Alameda County Health Committee Meeting – February 23, 2026
Alameda County Health Committee Meeting – February 23, 2026
The Health Committee of the Alameda County Board of Supervisors met on February 23, 2026, with Supervisors Cam and Miley present. The meeting focused on public comments regarding the severe impacts of Proposition 1 (transition from MHSA to BHSA) on behavioral health services, followed by presentations on the county's overdose prevention efforts and the opioid settlement funds planning and implementation.
Public Comments & Testimony
- David Shanner (CEO, The Better Way; President, Alameda County Behavioral Health Collaborative) expressed strong concern about Prop 1 implementation, stating it will cause ~15,000 clients to lose critical services and a loss of ~$27 million in funding in their collaborative alone, with many jobs held by people with lived experience at risk. He urgently requested a hearing to discuss the issue in depth.
- Chris Becker (licensed marriage and family therapist, Highland Hospital) provided information about planned closure of two behavioral health programs at Fairmont and Highland by Alameda Health System, serving clients with serious mental illness. Noted that these programs are Medicare-funded and provide unique services including transportation and interpretation.
- Jamie Campos (CEO, Horizon Services) spoke about elimination of Lambda Youth Program (serving LGBTQ+ youth aged 12–24) effective July 1 due to BHSA transition. The program was identified as needed because 45% of LGBTQ youth seriously consider suicide. Also noted outdated funding levels for other Horizon programs.
- Lynn Rivas (Executive Director, California Association of Mental Health Peer Run Organizations) reported that three peer-run organizations in Alameda County received cuts, with Peers and Peer Wellness Collective receiving dramatic cuts (Peer Wellness Collective 100% cut). Stated viability of these organizations is at risk.
- Narges Stollen (Executive Director, Crisis Support Services of Alameda County) described closing of hospital follow-up program and survivors of suicide attempt support group due to Prop 1. Noted a 40% increase in crisis line call volume in the past year.
- Sarah Markser (District 3 resident, works at Peers) emphasized that peer-run organizations provide living proof that recovery is possible and that the county cannot afford to lose them. Peers employs ~30 people with lived experience.
- Katrina Talou (Executive Director, Peer Wellness Collective) described the organization's 25-year history and that 25 staff all have lived experience. Called the cuts devastating and warned of a crisis similar to when state hospitals released individuals without community services.
- Giovanni Iglesias (COO, Bay Area Community Services) expressed concerns about BHSA cuts: BACS alone slated to lose services for 4,000 clients across the county, including closure of wellness centers and community-based teams. Asked for a formal hearing and longer off-ramp.
- Marcos Gonzalez (Associate Director, BACS) noted that four wellness centers serve unhoused/at-risk individuals with behavioral health concerns. Cuts will eliminate them.
- Shemima Abdullah (Program Manager, BACS SAGE program) provided details: SAGE serves 300 clients yearly with weekly wellness checks, support for appointments, Narcan distribution, etc. Cuts would push clients back to emergency rooms.
- Jamie Almanza (CEO, BACS for 16 years) stated BACS will close services for 600 individuals (80% African American, 80% unhoused) and all wellness centers. Noted loss of federal match (50 cents on the dollar) for Medi-Cal billable services. Warned of Santa Rita jail becoming the largest mental health institution. Compelled board to enact a special session immediately.
Discussion Items
Overdose and Poison Prevention Program Update
- Dr. Kathleen Clannen introduced the update. Joel Ravier presented data: overdose deaths peaked in 2023 and have decreased significantly over the last two years, but remain the leading cause of death for adults under 55. Disparities persist: 50% of overdose deaths are among people currently or recently homeless (4,300% higher rate than housed). African American/African descent community experienced a ~300% increase in overdose mortality over 20 years.
- Key interventions highlighted: EMS administering >2,000 doses of naloxone in the field (only 2% lead to treatment); Santa Rita jail is the second largest provider of MAT (medications for addiction treatment) in the county. MAT census increased from 100–200 to 300–500 patients. Opioid overdose and Narcan use decreased: from 18 incidents in January 2024 to 5 in January 2025 to 0 in January 2026 (per medical director comment). Challenges include post-release continuity of care, limited pharmacy availability for long-acting injectables, and funding sustainability.
- Dr. Karen Tribble and Kelly Bowers presented the Opioid Settlement Funds update. Total settlement revenue projected at $80 million; $31.7 million received to date. This fiscal year spending ~$18.7 million. Funds used for MAT at jail, residential treatment expansion (e.g., St. Regis now open, La Familia opened), and $5.5 million in mini-grants through Three Valleys Community Foundation. 22 grants funded out of 41 applications ($10 million in requests). Grants cover prevention, treatment, diversion, naloxone distribution, harm reduction, and serve vulnerable populations including unhoused, at-risk youth, Black men, and justice-involved.
