Want to Help Someone Quit Smoking?

When someone takes the big step of deciding to quit smoking, family, friends, and co-workers can make a huge difference by giving their help and support.

If your friend isn’t quite ready to quit, try to see it from their side. For most smokers, cigarettes have been a steady companion for a long time. Some reluctance is normal, and it doesn’t mean your friend won’t be able to quit for good. First, let your friend know you understand their doubts, then suggest they list their reasons for quitting. Be sure to tell your friend about Freedom From Smoking, 1-800-LUNGUSA and their state’s free quitline for support in quitting and staying quit.

How Do You Begin?

Get tips on what you can do from the start to help your friend quit and stay quit.

Be There for the Long Run

Quitting smoking is a journey and a process, not a single event. See how you can help your friend every step of the way, from making a quit plan to avoiding relapse.

Meeting Challenges Along the Way

Withdrawal, weight gain and urges are some challenges that might come up as someone quits smoking. Learn how you can be there to help.

For information, support and assistance, dial 2-1-1.

California Now Cleared to Offer Pfizer-BioNTech Booster Shots

With the Western States Scientific Safety Review Workgroup review and approval of the CDC’s recommendations regarding COVID-19 vaccine boosters, California is now cleared to follow the federal recommendations that certain individuals can receive a booster dose of the Pfizer-BioNTech vaccine. The booster dose is intended to provide enhanced protection to people who may be at greater risk of serious illness due to COVID-19.

At this time, booster doses are only available to those who have been fully vaccinated with the Pfizer vaccine. Boosters should be administered at least six months after an individual has received their last dose of the Pfizer vaccine.

 According to the CDPH, the following individuals SHOULD receive a booster dose:

People who MAY CONSIDER receiving a booster dose based on their individual benefits and risks include:

  • People age 18 through 49 years with underlying medical conditions; and
  • People age 18 through 64 who are at increased risk of exposure to COVID-19 due to their occupation or institutional setting.

The Pfizer booster cannot be administered to those who have been vaccinated with the Moderna or Johnson & Johnson vaccines. Officials are still awaiting information on boosters for these vaccines.

Pfizer booster shots are currently available at local and regional pharmacies and through health care providers. Some primary care physicians and health clinics may contact their eligible patients to schedule booster doses. There are currently no plans for a large-scale booster vaccination clinic locally.

For more information on how to schedule a Pfizer booster, go to MyNevadaCounty.com/GetVaccinated or MyTurn.ca.gov. Those who have questions about eligibility or would like assistance scheduling an appointment can call 211 Connecting Point at 1-833-DIAL211.

As pharmacies and health care providers administer Pfizer booster doses, the Nevada County Public Health department will continue to focus its effort on outreach to unvaccinated individuals who encounter barriers to vaccine access.

“Our primary responsibility is reaching residents who haven’t had their first dose yet. As we saw in this recent surge, unvaccinated individuals are far more likely to be hospitalized or die of COVID-19,” said Nevada County Public Health Director Jill Blake. “Our REACH Team is working closely with local organizations and businesses to ensure that everyone who wants to be vaccinated can get their shot.”

While over 114,000 COVID-19 vaccine doses have been administered to Nevada County residents, 35% of eligible residents remain unvaccinated. “The solution to ending this pandemic is through immunizations,” said Public Health Officer Dr. Scott Kellermann. “If you haven’t had your first dose yet, it’s not too late. We’re ready when you are.”

All California residents age 12 and over are eligible for free COVID-19 vaccine. For more information on where to get your vaccination, including a Pfizer booster shot, go to MyNevadaCounty.com/GetVaccinated or MyTurn.ca.gov.

COVID-19 Cases Surge in Nevada County as Delta Variant Takes Hold

With 443 cases last week, Nevada County is experiencing the largest surge of COVID-19 cases and hospitalizations since the beginning of the pandemic. Cases have increased by 1200% since the week of July 1st.

Similar dramatic increases are being seen across the state. The California Department of Public Health (CDPH) recently reported that California’s statewide case rate more than quadrupled from a low in May. The huge increase in infections is already taxing the healthcare system, with local and regional hospitals heavily impacted.

“There has been a substantial increase in COVID-19 patients coming to the hospital, which have resulted in more admissions,” said Sierra Nevada Memorial Hospital President Dr. Brian Evans. “Our winter peak was 15 hospitalized patients, and we have now seen numbers as high as 29 in the last few days. The number of admissions fluctuates on a daily, and even hourly basis. The substantial majority of admissions for COVID are unvaccinated individuals. Nationally, unvaccinated patients make up well over 90 percent of admissions. At Sierra Nevada, we are having a similar experience. If you haven’t received your COVID vaccination, I strongly encourage you to do so.”  

According to the State’s COVID-19 hospitalization data, there are currently 25 COVID patients admitted to local hospitals. Evans said that over 90% of those admitted to Sierra Nevada Memorial Hospital are unvaccinated.

As cases continue to surge throughout State, local officials are urging Nevada County residents to take precautions. “We would be beyond the Purple Tier if we were not Beyond the Blueprint,” said Health and Human Services Director Ryan Gruver, referring to the Blueprint for a Safer Economy, which state officials abandoned in mid-June.

 “The dismantling of the tier system happened to correspond with the introduction of the highly contagious Delta variant,” said Nevada County Public Health Director Jill Blake. “Unfortunately, this may have given people a false sense of security in terms of disease transmission risk.”

Surge in COVID Cases is Linked to Delta Variant

According to state Health and Human Services Secretary Dr. Mark Ghaly, the Delta variant (B.1.617.2) is up to 60% more infectious than the Alpha strain, and many more times more infectious than the original COVID-19 strain.

Public Health officials first confirmed the appearance in Nevada County of this highly transmissible variant from samples taken in early June. Over 80% of current COVID-19 cases statewide are confirmed to be from the Delta variant.

 “This variant is so contagious that people who are fully vaccinated can still get the virus,” Trochet said.  “And those who are unvaccinated are at much greater risk.” According to the CDPH, COVID-19 case rates are 600% higher in unvaccinated people than those who are vaccinated.

Breakthrough Cases in Nevada County

Breakthrough cases currently constitute approximately 20% of new weekly COVID-19 cases. Public Health officials consider any infection in a fully vaccinated person to be a ‘breakthrough’ case.

