Good morning.

Welcome to the Alameda County Board of Supervisors Health Committee meeting for Monday, March the 9th, 2026.

May I have roll call, please?

Supervisor Miley, excused Supervisor Tim Present.

Supervisor Miley will be arriving at about 1015.

So we will take item number two, the tax the ball to properties program update first because the first item is an action item.

May I have a staff report, please.

Good morning.

Thank you for the opportunity to be here.

We're here to give an update on the tax defaulted properties program for Alameda County Housing and Community Development.

So the tax defaulted properties program is an investment of $3 million in Measure A1's innovation and opportunity fund to support the acquisition of tax defaulted properties for affordable housing development.

The idea is to create opportunities for smaller and emerging developers and the in the development of those properties and transform them into new affordable housing.

So the tax defaulted properties program leverages the chapter eight property sale program process that's administered by the treasure tax collector.

There are a lot of challenges with these particular properties.

They're typically small or regular parcels that require significant work to become development ready, and they're very difficult to finance due to the need for upfront acquisition and pre-development costs and the lag that it takes to process transactions through the chapter eight property sale process.

So the purpose of this program was to reduce those barriers and make these properties more attractive and more suitable for affordable housing development.

So of those 13 proposals, only one project met minimum requirements to move forward with the pre-development loan.

So that was a conditional award given to Kingdom Builders Christian Fellowship Ministries, working in partnership with the Community Housing Development Corporation.

And so in addition to that first property, there's an adjacent property, 7963 MacArthur Boulevard, that was later added on to that proposal and that's being funded through that initial process for pre-development.

So, you know, of those 13 applications, only one went through, which meant most applications did not meet program thresholds.

And the reasons were uh they're substantial.

They had infeasible development budgets, unrealistic service plans, limited or no development capacity or experience, lack of technical expertise and affordable housing developments, and uh providing pre-development commitments to those projects would have put the county in significant risk.

Projects uh that don't meet those requirements often can stall for many, many years, and county investments could be tied up with no delivery or path forward for those projects.

Um, you know, despite the challenges related to the individual proposals, the RFP revealed that there was strong interest in this process of making these properties functional again into affordable housing, um, and that community-based organizations and emerging developers were aware of this as an opportunity, um, that they really were uh interested in in leveraging their local knowledge, their strong community connections, um, and you know, the opportunity to grow the next generation of affordable housing developers.

Um, so we determined that they really needed a lot of capacity building and structure support.

Um, so uh we have taken some of the intervening time to review the process uh that we've gone through to review some of the findings from our TA provider, Hello Housing, to revise the program to make it better suited to meet the opportunities where they are and to meet the community-based organizations where they are.

And so the key changes to the program are that we're gonna radically simplify the requirements.

We're going to pre-select certain sites which are optimal for development, and we're going to require that emerging or other developers partner with pre-qualified developers who've already been vetted in advance and that they can select from.

So this will allow those local-based community organizations to more easily navigate the complex development space.

And so they're going to be a nonprofit partner to those developers.

We're going to provide them with much more flexible affordability requirements and much more flexible financing structure.

So we're working closely in partnership with the Treasurer Tax Collector's Office and with Hello Housing, our TA provider who had previously run a successful chapter eight sale process to select two to three to four sites that will be optimal for development.

We're going to make those development partnerships I mentioned earlier.

And then Hello Housing is going to be brought on board to provide uh full support technical assistance to those three or four projects that are selected as they move through the whole development process.

And so instead of evaluating it based on uh some of the evaluation criteria based um around the large tax credit projects that we have done through Measure A1, we're gonna look towards new evaluation criteria that's based primarily on the feasibility of the project and the value that the project can provide to the county and to its future tenants.

Um we do expect that with these revisions, the process uh will have much more feasible project proposals, um, that the development process would will move much, much, much more quickly, um, and that the county um will see a much more predictable and and frankly a better return on its capital investment and producing these housing units.

Um and we also think that by from the outset requiring a partnership with vetted developers, we can engage in emerging developers and other players um for participation that will be much more successful.

Um so I don't know.

Uh supervisor, if you have any questions about the program changes.

Thank you.

Um you said you have 13 properties and 13 applications that you receive from the 11 applicants.

Do you just can you refresh my memory?

How long does a property need to be basically tax defaulted before it's available for consideration?

Um I believe it's a year and it needs to go through a tax defaulted sale process, which I think there are two every year.

And so once a property um is not sold during that process, then it moves into a separate list, which from which we selected um a short list with the assistance of the Treasury Tax Collector and Hello Housing's office of about 20 properties that we thought could be where the transaction could go through.

And so we provided that list uh with the RFP and allowed folks to select from it or to suggest a different site if they were aware of one.

Um and so they were all all sites that had been on that list that we provided, and so they had all gone through at least one sale process unsuccessfully.

So they end up on a list uh after a year and a half or so of not paying their property taxes, they get on a list, and uh I'm trying to understand like at what point um does the ownership get change and how does like an emerging developer um take title to that property?

Sure.

And and I I should say that there's a long period of delinquency before that year where it actually gets placed on the auction block that can happen.

Um but this actually was one of the chief challenges to the program is that the process of the transfer of ownership uh does need to cure, I think also for an additional year after the sale happens.

And so for these smaller organizations, it was very difficult for them to take responsibility for these properties, site unseen, since you're not allowed to inspect them, and then to hold them and hold liability for them while that process cured.

And so often there were substantial additional costs like securing the site, fencing it potentially, and all of that was happening um with only potentially a pre-development loan available.

So the emerging developers were taking on a significant risk that A, the sale wouldn't go through, or B, there would be some sort of a liability cost in the interim period and all of that without even necessarily knowing how to finance the full project at the end of the line.

So when the emerging developer takes ownership, do they end up paying the back taxes on the property?

Uh no, the taxes can be uh written down by the Treasury Tax Collector's Office, and then also uh the county tax collector's office and cities like Oakland in particular have been working very well together to make sure that a lot of the um liens on the property can be written down as well at the time of sale.

So there is uh savings there for sure.

Okay.

Um this is very helpful because I know when we talked about um the use of A1 dollars and we were looking at every opportunity where it's where preservation production and protection of housing, um, this became like one of the potential options.

It's just that I think over the last decade it's been somewhat challenging uh to identify properties that would likely work um with the confluence of emerging developers, funding support, and all the risks that you mentioned.

So I appreciate um the proposed changes to help streamline and make this more um feasible, excuse me for pre-qualified developers.

Um the one thing I wanted to understand is uh for the project that we talked that you mentioned that ended up being um conditionally awarded.

Is this the only project that we have had in this type of situation?

That's correct.

Yeah, only one proposal uh was met the minimum qualifications for for county investment.

And and what was uh particularly unique about this particular project?

Um just the quality of their application was much higher.

It had a realistic development budget.

Um they had they had partnered with a more experienced developer.

Um, so they had a clear um on they demonstrated a clear understanding of what would be required to move the project through to completion.

They also participated with Hello Housing's uh uh technical assistance program for the tax default properties program as well.

So they knew what they were getting into uh for lack of a more complicated way.

So they were able to put that in their application and we could review it and say make a commitment of pre-development funds, knowing that they understood.

They they had the pre-development funds and uh they had uh a budget that was feasible moving forward.

Okay.

Well, I'm I'm looking forward to seeing how this proceeds because this will hopefully be um a model for some other projects as well.

So thank you.

Are there any questions or comments on this item from the public?

Caller, you're on the line.

We're on item two.

You have two minutes, Casey.

Thank you.

Can you hear me okay?

Yes.

Okay, great.

Good morning, supervisors.

My name is Casey Farmer, and I serve as a policy advisor to treasurer tax collector Hank Levy.

Uh Supervisor Tam, thank you for your feedback and your questions.

Just to clarify, properties become defaulted after five years of delinquency.

So they are eligible for auction or the chapter eight process in the sixth year.

Uh I appreciate your feedback and how you frame the word streamlining.

That's truly what this proposal is in front of you.

And uh I appreciate that you you take that away from the staff report.

Uh Hank was unable to attend today, but he asked me to share his strong support for staff's recommendations at the board's direction.

The Treasurer Tax Collector's Office is focused on transferring these tax defaulted properties to affordable housing nonprofits, which he has the authority to do so under Chapter 8 of the California Revenue and Taxation Code.

Our office has led a collaborative effort with HCD and appreciate the interdisciplinary approach, which bridges the expertise in housing development and the chapter eight process with a mutual goal.

And what you have before you is a revised plan, again, streamlined as stated by the supervisor.

Um Hank urges you to accept the staff report and improve these changes.

Thank you.

Thank you.

Um this is an informational item, but as far as uh board direction, I'm comfortable accepting the staff report and appreciate um the efforts made toward trying to identify changes that would help move a tax default type property into a way that provides more affordable housing sites.

So thank you very much for the presentation.

Since Supervisor Miley is not here, let's go to item three at the moment, which is an information item that we've been talking about for a while for the last two years on the behavioral health services funding and the impacts because of proposition one and a transition on how the funds get used.

So I believe we have a staff report.

Oh, you're um good morning, Supervisor Anika Chadry and Director for Alameda County Health.

We don't have a staff report for for this item.

Uh this, I believe, is agendized for a request that the Behavioral Health Collaborative made a couple of health committees ago.

Uh so uh I'm here, and Dr.

Trible is here to answer any questions as they arise.

Um but I believe the presentation is from the collaborative.

Okay, so the presentation is from the collaborative first.

Thank you.

Good morning, Supervisor Chan.

Thank you for um having this hearing.

Thank you to the leadership of Alameda County, and thanks to everyone who's in the room and online um supporting this um topic.

Uh my name is David Channer.

I'm here as president of the Alameda County Behavioral Health Collaborative this morning.

I've also been a member of the CBO community in partnership with Alameda County for close to 25 years.

And um I'm presenting today with my vice president, Stacey Katz and past president.

We've been speaking with Alameda County leadership and the board and and our our um you know collaborative agency members and others for quite a while since Prop One passed, trying to understand the um the impact that it would have on the service continuum and also on the livelihoods and well-being of people in the county.

And we have been increasingly concerned about where we all currently stand for the working here.

There it is.

Thank you.

Whoops, I went too fast.

I'm so sorry.

Haven't used one of these in a while.

There we go.

So over the time that we've been a collaborative, and over the time that I've been um uh very, you know, proud participant in Alameda County's operations and work.

Um we've seen remarkable innovation leadership and capacity building within this county through EPSDT expansion through the through the real embrace of Prop 63 when when MHSA went through through Title IV waiver innovations, and just it's been pretty impressive to those of us working in multiple counties how well this county has worked to build a complex ecosystem of integrated programs that don't just provide services but also build lives, build careers where clients can come into the workforce from a career uh client to career pathways.

And as we know from all kinds of ecosystems, complexity, interdependency means strength.

It means that it's a it's a tight safety net that will hold people.

We still have a ways to go, but it's been a remarkable thing to be a part of.

And we come in the spirit of that same interest in a shared ecosystem that is functional, innovative, and that leads the way for Californians in this very important county.

Um we're more and more concerned that Prop One absolutely puts this at risk, what we've done, the way it's currently being imagined.

And we're here in short to implore everyone to please take the time and energy to seek alternates that can be put in place to slow down this abrupt termination of services.

We're gonna talk in more depth about the impacts, but in short, we're we're gonna see roughly 15,000 consumers at risk for losing services.

Um, although MHSA is framed as prevention early intervention, many of these services are life-saving response to crisis services, and they should not be taken lightly.

The framing to voters of of Prop One was that it was simply in a certain way an expansion of what was already there.

But in fact, we're we're gutting something to rebuild something else with not a very good bridge in between.

So again, we're here to say thank you to you all to share our this impact analysis in more depth and to present some recommendations that we hope can be um taken on to mitigate this damage.

And we're also here to really urge immediate collective action, a real commitment to bridge funding to make sure that while we're figuring out all the complexities of this transition, that we don't lose the carefully built um fabric that we've woven together over the past quarter century.

Um, we're also asking to please continue an ongoing focus collaboration to minimize this harm.

And to us, that means interdepartmentally through our interagency work with not just the collaborative but others as well in the public in the private sector and through public-private partnerships as we have had over the past quarter century.

I think we need to recommit to those with a redoubled effort.

And also, this may be something that Alameda County is already doing, but we'd hope that there's inter-county discussions about what strategies, other similarly MHSA embrace counties have what they're doing to make sure that we don't lose anything in this process.

Or that we lose as little as possible.

So as I said, we're serving about 50%, this collaborative is serving about 15,000 clients per year.

We have helped, we've really helped this county create uh what's closer to a true no-wrongdoor access um network where there's access points to mental health and housing throughout our collaborative.

Um we're like I said before, we're really saving lives every day.

It's not just preventive things that are so we want to thank you for being, you know, a county that invests in the CBO community.

I think not all the counties we work with have done that, and I think it makes us stronger.

And um we want to appreciate the collaboration and really call on you to partner with us deeply right now.

Um, with that, I'm gonna hand it over to Nar just Dillon, our past president from the collaborative.

And thank you very much.

Thank you.

Good morning.

Um, I'm gonna be focusing on the impact of the service losses on the community.

I'll start broadly, and then I'm gonna actually give examples of programs and communities that are going to be impacted.

As David said, we estimate that 15,000 individuals, including children and seniors are going to be losing access to their mental health services.

That number does not include outreach and education services that the collaborative members are also offering.

Um, that number is another 20,000 or so clients losing access to outreach and education.

Um, the loss of essential services is across the board.

We are losing wellness centers, we're losing suicide prevention services.

We're losing programs for LGBTQ plus communities at a time when that community is not feeling safe because of federal policies.

And we're losing programs tailored toward immigrant communities that are being providing services, language in language languages other than English, which feels really important during a time of ice raids and immigrant populations really feeling under attack by the federal government.

There's a broader erosion of a system that's happening through this.

I think a successful implementation of BHSA and truly getting people housed depends on some of these programs that are going to be cut.

Um without knowing how to navigate the very complicated systems in our county, people are not going to be able to go from being unhoused to being successfully housed.

And I think that's a really important point for us to hold.

Additionally, there is a there's a job loss that is going to impact our system beyond the immediate future.

We anticipate more than 350 people are going to lose their jobs as a result of these program cuts.

And many of these positions are being held by people who are themselves consumers of our mental health services and housing services.

The very successful peer movement that's been happening in Alameda County, it's about to get demolished.

Um, and there's no time to spare.

Kind of zooming out, there's a couple big ways in which the system's about to be overloaded.

One is around children entering child welfare system.

We already know that about half of them enter needing mental health services, but only a quarter of them are getting those services.