- Discussion on sustainability of programs given finite and declining revenue after 2031. Supervisor Tam asked about using settlement funds for CAT (Crisis Assessment and Treatment) program; response noted restrictive nature of opioid abatement activities, but possibility exists if activities directly address opioid use. Supervisor Miley asked about causes of overdose death decline (fentanyl, post-pandemic recovery), reasons for racial and homelessness disparities, and challenges of continuity of care for jail releasees.
Key Outcomes
- Commitment to hearing on Prop 1 impacts: Supervisor Cam committed to scheduling a hearing at the next Health Committee meeting (March) to further discuss the BHSA transition cuts and possible mitigation.
- Measure W allocation: Chair Miley noted the Board already allocated $4 million in Measure W funds in October to anticipate prevention and early intervention cuts. Department heads are reviewing programs for efficiency and backfilling.
- Ongoing monitoring: Behavioral Health Department will continue tracking outcomes of opioid settlement investments and report back with metrics and qualitative data. Mini-grant results expected by fall 2026.
- Potential funding for jail MAT: The upcoming July 1, 2026 CalAIM provision allowing 90-day Medi-Cal coverage during incarceration may offset some opioid settlement costs for medications at Santa Rita jail.
- No formal votes taken; items were informational.
Meeting Transcript
All right. I'd like to start the health committee on the board of supervisors for Monday, February 23rd. Supervisor Cam, present Supervisor Miley. Instructions. For in-person participation, the meeting site is open to the public. If you'd like to speak on an item, fill out a speaker's card in the back of the room and hand it to the clerk for remote participation. Follow the teleconferencing guidelines posted at www.acgov.org and use the raise your hand function. Thank you. So we're gonna take public comment first. So on non-agendized items. So any public comment on David Canna. We just stand or approach the podium. Okay. Can I hear me? David. Good morning, Supervisor Cam, Rosa Miley, everyone here. Um my name is David Shanner. I am the CEO at an organization called The Better Way. We serve kids and families throughout the area. I'm here today as president of the Alameda County Behavioral Health Collaborate, though. We're grateful for the collaboration we've had with Alameda County leadership and supervisory board. Um we are here today to again state our strong concern about the impact of the way that Prop 1 is being implemented and the transition from MHS to PHSA. We've um made clear our concerns about this, the impact on roughly 15,000 clients who are gonna lose critical services, and also a need for some urgent mitigation for that risk. We're gonna lose about 27 million dollars in funding in our collaborative alone. That's not counting all of the similar agencies throughout Alameda County, and we're gonna lose a lot of jobs that are currently held by people with lived experience who are going to be now both without livelihood and also without key services that are being removed without a direct immediate plan to fill those in. Um our biggest ask today is for a hearing. We would urgently request to schedule a hearing to discuss this in more depth. We've had some very um fruitful and helpful and appreciated conversations with a number of you and we want to keep that ball rolling. We're we're every day that we add up the calculus of what's coming. Um we are losing some sleep. We know there's other many urgent matters on the county's agenda right now and things that are big, so we appreciate your attention and we would love the chance to dig into this in an immediate and ongoing way. All of you, some of our colleagues are in the room today from the collaborative and also hopefully calling in. So you might hear from others of us today, but I just wanted to introduce that general topic. Thank you for having us here. Teresa Becker. My name is Chris Becker. I'm a licensed marriage and family therapist, and I work at Highland Hospital and the outpatient behavior program. I'm here just to give you some information because on Wednesday there'll be a balance and hearing. Highland Hospital is planning to, Alameda Health System is planning to close the two behavioral health programs that they have at Fairmont and at Highland, and these programs are first of all funded by Medicare. Um, only clients with Medicare can have them, which means that people basically have to be disabled or old like me. Um, the programs serve people with serious mental illness. So what I did is I just made a little printout of something from the VA and um also do the program brochure. So other programs serve those who receive brief treatment after a mental health crisis and continue their treatment with individual therapy and psychiatric health. However, Highland and Fairmont programs serve those who need a consistent support to be stable. The program is really amazing. Clients are picked up in a van, lunch, snacks, brought home. This is important because transportation is often an issue for people with serious mental illness. The thing that blows my mind is that we have interpreters who will sit with people in a group if they're not fluent in English and they'll quietly translate to them so that they can actually get treatment, and that is something that just doesn't happen anywhere, and I've worked in a large code places. Um many of the clients have been in the program for years. These are people with serious mental illness disability.
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