Breakthrough cases in fully vaccinated individuals are not uncommon, given that the vaccines are not 100% effective. Age and underlying health conditions can contribute to a lesser immune protective response to the vaccine. With 28% of Nevada County residents over the age of 65, our community is uniquely vulnerable to breakthrough cases.

While such cases are expected, officials are concerned by recent evidence that those who are vaccinated may be able to spread the virus, even if they have no symptoms.

Vaccines Continue to Be the Best Way to Prevent Serious Illness and Death

All three available vaccines continue to provide a high level of protection against the Delta variant. In fact, the vast majority of new cases are among the unvaccinated. Out of 100,000 Californians, 33 unvaccinated individuals will contract COVID-19 each day, compared to 7 vaccinated individuals, according to the CDPH.

While vaccines have been effective against the Delta variant, the virus continues to mutate as more people get sick. “If we allow people to continue to get infected, we will get a variant that escapes the effectiveness of vaccines,” Dr. Trochet said. “If everybody had gotten the vaccine when it was first available, we would not be here now. But it’s not too late to prevent this from getting worse.”

As families prepare to send kids back to school in the coming weeks, this is particularly important to protect children under 12 who are not currently able to receive a vaccine.

To schedule a vaccination, online at go to MyTurn.ca.gov or call 1-833-422-4255.

Tips to Stay Safe and Limit the Spread

With the recent rise in cases, the Nevada County Public Health Department issued a recommendation on July 29th encouraging vaccinated individuals to wear a mask in indoor public spaces. Both the CDC and the CDPH released similar recommendations the same week.

In California, unvaccinated individuals are required to wear a mask in indoor public places like stores, restaurants, and theaters. Everyone is required to wear a mask in certain public settings, including on public transit and in schools. To learn more about the State of California’s mask requirements, go to https://covid19.ca.gov/masks-and-ppe.

Local health officials are also encouraging residents to rethink attending large gatherings where people may be unvaccinated and unmasked. “I would think long and hard about attending large gatherings,” said Deputy Public Health Officer Dr. Glennah Trochet. “There are certain groups who are at higher risk, vaccinated or not. It would be better to not to go than to be exposed,” Trochet added.

Those who do decide to attend crowded events should wear a mask to protect themselves and others.

More Information

To schedule a vaccination, online at go to MyTurn.ca.gov or call 1-833-422-4255. For updates and information on COVID-19, go to MyNevadaCounty.com/Coronavirus

Delta (B.1.617.2) COVID-19 Variant Identified in Nevada County

The significantly more contagious COVID-19 Delta variant has been found in Nevada County. Six cases were reported to Nevada County Public Health on June 30, 2021. The specimens were collected between June 3rd and June 15, indicating that the Delta variant has been circulating in the county for at least 4 weeks. Patients with this variant were located on both the eastern and western sides of our county.  

The Centers for Disease Control and Prevention (CDC) has noted that the Delta variant is now responsible for about one in every four new infections across the country. However, as the Delta variant is spread much more easily from person to person than the original virus, it is anticipated to become the most common variant in the U.S.

Experts are warning that the Delta variant is our greatest threat to the elimination of Covid-19. It is estimated to be the cause of 90% of Covid-19 cases in Britain and India. “The Delta variant is much more transmissible than the original coronavirus. Our best defense is to become immunized,” said Nevada County Public Health Officer Dr. Scott Kellermann. “If you have previously been infected with SARS-CoV-2, although you do develop antibodies, you are not necessarily protected against this Delta variant”. 

Public Health urges all residents to become immunized as all the COVID-19 vaccines available in the United States continue to provide strong protection against all currently identified variants of the SARS-CoV-2, including the Delta variant. Dr. Kellermann added, “You are only partially protected against the Delta variant after one shot of Moderna or Pfizer vaccine; protection is much higher if you are fully vaccinated. Please complete the two-dose series as soon as possible, even if it is outside the recommended timeframe.”  Full protection against the virus occurs two weeks after the second dose of the Pfizer or Moderna vaccine or the single dose of the Johnson and Johnson vaccine.

Those traveling this holiday weekend are urged to continue following all safety measures, including testing and quarantine guidelines. Do not travel if you are sick, have a recent positive COVID-19 test result, are in quarantine, or are waiting for the results of a COVID-19 test after being exposed to the virus.

 Now, more than ever, people should continue to follow public health guidance to prevent the spread of COVID-19 and all variants. This includes:

  • Wearing a face covering in indoor public settings, public transportation, and businesses if unvaccinated. Vaccinated persons may choose to wear a face-covering to offer additional protection, especially if they will be in crowded, poorly ventilated indoor spaces.
  • Practicing good hand hygiene.
  • Getting tested for COVID-19 if you have been exposed, even if you are asymptomatic.
  • Staying home if you feel sick.
  • If unimmunized, please schedule a vaccine appointment through MyTurn.ca.gov. Most vaccine centers gladly welcome walk-in visits.

Vaccinations remain widely available throughout Nevada County. To view a full list of vaccine sites in Nevada County, visit: www.MyNevadaCounty.com/GetVaccinated.

For more information about variants in California, please visit www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/COVID-Variants.aspx

Pfizer COVID-19 Vaccine Approved for all Californians Ages 12+

As of May 13th, all Californians age 12 and over are eligible for the Pfizer vaccine.

All Pfizer clinics in MyTurn will show available appointments for patients as young as 12 years old. Any minor arriving for a vaccine appointment must be accompanied by a parent or guardian to attest to their age. Pfizer vaccines are currently offered at the Whispering Pines clinic in Grass Valley, Dokimos Pharmacy in Nevada City, and the Tahoe Forest Hospital clinic at Sierra College in Truckee. Schedule your family’s appointment online at MyTurn.ca.gov or call or 1-833-422-4255.

Make An Appointment

B.1.1.7 Variant of COVID-19 Confirmed in Eastern & Western Nevada County

Nevada County Public Health received notice that two specimens for SARS-CoV-2 taken in mid-March were determined to be the B.1.1.7 variant. One specimen was taken from a COVID-19 patient on the East side of Nevada County and the other was from a patient on the West side.

 “Like the discovery of the B.1.429 variant reported in Nevada County last week from a specimen in February, this is a reminder that every time an individual gets sick with COVID-19 it is an opportunity for the virus to mutate while it replicates within the body,” said Deputy Public Health Officer Dr. Glennah Trochet. “Everyone who receives a positive lab indicating they have COVID-19 should maintain isolation precautions, limiting contact with others in their household and in the community to reduce the spread of the virus.”