By further reducing services that identify students in schools, um, we are going to be reducing that number even further.

Additionally, I want to come back to housing, since that is supposed to be the emphasis of Prop One.

There's a true bidirectional relationship between mental health crises and housing.

I'll give an example.

If you're experiencing a mental health crisis and end up being hospitalized, let's say for three days, those three days and lost wages could mean a missed rent.

It could mean that people are going to lose their housing.

So our mental health services keep people housed in a way that is immeasurable.

And according to SAMHSA, mental illness can lead to housing loss, but the disrupting of person's ability to maintain employment, manage a household, and sustain interpersonal relationships.

That's the true safety net.

Additionally, when we think about elimination, complete elimination of our family support services, our peer support services, paired with the reduction in early intervention services.

The only system entry point we're leaving is the crisis system, and that's the costliest entry point.

According to National Institute of Health, family involvement in the recovery process is associated with up to a 60% lower relapse rate and significantly lower hospital admissions.

So those investments in family support and peer services save us a ton of money in the long run.

I want to give some additional examples of programs being cut and their impact on the bigger system.

Peer-led services reduce psychiatric hospitalizations by 72%.

I think that's really important to keep in mind as we cut programs like Mental Health Association's Family Education Resource Center and peer-based programs, as well as wellness centers throughout the county.

When individuals don't have access to support within the community, they're more likely to end up in Santa Rita or hospitals.

That's the most expensive care setting and the least trauma-informed ones available in our county.

Additionally, the approach of cutting supportive services in the name of housing is counterintuitive.

Permanent supportive housing only works when paired with intensive case management.

Without these wraparound supports, housing retention rates for severely mentally ill populations, which is supposed to be the target population for Prop One drops significantly.

Programs operated by a boat services and BACs are the very tools used to get people housed.

Without these navigation services, we're missing the mark.

Next, I want to talk about youth services.

Early intervention is the most cost-effective way to prevent long-term disability.

Prop one requires that 51% of behavioral health services go to youth under the age 25, but that pot is now 30% smaller, and school-based programs are being slashed.

EBAC, Fred Finch, Hume Center, Alameda Family Services, and Crisis Support Services of Alameda County are all losing school-based presence as a result of the Prop One implementation.

By doing so, we're effectively closing the front door.

Schools are the place where we meet our students where they're at.

Cutting the school presence is a direct path to increase youth suicide risk and school dropouts.

This is also an equity issue.

Prop one is that designed to help the most visible unhoused population.

Yet it's cutting the very culturally specific programs that prevent black residents from falling into that cycle in the first place.

Black and African Americans make up just under 10% of Alameda County's general population, but they represent 41% of the homeless population.

This is according to 2024 point in time count.

There's also the incarceration pipeline.

Our black neighbors are four and a half times more likely to be arrested in this county than white residents.

They make up nearly half of the population in Santa Rita.

Then there's the re-entry gap.

According to UCSF Benioff Homelessness and Housing Initiative, 18% of black Californians experiencing homelessness entered it directly from a carceral setting.

This is why we can't afford to lose programs like Roots Community Health Centers, Santa Rita Safe Landing Project.

This program provides a warm handoff for people being released from jail at midnight.

We also need bosses, havens to black healing project, providing culturally rooted healing that standard clinics cannot replicate.

We need mental health associations, African American family outreach program.

In the name of homelessness, we can't forget about racial equity issues.

When we cut these black-led outreach programs, we're dismantling a safety net that would prevent the jail to street pipeline.

When I talk about equity, I also want to name our immigrant communities that are being served by programs like La Familia and La Clinica in their own languages during a time when fear is keeping them from help seeking.

In conclusion, and I say this as the person who runs the county's crisis line, we're turning the continuum of care into a crisis, a continuum of crisis.

And yet at the same time, we're also cutting crisis related services.

Our agency's hospital follow-up program is one of the programs being cut.

Our survivors of suicide attempt group are being cut.

BACS Amber House is losing funding.

Bonita House's CAP program is losing funding.

This is all at a time that in the first six months of the fiscal year, 98 contacts to CSS increased by 41%.

Okay.

This is before we cut all these programs.

People are already not doing well.

Suicide related calls in the same amount of time increased by 73% compared to last year.

Attempts in progress, these are people calling while after having taken action has increased 42%.

The crisis system is already overloaded.

We can't be the only entry door remaining for thousands of people losing services.

I'm going to pass it to Stacy for our call to action.

Good morning, Supervisor Tam.

Thank you, Norges and David.

My name is Stacey Katz.

I'm the CEO of West Coast Children's Clinic, but today I'm here as vice president of the Alameda County Collaborative.

And really my role is what are the solutions and what's our ask.

First would be to explore all mitigation strategies.

The total plan cuts are 21 million dollars for collaborative members alone, and that's leaving out some that aren't represented in our collaborative.

So first, we would respectfully ask the Board of Supervisors to allocate bridge funding for fiscal year 2026 to 27.

So we would be in effect creating an MHSA to BHS BHSA bridge.

We've been asked, so how long would that bridge last?

I think during the time that money was allocated, it would preserve all of the programs that Nar just just described and would give us time to crosswalk services from MHSA to the new H and BHSA Bridge in these three ways.

It would allow us to identify which services are eligible for funding under BHSA's planned H services.

DHCS regulations state that counties can utilize up to 7% of housing intervention funds on identified outreach and engagement activities.

That's some of the activities that are happening right now under MHSA.

The second would be to identify which activities in which community-based services could be billed through MediCal.

Lots of the services, uh particularly under CalAim, would be eligible for services that MediCal covered.

And the third would be a crosswalk same thing.

Um that wouldn't be able to be funded by Medi Cal.

Um see if they could be funded by Measure W.

Um, I also same as MHSA, any money that's not federal, that would be state or local in its origin, can be used as a match to draw down Medi-Cal funding.

So MediCal can be used in two ways, like bill directly, but also some of this money could be used to leverage more funding from MediCal, that many of these services would be deemed as billable.

And then finally, um, the collaborative respectfully also is asking for an ongoing collaboration to ensure a smooth transition for 2027 and 2028 and for this crosswalking to happen.

I think there's layered um timelines where things are ending before other things are beginning.

So we would want to bridge that.

We would want to do the crosswalks I just mentioned.

Um, but this crisis isn't the last.

I think it's the first, and my experience is we become a very reactive system.

We try to plan for it, and sometimes more than one thing's coming.

And instead of having tables that are set where we could meet on a regular basis as a provider group, as a board of supervisors, as public agencies and constituents, we call these hearings and um we're grateful for those, but we would we think it would work better if we had regular forums that were interagency in nature, um, where we could see what's coming ahead and plan um more carefully.

So we weren't always in a sort of crisis-laden reactive cycle.

And with that, I'll thank you for your time.

And um we can take any questions.

Thank you for your presentation.

Um first off, I wanted to underscore um that the county deeply appreciates its partnership with the behavioral health collaborative.

You are a critical part of our ecosystem when it comes to providing behavioral mental health care services throughout the county.

Um I know that uh we've had these discussions at least since proposition one passed two years ago, even before proposition one passed, the county took obviously an opposed position to proposition one in anticipation of these kind of impacts and effects.

And even when we were um informed that we could use the measure W funding after the litigation had um been settled, we also realized that these kind of funds, whether it's bridge funding or transitional, was going to be important as part of our essential services fund.

So I know that Supervisor Miley and I had advocated very fiercely to have a good portion of the funds allocated um for the essential services fund.

And last year we did allocate four million dollars, but we we haven't basically figured out where those funds are going precisely.

And I know our staff, um both Dr.

Tribo and Nika has been working tirelessly because I meet with them every week and they tell me they're playing Tetris and trying to figure out how these programs could be reclassified in a different way, in a new way that meets the new uh regulations under Proposition One, and they try to find ways to minimize the impacts on every single one of the programs that um are considered preventive or early intervention.

So one of the things that I know has been um something that Supervisor Carson had started in anticipation of this type of situation was the uh the community provider advisory group that meets regularly.

So I know I met uh with several of the collaborative members um, I think maybe last month, and we were talking through um some of these ongoing collaborative efforts, and I'm I'm I wanted to get some feedback on how we could make it more interactive because um we we've worked very hard for the last two years to look at um making sure the services aren't abruptly ceasing, but it sounds like we didn't completely get there, is what I'm hearing.

And so what I would like to understand is whether or not there are um opportunities where we can help identify specifically some of the measured W funding and the medical funding because you all know we're also dealing with HR one, and we're trying to find ways to backfill funding for that.

But how can we best make this um a way in which we can help prioritize and figure out which programs um can be merged or maybe uh look at some opportunities?

This is also in in concert with what's happening at the Almeda Health Systems, which we're also in this committee uh working through.

So uh appreciate some of that feedback from you.

Definitely.

Um so I've been I've had opportunity to be on CPAG since it started.

And I think CPAG has been a great space for making sure we all have the same information, but it has not been used as a work group type setting where we can really brainstorm um how do we shift things around?

What if we put this here?

What if we combine these things?

That's not the kind of space that's been, and because of its quarterly nature, it doesn't really lend itself to a work group setting.

It's been used to make sure that we've been kept updated.

I think maybe initially there might have been different intentions, but so many changes in the system occurred during the time that CPAC has existed that this space ended up being a place where um there was an intentionality and information sharing, but not space to really talk about um solutions.

Okay.

Um would you what would a forum look like that would be more interactive?

You're you're saying the work group approach isn't working.

Keep in mind the group apologies.

Keep in mind the constraints that we have as a board with in terms of um how meetings can be um orchestrated and conducted.

I apologize for interrupting you.

Um I do think the work group would be a great approach, um, having representatives from your staffers to the health system to behavioral health specifically, to housing and homelessness in this case, because we're talking about a lot of services that exist in multiple domains now.

Um, it's just that CPAG hasn't been a work group.

It's been a um info sharing space.

Um so I do think a work group would be amazing.

How often should they meet?

I mean, during a time like this, um maybe every two weeks, I hate to say it, but we're in kind of a crunch time.

If we were to say, okay, we have bridge funding, we have 15 months to figure it out.

We could meet monthly.

But um if we truly only have till May to solve all of this or to try to mitigate the risks, I know it's not solvable.

Um, then we need to meet every other week.

Um part of our dilemma is that we don't always have um information.

For example, like with HR one, we we have some broad understanding of where the cuts might be, but we don't know specifically, just like we didn't with proposition one until we we got into the different categories.

So if you we don't have information for um a more like um you know uh a more interactive meeting, how do you think that would go forward?

Yeah, like I appreciate the desire to be comprehensive.

I think we can just make the best decisions we can based on the info we have.

And I think this is where the ask for bridge funding actually comes in.

It's hard to make all these decisions without having all the information.

And cutting programs is incredibly costly if there's any chance that we might want to resurrect them or have a different way to support them next year.

Um so I think we need to keep that in mind.

What's the cost of not doing anything?

I appreciate that.

Thank you.

Thanks, Supervisor Town.

Um let me turn to staff and get some feedback and then we can go to public comment.

Thank you, supervisor.

Um, and thank you to the collaborative for your presentation.

Yeah, I just I I want to acknowledge the incredibly difficult time that this moment is is putting us all in.

Um and as you noted, supervisor, there is um the compounding effects of Prop One and coverage coverage losses that are happening through HR1 and then the things that we don't know uh in terms of what impact it's gonna have on the state budget, right?

So kind of keeping that broader view.

Um I appreciate the feedback on the CPAG.

I think that that's something that uh at the last CPAG meeting, Supervisor Miley had recommended that there also be some sort of work group that's kind of time limited specifically around behavioral health.

So happy to connect further to see what would make sense there.

Um and then I just want to you know share a few high-level things in terms of what we have been doing on our end.

Um and I would also invite Dr.

Tribble to to share uh some additional details.

But so essentially, you know, um the the cuts that came about in Prop One were uh they're essentially a combination of us um not being able to fit current programs into the new BHSA buckets, and then also uh anticipating reduced uh a significant reduction in um revenue, right?

And then also anticipating reduced a significant reduction in revenue, right?

So it's less money and the boxes are some of the squares are turning into circles.

So trying to figure that out.

So on the back end and in you know collaboration with many of our community partners, we've been looking at ways where the Measure W Home Together Fund could support.

You know, and then I think to kind of to what you've heard is that that would also mean that maybe that program needs to shift because it doesn't again, uh behavioral health has certain things that they need to report to the state, and H H has other things that they need to report to the state.

Um and Measure W, as we know right now, is um not an ongoing funding source, right?

So kind of keeping those things in mind.

Um there are some adjustments that we've been able to make with Measure C in that planning that we did with the children's uh pediatric portion of that.

Um and then, you know, we're looking forward to just kind of working together to see what we might be able to bring forward to your board for an essential services ask or uh some other kind of bridging.

Um definitely want to agree that bridging is probably the only thing that uh but the amount and and anyway, there's a lot that goes into what would be bridged and what could be bridged.

Um, and our goals would be to really not set up an environment that sets up another cliff in another year.

Um, you know, I think some of our ARPA experience sort of lends itself to that, where that was identified as a um a uh limited time funding source, but then ultimately, you know, those requests uh haven't necessarily stopped because the system needs haven't necessarily stopped.

Um so really just want to share that in terms of the the way that we're approaching it and the and the things that we're considering.

Um, and if Dr.

Tribble wants to share anything else in terms of um the considerations that went into putting together the um the list and uh any of the system impacts.

Thank you, supervisor.

Thank you, Supervisor O'Miley.

Appreciate you uh all hearing this.

I think what I'll start by saying is I want to acknowledge what you heard in terms of the impact.

Um I don't believe our department would argue with much of the sentiments you're hearing.

This will be um for those of us that have been working in the field 25, 30 years, even healthcare in general, this is uh quite significant in terms of that.

So we very much appreciate uh the commitment and the conversation about bridging that will be essential.

Um I think uh ordinarily our department comes from a space where we're used to infusing uh funds.

We have a very large budget, the largest budget in our agency, and we're used to being the uh bridge.

I think what you're hearing though, because of the 200 million dollars that was BHSA now shifting to about 120 some million, it is catastrophic and it is complex for us.

Um what I would say is that uh their solutions are actually uh uh very wise.

When you look at a bridge funding, it will allow the system to kind of talk through uh some of the the variables.

Uh it is true that it is going to be complicated with HR one.

However, you can look at revenue generation now.

You can look at those providers that are eligible, you can look at billing, you can look at infrastructure.

So there is ability uh to look at that.

Um the benefit is that some of those uh programs will be untouched by Prop One, for example, EPSCT, full scope medical in our children's system of care that remains touched.

So those could there could be growth opportunity in their that area.

