, and we look forward to continuing this important work alongside our colleagues. We are aware that Santa Clara County is proposing to eliminate this valuable suicide prevention program and its...

BoardOperations From: Sent: To: Cc: Subject: Attachments: Peying Lee Monday, May 11, 2026 10:40 AM BoardOperations; Terao, Sherri; AbeKoga, Margaret Peter Stone; Mora Oommen; Steven Adelsheim; Shashank V. Joshi; TrackWatch Palo Alto [EXTERNAL] PSN Supports Full Retention of Santa Clara County Suicide Prevention Oversight Committee (SPOC) PSN Letter of Support for SPOC 2026.pdf Dear Board of Supervisors and Director Terao, Project Safety Net (PSN) strongly supports retaining our existing Santa Clara County suicide prevention program and Suicide Prevention Oversight Committee (SPOC). PSN deeply appreciates our 15-year collaboration with SPOC, which provides infrastructure for sustainable, comprehensive, and innovative suicide prevention in our county. SPOC is fundamental to PSN's work to promote youth wellbeing, mental health, and suicide prevention. Please see attached for PSN's letter of support. We strongly urge for the full retention of SPOC. Thank you, Peying Peying Lee - she/her Director of Community Partnerships Project Safety Net Cubberley Community Center | 4000 Middlefield Rd. T5 | Palo Alto, CA 94303 Main: 650.460.8302 | Direct: 650.460.8305 Email: Website:...

From: To: Subject: Date: BoardOperations [EXTERNAL] The growing imbalance between bureaucratic oversight positions and direct community service jobs within BHSD Monday, May 11, 2026 2:41:17 PM Good morning Supervisors, I want to raise concern about the growing imbalance between bureaucratic oversight positions and direct community service jobs within BHSD. Year after year, we continue seeing more executive, director, manager, coordinator, and oversight positions added or protected, while the programs the public actually uses are reduced, limited, or closed altogether. The community is paying for layers of administration while losing access to direct services. Residents do not walk into a department asking for more managers — they ask for counselors, case workers, peer support, outreach workers, crisis response, housing navigation, and treatment access. One executive salary can often equal the cost of multiple frontline workers serving the public directly. Yet the growth appears concentrated at the top instead of in the field where people are struggling every day. We should be asking: How many management positions have been added compared to direct service staff? How much of the...

From: To: Subject: Date: Ken Horowitz BoardOperations [EXTERNAL] Public Comment to CEO Recommended Budget on Santa Cara County Healthcare Section 4 (page 419) Sunday, May 10, 2026 4:21:11 PM Dear Supervisors As you consider the CEO’s recommended budget for SCVH for access and capacity for primary care in community satellite settings (page 419 added 29 FTE) 1. Please consider dentistry and oral health as primary care by adding dentists or dental hygienists to the list 2. Please consider employing physicians with training in integrative/functional medicine Thank you for your consideration Dr. Ken Horowitz Health Advisory Commission From: To: Subject: Date: Laura Nuno BoardOperations [EXTERNAL] May 11, Board Meeting. Monday, May 11, 2026 3:09:09 PM Good afternoon Supervisors, My name is Laura Nuno. I am a registered nurse with over 30 years of healthcare experience and a longtime South County resident. I am deeply concerned about the continued reduction of services at St. Louise Regional Hospital. Patients receiving prenatal care in Gilroy are being directed to deliver their babies in San Jose instead of locally at St. Louise. Operating room suites are being closed, physician call...

SCVH Budget Workshop May 11, 2026 Board of Supervisors Strategic Priorities & Focus Maximize Revenue Manage Costs • Strengthened revenue cycle performance • Manage expenditures within current County investment level • Payor contracting strategies • Federal and state advocacy to protect supplemental and directed payments • Improve operational efficiency • Maintain fiscal discipline and resource stewardship Outpatient Primary & Specialty Care Hospital Patient Access and Efficiency • Strengthen and improve timely access across primary and specialty care services • Improve hospital throughput, including emergency dept flow and length of stay • Support population health through expanded access and infrastructure • Leverage 4 hospitals and clinics as integrated health system Service Line Restructuring & Consolidation • Prioritize and invest in highimpact services that improve community health • Standardize care delivery across the system • Grow ancillary and surgical volumes to improve access and patient experience 2 Financial Sustainability FY 2025-2026 Mid-Year Budget Reduction Target Budget Mitigation Category FY 20252026 Mid-Year Revenue Improvements $40M Operational Efficiencies...

Good afternoon, Board, l'm Edith sona, l'm a 2g-year county emptoyee in Substance Use Treatment Services and Program Manager ll with Santa Ctara County, I manage the Atexian CFCS SUTS program. I want to hightight the reatities of the proposed budget changes. The current recommendation and accompanyingorganizationaI chart for BHSD witt putt our SUTS ctinicians providing on site care to students and witt ptace them in sunnyvate and Las P[umas MentatHeatth ctinics, not surs ctinics. The ptan is that they witt continue treating their ctients at the Mentat heatth Ctinics. That's not feasibte. we need to meet our clients where they're at, particutarty when they are minor students. They are entitled to confidentiaI treatment by Title 42 cFR part 2. There is a criticatwindow to attach these clients to treatment before serious heatth crisis impacts. The ptan to dissotve CFCS SUTS is the same as cutting CFCS SUTS, so the plan to reduce SUTS support for our students is the same as cutting SUTS support for our students. Lorena . - j:: i Good afternoon Boa rd, l' m Lorena Gonzalez 29 year county employeefrogram Manager ll and I am also a License Clinical Social Woiker. I manage and oversee...