Okay, so I'd like to call the health committee to order 1006.

Clerk take the roll.

Supervisor Town.

Present.

Supervisor Marley.

Present.

Any instructions.

For in-person participation, the meeting site is open to the public.

If you'd like to speak on an item, fill out a speaker's card in the front of the room and hand it to the clerk for online participation.

Follow the teleconferencing guidelines posted at www.acgov.org and use the raise your hand function when it's time to speak.

Right.

So I apologize for starting um late.

Apparently there were some difficulties with the technology.

Technology had been changed up and enhanced.

So apologize about that to the public, anyone who's listening online or who will hear this recording.

So please accept our apology.

And hopefully information technology.

I'll emphasize that.

Hopefully, information technology.

I'll say it again.

I hope information technology gets these glitches handled because it's an embarrassment.

That's all I need to say.

All right.

So let's go with information.

We have one item this morning.

Update on a new vendor pool for housing and homeless services.

Good morning, Supervisors.

Anika Chowdery, interim director for Alameda County Health.

And for this informational item, we also have Jonathan Russell, Director of Housing and Homelessness available online, as well as Mona Palacios if you have additional questions.

So just wait for the slides real quick.

So while we wait for the slides, I'll start with a little bit of background on the housing solutions for health vendor pool.

This was uh implemented in 2019, where our agency uh uh got approval from your board for an expedited ongoing procurement and contracting process that would allow for um homelessness services, uh and this is called the housing solutions for health vendor pool.

Um the idea is to create a pool of qualified vendors who would be available to uh provide services to people currently formerly or at risk of experiencing homelessness in the categories of outreach engagement and benefits enrollment, health and supportive services, housing and property related services.

Um those are the three main categories, and then there's also four service types, which are uh direct services, uh program startup, capacity building and technical assistance, and then innovation.

Um so in terms of how uh vendors qualify for the vendor pool, uh there are uh bitter minimum qualifications that uh the vendors must meet.

The bids are accepted monthly at this point.

Um, and since 2019, we have 93 approved vendors uh who've joined uh who've been approved into the pool as of January 2026.

Um those vendors are available for contracting as programming and needs and uh funding sources are identified by our agency.

Uh this pool is also open to other county agencies.

So for example, I know the Social Services Agency has used it.

Um the term of the current vendor pool is uh up in June 30th of 2027.

Um, and just you know, according to procurement best practices is why we're uh going out for an RFP.

Um sorry, uh we're issuing the procurement again.

It is not an RFP.

Um so awarded in uh over the last five or six years, we've awarded more than uh 299 million dollars in contracts across 10 master contracts.

And um, in general, this is one of the ways that we've been able to expedite getting funding out the door because uh our standard procurement uh timelines can run nine to twelve months, whereas with the vendor pool, uh we can cut that down to about five to six months.

Thank you, Tisa.

Next slide, please.

So now I'll transition a little bit to providing an overview of the new uh procurement that was recently posted on uh March 10th uh to replace the existing housing solutions for health vendor pool.

Um so the new procurement, as I just mentioned, the the vendor pool term currently will end at the end of this upcoming fiscal year.

And just for it's time for us to refresh and renew it, also because we've had Measure W come in, and so we want to update how we use the vendor pool for that.

The scope of work changes over time, as you know.

So we may be doing things now that we weren't doing when we contemplated that first vendor pool.

And I'll just a reminder again that this vendor pool mechanism continues to align with your board's adopted statewide state of emergency for homelessness.

And this was explicitly an efficiency recommendation that our team has put forward in our presentation to you earlier this year.

Next slide, please.

So on March 10th, our procurement team released a new ongoing procurement for homelessness services for housing and homeless services vendor pool.

And this new RFQ is similar to the previous procurement.

However, you'll note that the service categories have been updated to reflect our current scope of work.

So housing community supports, this is the same as we had before, but this sorry, I apologize, that is not the same as before.

But under the housing community supports category, this would include services like housing transition navigation, housing tenancy and sustaining services.

So this is a lot of our Cal Aim services that we currently have 24 providers who support that network of services.

And it also includes tenancy and sustaining services for people who are living in or transitioning to permanent supportive housing.

Under category number two, health and supportive services, this includes mental health care, health care, substance use services, case management, and benefits enrollment and assistance.

So this would also include things like our street health work.

Number three is interim and permanent housing administration.

So this includes things like housing surge services, funding for move-ins, rental subsidies, and flexible funding and administering funds to help with payment of rent, utilities, insurance, et cetera, for people who are experiencing homelessness.

Number four is a new category that we've added, and this is because the board authorized to significant investment in prevention through Measure W.

So we've not had a prevention category previously, but essentially this would be services that are intended to stabilize and support people in either preventing a return to homelessness or helping them retain their permanent housing or just preventing them from becoming homeless in the first place.

