Every year, CCH conducts the PIT Count using real-time GIS data to better understand homelessness and guide services countywide.

Thanks to all of our partners for their support.

Dear Contra Costa Health Team:

This week, Contra Costa Health (CCH) welcomed surveyors from The Joint Commission for a comprehensive accreditation visit. Each day the survey team visited parts of our system of care, from Contra Costa Regional Medical Center to many of the ambulatory care sites, including Antioch, Pittsburg, and West County.

I am pleased to share that the visit was extremely successful.

Across every setting they visited, the surveyors were impressed consistently by the dedication, professionalism and attitude of our staff. They commented repeatedly about the quality of care being delivered, the cleanliness and safety of our facilities, and – most notably – how deeply connected CCH is to the communities we serve. The team recognized our strong commitment to addressing the social determinants of health and our patient-centered approach to care.

Several departments and teams received particularly high praise. Surveyors highlighted the strength of our performance improvement work, describing elements of our Quality Improvement Program and patient safety initiatives as among the best they have seen. They also shared unsolicited appreciation for staff engagement at our ambulatory clinics, with one surveyor concluding their visit by saying, “Everyone did you very proud.”

As with any Joint Commission survey, we will receive a formal report that will include some findings. We anticipate them to be limited in scope, and teams have already begun addressing items identified during the visit. We will respond promptly and thoroughly, as we always do, and will use the feedback to continue strengthening our systems and practices.

This was, above all, a reflection of the extraordinary work you do every day, often under challenging circumstances, to care for our patients and communities. Thank you for your preparation and your commitment to excellence. You represented CCH with pride.

With deep appreciation,

Grant Colfax, MD
Chief Executive Officer
Contra Costa Health

As we approach the end of 2025, I thank each of you for the work you do every day for our patients and our community.

This has been a demanding year. Nevertheless, team CCH demonstrated professionalism, resilience, and commitment to our mission. That dedication is embedded in our history and culture of delivering the best care possible, and I am deeply grateful for it.

Looking ahead, we know the coming year will bring continued change and challenge. Together, we are approaching that work thoughtfully and deliberately, with a focus on sustaining access to equitable care and supporting the people who make that care possible – team CCH.

I hope you are all able to take some time over the holidays to rest and reconnect with the people and things that matter most to you. Thank you again for all that you do and for the difference you make for Contra Costa residents. Your work saves and improves lives.

Wishing you and your loved ones a happy and restorative holiday season.

Warmly,

Grant Colfax, MD
Chief Executive Officer
Contra Costa Health

Dear Contra Costa Health team,

Today we presented to the Board of Supervisors about major state and federal policy changes affecting Medi-Cal and public hospital funding, and how Contra Costa Health is preparing. I’m sharing the presentation slides so that you have the same information we shared with the Board.

At a very high level, the presentation covered:

• Significant numbers of residents are expected to lose Medi-Cal coverage as new federal and state rules take effect
• CCH is projecting a structural deficit exceeding $100 million by fiscal year 2028-29, driven by reduced Medi-Cal enrollment and cuts to safety-net spending
• These impacts compound year over year and are affecting public health systems across California and the nation
• The Board has asked staff to return with a proposal to update and strengthen the county’s healthcare supports for residents who have no coverage
• CCH is preparing now through planning, coordination with county partners, and performance improvement work

Four things matter most for staff to understand, especially looking ahead.

1. This is a structural challenge that requires disciplined stewardship.
   Federal and state policy changes will reduce Medi-Cal enrollment and significantly reduce funding for safety-net health systems like ours. These are external decisions, not the result of performance, effort, or commitment by CCH staff. At the same time, how we manage our resources matters. We have a responsibility to prioritize, to make every dollar count, and to be disciplined about where we invest limited resources. That means continuing to look for efficiencies, reduce avoidable costs, and coordinating closely with county partners.
   
   What to expect next: We will continue prioritization and planning work across CCH, informed by countywide collaboration and data. As state guidance becomes clearer, we will refine assumptions, adjust plans and share updates with staff as decisions move forward.
2. The impact is not confined to one department or system.
   These changes affect the entire safety net, including Contra Costa Health, the Employment & Human Services Department (EHSD), and other county departments that serve overlapping populations. Internally, reduced Medi-Cal enrollment and funding create pressure across health care, behavioral health, public health, social services, and the administrative infrastructure that supports them. Every public hospital and county in California is confronting the same challenge.
   
   What to expect next: Preparation and response will require coordination across departments, shared data, and a shared, consistent understanding of the facts across CCH and the broader county. There is no single department or single solution that can absorb changes of this scale on its own.
   
   
3. We are preparing, not panicking.
   We are taking a disciplined, proactive approach to managing constrained resources. That includes internal performance improvement work across multiple areas – workforce, pharmacy, revenue cycle, service optimization, supply chain, facilities, and technology – with a goal of reducing cost and improving efficiency while protecting access to care. At the same time, we will continue strengthening the infrastructure needed to operate a strong public health system, through key leadership roles, system improvements, and continued investment in facilities like the Regional Medical Center campus, so we are better positioned to meet the challenges ahead.
   