Uh the other thing that is a potential based on their uh the recommendations that you see is looking at how the uh current space is funded for Prop One in terms of the housing allocation.

It is accurate that most of the services that were uh continued or or funded, i.e., or partnership with H, those will continue.

And the department has done a very um creative and hard job to move existing program to fit the component.

So that is accurate.

Um I think there's opportunity for more uh look in terms of what is being unfortunately sacrificed by the implementation of Prop One in terms of the outreach.

Again, I I don't want to re-it reiterate their their commentary in terms of that, but they're they're accurate.

A lot of the programs at Alameda County were uh award-winning, recognized, uh, will be impacted and provided a direct throughput uh for the housing division that it operated for many years, including now in H.

So I I think it will be important to really look at it.

So I would say um the Medi-Cal funding will be the most tenuous because we're seeing I think uh just locally in our department, we've implemented smart care, which was adopted by the state.

Um there were some changes within the agency.

Year one, we lost about 5 million, I believe, uh dollars.

Uh the providers didn't feel that year two, we lost 17 million.

So there's some internal full court press activities that we can also use to minute to improve the billing structure and capacity of the department.

Um that's something that's not as well known with our providers, but I think that would have to happen because if we establish programs that can bill, draw down Medi-Cal, the infrastructure has to be there to allow that.

Otherwise, the county will not be able to recoup those dollars.

So there's a lot of work.

I think uh I I would imagine Al Media Health System is a lot of one speak for them, would appreciate the opportunity for cross-learning given their impacts, there's just so much throughput.

Uh so I I would affirm that.

I think the main piece that I believe would be important is that uh having a very uh clear and conscientious uh conversation with our community partners as well as our clients that although there may be bridge funding, although there may be opportunity if uh CPAG is reconstructed to really uh enable a work group approach, that this will be a year of transition, and that inevitably as a as a community we'll have to look at uh the final year and look at what that will be given that we don't know at this point what's going to happen with Prop One.

We were advised by the state.

Uh we had anticipated a $5.7 million dollar growth.

We were basically notified of a $7 million decrease.

So that's beyond the initial notices, but the department is still holding and will absorb those losses.

So I think it'll be important in the next several uh months.

We'll look at what the state revenues look like.

If there is any change, then the department as well as uh the agency will be able to pivot.

So all those factors being um uh an affirmation of what you heard, there is significant uh impact for sure.

Um thank you.

So I I appreciate um you're going down the list of what was being um essentially recommended as and requested by the collaborative in terms of addressing at least what we're seeing now as the 21 million dollar cuts.

And this includes the bridge funding, the uh basically shifting things to look around whether home together funds can be accommodating the Medicail Cal Aim funding, the measure W funding, the measure C funding that you mentioned.

Uh, and then I I understand Supervisor Miley is also looking at trying to re construct the CPAG meeting so that it's more interactive, roll up your sleeves type uh work sessions in terms of trying to address some of these issues in the coming months.

Is that correct?

I'm open to whatever needs to need to occur, yes.

Okay.

Hello?

Yes.

I just want to correct the record.

Um, as you heard, it's about 21 million or so for the collaborative partners, but this is a 53 million dollar delta.

There were other organizations that were not members of the collaborative.

So I just wanted to, for the record, uh comment on that.

Thank you.

Appreciate that.

I'll turn it over to Supervisor Miley.

Welcome back.

Oh, thank you.

So um so I just heard so it's an additional 21 plus uh 32 million.

Uh no, I think the, and I don't want to speak for them, but I believe what you see in the presentation for the collaborative, what they did is survey their own members and they quantified the impact fiscally of the members within the collaborative.

The total impacts uh locally were was 75.

Our department stopped and could see the hemorrhaging, obviously, and opted to end.

So the about 53 million dollars in notifications went out to community partners.

So the 21 million dollars is inclusive of the total uh impacts to locally this year.

So it's 21 plus 32.

Correct.

Right.

Okay.

So would we need bridge funding in the amount of 53 million?

If you're asking the system, I would say yes.

I know that logistically that'll be complex, but I think uh otherwise it would look at bridge funding to shore up uh outright program eliminations and look at uh reduction of services, both.

So whatever could be accomplished, but certainly I would not say no to bridge funding for the community uh in that total amount.

I need to understand maybe um supervisor Jam might know this already.

What's the difference between the collaborative in the community?

What I mean, I need to I thought everybody was the community or something.

Everyone is a color uh community, but I want to respect the collaborative is who is bringing the presentation to you.

And they are a member organization within uh the behavioral system.

And so the Albany County collaborative is made up of many different providers, which I think is included on one of the slides.

However, there are other uh organizations that exist outside of the collaborative.

They are not a member of this organization, they too have been impacted.

That's weird.

Okay, because I'm just looking at the list of collaborative members.

It seems like it's there are pretty comprehensive.

There are a lot, that is not all of the impacts.

Okay.

If I may, um so that also includes uh 11 and a half, the 53 million includes about 11 and a half million in uh county programs that were also affected.

Um excuse me, you wouldn't see those on that list.

Um, and then there are others that are you know kind of uh different flavor of program than might be in the the collaborative itself.

So we do have a full list, and in terms of your question about um bridge for the entire amount, I think that's what we've been trying to work out on the back end is that um you know there's a lot of demands on the measure w funding, there's a lot of demands and unknowns on what's gonna happen with HR1.

There's the HS conversation.

Um so there's just a lot for your board's consideration.

And so what we would like to do is you know, sort of pull together uh recommendations that we would bring to you that help us figure out what funding can uh backfill what.

So I I think you were here, uh you may not have been here, supervisor, but I'd mentioned that um some of the for example that 53 million includes a cut to reach, uh Ashlyn uh the youth center that we were able to anticipate with our measure C planning.

Um, and so you know, we've kind of adjusted for some of that.

So then there's others that might be for measure Wome Together Fund, and then others that might better fit the Essential Services Fund, for example.

So how soon before we get that uh analysis?

Because I think we've been kind of waiting for that for a while.

Yeah, we're we're working on it as as fast as we can.

And you know, one of the things that we're running into now is um in terms of, for example, if we backfill something with the Home Together Fund, um, what does that mean operationally, both for H and for Behavioral Health?

Um, because does that mean we need to shift contracts?

Does that mean behavioral health carries it for a little bit?

Does it, you know, and and then kind of thinking through the next step of what behavioral health needs to provide for the state in terms of their reporting and what H might need to provide in terms of alignment with the Home Together plan?

So it's sorry, not a satisfying answer, but we're we're working on it.

Okay, well, I'll probably come back to you a little bit later.

Have we heard the speakers yet?

Not okay.

Let's have the speakers.

There's 52 in-person and how many online 10 online, so that's 62 speakers.

52 hours if it's two minutes.

Can we have 90 minutes?

I mean 90 seconds, sorry per speaker.

Sure.

Okay.

Can we do that, Lisa?

Can you give them a minute and a half?

And then if so, a minute and a half, all speakers and all speakers, please sign up now.

If you don't sign up in the next five minutes, uh, we're we're closing out the speaking.

So anybody wants to speak either in person or online, sign up now.

And at uh 1040.

Um we will cut off speakers.

Yeah.

Okay.

Call the speakers.

Jamie Almanza, Zoe, Eat Barrel, and Jennifer Joel.

Good morning, honorable supervisors.

Thank you so much for calling this public hearing, one that should have been called, in my opinion, uh over a year ago, but I'm glad we're here today.

I want to share my name's Jamie Almanza.

I'm the executive director of Bay Area Community Services.

There's a great number of beautiful Baxters in the room today that I'm hoping you're able to hear from.

BAX is absorbing a more significant amount of cuts, and I know that's because we're a larger organization.

All of our wellness centers are closing and/or decimated.

All of our outpatient community-based treatment that was funded with MHSA, which actually brought in 50 cents on the dollar through Medi-Cal billing are closing.

So that's our Oakland Project Connect program, our SAGE program, and much of our re-entry treatment team.

Our staff bill Medi-Cal every day.

So it's not just losing the MHSA, it's losing the federal match from the Medic from Medicaid.

So those dollars also, I believe, need to be calculated in the overall loss to the community.

We will be closing 4,000 clients alone, one agency, 4,000 clients.

So if you look at that and you look at 15,000 clients, which may be underreported, BACs alone is closing 4,000 clients.

We don't know where to refer them to because you'll see all the decimation of cuts.

So I'm here today to implore you.

Um I hear the runaway.

We don't want to create another runaway, but we need a year more of runaway for the people we serve.

Thank you so much.

Morning.

Uh I'm Zoe Everly.

I am a resident of Senator Miley's uh district.

Supervisor Miley, sorry to give you the promotion.

Uh, and I oversee youth programs at Crisis Support Services of Alameda County.

Uh and my program, our program, uh, is Teens for Life.

We provide suicide prevention education to our county's middle and high schools.

So we teach students how to recognize warning signs for suicide and then the steps to connect that friend with support.

And our data is really clear.

Uh, students do seek help for themselves and for friends as a result of our trainings.

This broad early intervention saves lives before it can reach the crisis, before a crisis can reach the emergency room.

But because of these changes to funding under Prop one, our program is slated for elimination at the end of this school year, June.

These cuts won't save money, they won't save lives, they'll only compound the cost of a crisis later down the line.

During a time where suicide remains a leading cause of death for our kids and teens.

I urge you to prioritize our program and the lives of young people in our community.

Thank you.

John Douglas Hello, I'm Jennifer Johal, and I'm the health care engagement coordinator with Crisis Support Services of Alameda County.

I've been providing suicide prevention education to healthcare professionals for almost eight years.

My work is driven by the National Zero Suicide Initiative data that states 83% of people who died by suicide visited a health care provider in the year prior to their death, and roughly 45% of people visited their primary care provider in the month prior to their death.

These patients don't typically present with a mental health crisis, but rather physical concerns.

Therefore, it's imperative for healthcare professionals to be able to recognize the subtle clues of suicidality.

My program addresses this gap by training nurses and doctors across the county to screen for suicide risk, to do basic basic assessments, and to provide life-saving intervention.

Prop one's focus on high acuity cases hinders providers from seeing the sometimes hidden risk before it's too late.

My work is at risk of losing funding.

If we cut training for healthcare providers, we lose our chance to catch people before they reach the emergency room, or worse.

Education is life-saving, and we urge the board to protect prevention training.

Thank you.

Hello, and thank you for that I might speak.

Um, John Douglas, care coordinator with Barry Community Services Reentry Treatment Team.

Rehabilital health services and re-entry play a critical role in helping formerly incarcerated individuals, often referred to as returning citizens successfully reintegrate into society.

Many individuals leaving jail or prison experience untreated mental illness disorders, substance abuse issues, and significant barriers to housing, employment, and health care.

Without adequate support, these challenges can lead to homelessness, relapse, reincarceration in counties like Alameda County, where homelessness and justice involved already strained the community resources.

Behavioral health and reentry services are essential for both individual recovery and overall community stability.

Behavioral health services provide mental health treatment, substance abuse counseling, case management, and connection to the housing and employment resources for returning citizens with mental illness.

These services help stabilize individuals during the critical transition from incarceration back into the community.

Researching consistently shows that untreated mental illness is common among justice-involved individuals and contributes to higher rates of reoffending, if not addressed, programs that provide coordinated care and linking individuals with therapy, medication management, peer support, and housing assistance significantly improve the outcomes.

And California individuals who participate in community reentry programs are 34 less percent less likely to re-offend.

Um I have picked up people from Santa Rita jail, and without having somewhere to take those people and be able to get them to bridge the gap from jail to the community that they won't go back out on the streets and within days, hours have relapsed, have re-offended, and it's just a continuing cycle that puts strain on the budget of this county, above the budget of the state for housing these people when they do re-offend.

Thank you.

Hi, my name is Bernitz.

I own a program manager with Inside Housing.

Um, we are gravely concerned that these cuts will mostly impact this year.

We are really concerned that the cuts to mental health will definitely impact a lot of our clients.

Um we serve, we have a board and care program.

We have uh emergency shelters, permanent supportive housing, um, and that's the area that I work in.

I have been a um board and care operator for over 34 years within Alameda County.

I have seen um a lot of cuts and things that happened to our services where it increased the volume of homelessness and people going back out into the community because we don't have the services that's needed to help them.

Um we service uh LGBTQ communities.

And I overheard someone earlier say that a lot of the uh people start the mental health illnesses at an early age, at age of 14.

However, I think some of it's earlier than that, which leads to if people don't have the services that they need, it leads to people becoming drug offenders because they're self-medicating.

So we just employ you to make sure that the the that we can utilize the next fix of the fiscal year budget appropriately as far as helping the clients of mental health.

Thank you.

Excuse me, we'll start your time.

No more speakers.

We took we stop speakers at 1040.

Yeah.

Okay.

Start our time over again.

I said earlier, if you hadn't signed up by 1040, we're cutting it off because you know, Supervisor TAM has another committee meeting a little bit after one, and we have 60 some speakers, and that's at least two hours go.

All right.

Hello, my name is Hannah Funk, and I am a grants and contracts manager at Taversio Vasquez Health Center, TVHC.

For more than 10 years, TVHC has partnered with La Clinica to implement the Cultura Ibien Star CYB program for Latino families in Alameda County, supported by BHSA.

We are asking the Board of Supervisors to engage in a serious search for additional funding to protect these services and programs.

CYB stands to lose a number of staff physicians with over a decade of experience in preventative counseling, outreach, and psychoeducation for Latinx and Indigenous families in Central and South Alameda County.

Together, we may lose decades of combined knowledge and experience in serving our communities.

Just to explain why the proposed transition to the fee-for-service model is insufficient to meet the needs of all who currently benefit from our program.

It also only serves the specialty mental health delivery system, and providers like TBHC are excluded from this.

This results in immigrants and the uninsured who are most likely to be impacted by these changes and left behind.

Experience significant migration-related trauma.

They describe CYB as a bridge to hope, one we hope you can preserve.

Thank you.

I mean, outreach, excuse me.

I deal with at-risk um families and youth.

Um, cutting programs like the one that I am will be basically cutting a lifeline.

Um I'm in the streets of Oakland dealing with people every day, trying to connect them to resources and rebuild the community.

So that's all I wanted to say.

Kelly Gillian, Daryl Albums, Millie Alvarez.

Good morning.

Um, my name is Nasir Khan.

I'm here today to speak about the impact of BACS Oakland Project Connect closing.

This program serves most of the vulnerable residents of Lamida County, people experiencing homelessness in addition to mental health challenges.

Oakland Project Connect provides intensive community-based care coordination and housing navigation to help people move from the streets to stable housing and ongoing care.