Services here include rental assistance, eviction prevention counseling and advocacy.

And then the four service types within those categories remain the same.

Next slide, please.

So to get into the vendor pool, similar to our existing vendor pool, uh, bidders that meet the qualifications will be added to the pool for contracting as programs and programmatic needs and funding sources are identified.

So the qualifications are the same here in that the bidder must regularly and continuously engage in the business of providing services to people currently, formerly or at risk of experiencing homelessness and/or unstably housed for at least three years of the last 10 years.

We require that bidders provide a list of contracts and or supplemental documentation to verify the experience.

Next slide, please.

Additionally, the bidder must agree to complete the county's assessment for billing and financial leveraging opportunities and adhere to county recommendations for billing.

So this is particularly important for services where we may be able to draw down Medi-Cal funding, for example.

Bidders shall demonstrate willingness and capacity to collect data and report data, adhering to specific database systems or required performance measures and data metrics at intervals required by the county.

And I'll just note that you know the homelessness system has moved more and more toward using HMIS.

And so there are requirements for bidders to use that system.

The bidder must also possess all permits, licenses, and professional credentials necessary to supply products and perform services specified under this RFQ.

This is just a countywide standard that we have for procurements.

Next slide, please.

So we also have a couple of new minimum qualifications for the vendors.

So uh under number one, bidders who are applying to provide direct services, program startup services, or innovation services must also be currently certified either at the time of bid submission uh to use Alameda County's um HMIS, that's the homeless management homeless management information system, or agree to become a partnering agency uh that will use HMIS prior to getting the contract.

Um, and then number two, bidders who are applying to the housing community supports category must also demonstrate experience of at least two of the last five years in working with HMIS or an equivalent database that you know supports uh secure collection and tracking of client data and produces reports.

Next slide, please.

So similar to the previous procurement, the new procurement is ongoing.

Um, however, rather than a monthly due date, uh bids will be accepted every other month until October 13th, 2026.

Um after that, uh we'll switch to a quarterly cadence.

Uh the first bid due date is April 14th of this year, and uh for that first around one bid due date, the questions are due by March 24th.

Um, and we anticipate answering the those questions by April 3rd.

Um, and then we have a uh RFQ calendar of events for additional deadlines.

Next slide, please.

So we intend on notifying vendors that the applied uh who've applied to round one by May 27th.

Um, and then the board letter presenting the vendor pool term and round one approved vendors uh is expected to uh be brought forth to your board um at the end of June with a contract start uh start date of July 1.

The new pool and the previous pool will have one fiscal year of overlap to allow sufficient time for transition between the pools, both in terms of vendor qualifying into the new pool and to transition contracts from the old pool to the new pool.

Um the contracts resulting from the vendor pool, as always will continue to be brought forward for board approval uh via board letters.

Next slide, please.

Uh so another new thing compared to the previous procurement is that the new one is posted on the county's uh online uh new online procurement portal, uh which is open gov.

And so this system allows for a more user-friendly experience, including an online submission process.

And uh our team sort of sees this as a game changer as we didn't have infrastructure to support online bidding previously.

Um so all eligible under uh vendors are encouraged to apply through the procurement portal and written questions that uh we receive after you know the the initial uh um initial deadline for the first round uh will be answered in the next round.

Next slide, please.

That is all I have for you, and I'm happy to answer questions.

All right, thank you.

So this was an oral um PowerPoint report uh this morning presentation this morning.

Uh will the PowerPoint be available for the public?

It was available with the agenda.

Okay, good.

All right.

So I'll start with supervisor Dan, and then I'll ask questions and have some comments.

Um thank you for this update in this presentation.

This program obviously has shown some success over the last six or seven years since 2019.

And um, you know, this is one of the few things that the county clearly can do was streamline and exited its procurement process in response to declaring homelessness as an emergency, whereas we couldn't do things like streamlined sequel processes or other things.

The the questions I had pertain to uh the vendors uh do we know whether or not um we have will be seeing new vendors or drop off or of existing vendors because it seems that the criteria must require that they work at least two out of the last three years on the counties um HMIS system.

So is that pretty regional?

Like for example, an agency was working uh in Santa Clara County or Costa County, do they have similar systems and it's interchangeable?

Um yes, I might ask Jonathan or Mona to provide details on that, but my understanding is that HMIS is most counties that have homelessness uh work have HMIS there.

It's also a way for um uh counties to communicate with the state in terms of reporting data.

Um so that that's a pretty standard thing.

And you know, we're also willing to add I think the essentially the requirement is that people uh that the vendors use HMIS.

If they're already using it, great.

If not, they just have to agree that they will use it as we move forward.

And so we we would provide that technical assistance for them.

So not just Alameda County's HMIS, it's it's any HMIS.