The B.1.1.7 variant of the SARS-CoV-2 was first detected in the United Kingdom. It is designated as a variant of concern because it is approximately 50% more transmissible than the original virus, and may cause more severe disease, based on the number of hospitalizations and deaths associated with this variant. It appears to be susceptible to current monoclonal antibodies. The currently available vaccines continue to be effective against it. For more information about B.1.1.7  and other COVID-19 variants, visit the CDC website.

The best way to prevent infection is to get vaccinated. Until enough people are vaccinated, we should all continue to wear a mask while in public, maintain social distancing, wash our hands frequently. These actions help to protect others as well as ourselves. 

Public Health: B.1.429 Variant of COVID-19 Confirmed in Nevada County

The Nevada County Public Health department announced today that it has confirmed the first identified instance of the B.1.429 Variant of COVID-19 in Nevada County. Public Health officials requested genetic sequencing of a positive test in February, after a person who already had COVID-19 was re-infected. Results from the State lab came back yesterday.

 B.1.429 is one of the West Coast variants and is listed as a Variant of Concern by the CDC. Evidence suggests that these variants are more easily transmissible, can lead to more severe disease, and may be less responsive to treatment. As of April 1, 2021, there were 6,287 known cases of the B.1.429 variant in California.

“This adds urgency to the need to vaccinate as many people as we can, before a variant emerges that is not susceptible to our current vaccines,” said Nevada County Deputy Public Health Officer Glennah Trochet. “And for those who are not yet vaccinated, it is crucial to continue to wear masks, social distance, and avoid gatherings. Every time someone gets infected with this virus, they provide an opportunity for the virus to mutate as it replicates millions of times within their body.”

Last week, the Public Health department expanded vaccine eligibility at their Whispering Pines clinic in Grass Valley to anyone age 16 or over. Appointments are released on MyTurn.ca.gov every Friday at noon.

Though this is the first confirmed case of a variant in Nevada County, health officials caution that it is very likely that variants are already widespread in the county. “Because it is currently so difficult to get whole genomic sequencing, we do not know how widespread this particular variant is and if there are others circulating in Nevada County, but it is safe to assume that there are,” Trochet said.

“This is just another reminder that this pandemic is not over,” said Public Health Officer Dr. Scott Kellermann. “We’re seeing our case rates rise and are concerned about the increasing numbers of infections in younger adults. We must do everything we can to limit the spread. I’m asking every individual to do their part—wear a mask, avoid gatherings, and get vaccinated.”

For more information about B.1.429  and other COVID-19 variants, visit the CDC website.

The Nevada County Public Health department releases vaccine appointments on MyTurn.ca.gov every Friday at noon. Learn about additional vaccine appointment options at MyNevadaCounty.com/Get Vaccinated.

Nevada County Risks Moving Back into the Purple Tier Next Week

After only two weeks in the Red Tier, Nevada County once again met the metrics for the Purple Tier, meaning COVID-19 is widespread and case rates are increasing.  Nevada County will remain in the Red Tier this week but will likely return to the Purple Tier on Wednesday, April 13th.

“Communities that have strictly adhered to guidelines are opening up, while Nevada County is at risk of moving backward,” said Nevada County Public Health Director Jill Blake. We know how COVID-19 spreads, and we know how to prevent the spread. The science is clear,” Blake said. “When we say that the virus is ‘widespread’ in our community, we mean just that: it’s everywhere. We’re seeing it in schools, workplaces, social settings, and businesses. The virus continues to be transmitted through unmasked gatherings, whether that’s in a restaurant, a bar, a workplace, or a private home.”

With certain restaurants and bars fully open–in defiance of health orders–large gatherings of people from multiple households and mask-burning demonstrations during a global pandemic, cases will increase. County officials attribute the case rise to local, organized opposition to proven public health prevention methods, particularly in Western Nevada County.

Local Public Health officials expressed disappointment and concern about the upward trend in cases. This week, with the State’s update to county metrics under the Blueprint for a Safer Economy, Nevada County jumped from an average daily rate of 6.9 cases to 12.7 cases. “This is an alarming trend,” said Nevada County Public Health Officer Dr. Scott Kellermann. “And this data is from the week before Spring Break and the Easter holiday. We have yet to see the result of gatherings that may have taken place last week.”

Kellermann urged Nevada County residents to take individual actions to protect the health of the community as a whole. “The good news is that we all know how to protect ourselves and those we love. Wear a mask. Avoid gathering. And, of course, getting vaccinated is the best protection for yourself, your family, your friends, and your neighbors,” added Dr. Kellermann.

“We are seeing fewer cases in people 65 and older,” said Dr. Kellermann. “Although this is good news, we are finding that younger individuals are becoming infected. Although much less likely to die than older folks, a significant number of those infected will have symptoms of long COVID-19, like persistent lethargy, brain fog, and pulmonary conditions.”   

Nevada County Public Health has opened vaccine eligibility to anyone 16 and over for their Whispering Pines Grass Valley clinics, which use the Pfizer vaccine. Appointments can be made on MyTurn.CA.Gov; new appointments are added every Friday at noon. Vaccine appointments through other local vaccine providers can be found at www.MyNevadaCounty.com/GetVaccinated.

“We are in a race against time regarding the variants. If we adhere to the guidelines of masking and distancing and get immunized – we will win.” Kellermann said. “You all are aware that through working together, much has been accomplished by this community. We need to do that now. We all have a part to play. We can do better.”

Eligibility Expands to 16 and Older at Nevada County Public Health Clinics

From Nevada County Public Health:
We want to make sure that our rate of community vaccinations stays as fast as possible and that people who are ready to get vaccinated can get an appointment. Public Health has seen the availability in our appointment scheduling system increase in the last few weeks, so we have opened up eligibility for Nevada County Public Health clinics to everyone 16 and older. 

  • Everyone 50+ is eligible at all vaccine providers, including Public Health clinics.
  • Everyone 16+ is eligible at Nevada County Public Health clinics.