Each year, the program is designed to serve 55 to 75 clients in the county's highest needs clients.

In recent years, it has supported over 100 individuals annually who otherwise struggle to access to stay connected to basic services.

These are individuals who often cycle between homelessness, emergency rooms, psychiatric crisis services in jail when they lack the basic services that should be amenable to programs like this helps break the cycle by building trust, coordinating care, and helping people secure and maintain stable housing.

When a program in a program like this um closes, the impact is not just abstract.

It means that dozens of people who are finally connected to services may lose stability.

It means frontline providers lose a critical tool for housing people move towards recovery and housing.

I urge the Alameda County to consider the long-term cost, both human and financial of losing programs like this, and to prioritize sustainable investments and services that keep people housed and supported in our community.

Thank you.

I can speak about the participants that we have supported the thousands and hundreds of families victims of violent crime and domestic violence survivors, uh supposed to human trafficking.

But I'm gonna speak about myself.

Three years ago, I lost my son to a major court accident, and I was at the rock bottom of my life dealing with substance abuse, dealing with depression, dealing with grievance.

But this program doing the training and doing the support with boss, it saved my life.

It saved my life, it saved my family life, it saved my grandkids' life, right?

Cutting this program is gonna hurt the families, the black families in Oakland, California that need support.

We are grassroots organization, boost to the ground on a daily 24 hours, seven days a week.

We're supporting our black community to connect in with resources and services, but we're not just doing a hand, a warm handoff.

We're holding hands, we're supporting, we're healing through healing circles, and also by living experience.

I'm not just director of this program, I'm a participant.

And I'll say that again.

I'm not just a director, I'm a participant.

This program saved my life.

You're cutting the war off for so many films of old California.

Thank you for your time, boss.

That's a hard act to follow.

I'm uh Millie Alvarez, uh social worker who for almost 30 years was director of BACs, the Town House Wellness Center in Oakland.

Townhouse was founded in 1969 at the time when state mental hospitals were closing and town health helped people reintegrate back into their communities.

And it has continued to be a main support and treatment for thousands over the years and has greatly reduced relapse and hospitalization.

We thank Alameda County and the behavioral health and the board of supervisors for supporting us all these many years.

And we hope we can find a way to continue this Oakland institution that for the past 57 years has been a haven of support, connection, hope for those with the most serious and chronical mental illness.

Thank you.

Catherine Schwartz, Veronica Palutro, Catherine Ward.

Sarah Markson, Berdo Perez.

Hi, my name is Veronica Palutro, and I am the former supervisor of BACS Team Sage.

Our entire program was cut.

200 clients are going to be left without any services unless we can scramble and try and find something for them.

We are now going to be forced.

Um, our clients are going to be forced to engage in calling 911, going to John George.

You're not going to get the services that they truly need.

I live across the street from the Lake Hearst Hotel.

Those clients need our services.

They're by themselves in the community without backs.

They're going to be in a lot of trouble.

The community is going to be in a lot of trouble.

OPD is going to be getting a lot more calls.

So I ask that some real decisions are made.

And as our executive director said, this should have been done a year ago.

Thank you.

Hi, my name is Catherine Ward, and I'm the school-based coordinator with Crisis Support Services of Alameda County.

I also live in Castor Valley, which is Supervisor Miley's district.

As you implement Proposition One, I'm here to sound the alarm on a looming gap.

School-based grief support following incidents of community violence.

When a community member is killed on our streets, the trauma follows students into the classroom.

Research shows that youth exposed to community violence are almost twice as likely to attempt suicide within the following year.

Currently, our therapy services focused on traumatic loss, provide the immediate stabilization these students need.

But under Prop One's new high acuity rules, a grieving student might not qualify for help until their trauma has spiraled into a chronic and severe disability.

Community violence is a public health crisis in Alameda County.

We cannot wait for a student's trauma to develop into a permanent mental illness before we offer them grief support.

We urge the board not to let this funding cliff turn into a community tragedy, turn a community tragedy into a suicide cluster.

Thank you.

Hi, my name is Sarah Markser.

I live in District Three.

I'm the evaluation and policy specialist at Peers Envisioning and Engaging in Recovery Services or Peers.

I'm also the mother of a young adult with a mental health disability who lives in district two.

I wanted to point out that much of what is being dismantled grew out of the civil and human rights movement against the horrendous abuses of institutionalization of people with mental health disabilities.

And these services enable people to live in the community and to build lives where they belong and contribute, which are also basic human needs.

Provided life-saving services to my child in her young adulthood.

And I have been served by Crisis Support Services and by the Mental Health Association's Family Education Resource Center or FERC, which I believe is slated to be closed entirely.

And that the values of this county do not require that we not let it happen that people are served only in lock settings or in jail.

Thank you.

Monica.

I want to remind us all that pension work gets there before first responders get there.

So we are ahead of the first responders, and so we think about saving these programs, think about that.

Thank you.

Thank you for the opportunity to speak.

My name is Monica Suniga and I work at Tibursio Basque Health Center.

I want to speak about the impact of Proposition One on Community Defined Evidence Programs, CDEPs serving Alamira County.

Programs like Cultura Bienestar, where I have worked for more than nine years, have shown over 15 years that prevention works best when it's culturally rooted and community-based.

These programs work because they follow an integrated model that start with community outreach, continue with prevention and education, and other support groups and individual help when families needed.

The full continue of care is essential for immigrant families we served, many of whom live in chronic stress and face barriers to access traditional mental health services.

Access begin with trust.

Prevention only works when communities trusted.

Programs can be rebuilt.

The trust these programs have built with immigrants' families, have taken more than 15 years.

Thank you.

Rashad Norton, Shanice Kelly, Sasha Ellis.

For many of us, especially older adults, these spaces are essential to combat loneliness and take care of our emotional well-being.

Programs like Cultura provide services that are culturally appropriate in our language and free of the stigma.

This allows many people who might not normally seek help to receive support before their problems come become more serious.

If that happens, many older adults and families in our community will lose a very valuable resource to help us stay healthy and connected.

For this reason, I respectfully ask that you seek additional funding to protect programs like cultura y bienestar.

For this reason, I investing in prevention means healthier communities, fewer crisis, and greater well-being for everyone.

Thank you for thank you very much for listening.

Hi everyone, my name is Jen Marshall, and I'm the community education director with Crisis Support Services of Alameda County and a resident of Oakland.

Last year, our suicide prevention education and outreach program served over 17,000 people across Alameda County.

This included 10,000 students, educators, caregivers, healthcare providers, and community leaders.

For next fiscal year, our department is facing over 600,000 in cuts and has been asked to shift our programs to become a medical intervention.

When I told my team, they asked, what about the lives that will be lost?

Our work is built on a single hard truth.

In suicide prevention, prevention is all we have.

Once a tragedy occurs, we are left with the aftermath.

Before it happens, we have the opportunity and the responsibility to change the outcome.

When someone is trained to recognize the warning signs, or it's okay to call for support, they become a lifeline for their community.

That is how we build a safety net.

That is how we save lives.

When prevention disappears, crisis becomes the only option.

We ask the board to protect the preventative side of this work so that when a crisis hits, there is someone who knows how to help before it becomes a 9-1-1 call.

And I'm here because I am alumni of Haven for Black Healing.

Not only gave me the opportunity, I will call Heaven for Heaven for Black Healing is the apprenticeship for mental health.

I say that because now I'm a SUD counselor and that has gave me the experience, the life experience to really work with my people.

I'm on the ground.

Taking having for black healing is like taking the boots away from a soldier to the war.

Thank you.

Not because their needs were new, but because the entry points we rely on to connect people to services are disappearing.

Our systems are complex and people's needs are not siloed.

Bax Outpatient's programs and wellness centers have long served as the bridge across those systems, offering low barrier community-based spaces that people can walk in, be welcomed, and be connected to the support that they need.

From assistance perspective, these centers are often where crises are prevented before they escalate.

They help stabilize people before they end up in emergency rooms, psychiatric hospitals, jails, or back in the streets.

If the doors close for good, partners will still show up.

They will still come looking for help, connection, and most importantly, safety.

The difference is that without these centers, many of these needs will show up later in our hospitals, in our jails, and on our streets.

So the question becomes who will be there to answer the call.

So I urge you to reconsider funding for these critical services.

They are not just programs, but they are lifelines and are a vital part of our community system of care.

Thank you.

Joanna, Joanna Parnes, Nicole Avchlamov, Gary Tia Thank you.

My name is Sasha Ellis, and I'm a supervising attorney of our Social Security work at Bay Area Legal Aid.

Bay Legal provides free legal services, civil legal services to Bay Area residents living in poverty.

For the past 14 years, the behavioral health department has funded Bay Legal to help high utilizers of county mental health services obtain SSI.

Our work would be an example of another funding source, not in the collaborative that is being cut.

This partnership funds part of this partnership.

The work we do is we meet with clients while they are in mental health facilities, such as John George or incarcerated at Santa Rita jail.

And we're able to begin working with them early as part of that team to help stabilize them.

The partnership also allows our team to work closely with clinicians across many of the behavioral health department case management teams and clinics, many of whom are here today.

These cuts are devastating to all of these providers, and we're going to feel it mutually with our clients in our community.

That close collaboration is vital in maintaining contact with the client, helping connect them to other services, and sometimes assisting with other legal issues that might arise as well.

And ultimately, when we all work together and meet the clients where they're at, it means better outcomes.

Many of our clients have no income or live on GA when we meet them.

They're unhoused, they're at risk of being unhoused, they're in and out of jail, in and out of facilities.

Um, and we are struggled to connect them to vital services.

Um, this funding has allowed us to do so with the partners that are here today.

And any of these cuts will drastically affect our clients and community.

Thank you so much.

Good morning.

My name is Kareem Hines.

I'm a housing locator with Bear Community Services, and immediately I've experienced this loss of services, keeping partners from being able to access the housing that they're already eligible for.

A number of partners are eligible for vouchers, but they don't know how to work the system in order to understand a lease or go to a neighborhood and get used to the community and make sure that they're making sound decisions for themselves.

That is where the wraparound services have come in.

That is where they've got the most success.

And unfortunately, I'm seeing time and time again, individuals not being housed.

And on the other side, they're having a difficult time remaining stably housed.

They are having problems with hoarding or just sticking to budgets, and this is where these wraparound services come in.

I understand that we all are coming here to support these clients and in Alameda County.

That is something that I see.

So I'm proud to be a part of these individuals and all the services that they provided.

If there's any opportunity to provide a bridge, please do so.

Thank you.

My name is Joanna Parnes, and I'm the managing attorney of Social Security at Bay Area Legal Aid.

Bay Legal provides free legal services to Bay Area residents who are living in poverty.

For the past 14 years, the Bahavioral Health Department has funded Bay Legal to help high users of county mental health services and pre-release Santa Rita inmates obtain SSI.

Many of our clients have no income or subsist on general assistance benefits.

They are unhoused at risk of homelessness or cycling in and out of jail and John George Psychiatric Hospital.

They are unable to navigate the complex bureaucracy of Social Security on their own.

Through this partnership, we have helped thousands of people obtain life-stabilizing SSI benefits.

Data from this project has shown that this increased income reduces housing instability, recidivism, and crisis hospitalization.

SSI provides a stable link to Medi-Cal, which is ever more important as HR1 threatens to strip many Californians of their health insurance.

Additionally, Alameda County has been able to recoup millions of dollars in general assistance paid to SSI recipients while their SSI application was pending.

I urge the board to address these drastic cuts.

Cutting legal services for Alameda County residents with serious mental health needs will cause homelessness, incarceration, and psychiatric hospitalization to spike.

Thank you.

Hello, my name is Nicole Vshalomov.

I am a clinical supervisor on BACS FSP teams.

For those that don't know, FSPs deal with the highest severity mental illness clients in the community.

To work on an FSP is basically to do an impossible job.

Our programs aren't getting cut, but our level two programs and our wellness centers are.

Without our level two teams, our wellness centers are our jobs will become beyond impossible.

Our wellness centers and our level two teams make it so they never have to get to the point of being on an FSP.

Our teams prevent further tragedy and traumatization from happening in the first place.

Our FSP should be a last offense, not a first.

The loss of our wellness centers, Townhouse, and Wedcoat HEDCO is absolutely unfathomable to me.

These are the places that our clients call home because they don't have a home.

It's where their mail goes, it's where they find their psychiatric support.

It is where their team is.

It is where people who appreciate them and care about them and respect them just for who they are.

It's where they are, it's where they find them.

And we're taking it away.

And first and the most importantly, it's where they get coordinated entry, which is what gives them access to housing, which we say is what we want for them.

I don't know how the FSPs are going to be able to do their job without the support of these programs.

Our jobs are already hard as it is.

Kelsey Newson.

My name is Gary Tia, and I'm a representative of Bay Area Community Services.

I also work overseeing some of the crisis programs and the wellness centers at Bay Area Community Services.

I just want to briefly say that a lot of what's been said today is it's a demonstration of the worry that we have right now about being able to identify like the bridge funding that to help with bridging MHSA to BHSA.

I do just want to share one experience that I've had at the wellness center about like the impact of the wellness center, and that is uh not too long ago an individual came in and he was struggling and decided that he wanted to take his life at the wellness center.

He pulled out a knife and tried to stab himself in the heart, and we were able to help with de-escalating that service, de-escalating that situation with him.

We sat down with him, we talked with him, and it makes me really wonder if if people are gonna have a place to go.

There's about 4,000 partners that are going to be impacted from BACs alone.

And we talked about, I think the collaborative brought up a number where they said about 400 people are at risk of losing jobs.

150 to 200 of those individuals come from BACs alone.

So the impact is great.

Um, and the stability that we see that peer-led programs have is something that um they also mentioned.

It was like a 74% stability rate when it's when it's provided by by the community, and we're losing these resources that provide stability for our partners.

Good morning, supervisors.

Thank you for your time today.

My name is Breet Gore Subberwall, and I'm a clinical community program director at the Hume Center in their South Asian program, a prevention early intervention program funded through MHSA funds.

For the past 13 years, my work has focused on the South Asian community, specifically the Punjabi community here in Alameda County.

As one of the few Punjabi therapists in the region, the UELP program has allowed me to create sustainable programs rooted in community-defined practices, language and faith-based healing, and other sustainable approaches.

The South Asian community is often seen as wealthy, educated, and self-sufficient.

This stereotype masks the real challenges many face, including poverty, housing instability, mental health stigma, domestic violence, and lack of access to services.

This model minority myth leads to underinvestment in programs that could support our vulnerable.

The MHSA funding has been a lifeline.

It has helped us increase access to care, prevent substance use, loss of housing, and help gather aggregated data.

