Alameda County Health Committee Meeting – December 8, 2025

The Health Committee met on Monday, December 8, 2025, at approximately 9:45 AM. The meeting covered three agenda items: the fourth annual report on Measure A1 (action item), an update on HUD’s Notice of Funding Opportunity (NOFO) for the Continuum of Care (informational), and a discussion of Alameda Health System (AHS) governance options (informational). A brief recess was taken when quorum was lost, but the meeting reconvened. The committee approved the Measure A1 report and directed that the AHS governance legislation be sent to the Policy, Administration, and Legislation (PAL) committee for sponsorship consideration.

Public Comments & Testimony

• David (caller, representing SCAU 1021 members) spoke in support of the AHS governance discussion, stating that it would help address ongoing labor and personnel concerns and thanked the committee for taking up the item.

Discussion Items

• Measure A1 Fourth Annual Report – The report covered the period July 2020 through June 2022, catching up on annual reporting. Highlights include: 73% voter approval for Measure A1; 54 rental projects (15 pre-development, 14 under construction, 25 completed) totaling over 3,900 affordable rental units; leverage of $6 from other sources for every $1 of Measure A1; 173 homeowners assisted through two homeownership programs with over 800 workshop attendees; acquisition of two hotels using state Homekey funds and the county’s acquisition fund. The report noted delays due to COVID-19 (over 50% staff vacancy rate) and quorum issues for the oversight committee. Proposed bylaw changes would allow informational meetings even without a quorum. The report also highlighted that the borough’s locally funded housing portal (Doorway) had been transitioned to a regional Bay Area system. Supervisor Miley noted that local hire goals (30%) were exceeded (42%) and that 105 Alameda County businesses received $180 million in construction contracts, while 73 small local businesses received nearly $79 million. Supervisor Tam inquired about coordination of funding streams for Homekey projects and the potential for reauthorization of a new bond measure. Staff reported that Measure A1 funds are fully committed except for program income, and that discussions with the city of Oakland regarding hotel operations are ongoing. The committee adopted the report as an action item.
• Housing and Urban Development (HUD) Notice of Funding Opportunity (NOFO) for Continuum of Care – Jeanette Rodriguez (Deputy Director for Housing, Housing and Homelessness Services) presented an update on the FY25 NOFO, released November 13, 2025, with a short turnaround (due January 14, 2026). Key changes: only 30% of funding (tier 1) can be protected, down from historical 90%; the share for permanent housing is capped at 30% (previously 86% locally). This puts up to $42 million of the county’s $60 million in HUD funding at risk, with $33 million in permanent housing needing reallocation or loss. The new NOFO shifts away from Housing First principles and includes requirements aligning with recent executive orders on DEI, gender identity, and harm reduction. Local actions include forming a NOFO response team, assessing local backfill funding (e.g., Measure W), and coordinating with grantees. The committee noted that HUD withdrew the NOFO during the meeting for revisions, which may further delay funding. Supervisor Miley stressed the need to be proactive, prepare bridge funding, and potentially adjust Measure W allocations to prevent service gaps. The item was informational.
• Alameda Health System (AHS) Governance Options – Scott (County Counsel) and Amy (County Administrator’s Office) presented two governance options developed by a prior subcommittee: Option A gives the Board of Supervisors the authority to become the governing board of AHS with a subsidiary board of trustees for day-to-day operations; Option B retains the current board of trustees but gives the Board of Supervisors appointment authority. The presentation summarized key legislative decisions made in 2024, including flexibility for the board to choose its governance model, explicit conflict-of-interest waivers, delegation language, and representation for the City of Alameda Healthcare District. The legislation (amending Health and Safety Code Section 101850) needs to be introduced by February 20, 2026, with a request to legislative counsel due by January 23, 2026. Supervisor Miley provided historical context and expressed support for moving forward, noting labor’s eagerness. Supervisor Tam agreed to send the item to the PAL committee for sponsorship consideration. The committee directed staff to prepare a request for the January 13, 2026 PAL meeting.

Key Outcomes

• Measure A1 Annual Report – Approved unanimously (Supervisors Tam and Miley voted yes). The report will be forwarded to the full Board of Supervisors for adoption.
• HUD NOFO Update – No formal action taken (informational item). The committee emphasized the need for continued monitoring, backfill planning, and coordination with the board on Measure W adjustments.
• AHS Governance – The committee directed that the item be placed on the January 13, 2026 PAL committee agenda to seek a legislative sponsor for the proposed bill. Supervisors Tam and Miley will jointly submit the request.