Board of Supervisors Advance Next Phase of Measure ER Implementation

On Tuesday, July 21 the Los Angeles County Board of Supervisors approved a motion co-authored by Supervisor Holly J. Mitchell and Board Chair Hilda L. Solis authorizing the Los Angeles County Department of Health Services (DHS) to begin executing contracts with community-based nonprofit health clinics necessary for implementing Measure ER — the voter-approved Essential Services Restoration Act.

According to the County, the Board action will help ensure the program launches on schedule in January 2027, expanding access to no-cost and reduced-cost health care for low-income and uninsured residents.

Measure ER is a temporary half-cent increase in Los Angeles County’s general sales tax, raising the rate from 9.75% to about 10.25% for five years, through October 1, 2031, to shore up funding for health and other essential county services in response to federal and state cuts.

County officials have estimated it will generate roughly $1 billion annually; groceries, prescription medications and medical equipment are exempt. The measure narrowly passed in the June 2, 2026 election with just over 50% of the vote, a result later certified by the county Registrar-Recorder/County Clerk.

The action carries direct consequences for Pasadena. The Pasadena Public Health Department could ultimately receive as much as $1 million a year in funding from the tax, according to a city estimate.

Pasadena is one of only a small number of California cities that operate their own public health jurisdiction rather than relying on the county, and Measure ER’s spending plan directs a roughly 1 percent share to Pasadena and Long Beach for that reason. The city’s most recent recommended budget did not assume any Measure ER revenue.

“Measure ER, approved by Los Angeles County voters, dedicates 45 percent of its revenue to community-based nonprofit clinics that provide essential health services to residents who would otherwise face significant barriers to accessing the care they need. Today’s action ensures we can move from voter approval to implementation without unnecessary delays,” said Supervisor Mitchell.

“By investing in trusted community clinics and building this program with transparency, accountability, and equity at its core, we are strengthening our health care safety net for the residents who need it most.”

“Los Angeles County voters made a clear choice to strengthen our health care safety net, and now it’s our responsibility to turn that commitment into real access to care,” said Los Angeles County Board Chair and First District Supervisor Hilda L. Solis. “This action helps ensure we can move quickly and thoughtfully to build the partnerships, systems, and accountability needed to deliver on the promise of Measure ER. As implementation moves forward, transparency and community collaboration must remain at the center of every decision so that families who have long faced barriers to health care access see meaningful results.”

According to the County, the motion establishes multiple safeguards for transparency and responsible stewardship of Measure ER funds: advance notification to the Board before contracts are executed; public presentations at the County’s Health and Mental Health Cluster meetings for major agreements; ongoing stakeholder engagement throughout program design and implementation; and regular public reporting on contracts, expenditures and performance through the County’s Safety Net Dashboard.

The motion also directs DHS to prioritize administrative efficiency by minimizing new infrastructure costs, maximizing funding for direct patient care, coordinating with existing Medi-Cal systems where appropriate, and ensuring continuity of care for participants.