How to get an appointment when you are eligible

  • Appointments for 50+ and eligible employment sectors:
    • As of today, everyone 50 and older is eligible statewide, plus people who work in health care, education and childcare, food and agriculture, and emergency services. For a detailed list of eligibility, check our Vaccine Schedule page.
    • See our Vaccine Provider page for info on available appointments at individual providers. 
    • Use MyTurn.ca.gov or 1-833-422-4255 for Public Health clinics. We release appointments Fridays at noon.
  • Appointments for people 16 and older:
    • Public Health appointments are available via MyTurn.ca.gov or 1-833-422-4255 for our clinics in Grass Valley.
    • We post new appointments every Friday around noon for the following week.
    • Vaccine is free and you don’t need insurance to get your dose. However, if you have insurance, have your insurance info ready when you book your appointment via MyTurn.ca.gov.
    • Pfizer is the only vaccine that 16 and 17 year old’s can receive. Everyone 18 or older can receive all vaccine types. If you are 16 or 17, make sure you are signing up for a Pfizer vaccine clinic only. Public Health’s Whispering Pines clinics are Pfizer. 16 and 17 year old’s must be accompanied by a parent or guardian at their appointment.
    • People 16 and older will be eligible statewide starting April 15 statewide.

More than 46,000 doses of COVID-19 vaccine have been given in Nevada County

  • CDC guidance on what you can and can’t do once you are fully vaccinated (fully vaccinated means two weeks after your final dose).
  • You are not jumping the line if you are eligible! Every vaccine administered is a win for the whole community. 
  • Please make every effort to keep your second appointment for Pfizer and Moderna vaccines. Every dose is precious.
  • If applicable, you need to receive your second dose where you received your first dose. Public Health cannot schedule second dose-only appointments.

Please stay informed as this is an evolving situation

  • We are in Red Tier. Please wear a mask, don’t gather, stay socially distance and stay home when you can so we can move to a less restrictive business tier as soon as possible. If you are fully vaccinated, continue to wear your mask in public, don’t attend large gatherings, and social distance when in public.
  • Text VACCINEINFO to 898211 to receive text updates from Public Health straight to your smartphone. Subscribe for those same alerts via email by filling out this online form.
  • Call 211 (1-833-DIAL211) with questions about your tier or other general questions about COVID-19.
  • YubaNet will be hosting weekly, short webinars every Thursday at noon to provide updates on COVID-19 and vaccine distribution in Nevada County. Register here – only one registration for all webinars is required.

Nevada County Will Move into the Red Tier, Wednesday, March 24th

Today, Nevada County met the State’s metrics for the Red Tier for two consecutive weeks and will move into the Red Tier on Wednesday, March 24th. With this Tuesday’s update, Nevada County has a daily case rate of eight, qualifying Nevada County for the Red Tier under the reassessment of the State’s Blueprint for a Safer Economy thresholds. 

In the Red Tier, business sectors such as restaurants, gyms, and movie theaters will have reduced capacity indoors:

  • Restaurants: 25% capacity or 100 people indoors, whichever is fewer
  • Gyms: 10% capacity indoors
  • Movie Theaters: 25% capacity or 100 people indoors, whichever is fewer
  • Retail: 50% capacity indoors

View the guidance for all business sectors at covid19.ca.gov/safer-economy.

Business Task Force Webinar on New Grants and Tier Changes

On Thursday, March 25th, Nevada County is hosting a special, 30-minute Business Task Force meeting from 4:30-5:00 p.m. to review new grants and the changes for sectors between the Purple and Red Tier. Register in advance for this webinar: https://zoom.us/webinar/register/WN_774CYkJVSTilos4hqwLLQQ. After registering, you will receive a confirmation email containing information about joining the webinar.

Sierra Business Council will provide an update on the following grants and business resources:

  • The Restaurant Revitalization Fund provides grants of up to $5M per restaurant, food stand, food truck, food cart, caterer, saloon, inn, tavern, bar, lounge, brewpub, tasting room, taproom. Learn more at: restaurantsact.com.
  • The California Relief Grant provides micro-grants ranging from $5,000 to $25,000 to eligible small businesses and nonprofits impacted by COVID-19 and the related health and safety restrictions. Apply or apply for Rounds 4, 5, and 6. Note that Round 4 applications for nonprofit cultural institutions are due March 26, 2021. Learn more at: careliefgrant.com.
  • The Paycheck Protection Program is a loan designed to directly incentivize small businesses to keep their workers on the payroll. Borrowers may be eligible for PPP loan forgiveness. SBA is currently offering PPP loans until March 31, 2021. Learn more at: www.sba.gov/funding-programs/loans/covid-19-relief-options/paycheck-protection-program.
  • The Shuttered Venue Operators Grant provides grants to live venue operators or promoters, theatrical producers, live performing arts organization operators, relevant museum operators, zoos and aquariums who meet specific criteria, motion picture theater operators, and talent representatives. Eligible applicants may qualify for grants equal to 45% of their gross earned revenue. Learn more at: www.sba.gov/funding-programs/loans/covid-19-relief-options/shuttered-venue-operators-grant.

For updates on grants and business resources, subscribe to the Coronavirus Business Task Force list at www.mynevadacounty.com/BusinessResourcesSubscription.

Stay the Course

Over the past few weeks, many have been frustrated that Nevada County had remained in the Purple Tier, with many wondering why. Masking, distancing, avoiding gathering, and getting vaccinated when it’s your turn are the ways we can continue to lower our community’s COVID transmission. Individual action leads to collective mitigation, and everyone’s efforts to help lower COVID transmission are reflected in our tier data.

Collective Focus and Commitment Will Get Nevada County out of Purple Tier

Nevada County’s COVID case rate has kept our communities countywide in the State’s Purple Tier. We are one county and can only open when, together, we have numbers that align with the State’s blueprint.  The past year has been challenging and frustrating, but the science is very simple and settled–  each one of us must remain vigilant, avoid gatherings, wear our masks, limit indoor activities with others, practice social distancing, and take all precautions to avoid spreading the virus. Individual action leads to collective mitigation that will get us all out of the most restrictive tier.

“We are at the cusp of moving forward towards the Red Tier, but we need everyone in our community to do their part so we can get back to business,” said Vice-Chair and District 4 Supervisor Sue Hoek.

To move into the less restrictive Red Tier, our county must meet specific criteria for two consecutive weeks. Today, Nevada County met the metrics for the Red Tier for the first time since November. If our case rate stays below 10 cases per day and our positivity rate stays below 8%, we will be able to move into the Red Tier as early as March 24th.

“To keep our case rate low, we rely on each individual and business in our community to help slow the spread,” said Truckee Mayor Anna Klovstad. “This means helping all of our communities countywide to understand the importance of following the health mandate, providing support where appropriate, and building a sense of partnership.”

