Ken Yeager, president of the county Board of Supervisors, laid out a broad plan at his State of the County address earlier this week, listing healthcare, gun violence and the environment among his top priorities. Noticeably, Supervisor George Shirakawa wasn’t one of them.

“My goals for 2013 are as ambitious as they were in 2010, if not more so,” he told a standing-room-only crowd, referring to his last time as board president, when he pushed for bans on smoking, single-use plastic bags and candy-and-soda-packed vending machines. (Here is video of Supervisor Yeager’s State of the County speech.)

The topic of immigration, possibly because of its absence from Tuesday’s speech—or perhaps because someone wanted a share of the spotlight—came up a day later in a Mercury News op-ed penned by Yeager’s colleague, Supervisor Dave Cortese, and co-authors Molly O’Neal and Cynthia Hunter.

Healthcare reform
The federal Affordable Care Act becomes a reality in 2014, Yeager noted on Tuesday, so it’s vital the county is prepared to accommodate the 20,000 residents who become eligible for Medi-Cal coverage under the new plan.

“We must get it right,” Yeager said. “Literally, the lives of tens of thousands of people in our county depend on it.”

That means installing new information systems, building new clinics and beefing up staffing at existing locations, increasing access to primary care, improving quality and access of care for those already covered and teaming up with safety net providers.

“We must measurably improve health outcomes, client satisfaction and lower the cost of care,” he said.

The county will also have to create a campaign to educate the public about what they qualify for under the new healthcare laws. Yeager plans to push for the county to hire a Capitol Hill lobbyist to support the county’s public health interests.

Yeager aims to implement medical and dental coverage for 100 percent of the county’s children from low-income families, partly by using funds from Measure A, a $50 million-per-annum sales tax voters approved last fall that pays for county programs like public health.

Gun violence
As the debate over gun control fires up on a national level, Yeager believes the county can do its part to rein in gun violence.

“[Gun violence is] something that is very much on all of our minds, here and throughout the country,” Yeager said. “The horrific senseless shootings we have seen over the past year highlight a particular need to focus on this issue … I believe we can make a significant impact here at the local level.”

Getting the sheriff’s office to buy back guns, no questions asked, will reduce the number of firearms in the county, he said, and theoretically curb gun violence.

Yeager said he’ll also work with the sheriff’s office to take back guns from people with no legal right to own them in the first place. The Attorney General’s office supplied a report that counts 529 people in the county who own guns but shouldn’t because of felony convictions, restraining orders or some other legal injunction. They collectively own 1,239 weapons, 54 of them assault rifles.

Public health
About a quarter of the county’s kids are considered overweight or clinically obese, Yeager said. In some unincorporated parts of the region, it’s one in three.

“If we do not reverse this trend, this generation of children will likely live shorter lives than their parents,” he said.

To address the problem, Yeager wants to promote water over sugar-bombs, like sports drinks and soda, as standard refreshment. Again tapping in to Measure B funds, he wants to build “hydration stations” at local schools, parks and community centers, where kids can refill their re-usable water bottles with clean water.

He also wants to focus on some “winnable battles” in public health, like teen pregnancy, obesity, smoking, HIV and AIDS, food safety and nutrition. Yeager focused part of his speech on HIV/AIDS, because more than 3,000 people in the county live with the disease, he said.

Knowing one’s HIV status lessens the chance of infecting others, and gives them options to get treatment, he noted. The FDA recently approved home testing kits, 500 of which Yeager wants to hand out to at-risk populations as part of a pilot public health effort.

Other STDs like Chlamydia, gonorrhea and syphilis continue to rise, too, something Yeager wants to address by supporting family planning and public health services and creating an educational ad campaign.

A community health assessment should be conducted, too, particularly for specific populations, like the black, Vietnamese, LGBT and Latino communities, he said.

“We also need universal … frequent screening,” Yeager told the audience, noting that 18,000 children younger than 6 live with undiagnosed developmental delays. “That’s why I’m asking our clinics to perform routine developmental screenings as recommended by the American Academy of Pediatrics.”

Since drug and alcohol dependence are overwhelmingly linked with mental health, Yeager proposes linking the county’s substance abuse and psychological services into one behavioral health department.

The environment and sustainability
Climate change: Another national conversation with regional applications. Yeager wants to reduce greenhouse gas emissions by encouraging people to use electric cars. That means updating county building codes to require all new construction to come with wiring to recharge electric vehicles.

He also said he’ll re-negotiate waste contracts, many of which are about to come up for renewal, to figure out how to keep more trash out of our landfills.

Seniors
Many elderly people, even in wealthy Silicon Valley, go hungry. Recruiting more senior citizens to the CalFResh program will fight hunger amongst our aging populace. Yeager hopes to add some 10,000 more applicants to the program, in addition to focusing on health issues like chronic disease that plagues the elderly.

Veterans
The region is home to 70,000 military veterans, which means the county must work closely with the federal Veterans Affairs to connect that population with the benefits they’re entitled.

Housing
With redevelopment gone, so is a lot of affordable housing funding. Yeager said we have to figure out how to replace that.

LGBT community
Because of historic inequitable treatment of gay youth in the criminal justice system, Yeager wants to train public employees working in juvenile justice to treat them with respect.