In fiscal year 2024, 2025, we served 108 individual therapy clients and engaged in over 5,500 people through community outreach.

While many organizations exist that focus on other communities, there are no programs that are dedicated to the South Asian mental health across the nation.

This is one of the only ones.

As a member of the Prevention Matters Collaborative and the Behavioral Health Collaborative, we urge you to prioritize mental health prevention program recommendations.

And we want you to find ways to bridge the gap in funding.

Thank you for your time and support.

Hi, my name is Kelsey.

I'm an associate director of programs at BACS, and I'm a proud lifelong Alameda County resident.

The continuum of care in Alameda County is already so impacted that we barely have the resources to meet the current demand.

And with the closing of all of the BAX's wellness centers, I'm extremely concerned that it will make the situation worse.

As Jamie mentioned, we will have nowhere to send our community members and our neighbors.

And quite frankly, their lives will be in danger.

And as many of my peers here have mentioned, these services are a vital lifeline for the community.

And my staff and I are devastated by these cuts as we'll no longer be able to support our neighbors in the way we deserve.

And just personally speaking, listening to everybody else's experiences and their stories of their clients.

It brings me to tears, frankly, that that work is going to be made so much harder as I find this work to be absolutely vital to myself, to the community, to everyone.

And I hope that the county is able to find some bridge funding and we're able to keep some of our services open at least.

Thank you.

I live in Oakland.

I work in Oakland.

I'm raising my family in Oakland.

So to do this work with my fellow colleagues, my peers, community members who are deeply rooted in this work means a lot.

It has changed.

I've seen the change in the last 10 years, just being in the field with BACs, boots on the ground, making sure that individuals' first contacts are us as individuals, their peers, not police or emergency services, but individuals who have experience and would want to talk and work with individuals who are coming from struggles and trauma.

I deploy today to put funding back into our community mental health programs.

We no longer want to be able to continue with areas of being deprived with our health care.

Our mental health programs are our first stops.

They eliminate incarceration.

They eliminate institutionalization, they eliminate a lot of worry and trouble that our emergency responders are going to have to deal with.

We are the first, we are the first place.

We are the first stepping stones into emergency supports.

We are the first families when they don't have no families.

We are their friends that we show up when nobody else wants to show up in the county.

So I do ask that you guys please reconsider and make sure that funding gets back into our community into our homes, as well as our staff.

Over 200 uh staff members are going to be impacted.

And the worst thing to do is those staff members become individuals that we are serving today.

Good morning, supervisors.

Thank you for listening to all of us in this important matter.

My name is Vivian Juan.

I'm the CEO of Abode Services.

I'm a collaborative member.

I'm also representing the newly formed nonprofit alliance of housing and homeless providers.

Housing is health.

Health is housing.

If we didn't learn this during COVID, then we missed an opportunity here.

So I'm really frustrated with the county operating in such silos that we all need to be talking together.

This division between are they a collaborative member?

Are they not?

Honestly, we all just care about serving those that need to be served in Alameda County.

And we see the impact that this is going to be having in our own organizations, but moreover, with all of our Alameda County residents.

I also want to say that the county continues to really prioritizing building their reserves while we're being asked to deplete ours and at the expense on the back of the people that we're serving.

This is the time where we need to invest the resources into our communities.

Strong leadership is all about making really hard decisions, particularly when you don't have all the information.

Lastly, I want to talk about that information.

We still don't have a comprehensive list of all of the cuts that are coming.

And to be able to play that dominoes, that chess game, that moving things around, we need to be able to look at that on a sheet of paper.

This is resources that you and your staff have that could be shared with the community so we can all make the decisions that are best for those that we're serving.

Thank you.

Good afternoon.

My name is Halima Akiode.

I'm a care coordinator at BACS and concerned about the recent cuts to mental health services from our agency.

The closure of LPC program that many rely on for support, stability, and whole person care will severely impact our mental health population.

When these services disappear, people don't stop needing help.

They just lose access to it.

Since the knowledge of budget cuts, I've seen a noticeable increase of anxiety and depression amongst my clients.

Many of them depend on this program, not just for treatment, but for stability, routine, and a sense that someone was there to support them.

Without these services, people are feeling overwhelmed, uncertain about where to turn to clients who have had who had been making progress are now experiencing setbacks.

Some are reporting higher stress levels, worsening depression depressive symptoms, and increase of fear about losing access to care altogether.

Mental health services are preventive care when these supports disappear.

People don't simply stop needing care or help.

Many end up in crises, which are far more harmful for individuals and far more mostly for the community.

Thank you.

Nancy Fascher, aren't you, Lena?

Good morning.

My name is Clary Villa Cres with La Clínica de la Rasa.

I respectfully request the breach funding to prevent the loss of life-saving services as much as possible in the relevant models that have been developed for over the past 15 years in prevention and early intervention and have proven effective to prevent the development of severe symptoms, crisis, and help decrease the suffering of our most impacted communities in these train types.

In collaboration, of course, with our partner organizations in Alameda County.

Thank you for your support.

Hi, I'm Ervin Reeves.

And I have a statement to read here.

I'm here to speak for county's homebound older adults, the residents who can't access clinic-based services or come to this chamber to advocate for their services.

There is a persistent and deadly myth that depression, isolation, and a fading desire to live are just natural parts of advanced age.

They are not depression is a treatable medical condition.

At CSS, we provide specialized in-home therapy for seniors who are socially isolated, frail and critically, those who do not have public health insurance like Medi-Cal.

These individuals often fall into a service gap and are too isolated to access traditional care.

Many also have barriers such as disabilities or lack of access to transportation.

We must address a hard truth.

Well, older adults make up about 17% of our population.

They account for over 22% of suicides in this age group.

An attempt is far more likely to be fatal.

If we cut in home therapy, we're choosing to leave our elders to struggle in silence and isolation.

We urge you to protect funding for non-Medi-Cal home-based senior mental health.

Thank you.

Good morning.

My name is Nancy Fasher, and I'm the chief of behavioral health at La Clinica de la Rasa.

And I'm here today representing uh Culture Vienastar.

I'm also a member of the Behavioral Health Collaborative, and I want to thank you for this conversation.

I want to echo the description of the threats to the service continuum outlined by my colleagues and repeat the request for mitigation, the gutting of essential outreach and services to the most vulnerable populations, including children, immigrants, monolingual communities, et cetera, will have life-threatening consequences.

And of course, as we've heard and know, this crisis will have disproportionate impact on people of color in Alameda County.

As uh the lead agency for the collaborative culture with my esteemed colleagues, La Familia and diversio Vasquez Health Center.

We have for over 15 years successfully provided prevention services to monolingual Spanish-speaking residents of Alameda County.

Unfortunately, the way things have been currently constructed, La Familia and Dirosi Vasquez can't fully participate in the transition to specialty mental health as required under BHSA.

Under the current plan, cost-effective programs will be lost, and thousands of clients will lose access to a community-defined evidence-based practice.

I'm asking for your support to reduce these impacts.

Finally, for those of us trying to build an early intervention program, we do not yet know essential information for program planning.

I repeat the request for bridge funding and identification of other opportunities through Medi-Cal, BHSA shifts, and Measure W, as well as the work group that creates a regular space for planning together.

Thank you.

Susan Susan would you Brian, Craig, Virginia Lawrence.

Hi, my name's Virginia Lawrence.

I've been supporting the Bay Area Community Service since 1990.

Um I'm like stung about the programs trying to be cut and everything.

And we need this program.

And my point is, you know, I don't want to give up on, you know, just my mental health because you know, last Friday, my son was murdered in the street shop 15 times, and I go my mental health Bay Area Committee serves.

I run to them, I support them.

They treat, they help me and they treat me.

And my point is not giving up.

I live in a motel room and I get up out of that bed every day because that's not my best friend.

And I'm standing up here today to support my mental health because I'm going through stuff, you know, and they close.

I don't know what I'm gonna do.

I'm using my SSI for the room, plus my savings with SSI, and I ain't trying to give up on myself and no one else, and I'm teaching another mental health person that we're not alone.

And thanks for letting me share.

Thank you.

My name is Brian Craig, and I am an SSI attorney at Bay Area Legal Aid.

Uh, in the time that I have served in my position, I've represented clients who are on GA.

They have experienced homelessness, have been previously incarcerated and have gone through so many struggles uh throughout their daily lives.

Um, I just want to say that any cuts for legal services will be extremely devastating for our clients because um I've seen the application process in the four months that I have served as an attorney there, and it is extremely complex from the initial process to the reconsideration process to the Ministry of Law Judge process to the appeals counsel with all the forms that are going on.

And then the Social Security administration is extremely hard to get a hold of for individual clients, and even for me to get a hold of for crucial information.

And frankly, I just do not see how any person, especially given that the federal definition um for applicants is that it requires for someone to be severely disabled, uh, could be able to access uh getting SSI in the first place without uh legal representation at all steps of the process.

So I urge the board to address the devastating cuts because this would be absolutely devastating to our clients if there were any cuts uh to our system.

Thank you so much.

James Brooks, James Brooks, Richard Williams, Vilma, Vilma from Peers.

Thank you very much.

I'm James Brooks.

I'm a resident of uh Alameda County.

I'm a part of peers and under peers is to lift every voice and speak program.

We go into different facilities and we talk to the mentally challenged, let them know that they are not alone.

We share our stories with them to help them know that there's room for them to do some uh the great things for themselves.

And it's such a reward to see some of the people when we go into Highland and different places and we see some of the folks in such certain situations and conditions, and just being there with them, encouraging them to see them start to developing and coming out and stepping up and start to speak and telling their stories so they'll be able to go back out and help their communities.

I really hope that we can continue this program to help our people.

Um I really hope we can.

Thank you so much for your time.

Hello, my name is Vilmasekaloscaide, and I thank my high power for the opportunity to work at Peers in Oakland for my 10 years of living in the recovery and immigration.

I speak from a place of my own lived experience and mentoring and developing support group facilitators at Peers.

Our work is built on the principles of mutuality and shared experience.

We operate on the idea that everyone is an expert of themselves.

When we define the programs, programs like taking action.

Uh, we aren't just cutting a line item, we are dismantling a lifeline.

The loss of our Spanish language groups will abandon a community already facing massive barriers to care.

Without these peer spaces, we lose the cultural bridge that clinical models cannot replicate.

Defunding us won't save the money.

It will push people back into the R some Crisis cycles.

We provide the dignity of being seen and heard.

Keep the peer in peer support.

JC Santos, Marcos Gonzalez, DeAndre Thompson.

Hi, my name is Richard Williams.

I've been a caseworker for over 38 years, 17 with Bay Area Community Service.

And I come today to ask you and to plead with you to look at the situation.

You know, when I first got into the Sage program, I was in the encampment camps.

We were picking people up.

And we were trying to get them into the program so that they could empower themselves.

Today it happened.

If you look in your community, or I should look in my community, it's a different.

Help our clients that need help.

Thank you.

Good morning.

I'm ceding my time to Stanley Vaughn.

My name is Jay-Z Santos.

Hello, everyone.

My name is Stanley Vaughn, and I'm a care coordinator for Bay Area Community Services.

I just want to say there are no words to describe the concerns we have regarding the impact of these cuts.

I work in the Pleasanton facility, and my heart goes out to all our clients who depend on us as some are homeless and our wellness center is their home.

We are praying fervently that somehow we can continue to provide needed services, not to mention the fact that there are no services in that area to support the needs of the homeless and mentally and mental health needs.

I've witnessed many success stories since I worked for BACs, and I realize the devastating consequences of the closing of our wellness centers.

So we pray that somehow the funding can be made available for us to continue to serve our community.

We've been doing for years.

And I thank you guys for allowing me to be.

Logan, Logan McDonald, Kima Hamid, Zach Thayer.

Marcos Gonzalez.

I'm a peer first and the associate director of Street Outreach BACs.

I've overseen our street outreach program for the past six years.

And although we have made strides to support that community, we're still very far behind.

The loss of these resources will further set us back and create even more barriers for our most vulnerable.

We will see an explosion of need in an already strange system, and the ripple effects will impact all communities.

Yes, even yours.

If these cuts happen, we will be able to identify it as the inception of the destruction of our communities in the near future.

That is not an exaggeration.

Thank you.

My name is Logan McDonald, and I serve as regional vice president of operations at Bay Area Community Services.

We're proud to be alongside of the providers who work tirelessly to uh form the safety net that stands between thousands of our neighbors and extreme crisis.

I'm here today because what is being proposed isn't a isn't just a policy adjustment, it's the edge of a cliff, and a potential 15,000 people about to be pushed off of it.

4,000 from back specifically.

Like my colleagues mentioned, when services disappear, people re-enter the system harder, sicker, at a more catastrophic and compounded cost.

And you know who's overrepresented in this?

Black and brown people.

Black people in Oakland make up 20% of the population, but half of the unhoused population.

Extremely overindexed.

And although racial disparities are often cited, there's no plan released to reach functional zero for the segment of people falling into homelessness at the most disproportionate rate.

But I digress.

The ones who are attacked in their tan in the middle of the night.

I worry about these people every day.

And these cuts, these abrupt cuts, make it less about worrying and more about knowing that a lot more names are gonna be added to that list.

We still know what's gonna happen with the HUD funding changes, reductions with the Alameda County Health System, HR1, but stacking this on top of all that, at minimum, it's a gamble.

At most, it's a force multiplying real effect of foundational harm.

Please commit to bridge funding through fiscal year 26-27.

Identify every eligible dollar under BHSA housing and homeless services, Medical Measure W and require immediate ongoing collaboration to ensure that fiscal year 27-28 doesn't become the disaster that the current trajectory promises.

Thank you.

Donald, Donald Frazier, Quintina Barkis, Taylor Jones.

Thank you, supervisors, for having us here.

My name is Kima Hamid.

I'm the VP of Community and Landlord Engagement for BACs.

I've been here for about nine and a half years.

As a matter of fact, uh Virginia Lawrence, who spoke earlier, was the first partner that I met and saw on my first day at work at HECHO Wellness Center.

So to have her in the room is an honor to speak to the impact.

She has long subsequed my time at BAX and her utilization of HECHO as a wellness center has surpassed 20 years.

This sites are the posts.

They are silent for us and they are a response to the counties and states' lack of ability to bridge and braid services together.

And this room does that for you.

We are not asking for you to fix the problem between BACs, La Familia, Boss, all of the entities in this room.

We braid and bridge community in the way that it's been a response for belonging and wellness, and that has detriment to exactly the faces you see reflected in this room today.

I urge you to bridge.

I urge you to mitigate.

I urge you to analyze the budget, whatever needs to happen.

It cannot happen in this way.

It cannot happen abruptly.