“We are only going to get through this by working together, all our communities, across Nevada County,” added District 5 Supervisor Hardy Bullock.

We all have the same common goals: to reduce the spread of COVID so we can begin to safely reopen our businesses and return to some level of normalcy.

“City, Town, and County staff continue to collaborate to reduce current case rates, improve awareness and speed our safe reopening,” said Nevada City Mayor Erin Minett.

“By reducing the spread of COVID, we support the safe reopening of our businesses and our community’s health,” added Grass Valley Mayor Ben Aguilar.

Just as our businesses and community members each have individual roles in minimizing local transmission, local government continues to partner to gather all resources possible to support our communities through the hardships of a pandemic. The new relief package from the federal government will provide additional and much more substantial relief for our business and non-profit community compared to previous rounds.

Nevada County Public Health continues to partner with vaccine providers throughout the community. Nevada County’s vaccination rate puts us in the top five California counties by the population percentage through these partnerships. Efforts like the Public Health REACH (Resources for Equity and Access in Community Health) Team meet people where they are, bringing vaccines to those who are hardest-to-reach and have some of the highest levels of exposure and risk.

As more vaccines continue to become available, residents are encouraged to make every effort to be vaccinated. “We have three safe, highly effective vaccines available to fight COVID-19. This is one of the best tools we have to protect not only yourself but your friends and loved ones you come into contact with. Being immunized will get our businesses back on track,” said Dr. Scott Kellermann, Nevada County’s Public Health Officer. “If you have been offered a vaccine, take it. Every vaccination gets us closer to the finish line.”

If you are over 65, a frontline worker, or have a chronic health condition, you may be eligible to be vaccinated. Register with MyTurn.CA.Gov to check your eligibility and check the County’s Vaccine Provider webpage for additional vaccine opportunities near you. As your local government representatives, our promise is to continue to bring creative and collaborative solutions to emerge from this pandemic stronger than before. As we have many times throughout the past year, we are facing a pivotal moment when we must stand together. It depends on each of us to do our part to end this pandemic. Together we are Nevada County Strong.

State Announces Changes to Business Tier System

Today, the State announced changes to their Blueprint for a Safer Economy after reaching 2 million California residents vaccinated in some of the hardest-hit communities triggering an update to the Blueprint for a Safer Economy tier system. Nevada County remains in the Purple Tier with the update and reassessment of the new statewide Blueprint for a Safer Economy thresholds. Our pathway to the Red Tier is to continue social distancing, masking, and refraining from social gatherings.

Update to the Daily Case Rate Threshold Beginning March 14th

The State has updated the thresholds in their Blueprint for a Safer Economy due to increased vaccinations in the hardest-hit communities. When our case rate drops below 10 per day per 100,000 people and our positivity rate stays below 8% for two consecutive weeks we will advance to the Red Tier.

Update to Breweries, Wineries, and Distilleries Beginning March 13th

The State has updated its guidance for breweries, wineries and distilleries to open outdoors without food service beginning March 13th. Breweries, wineries, and distilleries that provide food service should continue to follow the restaurant guidance.

  • Purple Tier: Open outdoors with modifications including reservations, 90-minute time limit, and ending onsite consumption by 8 pm. Food service is no longer required. 
  • Red Tier: Open outdoors with modifications including reservations, 90-minute time limit, and ending onsite consumption by 8 pm. Food service is no longer required.
  • Orange Tier: 25% capacity indoors or 100 people, whichever is fewer, with modifications.
  • Yellow Tier: 50% capacity indoors or 200 people, whichever is fewer, with modifications.

Update to Outdoor Events Beginning April 1st 

The State has updated its guidance for outdoor events (including sports events and live performances) with attendees beginning April 1st.

  • Purple Tier: 100 people or few. Limited to regional viewers within 120 miles, advanced registration required, and no concessions or concourse sales.
  • Red Tier: 20% capacity. Limited to in-state attendees, advanced registration, and in-seat concessions.
  • Orange Tier: 33% capacity. Limited to in-state attendees, advanced registration, and in-seat concessions.
  • Yellow Tier: 67% capacity. Limited to in-state attendees, advanced registration, and in-seat concessions.

Connecting Point and Community Partners Celebrate National 211 Day

Today, February 11th is 211 Day and, for the first time, it is being celebrated nationwide. 211 Day spreads awareness of how the service supports the community with information and resources.

211 is Nevada County’s free, multilingual and confidential information and referral system. 211 connects residents to community and health resources and various services, including senior care, transportation, housing assistance, suicide prevention and disaster services. 211 is available 24/7, 365 days a year (including holidays) and serves the people of Nevada County, Placer County, and the Tahoe-Truckee region.

Our local 211 call center has been serving the community since September 2013. Ann Guerra, executive director of Connecting Point, which operates the call center, credits the success of 211 to the collaboration with the local nonprofits and County offices. “We are so grateful for community partnerships that have allowed the 211 service to flourish.”  These partnerships include Nevada County Social Services and Office of Emergency Services, First Five Commission and Agency on Aging Area 4.

But most recently, as COVID-19 vaccine information is in high demand in the community, a strong partnership between 211 Connecting Point and Nevada County Public Health has helped meet the need. Together they have launched the Nevada County COVID-19 Vaccine Alert Text Line, in which users can text VACCINEINFO to 898211 to subscribe and be kept up-to-date with all the latest and most accurate information regarding the COVID-19 vaccines.

Nevada County residents can access 211 by:

  • Calling 2-1-1 (or 1-833-DIAL211; for TTY 1-844-521-6697).
  • Texting their zip code to 898211 (your text plan’s rates will apply)
  • Visiting 211ConnectingPoint.org to access the online searchable database and email or chat with specialists.

Nevada County and Tahoe Forest Hospital Vaccinate TTUSD Teachers

On Wednesday February 3, 2021, teachers from the Tahoe Truckee Unified School District received their first COVID-19 vaccinations, administered by Tahoe Forest Hospital staff and school nurses from Tahoe Truckee Unified School District. Nevada County is currently in Phase 1B of COVID-19 vaccinations, which includes essential frontline workers. Vaccinating educators helps children remain in or return to the classroom, where critical social interactions and the best learning takes place, while preventing outbreaks in congregate school settings and supporting parents to remain in the workplace.