Um Jonathan, are you on?

Well, there's so the minimum qualification across all service categories is uh certification to use our HMIS.

So that can be done in process, whether someone has or has not.

The additional criteria you mentioned, the two of the last five years using HMIS is for one of those specific program areas, which is called housing and community supports.

And the reason for that, Supervisor TAM, is that's um we actually do the billing through HMIS.

So that's a medical Medicaid billing that really requires uh a level of proficiency and um aptitude in order to enter those services.

So that one category has that two-year minimum experience requirement in addition to the standard requirement, which is to use HMIS.

And so people under the overall requirement, uh, as long as they go through the process to get certified and are ready to use H HMIS, that would qualify.

As you say, many folks, whether they are doing services in our community or others, have experience in in similar systems or you know, comparable HMIS systems in other communities.

Um, but it's really that one category of services that has the two-year previous experience requirement.

As far as like so you had 93 approved vendors, uh have you seen uh a drop off?

Are there new vendors coming into the mix?

Um, so one important thing to note about the vendor pool is that qualification into the vendor pool doesn't guarantee a contract.

So we currently have, I believe, contracts with 53 vendors.

Um, and we're hopeful that we'll actually get additional vendors coming in.

So for example, prevention in that space, we've not had um that category before.

So that should be uh more folks coming in.

And um in terms of the outreach, so uh more than 5,500 individuals were notified of this new opportunity via OpenGov, uh, and that includes our slabs, the local chambers, uh, vendors who are already in the pool as well as um our local and community-based homeless services organizations who may not be in it now.

Um, and uh just generally vendors who's who've uh subscribed to receive notifications.

So our hope is that we will get additional folks in.

Um I don't know, Mona, if you want to say anything about any patterns that we've seen.

I could I can chime in on that.

Um, I think we've seen a steady growth in people that have the the pool has grown over time, which is which is a good thing.

And I think we expect it to um uh stay consistent uh and continue to grow with the new category.

So I don't think there's been any fall-off trends in terms of who's entered the pool, as you can tell.

That's a uh wide range of of partners, um uh potential contracting partners, and we expect that uh to at least sustain and as um director Chaudry mentioned, grow as we have those service countries.

Okay.

Thank you.

Um just the last question.

What is the largest contract and and is there like opportunities to unbundle contracts so that maybe some of the smaller vendors would have opportunities?

Um I don't have the information on the largest contract uh available for you right now.

We can follow up with that.

Um but my sense is that you know there's a wide variety of services here and a wide variety of types of contracts.

Um, but we can take that into consideration.

I'm satisfied.

All right, thanks for those questions.

So I have a number of questions as well.

So first of all, um what are the state requirements for reporting?

Are we still uh obligated to report monthly to the state?

I I believe you're referencing the HAP requirements.

Jonathan, is that still monthly?

So yes, there's monthly reporting required for all five.

So maybe six, we were just rewarded our sixth round of HAPS.

So those five grants are reported each month.

In addition to that, on the data side, as we were speaking to HMIS earlier, our data from our HMIS system is sent, I believe, quarterly, but uh regularly to the state to be a part of their aggregate HDIS system that takes all so there's the monthly reporting on the grants through the HAP that changed at this last round.

Uh and then regular data reporting as well, where we're sending our information so that they can aggregate and look at statewide HMIS data.

And how are we managing that?

Are we able to manage it?

Comfortably, or is it burdensome?

Uh we find it of value, or are we finding it to be a nuisance?

Uh it is quite burdensome.

Um as we've and many other communities have shared uh with the state that the change to the monthly billing uh in HAP 5 was an intent to increase uh accountability, transparency, performance measures generally at from the state.

Uh how it is translated to uh us locally um is uh 20 plus hours of staff time, uh one staff uh our grants manager staff uh in this seat every month 20 plus hours, just uh putting together the report for each of the five different rounds of HAP.

So it is quite onerous to say the least.

Um we're certainly on along with others, uh, you know, ex giving feedback to the state of of what we think is helpful or not toward achieving accountability.

But the bottom line is uh it has really stretched our teams, and this is part of the uh one of the main reasons that we really need to expand and have a state grants person dedicated to that work uh as we uh expand and broaden our team and we continue to advocate to the state for optimizing changes, for example, going back to quarterly reporting.

Uh the fact of the matter is is time spent on on tracking these detailed fiscal reports uh on the accounting side each month has uh actually pulled away from the ability to focus on the performance and outcome side um given the level of detail that's required.

So we'll see what they do, but there's strong feedback, I think, from a lot of different parties to so it sounds like it's burdensome and it's not it's not adding value.

So I'm gonna ask my staff um when we meet with our lobbyists this week.

Please bring this up so we can try to get Sacramento to consider some modifications to this, because I thought it would be problematic when I heard about it years ago.