It will harm our communities in ways that you have not been able to fathom.

And the need to be reactive to those things have never historically led us to a good place and will not do so.

We are seeing history repeat itself.

And I think it's clear's day.

Hello, good day.

County Supervisor.

Mitchell 26926 CA via the United States or State of California.

24-721 Epic Law Center via Beauford Capital, V Soho Capital via the state uh the state or the United States.

It is asked in Barnes v.

Felix to be a valid uh compliance and view of interagency application and Keishin Capital against the United States and also against Soho Capital via the United States.

Um model applications, interagency applications, a bond ETFs tied to Alcohol Interagency cost ETFs, also known as the budgetary finance of the interagency, including the transportation, sewer, school bonds, as well as the BART bonds never being asked in over 10 years based on uh pay-for-pay performance, where you could use your bond ETF, justifying it to city and county and trade range between 20 and 50 dollars, where it's allowed then to be able to be used as a capital compliance for your tax write-off as well as it and what was taken against CHIME and Zell.

I ask that these cases be valid against the state of California and be held in negligence.

Thank you.

Good morning, Supervisor Miley.

I guess uh Supervisor Temp stepped out for a second.

My name is Donald Frazier.

I'm with Boss.

Uh I've been in this business for about 30 years, uh, the human services business, and I learned early on that you can't take something away without replacing it, uh, just keeping things simple.

We examine the outcomes in every key determinant of health assessment since the first landmark Alameda County study that was initiated in 1965.

And to date, all of which identified low-income communities of color face systemic disadvantages, highlighted with the undeniable fact that black people experience a disproportionate impact across all health determined determined domains.

Based on that context, Boss was extended a contract with Alameda County Behavioral Health Health Equity Division in collaboration with uh contracted providers, community members, and community-based organizations currently operating in supervisor with districts three, four, and five to support culturally congruent mental health services to the black community.

We work uh collaboratively with Bay World Health in the city of Oakland to increase mental health service utilization among black people who are vulnerable to community violence, housing instability, homelessness, political disenfranchisement, and who are living below the federal poverty levels with the intent to promote access and linkages through the use of credible messengers.

We'll talk briefly about credible messengers.

Uh, it's a perpetual cohort of 12 weeks of training before they even hit the streets.

Uh, they get uh evidence-based training with uh relational outreach and engagement, uh motivational interviewing stages of change, uh uh trauma-informed care.

Uh they're all down on the street, really touching people's lives.

Uh, we are uh uh they see 250 people a week.

That's 13,000 a year.

Now, granted, not all 13,000 people are connected to services, but those people are still a lifeline to our credible messengers, which is important.

I want to say this in closing.

There's a real human impact of the Haven of Black Healing, along with all of the programs funded or the Mental Health Service Act are expire at sunset.

I appreciate the time you're given with gratitude.

That's for consideration on behalf of the people we serve.

Um, good morning.

Um, my name is Tina Barcus.

I'm the director of finance contracts and data compliance at St.

Mary Center, and this is my colleague Kim Lynch.

She is our wellness and recovery counselor at St.

Mary Center.

We provide housing and other senior wraparound services focusing on hope, healing, and justice for our seniors in Oakland.

I want to be clear at the onset, these proposed budget cuts may not impact St.

Mary's center contracts directly, at least that we are aware of at this time, but they will impact the broader behavioral health ecosystem that our work depends on.

Behavioral health does not operate in silos.

When mental health substance use and prevention services are unfunded, the pressure shows up everywhere.

Emergency rooms, housing instability, chronic illness, and unmet needs amongst our seniors and families.

We see it when partners have fewer resources, longer wait lists, and reduce capacity to collaborate.

Total health means mental health, housing stability, and community support working together.

When one part of the system is weakened, the entire system feels it.

Protecting behavioral health funding is not about organization, it's about sustaining a network of care that keeps people stable, housed, and healthy.

We urge the board to consider the ripple effects and invest in solutions that strengthen the whole ecosystem.

Thanks.

Thank you.

Hello, my name is Taylor Jones.

I'm a clinician within BACs working for OPC.

And the work we do here is not just a service, it is a lifeline for some of the most vulnerable members of our community.

The individuals we support are people living with serious mental health challenges who are at risk or already experiencing homelessness and stable housing alone is just not enough.

Without consistent mental health support and case management, maintaining housing and mental health becomes difficult.

BACs does its best to bridge that gap.

Every day we work with individuals managing trauma, grief, depression, psychosis, and other serious mental health challenges.

When we have the excuse me, when we have our programs, our program support with them, just dealing with all the overwhelming feelings that they're experiencing.

Without programs like ours, many of our clients will simply not be able to just transition to other services, which we are experiencing now.

The reality is that these people will fall between the cracks.

Keeping our program open means preventing homelessness, reducing emergency room visits, and psychiatric hospitalizations.

It means helping people maintain their housing, build stability, reconnect with their community, and providing a safe haven for all of them.

Closing our program would not only remove critical support for clients, it would also mean the loss of jobs for professionals who have families as well.

Most importantly, our clients are not statistics.

They are mothers, they are fathers, they are veterans, neighbors, and community members who deserve the opportunity to live with dignity, excuse me, dignity and stability, and that is exactly what we strive for.

Closing our program will not eliminate the need for these services.

It will simply shift the burden elsewhere in which our systems are already overwhelmed.

Investing in our program is not only compassionate, it is responsible, effective, and necessary for a healthier community.

Please support your community.

Thank you.

Heather Little.

Good morning.

I'm DeAndre Thompson, supervisor on Bayer Community Services.

Just want to say that mental health is real.

All um barriers come from trauma, create trauma.

And I think that we're all thankful for those who can get through them barriers and have trauma independently.

Right?

But there's a lot of people who want to get through them traumas and get through them barriers and don't know how to do it.

A lot of people who want to get through them barriers and trauma, they don't really want to get through it.

That's where backs come in at.

Right.

That will that will affect those who are not relevant to that in the sense of taxpayers who are doing well, right?

But they're in the same community of these people, right?

When these people don't get the proper support, they will be out there, you know, trying to do what they do.

And then when people complain about them, right?

How are we going to address that?

Right.

We're going to call the police.

We're going to call, no, they're going to become a problem, but it's not fair to consider them people problem.

You don't even look at the problem.

That's what we're here for.

Supervisors, my name is Kimberly Marquez-Cortez.

And for the past 15 years, I have worked in peer run mental health support services with organizations serving communities across Alameda County.

I'm currently a program manager at Peers where layoffs are set to start this month.

I grew up in Alameda County in District 2, where as a child and young adult, I access peer support services.

I credit these services with my being here today, not metaphorically, but literally.

I am alive today because I found support that showed me life is possible.

And worth living beyond the trauma and crisis.

I know.

Excuse me.

Without bridge funding, many of these life-saving peer-led programs will disappear entirely.

Taking with them hundreds of jobs and eliminating critical services that people rely on to stay well, housed, and connected to their communities.

The loss of this workforce will impact the entire community.

Many of us who provide support today are living proof that recovery is possible.

We represent resilience, lived experience, and hope.

Yet the reality is that any one of us in this room may one day need the very services that are at now at risk of disappearing.

As Alameda County implements the new behavioral health framework, we must remember that healing doesn't happen through treatment alone.

Real recovery happens when people feel seen, heard, valued, and connected.

Peer organizations create those spaces.

We foster belonging, offer support, grounded and lived experience, and help people rebuild their lives with dignity and purpose.

Peer-led organizations and peer support services must be a funding priority, not an afterthought, afterthought, but a foundational part of our behavioral health system.

Thank you.

Hey, what's up with it?

My name is Champ.

And I just want to shout all our mother hands and father uh figures that uh just helped me uh transform my trauma so I can try them, which allowed me to evolve and problem solve.

And so um, if y'all cut this bread, it's gonna be real devastating.

You know, we got participants as you know as 16 all the way to 92, and they look forward to it.

So um, I hope y'all just, you know, everything we good and y'all uh open up the budget and find some bread so everybody can get ahead.

I appreciate y'all.

Y'all be smooth.

Zick M.

Zekia Johnson, Damon Johnson.

Good morning, Supervisor Tam and Supervisor Miley.

My name's Heather Little, and I am actually an elected official in the city of Alameda.

And I understand firsthand what you're being asked to do because I'm asked to do that all the time as well.

Trying to do something miraculous with the limited funding that you have.

But I also recognize that, you know, I've heard people say, you know, we should have started this process.

I know everybody was thinking about what was going to be happening, but uh it's come upon us too soon.

What I heard loud and clear also, uh, because I'm also a representative of the Alameda Collaborative is you have a lot of partners in this room who want to work with you, who don't want you to shoulder the burden of the decision making alone.

Uh, they are incredibly smart people who understand firsthand the impact of what this devastating uh decision making is going to have.

You've also heard from people with lived experience as well.

And I understand that hearing those voices and understanding the implications of what failed policy will actually end up doing to our community, a community that says and a county that says that we put people of color, children, elderly first and foremost.

Uh at the heart of what our budget's trying to say.

I'm just letting you know you're not alone and that we're willing to do the work with you.

And we would love to have the bridge funding come across so that we can have the time to do it properly.

Thank you.

Hello, supervisors.

I'm Damon Johnson.

They call me Brother Sudier, the executive director of Black Men Speak.

I end up here in a funny way because 35 years I served in prison.

I've been home seven years, and today I stand as executive director due to the director of Black Men Speaks, wrote me the house in prison.

Uh I trained over 300 peer specialists.

I'm a forensic peer specialist trainer since I've come home.

And to do this, I also train the police in crisis intervention training.

I have the police asking me, where will we send our clients now?

Because due to these other agencies are receiving these big cuts where we refer people to.

I asked them, Well, we got people coming to the library.

How will we deal with them?

Because they don't have those wellness centers to go to.

So being able to make this connection and ask for this bridge funding and all whatever we have to do.

I thank the team out here because I've worked with a lot of y'all.

And this is in real time and real life, just not the ones who've got jobs.

Most of us have jobs, but the people we serve don't have the jobs.

So where do they plug in?

When I came home, I worked with CareConnect access.

And that was to reduce high frequency users to save the county some money and the states with money.

But now I hear people, where would they go?

Uh who would they talk to?

Today they can call black men speaking, and you get the executive director who's also a member to answer the phone and call back.

But if agencies like mine or others are nilated, we will be dealing with crisis.

Um break a window.

If we thought COVID was something, are the three strike law impact us?

How will this impact us if we don't do something greater than what we're doing now?

Thank you.

Good morning, supervisors.

My name is IKEA Johnson and I live and work in Alameda County.

I work as a program manager at Peers, Peers of Vision and Engaging and Recovery Services.

Our programs help me and my peers in a multitude of ways.

I will focus on the fact that the programs offered at peers, which funding has already been cut for the upcoming fiscal year, are needed.

Our programs are the solutions and the support to so many people dealing with mental health challenges.

These programs truly support our mental health and self-sufficiency.

Because of these programs, it's possible to have hope to just demonstrate resiliency and stay well.

And when our wellness does does become more challenging, peers programs give support and faster recovery is possible.

We are able to take our good to great.

If these programs become no more, so many people's mental health will be harmed, even leading to a faster death for some.

Please because reconsider these cuts and take immediate action and saving these essential services.

Help us continue to help people and meeting people where they are and saving their lives.

Thank you.

You have 90 seconds.

Mia Um Hello, my name is Mia Cooper Khan.

I'm the senior manager of integrated health at Alameda Health Consortium, as well as Supervisor Bass's appointee to the Mental Health Advisory Board.

I wanted to thank the Behavioral Health Collaborative for this presentation, as well as our colleagues at AC Health and Alameda County Behavioral Health who are tasked with implementing this BHSA.

On behalf of our eight federally qualified health centers, I wanted to echo the behavioral health collaborative's proposal for bridge funding to develop long-term sustainability plans for continuity of services that aren't eligible under the BHSA spending categories.

Some examples of impacts to our network include the Access Urgent Bridge mental health services as diversion from presentation to the emergency rooms, which uh has created significant amid estimate of 900,000 annual savings from ED and inpatient diversion.

Um also care coordinators across the eight health centers that provide similar function as Alameda Health Systems non-billable health advocates discussed during the violence and hearing to connect patients to essential wraparound services, ensure referrals are made and um re uh reduce the burden for for clinicians and allowing clinicians to see more patients and open up access to mental health and primary care services.

And finally, uh Alameda Health Consortium's support of the integrated behavioral health programs at our member health centers is is um impacted and eliminated, which creates concerns about the lack of continuity across um behavioral health activities and programs at our health centers.

Um thank you so much.

Just echoing the the um the comments around bridge fund.

Susan, Susan, would you?

I'm an attorney with Bay Area Legal Aid.

I missed when my name was called because I was assisting a mentally ill client to go down to the Social Security office to implement his SSI benefits that my office helped him get.

Um, we are facing the loss of funding that has been designated specifically to assist people who are very mentally ill to obtain SSI benefits.

By definition, we don't take them if they can work.

Um, and most of our clients have applied multiple times prior to coming to us and been denied, mostly because they can't keep stable housing, they don't know how to respond to notices, they don't know how to attend required appointments.

All of this we assist them with.

Um to lose this funding will mean that people uh who lack full access and capacity will be facing the morass that is the social security process by themselves.

Um, this is not acceptable.

And I would say that a majority of my clients have mentally mental ill problems, many of them quite severe.

So please, thank you.

Hi.

Um good morning.

I am Edna Olivares Gomez.

I'm a clinical director, and I am part of the school-based program at the GIME Center, where I have provided services to the Spanish speaking population for eight years now.

School-based mental health services are often the first and only place where many young people receive the support they need.

The Hume Center serves the Tri-Valley and the Tri-City areas, bringing mental health care directly onto school campuses so students can get the help early before challenges become crisis.

Last year, these programs reached 879 students, families, and educators, and provided over 3,600 services to unserved and underserved communities.

When students receive support early, they are more likely to stay engaged in school and prevent crisis.

These services are especially critical for newcomer and immigrant students whose presence has increased in these areas.

Through these services, we have also been able to connect families to critical resources, including housing support, medical enrollment, and financial assistance.

Because of the upcoming BHSA transition and cuts, we anticipate that we will be able to provide only half the amount of these essential services in the coming year.

That means fewer students supported and increasing crisis and more young people lived without help.

This will also overwhelm the school systems that are left with limited resources to manage the students and families' needs.

Investing in prevention today predicts the well-being of our students, our schools, and our entire community.

So thank you.

Dr.

Abuara.

Good afternoon, supervisors.

I'm Dr.

Noha Abalada, founding CEO of Roots Community Health.