“I am so thankful for the amazing collaboration between all parties – Nevada County, Tahoe Forest Hospital, Placer County and the school district,” said Kim Szczurek, Tahoe Truckee Unified School District Board President.  “The work of these entities, both by the elected officials and the Superintendent Chief Learning Officer, County Executive Officer, TFH CEO, and their staffs make me so proud.  We have done this to protect our TTUSD staff with one goal in mind – focusing on the education and social and emotional well-being of our kids.”

The Tahoe Truckee educator clinic is the biggest single-day COVID-19 vaccination clinic hosted in Nevada County so far, with approximately 700 teachers and school support staff vaccinated in one day. Tahoe Forest Hospital took the lead in making this event happen for the Tahoe Truckee community.

“Tahoe Forest Health System is very happy to assist in the vaccination efforts for our educational staff in our region,” said Harry Weis, President and CEO of Tahoe Forest Health System. “Helping the students, teachers, staff and our schools return to a greater sense of normalcy or health security is very important to us!”

“From a public health perspective, we recognize the value of vaccinating school staff,” said Jill Blake, Nevada County’s Public Health Director.  “National data tells us that families and women in particular have been negatively impacted by schools closing, with many forced to leave the workplace and stay home because there is no school for their children and they cannot afford childcare. These vaccinations help keep teachers safe, children engaged, and parents employed.”

Nevada County has received 10,625 vaccines to-date, which includes first and second doses of the vaccine. Nevada County has partnered with local hospitals, clinics, pharmacies, and local healthcare providers to vaccinate our community.

“The complexity associated with vaccination programming and the actual scarcity of the vaccine has put the County in a really tough position,” said District 5 Supervisor Hardy Bullock. “Vaccinating educators and getting our schools back toward a more normal operation is a top priority. It allows our families to return to work, our children to begin learning and connect socially, and get our economy back on track. We want every person to get vaccinated. This group of educators is a catalyst, not only for learning but now our entire economy and social connection. County Public Health staff and all the officials from the Tahoe Truckee Unified School District, Tahoe Forest Hospital, Placer and Nevada County have been working full time on this. I’m so proud of this decision and our teamwork; this is how government serves and leads.”

More Information

While COVID-19 vaccine supply is still limited, California is prioritizing vaccines for specific groups based on exposure risks, health risks, and health equity. My Turn is the State of California’s new tool where you can find out if it’s your turn to get vaccinated and schedule vaccination appointments. If it isn’t your turn yet, you can register to be notified when you become eligible. Although there are currently no appointments available in Nevada County via this system, we expect this to change over the next few weeks. 

Find more information and ways to receive updates on COVID-19 vaccines in Nevada County at www.mynevadacounty.com/coronavirus/vaccine. Vaccination is an essential tool for ending this pandemic. Even after you are vaccinated, we must all stay vigilant and continue to wear masks, keep our distance, wash our hands, and avoid gatherings so that we can return to a more normal way of life as quickly as possible.

Nevada County Exits COVID-19 Stay Home Order into Purple Tier

The State has lifted the Regional Stay Home Order for the Greater Sacramento Region, which includes Nevada County. Due to Nevada County’s current daily average of COVID-19 cases and positivity rate, Nevada County will be exiting the Stay Home Order into the Widespread Purple Tier.  

Although this is welcome news that our ICU capacity is projected to be above 15%, Nevada County remains well into the Widespread Purple Tier with significant business modifications. Nevada County Public Health continues to thank the community for wearing a mask, being mindful of social distancing and refraining from social gatherings. Together, we can stop the surge to save lives and work towards lowering our daily COVID-19 cases and positivity rate which may allow us to move into the less restrictive Red Tier.

Moving into the Widespread Purple Tier

As we move back into the Widespread Purple Tier, some businesses will be able to reopen with modifications. Most notably, these are:

  • Hair Salons/Barbershops/Personal Care: Open with modifications in the Purple Tier
  • Hotels and Lodging: Open with modifications in the Purple Tier
  • Movie Theaters: Outdoor only with modifications in Purple Tier
  • Wineries: Outdoor only with modifications in the Purple Tier
  • Restaurants: Outdoor dining with modifications allowed in Purple Tier

Find a summary of the differences between the State’s “Blueprint for a Safer Economy” tier system on California Department of Public Health’s website.

COVID Vaccines in Nevada County

Nevada County Public Health is working to vaccinate Nevada County as quickly, safely and equitably as possible. Bookmark www.mynevadacounty.com/coronavirus/vaccine for updates on where we are in our local vaccine rollout. 

More Information

For more information visit www.mynevadacounty.com/coronavirus.

Nevada County Remains in Regional COVID-19 Stay Home Order

Nevada County continues to be under the State’s Stay Home Order along with neighboring counties in the Greater Sacramento region. According to the State’s latest COVID-19 facts, the Greater Sacramento region’s daily current ICU capacity numbers have been relatively consistent at approximately 14%, however early projections over the next four weeks show ICU capacity is likely to drop. Therefore, the order will likely be extended for the Greater Sacramento region. The Greater Sacramento region’s official ICU projections and status under the Stay Home Order will be known and posted tomorrow, January 2nd based on the January 1st projections that will be run today. The ICU capacity projections are based on four factors: current estimated regional ICU capacity available, measure of current community transmission, current regional case rates and the proportion of ICU cases being admitted. Decreasing community transmission and increasing the health system capacity can help a region’s projected ICU capacity so they can exit the order.

The Stay at Home Order means that gatherings of any size are prohibited. Bars, wineries, personal services and hair salons must close temporarily.  Retail can stay open with a cap of 20% capacity and restaurants must stop all on-site dining and only provide take-out or delivery services. Critical infrastructure and schools are allowed to stay open.  Non-essential travel is not allowed across the state of California and the travel advisory to quarantine after any out of state travel is still in place. Masking and physical distancing are mandatory. In Nevada County, there are many opportunities to get outside and enjoy the outdoors. Local recreation with members of the same household is encouraged. Learn more about the regional Stay at Home Order at COVID19.ca.gov.

To protect our essential and healthcare workers, first responders, vulnerable residents and businesses, please stay home except for essential needs. A few weeks after a holiday, Nevada County typically sees a spike in new COVID-19 cases. Individual action leads to collective mitigation and we thank Nevada County residents who remain diligent about wearing a mask, social distancing, avoiding gatherings and staying home when sick. We can stop the spread together. Thank you for keeping Nevada County Strong.