   What to expect next: This work will continue through 2026 and inform internal planning and decision-making across CCH. The purpose is to ensure that choices we do make are deliberate, informed and aligned with our mission.
4. Our commitment to equity remains central.
   As coverage changes and pressures increase, working closely with community partners and engaging the communities we serve will be more important than ever. CCH exists to ensure that essential services remain available to people who are most vulnerable, and that commitment does not change during difficult fiscal periods.
   
   What to expect next: We will work closely with community partners and county departments to understand impacts, identify gaps, and inform program design. Equity will continue to guide these discussions so that decisions reflect the needs of the communities we serve.

In the coming months, the state and federal governments will issue guidance and make implementation decisions. As that happens, we will refine our projections and return to the Board with updates. This will be an evolving picture, not a single announcement.

I know this is difficult information to absorb, and that uncertainty can be unsettling. I commit to continuing to communicate frequently, returning to the Board as plans evolve, and keeping staff informed as decisions are made.

Thank you for the work you do every day to care for our community, especially during these challenging times.

Sincerely,

Grant Colfax, MD
Chief Executive Officer
Contra Costa Health

Contra Costa Health (CCH) has been honored with the 2025 Quality Leaders Award (QLA) by the California Association of Public Hospitals and Health Systems (CAPH) and the California Health Care Safey Net Institute (SNI).

CCH received the Top Honors award for our countywide initiative to improve behavioral health transitions from emergency departments to ongoing care.

Across Contra Costa, many residents experiencing mental health or substance use crises rely on emergency departments as their first and only connection to services. Often, those visits did not lead to follow-up treatment.

Staff across Behavioral Health, CCRMC, EMS, the Health Plan, Public Health, and hospital partners at Kaiser, Sutter and John Muir came together to change that.

The team built on existing strengths, including the County Access Line and CCRMC’s Substance Use Navigators, to create warm handoffs to services and support before the patients ever left the ED.

More than 70 ED physicians, nurses, case managers and social workers received training that helped hospitals better understand county services and how to connect patients to care. Partners also collaborated to refine workflows, strengthen communication and address challenges unique to each hospital system.

The impact has been significant:

• Mental health follow-up increased from 46% to 62%.
• Substance use follow-up increased from 27% to 46%.
• 87 people started buprenorphine after an overdose, with nearly one-third staying in care after 30 days.
• More than 300 people were directly connected to outpatient services.

What began at CCRMC is now a shared model spreading across hospital systems throughout the county.

The QLA recognition reflects the dedication of every staff member and partner working to build a stronger, more connected system of behavioral health care for our community.

The award was presented to CCH during CAPH and SNI’s annual conference on Dec. 4.

The Layette Program at Contra Costa Regional Medical Center (CCRMC) is a shining example of community care in action. Through this initiative, new families receive a thoughtfully assembled package of essential items designed to welcome their newborns with warmth, comfort and support.

Each layette includes handcrafted blankets or quilts, knitted baby caps, a blanket sleeper or onesie, socks, a thermometer, a small baby toy and a newborn book with early bonding and literacy tips. These items are carefully selected to provide comfort and encouragement to families as they begin their parenting journey.

Every week, a dedicated team of volunteers gathers to assemble and deliver more than 200 layettes each month to CCRMC’s Perinatal Unit. These gifts are made possible through the generous support of local community groups, crafting guilds and individuals who donate handmade or purchased items.

“The Layette Program is community in action,” said Casey Castaldi, volunteer program coordinator at Contra Costa Regional Medical Center. “It’s individuals, nonprofits, church groups, volunteers, medical staff and more all coming together to create something one of a kind for the newest and smallest members of our community.”

That spirit of collaboration is reflected in the many organizations and individuals who contribute to the program each year. Their donations ensure every newborn at CCRMC receives a warm and loving start.

2025 Layette Program Donors

• St. Matthews Lutheran Church
• Diablo Threads & Treads – Porsche Club
• Byron Delta Lions Club
• Inner Wheel of Walnut Creek
• Delta Quilters Guild
• Martinez Women’s Club
• Scrappy Quilters
• Pinole Valley Community Church
• Christ the Lord Episcopal Church
• Order of the Eastern Star No. 384
• First Congregational Church Women’s Fellowship
• Project Linus of East Contra Costa County
• National Council of Jewish Women
• Countless other individuals and organizations who have generously donated in-kind and monetary gifts
• REadingADvantage, Inc

To donate, volunteer, arrange a group visit or deliver completed items, contact the CCRMC Volunteer Office at (925) 370-5440 or email volunteer@cchealth.org.

Dear Colleagues:

As Contra Costa Health enters a period of rapid change, I am sharing what we know and how we are preparing for the months ahead. New state and federal policies will alter eligibility, reimbursement, and the landscape in which we deliver care.