We intentionally founded and anchored roots in Deep East Oakland to serve those most marginalized by the traditional safety net.

We are saddened to see today what amounts to a cannibalization of our own safety net due to Prop 1 roots alone is facing over $1 million in cuts.

This includes the total elimination of a FIA care, which was actually an intentional investment by the county to bring an African-centered specialty mental health provider focusing on re-entry into the fold.

By eliminating this program, you are effectively eliminating roots as a specialty mental health provider for the county and removing critical resources for those with serious mental illness leaving incarceration.

We're also facing a dramatic reduction in safe landing at the jail parking lot where we meet people at that critical moment when they leave incarceration.

An innovation that this county is widely recognized for.

Thank you.

My name is Nora Daly, and I'm the chief development officer at BACS.

I'm a lifelong Oaklander.

I'm a family member of someone who's been served by Alameda County's behavioral health system.

You've heard from countless people today.

This is the edge of a cliff.

We are all doing everything we can to make our community healthy by helping the people most in need.

When these programs are eliminated, crises do not disappear.

They grow, they become more expensive, they become more visible, and they become more deadly.

These cuts also threaten to undo real hard-won progress.

Alameda County statistically has finally begun to see a decrease in homelessness, the result of years of coordinated investment relationship building and trust across the behavioral health and homelessness systems of care.

We are on the verge of losing all of that momentum.

And because some providers are facing cuts so severe, they may be forced to shutter entirely.

The damage will extend far beyond what the county is currently projecting.

Alameda County's own plans going forward depend on a provider infrastructure that may no longer exist.

At BACS alone, we anticipate over 4,000 people will be impacted and over a hundred staff as well.

The safety net is not being restructured.

It is being dismantled.

Wellness centers are a first point of entry, and they support every other type of service that is offered in Alameda County.

I know the people of this county care about this, not just because visible homelessness affects our neighborhoods and our sense of who we are as a community.

Every person I talk to who is housed in Alameda County will tell you the same thing.

They love this place.

They're heartbroken with their already seems to be a very strong.

Caller, you're on the line.

Good afternoon.

My name is Lavon Gibson.

I'm the family services administrator for the city of Fremont.

Uh, specifically over the aging and family services division.

Alameda County is experiencing one of the fastest growing older adult populations in the region with more than 340,000 residents aged 60 and older.

And uh 20 25% of the county is soon to be entering older adulthood.

For nearly two decades, the City of Fremont Senior Mobile Mental Health Program has been a lifeline for older adults in Southern Alameda County who cannot access traditional clinic-based services.

In 2008, the program funded through the MHSA Act has ensured that seniors with mobility challenges, isolation, disabilities, or chronic health conditions receive consistent cultural competent mental health care directly in their homes.

Beyond its core services, our mental health program has expanded to meet countywide needs, including a recovery and resilient step-down program, peer support programs for the LGBTQ, older adult population, and the AAPI psychoeducation program delivers workshops to seniors throughout Southern Alameda County.

Now with the BHSA transition, services are set to set to stop at the end of June of this year.

Vulnerable adults stand to lose a very unique program for older adults in this county.

Few other service providers in Alameda County offer uh the comprehensive mobile model that integrates in-home therapy, crisis intervention, case management, and medication support from both a psychiatrist and a physician assistant.

Services are delivered weekly, bi-weekly in multiple languages, including Mandarin, Cantonese, Togalog, and Farsi, making the program uniquely accessible to Southern Alameda County's diverse older adult population.

Thank you.

Your time's up.

Jason, you're on the line.

Good morning, supervisors, and thank you for the opportunity to speak.

My name is Jason Espinoza.

I'm the director of Tennessee Services at BACS.

For the past three years, I've worked with Alameda County and Alameda County serving some of our most valued vulnerable residents.

Every day I work with people experiencing homelessness and those on the edge of losing their homes and individuals living with mental health challenges who have lost stability due to economic realities of our region.

Our programs connect them to limited housing and support resources that exist and support resources that exist.

Through overseeing outreach across the county, I've seen firsthand both the hardship people face and the progress these programs have made.

Even with limited resources, we help prevent homelessness, move people into housing and support them in keeping that housing.

The services like Hedro and Townhouse are not only passionate, they are cost effective.

When people are housed and supported, we reduce reliance on emergency rooms, crisis services, and other costly public systems.

My concern is that these resources are reduced.

More people will lose services, more will become street homeless, and we'll likely see increased pressure on emergency services and systems like Santa Rita Jail.

Simply put, when we cut housing and prevention services, the costs don't disappear.

They ship to our most expensive emergency systems.

I urge you to continue supporting the programs through bridge funding that help our most vulnerable residents move towards stability and dignity.

Thank you.

Letitia, you're on the line.

Hi, my name is Letitia Jackson, and I'm a case manager with BACs, the Sage program.

Um, additionally, I'm a single mother of four who will soon be without work.

So I speak from multiple angles of where these cuts will hurt.

Quite frankly, I mean, it feels like an attack.

I feel like those at the top are making decisions about the lives of those on the bottom.

I know some of you are safe and you will sleep peacefully in a warm bed each night, regardless of the outcome.

So you don't quite understand that these cuts will take food off the tables, you know, leaving people scrambling to figure out how to manage their already chaotic lives.

As a case manager, I show up for um people, you know, some of the people you walk by on the streets, the people yelling randomly in the air.

When I go to work, I make people feel connected in love.

I have clients that look forward to meeting with me every week because they have no family.

My support is their only social engagement or hot meal for the week.

So it'll do significant damage to already compromised communities, causing children to go without.

I'm asking, I mean, I'm I'm begging that you hear these voices.

Every person that spoke in here today, hear their voices with your hearts, listen to what we're saying, look at what you're doing, and please do not gamble with the lives of vulnerable people.

If the ultimate goal is to improve the lives of the impoverished communities, you got to include us in the conversation and planning.

That's if you want it to work.

Brenda, you're on the line.

Yes, Brenda Perez.

Yes, good morning, everyone.

My name is Brenda Perez, and I work at La Clinica Cultura Benestar here in the Fulbright area.

And I just want to encourage all of you to listen to all the people who is there present and online, and especially an advocating uh for the indigenous community.

I'm from the mom community, and I'm the only one who speaks mom here at Cultura Benestad and providing this prevention and earn interventions has reached a lot of this community, and they and they're looking for a lot of support as well.

And especially those who are like undocumented, without um uh uh access to medical or without like actually getting those services through through that, I have been able to get those services through them through prevention and early intervention.

So I do advocate for all of them.

Please listen to everyone, listen to those communities who are in need, and especially this helps a lot of uh this profession program helps a lot of the community to actually learn about mental health and how and how this actually impacts a lot of the services here.

Um so please, please, please.

I do ask for your support.

And like we said in my language, thank you so much.

You're on the line.

Good afternoon.

My name is Hang Mosher, and I'm the community engagement program director at Satellite Affordable Housing Associates, SAHA.

We are a nonprofit affordable housing organization serving low-income seniors, families, and people with special needs.

We're grateful for the recognition and the dedicated funding for housing, stable housing is a critical component of a person's overall well-being and an essential part of a transformation envision within the BHSA system.

A focused investment in the development of behavioral health housing and treatment facilities will help improve the overall quality of life for people experiencing serious mental illness and substance use challenges.

At the same time, we are concerned about the significant reduction in behavioral health funding that occurs once full implementation of the BHSA begins.

Our tenants rely on behavioral health support services to prepare for their transition into housing, and just as importantly, to remain successfully housed.

Housing and behavioral health services function as an interconnected system, and reductions in supportive services could undermine the stability that housing investment aim to create.

A successful transition requires time and continuity of care.

The state has provided counties with a year, uh one-year transition timeline, and we ask that the county fully use this time to ensure people being served are supported and transition appropriately.

Thank you for your time.

Lynn, you're on the line.

Hi, my name is Lynn Rivas.

I'm with the California Association of Mental Health Peer Run organizations.

Um I lived and worked in Alameda for 30 years, uh, including with uh peers.

And uh wanted to speak about the devastating cuts to peer services in Alameda, um, particularly to peers and to the peer wellness collective.

This county for decades has invested in peer services and built uh a pretty robust infrastructure for peer services in these organizations.

Um these cuts will destroy that infrastructure.

And the reason that matters is because peer services are an evidence-based best practice.

There's there when you walk into a peer one organization, as a person with mental health challenges, which I am, I'm a person with a severe mental illness.

The minute you walk in, you feel the stigma lift off of you, and you feel feel the hope almost immediately because here are people who are just like you with mental health challenges, and they're actually working and functioning in society, and it gives you hope that you can do that as well.

Um, they're such important services.

If these cuts not only impact all of their clients, but they also impact their staff.

And uh, I hope that you'll reconsider.

Thank you.

Good afternoon, supervisors and staff.

I'm Adriana Furuzawa with Felton Institute, American Family Therapist and Community Health Community Mental Health Provider in Alameda County for 20 years.

I have witnessed firsthand all that has been shared today.

I am here on behalf of the Behavior Health Collaborative Felton Institute, our deaf community counseling services, DCCS program has lost its funding.

And giving voice to the larger community of service users, family members, behavior health and social services affected by the broad discontinuation of services for BHSA and Prop One implementation.

All these programs are not optional services.

They're a core public health infrastructure.

And severe cuts to outpatient care, case management, crisis services will not eliminate costs.

The costs will shift to more expensive systems such as hospitals, sanitaire jail, and child welfare.

All solutions proposed today are workable.

I urge the health community, the board of supervisors to consider all of them, and to include more longer term solutions.

After all, all Prop One, I'm sorry, Prop One BHSA statutory resources for funding distribution across category.

Not all options were considered.

And it seems that opting out of them became more viable than dismantling our public health infrastructure.

Adding to the many examples of the human impact of these cuts, the deaf community counseling services program employs unicorns, individuals of color, licensed and or pre-licensed deaf and hard of hearing behavior health.

Thank you, your time's on.

Thank you.

Hello, my name is Catalina Claus, and I am a bilingual health educator with crisis services of Alameda County.

Most important, I am an immigrant.

I am first generation immigrant, and I have received mental health services when I immigrated to this community, which made me uh feel a sense of belonging, which a lot of my people are looking in this time of stress.

Um we are serving a community that is unseen.

People are suffering in silence because they're afraid of persecution.

And I am asking you to please continue to protect our community with the services that are culturally infused for our clients.

Thank you.

We have no more speakers for item three.

All right, thank you.

Okay.

I know we're running this real tight time frame here.

So I want to thank all the speakers.

Let me call on supervisor.

Linda.

I'll see if she has any questions or comments.

Then I know I have some questions and comments about this information item.

So go ahead.

Um thank you, Chair Miley.

And I wanted to thank all the speakers for sharing their experience, especially um helping with the county's efforts to provide these really critical services.

We are committed to trying to make sure there's a bridging between MHSA and BHSA.

And we are going to be meeting and hopefully rely on your expertise going forward.

And many of you pointed out that we are juggling a number of issues with HR1, with the uncertainty with the state budget.

But we do have resources at the county that other counties don't have.

So I appreciate all of your time and we will go forward with that effort.

Thanks, Savage Tim.

So I want to just ask the behavioral health director to come back to the mic.

So the uh the Prop One challenges, that's not just a challenge in this county, it's a challenge throughout the state.

That's correct.

Yes.

And what was the intention behind Prop One?

Um, it was a state's belief that uh county behavioral health resources, number one, were not always sufficiently spent.

There was a fair amount of reversion funds.

I'm proud to say Alameda County never did that.

There was also the concern that there's a through line between people who are homeless and people who have severe mental illness.

So their belief was that shifting the fund downstream to those that are more severe and potentially unhoused by creating different components could be of benefit.

Um also believe that prevention in and of itself may not be an effective measure of counties' um ability to combat that crisis.

So at least that is uh some of the thoughts that were put out to the communities.

So I wanted you to just because I kind of knew all that, but I wanted you to state that once again so that everyone understood that the state made certain assumptions.

The the voters approved this.

Uh we always felt not least, I think a number of us always felt it's not either or, it's both, quite frankly, and it really annoys me.

I'm not annoying if you annoys me at the state, because once again, it's not either or, it's both.

We've got proven strategies and interventions that have worked, and it's frustrating that the state puts forth a proposition that didn't take that into consideration.

So that annoys me.

Now other counties, have they been able to address this more effectively?

Have they come up with strategies that we could utilize here, or we're at the vanguard on this?

Um I'll say different ways.

Uh, we, according to our county partners and some of the community members and uh stakeholder CBOs are have actually engaged far earlier with conversations about the impacts of Prop One.

Um, our process is to be transparent, or unlike some other counties.

That being said, some counties have simply issued notices, some began in fall, and there are no mitigation strategies.

Other counties do have set aside dollars that they are buttressing to enable their smooth transition.

Okay.

And then if I recall correctly, and I think it came up during the public comment, we have a runway of one year to transition from MHS to mental health to behavioral health.

That's correct.

The state will allow you not only to apply unspent dollars, it allow you that transition time.

And you've taken a consideration that runway with the um the strategy you've presented.

The strategy that will prevent it to you allows us to use uh carry over dollars so that we don't have we did not have to cut about 30 million dollars more.

So additional funding would be the only way to mitigate arrest.

Yes.

So to mitigate the rest, you need additional funding.

apply unspent dollars it allow you that transition time and you've taken a consideration that runway with the um the strategy you've presented the strategy that will prevent it to you allows us to use uh carry over dollars so that we don't have we did not have to cut about 30 million dollars more so additional funding would be the only way to mitigate arrest yes so to mitigate the rest you need additional funding correct and and earlier we talked about it could be as much as 53 million dollars right yes okay um now i've been told that behavior health is meeting with the collaborative partners now we have been yes for some time and now that the information is public we've released those they have been very uh creative with us together independently and talking to us in our department yes now we have a CPAC meeting next week so we have the uh placeholder for a uh an ad hoc work group the CPAC meeting next week on on the 19th in the work group the ad hack CPAG meeting next week is focused on this is it per the direction from the last CPAC which was in February you would wanted to have a ad hoc group and um I don't think we've confirmed it with the invitees yet but on the all right so once again um I'm annoyed not annoyed at you or the speakers anyone else I'm just annoyed at the in the entirety of the circumstance we find ourselves in um and I'm not trying to uh you know throw behavior off under the bus nor Alameda County health under the bus but I think now it's gonna require my direct intervention and um and I'm gonna make sure Aaron who handles this policy area and has been promoted to deputy chief of staff is with me with this so we're gonna be at the CBAC meeting I want to make sure the agenda is set so that we can have a a comprehensive discussion around how we can address this.