Upcoming Business Resource Opportunities

Nevada County is hosting a COVID-19 Business Task Force meeting at 3:00 pm on Wednesday, January 6th. Get an update on COVID-19 and learn about federal, state, and local relief funding available to businesses. Hosted by Supervisors Dan Miller and Ed Scofield, with speakers from Nevada County and the Sierra Business Council. Register on Zoom at www.mynevadacounty.com/COVID19BusinessTaskForce..

The Nevada County Relief Fund is currently accepting applications from for-profit small businesses who are complying with public health guidelines to protect their customers and staff through January 6th. For-profit businesses may apply for micro-grants up to $5,000 that may be used for rent relief or other critical business expenses needed to stay open this winter. Apply at www.nevcorelief.org

The California Small Business COVID-19 Relief Grant opened December 30th and will close on January 8th at 11:59 p.m. A total of $475 million will be available in two rounds. Round one will distribute $237 million. Find more information at www.careliefgrant.com. The Small Business Development Center (SBDC) will provide a daily webinar at 11:00 am  through January 4th. Webinar topics will include updates to the program including eligibility requirements, application process, required documents, and who to contact for assistance. Register for an upcoming Small Business Grant Webinar on SBDC’s website at www.sierrasbdc.com/events/state-california-covid-19-small-business-grant-webinar.

More Information

For more information visit www.mynevadacounty.com/coronavirus or speak with a local call center representative at 211 Connecting Point by calling  1-833-DIAL211. For more information on local immunization efforts and weekly vaccine updates visit www.mynevadacounty.com/coronavirus/vaccine

Nevada County Hospitals Receive First Shipment of COVID Vaccine

On Thursday morning Nevada County received the first shipment of the COVID-19 vaccine which included 975 doses of the Pfizer-BioNTech vaccine. These first doses are being distributed to our two hospitals, Tahoe Forest Hospital in Truckee and Sierra Nevada Memorial Hospital in Grass Valley and will be used to begin vaccinating our front-line health care workers. This first shipment of COVID-19 vaccine represents a significant milestone, and congratulations are warranted to the community, our healthcare providers and Public Health for getting us this far.

“Although our initial allocations will be small, we expect that soon we will begin to receive vaccine allocations each week,” said Nevada County Public Health Director Jill Blake. “This is very welcome news, as the arrival of the vaccine indicates the beginning of a pharmaceutical intervention that will eventually end this pandemic and allow us to return to normalcy.”

COVID Vaccines Arriving at Tahoe Forest Hospital & Sierra Nevada Memorial Hospital

“This week is a huge, positive week for our region considering the past nine months in that this is the first step of Part B of our strategy which is to receive and begin administering vaccines following state and county guidelines.  We’ve all waited impatiently for this week,” said Harry Weis, President and CEO of Tahoe Forest Health System. “It’s a small start so please stay tuned for advice as to when vaccines will be available for the general public”.

At Sierra Nevada Memorial Hospital (SNMH) preparation included acquiring necessary equipment to store and administer the vaccine, the training of staff, and developing relevant processes and procedures. 

“At Sierra Nevada Memorial Hospital, safety is our priority, and we only administer vaccines that are proven safe and effective. While there are always unknowns when a new vaccine is developed, data from the Pfizer and Moderna clinical trials looks extremely promising, and the vaccines they are creating appear to be very effective,” said Dr. Brian Evans, Sierra Nevada Memorial Hospital President. “As we reach this historic moment in time, I do want to take pause to recognize our healthcare workers that have and will continue to do their part to keep our communities healthy and well – it is truly heroic work and we can’t thank you enough.”  

As with all COVID-19 communications throughout this pandemic, Dr. Evans stressed, “Sierra Nevada Memorial Hospital has been very transparent and attempts to always communicate vital information to community members in the timeliest manner.” He explained they will be taking this same approach with the vaccine distributions. 

Next Steps

Nevada County is following the  vaccine allocation guidelines developed by the California Department of Public Health. The California Department of Public Health (CDPH) has developed phases and tiers within those phases. CDPH continues to define/clarify who is included in which tiers. Nevada County’s first doses are going to front-line health care workers at our two hospitals. Congregate care settings such as Skilled Nursing Facilities and Assisted Living Facilities are also prioritized in Tier 1 of Phase 1A. As availability increases, vaccine will eventually be available via local health care providers and Nevada County Public Health.

While this is a tremendous milestone in the fight against this pandemic, it will be some time until the vaccine is widely available. Until our community is widely vaccinated, stay home as much as possible, wear a mask when out of the house, and maintain social distance from non-household members. If you are a healthcare worker with an active license and would like to volunteer as a disaster healthcare worker, you can sign up with California’s Disaster Healthcare Volunteer database. If you are a healthcare provider with a current practice, Nevada County Public Health is planning to hold meetings with providers to consult about the best way to ensure that everyone who qualifies for these initial doses has access to them.

If you have more questions about vaccine safety, efficacy, distribution, approval or other related questions, visit the State of California’s Vaccine page for up-to-date information. For more information on Coronavirus in Nevada County, visit www.mynevadacounty.com/coronavirus or speak with a local call center representative at 211 Connecting Point by calling 1-833-DIAL211.

Nevada County moves into regional Stay-at-Home Order beginning Dec 11th

Today, the State announced that Nevada County, along with neighboring counties in the Greater Sacramento region, will be moving into the State’s Regional Stay at Home Order beginning Friday, December 11th. The order will remain in effect for a minimum of three weeks. The State’s Regional Stay at Home Order is triggered when a region’s ICU capacity drops below 15%. Today, the Greater Sacramento region’s ICU capacity has dropped to 14.3%.

The Stay at Home Order means that gatherings of any size are prohibited. Bars, wineries, personal services and hair salons must close temporarily.  Retail can stay open with a cap of 20% capacity and restaurants must stop all on-site dining and only provide take-out or delivery services. Critical infrastructure and schools are allowed to stay open.  Non-essential travel is not allowed across the state of California and the travel advisory to quarantine after any out of state travel is still in place. Masking and physical distancing are mandatory. In Nevada County, we have many opportunities to get outside and enjoy the outdoors. Local recreation with members of the same household is encouraged. Learn more about the regional Stay at Home Order at COVID19.ca.gov.

Nevada County is hosting a COVID-19 Business Task Force meeting from 3-4pm today, Wednesday, December 9th to discuss the most recent business resources. Register on Zoom at www.mynevadacounty.com/COVID19BusinessTaskForce.