CCH faces significant financial pressure. We project these changes will reduce our revenue by more than $330 million over four years, including major cuts in supplemental payments and fee-for-service reimbursement. At the same time operating expenses, labor costs, and required capital projects continue to rise.

These forces will affect how we operate. As Med-Cal eligibility changes take effect, Contra Costa Health Plan may lose as many as 100,000 members, meaning more residents will be uninsured.

This increases demand for our services at a time when reimbursement will be falling, which is why strengthening operations and spending wisely is essential.

To manage these pressures responsibly, we are taking steps across the department to operate more efficiently and reduce costs without reducing essential services. This includes improving staffing models, strengthening billing and revenue processes, reducing external spending, and finding better ways to use our space, technology and supplies. These efforts are already underway, and many of you are contributing to them.

Our goal is to stabilize our finances while protecting the services our community relies on and the workforce that delivers them. The work we are doing now will help us manage and mitigate these state and federal changes.

Later this month, we will present this financial outlook in detail to the Board of Supervisors. Sharing this information publicly is an important part of my commitment to transparency and responsible planning.

We will continue to communicate as openly as possible as the policy landscape evolves. Through all this, our mission remains the same. Contra Costa Health has weathered major transitions before by staying grounded in service, compassion, and the needs of our community. I am confident we will do the same in the year ahead.

Thank you for everything you do each day. Your work matters deeply, and it is the foundation of our ability to navigate this moment together.

With deep respect,

Grant Colfax, MD
Chief Executive Officer
Health Director, Contra Costa County

The Holiday Food Fight is a friendly competition between Contra Costa and Solano County employees to raise funds for the Food Bank of Contra Costa and Solano. This effort, spearheaded by individual county departments, has raised nearly $2.7 million since 2004. The county that raises the most funds per employee will win the Big Apple trophy. The trophy and bragging rights pass back and forth annually, but the real winners are the recipients of the funds you raise: those who go hungry in our communities.

Donate today and help your county win the Big Apple!

Counties Care - Food Bank of Contra Costa and Solano

Dear Colleagues:

We have had an eventful few weeks across the department. I want to share several important updates and offer my thanks for the extraordinary work happening throughout Contra Costa Health.

Leadership Update

I am very pleased to announce that Dr. Ori Tzvieli has accepted the permanent role of Director for our Community Health & Safety Branch, which includes the Public Health, Environmental Health, Emergency Medical Services, Hazardous Materials and the Health, Housing & Homeless Services divisions.

Many of you know Ori from his steady leadership as our Health Officer (a role he will continue) his 25+ years serving Contra Costa County in our system, and his capable tenure as interim department CEO earlier this year.

He brings deep knowledge of our work and deep commitment to caring for our patients and clients, and I am grateful he is stepping into this role at such a critical moment for our organization.

I also want to thank Dr. Sefanit Mekuria for serving as interim branch director for most of the year. Sofe’ stepped in during a period of transition and provided steady, thoughtful leadership. She now returns to her position as Public Health Director. We are fortunate to have both guiding this important work.

SNAP Response

Many Contra Costa Health teams ably supported the county’s emergency response to the federal government shutdown, which halted Supplemental Nutrition Assistance Program (SNAP) disbursements earlier this month. Even a brief interruption puts thousands of families at risk, and our teams responded quickly to help.

Staff at our health centers in West County, Brentwood, Martinez and North Richmond all pitched in with the Equity team to receive and distribute food in our lobbies – 2,915 boxes in all over two weeks. A box feeds a family of four for two weeks.

This was part of a coordinated effort with the Employment & Human Services Department (EHSD) and Food Bank of Contra Costa and Solano to ensure access in neighborhoods with great need in our community.

Fortunately, all our recipients did receive their benefits for November. But I was encouraged by the decisive actions of EHSD and the Board of Supervisors when that outcome was in doubt. The Board identified $21 million in emergency funding to cover direct payments for more than 100,000 recipients if needed, and EHSD pushed through enormous logistical challenges to ensure the county was ready to deliver.

Their work, combined with yours, showed what coordinated public service can look like. We will need the same level of teamwork as we prepare for a rapidly changing federal funding environment in the months ahead. Thanks to all who participated.

Town Hall

Thank you also to more than 250 staff members who joined our first virtual staff town hall last week. I appreciated the thoughtful questions and the candor of the discussion. We covered many topics, including the federal budget outlook, county remote work policy, capital projects at Regional Medical Center, and opportunities for staff development and advancement. Your engagement and insights make these conversations meaningful.

Two more staff town halls are also scheduled:

• Tuesday, December 2, 8-9 a.m.

• Wednesday, December 10, 12-1 p.m.

I hope to see many of you there. You can also submit questions in advance at together.cchealth.org.

Thank you for everything you do for our patients, clients and the community.

Sincerely,

Grant Colfax, MD
Chief Executive Officer
Health Director, Contra Costa County