Yeah this this is from CPAC I mean this is from um the collaborative right okay so the collaborative is identified three funding streams in addition to those three back on measure w for instance we set aside a quarter of a billion dollars for essential health yes I believe it's a little bit less than that's that's over the next five years right and we set aside about 170 million uh for prudent reserve yes okay you have access to the 250 the quarter of a billion but you don't have access to the prudent reserve or do you I would say I would defer to the board any questions on those to defer to who?

The board.

The board okay all right and then um but that the prudent reserve and the quarter of a million quarter of a billion of the central services that's all we've allocated all that to health care.

It's not in another agency it's all in health care.

The the prudent reserve was off the top of the measure W so that is a a prudent reserve for measure W all of it um and then your board allocated about 1.4 billion towards homelessness with the home together fund right um and then the remainder to these is all that allocated to your agency or or can other agencies access it the essential services fund your board had about six different categories that you were interested in in supporting with that fund.

So that's what we've been working with the CAO's office to sort of share with you the needs analysis and potentially a multi-year plan for that.

Because I know everyone here and surprise it out you know but for us having the access to measure W and you know I've said it before I was pissed at the taxpayers association for pursuing us but you know the look you know Laura works in mysterious ways and we have this large as that we can use to try to smooth some of this difficulty we're experiencing and I'm not saying it all needs to come from measure W, but I need you to look at these three A the um BHS plans housing and homeless services B mental health C measure W.

Do you have any in access to any other homeless through H and H no Measure W is the largest okay so you'd have to look at the the everything else come together piece if we were okay we have done some of that cost talk all right well I I want to have and if I'm okay with this through the committee I want to have Alameda County Health look at every internal source you have within your agency I don't care if it's behavior health H I know environmental health doesn't have any money office of administrator you might have some money um let's see public health might have some money I don't know but look at every source you know your funding streams better than me you know the color of money better than me you know but I'm gonna insert myself with Aaron so we can figure this out because quite frankly the folks who have talked to us today this isn't the first time they've talked to us they've been talking

I don't care if it's behavioral health, H H, I know Environmental Health doesn't have any money.

Office of administrator, you might have some money.

Um let's see, public health might have some money, I don't know, but look at every source.

You know your funding streams better than me.

You know the color of money better than me.

You know, but I'm gonna insert myself with Aaron so we can figure this out.

Because quite frankly, the folks who have talked to us today, this isn't the first time they've talked to us.

They've been talking to us for maybe two years, quite frankly.

Um, and now we're at a place where we've got to because I remember when we're trying to deliberate on the budget last year.

We said, well, don't worry about this just yet.

We'll take it up timely.

That was last fiscal year when we decided to pass the budget that we're presently operating on.

Now we're looking at a new fiscal year, and we I want to get this resolved.

Absolutely.

And I can add uh a point of clarification.

I believe, and the collaborative can can um can clarify that.

I believe in uh item A, they're looking at wanting more clarity on what the actual BHSA housing components pay for.

I believe uh some of the organizations have mentioned they'd like to have a little bit more specificity on that.

And you they're gonna provide that, Karen.

Um Dr.

Tribble?

Those services I believe are in H and H.

Okay, well, Hes, we would like to have that.

That's under you.

Make sure it happens.

Because I'm I want to get this resolved so we know how much we can access from different funding streams to address the prevention piece, because folks here don't have to convince us of prevention.

I think the staff recognizes that we recognize that.

We are committed to that.

Now I need the staff to figure this out in collaboration with them.

And if you need the um additional authority, you know, I gotta get the board to authorize it, but I'm gonna insert myself so we can ultimately get the board to authorize it if we have to.

Uh I you know, I don't, I would hope I have three or four votes if we if needed.

Because we do believe in prevention, we do believe in everything you've said, all of you.

We do know you need to have um some bridge funding.

Now, when do you need the bridge funding?

Um you need it by the the beginning of the fiscal year.

The yes, in fact, they would need uh so once the bridge funding is identified, we would immediately have to uh issue retraction letters, and then we would also need to look at then what would be the term of the contract.

So that would be as soon as possible, but certainly by June 30th.

Okay, yes.

And what I would say is we uh behavior health with the collaborative actually for the last few years have gathered quite a bit of information about alternative funding and strategy, so we can bring that to bear.

So will you be able to bring that to bear next um absolutely next week?

Absolutely.

Okay, and then the final piece is and and I mentioned this to you, Nika.

If if let's suppose I'm not saying it's 53 million, but let's suppose it is 53 million, and we figured out 45 million, and you just if you pulled your hair out, you can't figure out where we're gonna get the rest of the money from.

So if we have to go outside of your agency to look at other sources that are outside your agency, I need to know that so we can press that agenda so we can look at other funding sources outside of your agency that you have no uh authorization over.

Okay, but but I don't think we've gotten there yet, because I don't think you've done everything that's been asked of you internally within your agency, within your department, and with you know, within all the rest of your um um agencies, um departments or offices.

To that in, uh, supervisor, I can clarify.

We the behavior health department has looked at every single funding source available, all the categorical sources, so we can have that information.

What we're I think they're really uh most concerned about is the BHSA funding.

That part is the most difficult.

So we can bring that.

We have done that already.

So we're we're gonna have a work session next Wednesday.

No, the 19th is Thursday, Thursday at three o'clock, not two o'clock, three o'clock, I think.

Um please work with Aaron on the agenda, so and the collaborative on the agenda so we can make this a good work session, uh so we can cut it and get our hands around this, because you know, I'm gonna exit.

I'm gonna personally get involved now because I'm a you know, I'm a little annoyed.

Once I'm not annoyed at anybody, I'm just annoyed at the overall circumstances we find ourselves in with HR1, ROP 1, decisions that are made in Sacramento that don't befit anyone.

You know, don't get me started on Sacramento.

Uh, because like I said, it's not either or it's both.

You don't cut money to prevention to help housing.

You it's not either or it's both.

Um, and it's just frustrating.

Um, but we're gonna figure this out.

And keep in mind at Supervisor Cam and I in the board, we have to do this in a fiscally prudent manner because we can't um do stuff that's gonna put the county at jeopardy in future fiscal years.

So we have to be looking at that, and we'll look at all funding streams we can look at outside of the agency as well.

But we've got other demands, and you know, some of you know we've got demands because of uh Alameda Health System with the hospital.

So I mean, we're trying to balance all this stuff out and try to figure it out to the best survivability.

So uh thank you for your um um testimony this morning, and our staff's gonna get on it with even more of a sense of urgency because I'm gonna be on them now about this.

Yeah.

You're right there with us.

Thank you.

We have been urgent for two years.

May I make one recommendation, supervisor, with your permission is when the CPAG organizes and restructures.

I would recommend that we look at uh out years that we not just look at the next fiscal year, even if there isn't bridge funding that we look at year two and three.

That'll be very important to uh extrapolate.

Definitely, yeah.

Because we're going to try to do the same thing with Alameda Health Systems.

Yes.

Look out two fiscal years as opposed to, yeah.

But thank you.

All right.

So let's let I mean you're all smart people.

So I'm depending on your help, you know.

I could tell Supervisor um not supervisor uh pass.

She's got the brains, I've got the bronze.

So let's do this.

Okay.

So let's go to our final item, uh, which is an action item this morning.

Item uh one.

I think right.

Get us to item one.

And this is pretty pretty straightforward.

So give us the reader digest version.

Yes.

Good morning again.

Uh yes, I'll make sure to move quickly and thank you for the opportunity to present on the scalable housing uh infill funding toolkit or the shift program.

Uh, this is the framework and design consultant contract.

That's the results.

If no folks could keep it down.

Please keep it down.

So we so the scalable housing infill funding toolkit or shift is a new initiative that housing and community development is putting forward to uh work towards solving the problem of the 12,000 low-income households, and that's 60 to 80 percent AMI who are severely irregular cost burdened here in Alameda County and can't afford their housing.

Um, so we're looking at serving those folks by leveraging industry best practices and innovations to unlock development in smaller sites, such as the tax-defaulted ones we mentioned earlier.

Um, and the idea is to deliver both lower cost affordable housing and to develop it a little bit faster, and then to make that partnership opportunity available for private developers as well.

So without county investment.

Um, so the 10-year housing plan identified the need to reduce costs, remove barriers, and increase the pace of development on smaller underutilized sites that aren't suitable for standard affordable development.

Uh, on May 12th of 2025, we received direction from the joint health and social services committee to launch a procurement for shift uh for a architectural design and program design um consultant in August 27th of last year.

Uh, we released that RFP and in January 26th this year.

Uh we also came before this health committee to uh request funding for the shift development pilot uh with 7.4 million dollars from Measure A1's program income.

Um and we receive that recommendation.

So the design and consultant RFP that uh we went through last year um was designed to select a program design consultant who had practical experience delivering housing at the scale um so that they could work towards developing pre-approved architectural designs.

So designers submitted renders and designs for three real sites uh that would be the type of sites that we would target in the shift initiative here in the county, and we received six high quality design proposals um from uh different local organizations.

Um and so you can see them there inspired ADUs was selected with the highest score.

They're an Oakland-based company.

Uh, we received several other very high quality um designs and statements of qualifications, and the idea is to look at adaptable designs that are feasible that minimize costs, construction costs, and that are optimized for the streamlining and permitting streamlining process countywide that we're hoping to get to with the shift toolkit in this process.

So we can do the next slide.

Um so this is one of the designs for a site that's here in Oakland from Inspired ADU.

Um, and we are recommending uh, you know, from the staff level that we enter into a contract with them to support the shift initiative here.

Uh they're a certified sled based here in Oakland.

So in addition to that contract, we also have a a framework document which explains the general um the multi multiple interlocking pieces of shift as an initiative.

It has two key components, which is a development toolkit, which will be these pre-approved designs that inspired ADU will start developing, um, as well as planning and streamlining and project cost estimator tools again that'll be available countywide in multiple jurisdictions, including available to private developers who want to just build market rate housing.

The second piece is the shift development program.

So that's related to the 7.4 million dollars mentioned earlier.

This will be a direct investment from the county to prove this concept and to build affordable housing on these sites.

Um the idea is to move forward with that uh measure A1 program income RFP, but as additional um sources of funding become available potentially uh going forward with additional RFPs as well.

Um so next steps is um this March uh in about a week and a half, we're gonna take this contract as well as some other items uh related to shift before the Board of Supervisors for final approval.

Um in April and June, um, we are submitting several grants to support this work and the extension this work, potentially producing more plans and supporting the cost that it takes to do this permit streamlining on the with partner jurisdictions.

Uh this summer we're gonna launch an RFQ for a shift developer pool.

And so this will be open to inspired ADUs, but also to many of the other applicants who applied and other applicants as well who did not apply.

And we're gonna maintain that pool as a source of partnership for those um emerging developers who mentioned earlier.

And then this fall, uh, when that RFQ pool is established, we're gonna launch the NOFA with those program income funds if we have those approved by the full board as well.

Um so our recommendations here are to approve uh that agreement with inspired ADUs, refer that to the full board of supervisors as well as the uh shift program framework.

Okay, thank you.

Do we have any speakers on this item?

I have no speakers.

No speakers, okay.

Supervisor Tam, do you have any questions or comments on this item?

Um thank you, Chamarley.

I just have a quick question.

Uh and I'm supportive of the recommendation.

Um I just wanted to understand in your staff report, you mentioned that the cities of Oakland, Livermore, and Newark were also interested in uh being the designer for this program, but they were not even considered, right?

So actually we had representatives from each of those cities on the review panel for the architecture RFP.

So we uh circulated this proposal uh with uh all cities group where other housing staff meet from our jurisdictions, and those jurisdictions were particularly interested and they requested to be engaged at the beginning of the process.

And so they uh help to rate and select the proposal.

And as we move forward with the pre-permitting process, we're gonna take those architectural plans that Inspired ADU generates, and we're gonna work with those planning departments in those cities as well as in you know our planning department and the unincorporated county to get those designs pre-permitted.

Okay.

So and then the $7.4 million in measure A1 funding.

Um that is to seek the program for uh piloting uh basically uh in fill uh ADU opportunities for low-income uh applicants.

And is there going to be uh like uh because it's it's not always easy to help guide some of these applicants through this process.

Is part of the programming to provide that kind of assistance on applications?

Um absolutely.

So um part of the shift toolkit is uh streamlines, streamlining and changes to the way in which our procurement process works for projects like this and accepting the small scale of these projects, we expect to receive applications from lower capacity applicants.

And one of the ways in which we expect this to work best is by having that RFQ where we have the developers uh reapply and we work through the process with them to pre-screen them and to educate them about this new process, and then as other partners move forward, they will have to partner with folks from that RFQ.

So that way we can link community-based organizations and qualified high capacity local developers.

Yeah.

Okay.

And Mike, um, a couple quick quick questions.

So is this program countywide or is it just unincorporated area?

It's countywide.

County wide, okay.

And then I'm sorry I missed the information on the uh tax defaulted uh properties.

Will this have any linkages to that?

Um, so a lot of the approaches to building at this scale are going to be very relevant to the tax defaulted properties program.

And we do expect that some of the developers who apply in the RFQ will be excellent development partners for the tax defaulted property sites.

And so um we are looking at um maybe not directly, but certainly indirectly linking these programs.

And when do you anticipate coming back to the see the board if the board approves, which I think they will, and Supervisor TAM make the motion and I second it um that we support the action item and I think we're called the role in a minute, but the board approves uh the scalable housing investment fund with that and all with also with the implementation of the updated tax defaulted program.

When would you anticipate coming back to this committee?

Because I'm very eager to see some results.

Uh we're moving with as much urgency as possible.

Um we have a lot of other uh potential funding source that would fit into the scale, and we're gonna be moving all of them through this committee.

Um so I think between uh the technical assistance grant for the tax defaulted properties is likely to come back before this committee in June, I believe.

Okay.

Um and so that will sort of finalize the um program for tax defaulted properties.

Um and then we'll need to come before the full board of supervisors for the program income allocation as well.

Okay, so maybe maybe by the end of the year you might be able to give us some indication of how it's going, maybe.

Our goal is to have received applications for specific sites by the end of the calendar year.

We're trying to move as quickly as possible.

Okay.

So can you take take the role?

Supervisor Tam made the motion on the uh scalable housing investment fund.

I second it.

Supervisor TAM.

Aye, supervisor Miley.

Motion passed.

Okay, thank you.

And then we will anticipate uh a follow-up update on all of this um either towards the end of the year or at least the first of next year.

Okay.

So thank you.

So with that being said, do we have any public comment on non-agendized items?

I have no speakers for public comments.

All right, so we are adjourned.

So Supervisor Tim, can you get to our meeting?