The State is planning to send out a Wireless Emergency Alert (WEA), similar to our CodeRED Emergency Alerts, to residents of Nevada County and neighboring counties in the Greater Sacramento region who will be under the regional Stay at Home Order. Any messages are informational only, and individuals who receive wireless alerts should not contact law enforcement or call 9-1-1. If you have questions, please call 211 Connecting Point by calling 1-833-DIAL211 rather than 911 dispatch.

To protect our essential and healthcare workers, first responders, vulnerable residents and businesses, please stay home except for essential needs. Eight more Nevada County residents have died of COVID-19 in the last week. 

We can stop the spread together. Thank you for keeping Nevada County Strong. 

For more information visit www.mynevadacounty.com/coronavirus or speak with a local call center representative at 211 Connecting Point by calling  1-833-DIAL211.

Community Update on COVID-19 and Regional Stay-at-Home Order

To blunt the curve and save lives, California has introduced a Regional Stay-at-Home Order today for counties whose regional hospital systems fall under 15% ICU capacity. Although Nevada County is not immediately placed into a Stay-at-Home Order due to regional hospital capacity, the “Greater Sacramento” health system is projected to fall below 15% ICU capacity in early December and would move Nevada County into a Stay-at-Home Order for a minimum of 3 weeks with neighboring counties in the “Greater Sacramento” health system. Find more information about the possible Stay-at-Home Order at COVID19.ca.gov.

“We’re seeing a concerning increase in hospitalizations across the state, the region, and locally,” said Nevada County Public Health Director Jill Blake. “As a county with two small hospitals that regularly rely on the ability to transfer patients to hospitals outside our jurisdiction, it’s important to remember that there is a regionality to our healthcare system and that what happens in neighboring counties impacts us as well.” 

In Nevada County, we’re experiencing an unprecedented escalation in new COVID-19 cases. From March through October, Nevada County had a total of 642 cases; in November, we had 706 new cases. At the end of October, we had 51 active cases and 2 hospitalizations, and as of today, we have 371 active cases and 17 hospitalizations. We anticipate another large increase in cases within the next 1-2 weeks from Thanksgiving activities and gatherings. Since mid-November there has been an 89% increase in COVID-19 hospitalizations across California. Current projections show hospitalizations could increase 2-3 times the current amount in one month alone. 

Join us Friday afternoon from 2pm-3pm on Zoom to learn about the individual actions required to protect our community and our essential workers. This is an urgent update that will feature reliable, expert information from those working on our local COVID-19 response including our two local hospitals, Sierra Nevada Memorial Hospital and Tahoe Forest Hospital, and our Public Health Department. What we all do these next couple weeks will be critical for our community’s health and economic well-being. Register at www.mynevadacounty.com/COVID19communityupdate.

To help keep the community informed, protect our essential workers, and to prevent the healthcare system from being overwhelmed, Nevada County plans to send out a CodeRED Emergency Alert to residents and visitors if Nevada County does move into a Stay-at-Home Order due to regional hospital capacity. Learn more and subscribe to CodeRED Emergency Alerts at www.readynevadacounty.org/codered

For more information visit www.mynevadacounty.com/coronavirus, and to speak with a local call center representative, please call 211 Connecting Point at 1-833-DIAL211.

Governor Announces Actions to Curb COVID-19 Transmission

As COVID-19 cases sharply increase across the country and California, Governor Gavin Newsom and state public health officials announced immediate actions today to slow the spread of the virus. The state is pulling an emergency brake in the Blueprint for a Safer Economy resulting in 94.1 percent of California’s population in the most restrictive tier. This change is effective tomorrow. The state will reassess data continuously and move more counties back if necessary. California is also strengthening its face covering guidance to require individuals to wear a mask whenever outside their home, with limited exceptions.

“We are sounding the alarm,” said Governor Newsom. “California is experiencing the fastest increase in cases we have seen yet –faster than what we experienced at the outset of the pandemic or even this summer. The spread of COVID-19, if left unchecked, could quickly overwhelm our health care system and lead to catastrophic outcomes. That is why we are pulling an emergency brake in the Blueprint for a Safer Economy. Now is the time to do all we can – government at all levels and Californians across the state – to flatten the curve again as we have done before.”

The rate of growth in confirmed COVID-19 cases is faster than it was in July, which led to a significant peak in cases. This requires a swift public health response and action from all Californians to slow the spread of the virus. Immediate action will help protect individuals at higher risk of severe illness or death from COVID-19 and will help keep the state’s health care delivery system from becoming overwhelmed.

“The data we are seeing is very concerning. We are in the midst of a surge, and time is of the essence. Every day matters and every decision matters,” said California Health and Human Services Secretary Dr. Mark Ghaly. “Personal decisions are critical, and I am I imploring every Californian to stay home if they can, wear a mask whenever they leave their homes, limit mixing, practice physical distancing and wash their hands.”

The 28 counties moving back into Tier 1(Purple/Widespread) include:

AlamedaNapaSanta Cruz
ButteNevadaSiskiyou
Contra CostaOrangeSolano
El DoradoPlacerSutter
FresnoSan BenitoTrinity
GlennSan JoaquinTuolumne
KernSan Luis ObispoVentura
KingsMendocinoMercedSanta BarbaraSanta ClaraYoloYuba
   

The nine counties moving back into Tier 2 (Red/Substantial) include:

ColusaMarinPlumas
Del NorteModocSan Francisco
HumboldtMonoSan Mateo

The two counties moving back into Tier 3 (Orange/Moderate) include:

CalaverasSierra

Today’s action will remain in effect until the State Public Health Officer determines it is appropriate to make modifications based on public health conditions and data.

California has taken steps to prepare the state for an increase in COVID-19 cases. The state has developed additional testing capacity to allow cases to be quickly identified, recently opening a new laboratory in Valencia that is already processing thousands of tests a day. The state is averaging 164,345 tests over the last seven days.

The state has been working in partnership with hospitals, clinics and physicians on the COVID-19 response. To support California’s health care delivery system, the state has an additional 1,872 beds available at alternate care sites outside of the system that can be made available quickly if needed to respond to a surge in cases.

California will continue to update the Blueprint for a Safer Economy based on the best available public health data and science. For more information about the Blueprint and what Californians can do to prevent the spread of COVID-19, visit covid19.ca.gov.