And this is the first opportunity I've had to check in on this, and it's very disturbing.

So let's see whether or not we can get some modifications around this because it's burdensome and it's not adding value.

Um quite frankly, it disturbs me.

But are our vendors in the vendor pool required to require uh follow results-based accountability?

Yes, all of our contracts have RBA measures.

Okay.

What's what will be the term for the new vendor pool?

Uh I believe it's another five-year term.

Five years.

So July 1st, 2027 through, I guess June 30th, 3032.

Uh, we would start it uh July 1 of this year, uh, because we want to have a one-year overlap between the old pool and this pool, just to make sure that we close that one out appropriately.

Um so it would be starting in July of 26 and going to July of 31.

31, okay.

Okay.

Uh then the source of funding, what's the source of funding for the vendor pool?

Uh the source of funding can vary.

So some of these might be um, you know, measure W, some of it might be uh, for example, SSA has used it with some of their funding sources.

Um there's opportunities for probation to use it, et cetera.

So the source just varies depending on um what resources we have available to us.

The HAP funding is another one that has gone through this.

And many many of those contracts have multiple sources within them, for example.

So there may be Medicaid, there may be HAP, and there may be general fund in each individual procurement.

So it's myriad sources are utilized through this common mechanism.

You'll be will there be another report to the board on this.

So our our intent is to bring the board letter uh for this this uh new pool uh by June.

Um and that should include some of the initial contracts that that are going to start in the new vendor pool.

Um and uh, you know, I think one of the other things we've been talking about just on the back end is being able to provide more timely reporting to the board on how the vendor pool has been used, et cetera.

I think now you see it um coming through in board letters.

Every time we have a new vendor pool contract, there's a lot of information in there.

Um, and we've been thinking about ways that we can make that a little bit easier to digest.

Um, and uh, you know, going quarterly to new uh uh requests for vendors will give us a little bit of time and space to be able to bring back maybe an annual report or a semi-annual report to the board on how the the pool is being used.

Okay.

So when you um bring it to the board, make sure you include the time frame from the start to the end, and then also um if it eases some of the burden, you can also try to make reports to this committee as a as opposed to going to the full board, maybe the full board annually, I don't know, but just a suggestion um bringing um maybe updates to us on whatever um time sequence we can figure out that works comfortably for the agency, and then maybe something annually to the board, but just a suggestion.

Now one of the new areas is homelessness prevention services.

So would we consider the issue around Prop one and the reduction in funding for mental health prevention and intervention to now qualify for homeless prevention services, those those providers?

Um I think we would have to take uh a closer look at that.

So for um there are some prevention services that are provided under uh MHSA right now that are serving people who are experiencing homelessness or you know are at risk of experiencing homelessness.

Um then there's others that don't have a lot to do with homelessness prevention in particular.

So we're looking for crossovers, um, and then maybe Jonathan can talk a little bit about the overall prevention framework that we're wanting to deploy um as a part of this, but we're we're looking for those opportunities where possible.

Um, but not everything is a neat fit.

Right.

So Jonathan, you want to give us a little bit more than I think to Anika's general point, there are uh uh certain projects that overlap with homeless services uh more closely than others of some of those projects that are having funding uh transition away from them as a part of the PRP1 transition.

In terms of homelessness prevention overlap specifically, I think that may be an area where there is is less actually than general overlap with homeless serving programs that are receiving reductions.

And that's really specifically because what we mean uh by homelessness prevention is a pretty focused uh emergency kind of intervention service to serve people that are right on the cusp of falling into homelessness and really focused on either diverting them, helping to rehouse them, uh helping to shift them into a more stable environment or stabilize them where they are.

So it's a specific suite of services, and and while we are happy to have that expanded investment, we um it will be for context about 12 to 13 percent of what we plan to spend annually each year of the additional measure W investments.

We need to be really laser focused to make sure those dollars are serving that target population most at risk to really get the most uh uh efficiency with that.

So it's a pretty it's a pretty specific scope of service as opposed to the more broad and inclusive um ranges of prevention.

So there is potential overlap, but just highlighting again that it'll be a very specific service we're procuring for, uh, analogous to some programs in our local communities that are showing real effect to prevent those imminent returns or uh you know a matter of days risk of falling into homelessness.

That'll be our that'll be our primary focus.

Okay, well, thanks for that explanation.

Um because you know, I know the board has heard it a lot a lot about the fact that with the resources not going to be available for mental health prevention and intervention that that's gonna lead to homelessness for some of those folks, more folks ending up in John George, more folks ending up in Santa Rita, uh more folks just dying.

More folks ending up in John George, more folks ending up in Santa Rita, uh more folks just dying.

So the segment of folks that are gonna be uh let's say end up homeless.

Hopefully, they will be able to you know be considered in this um new category of homelessness prevention, and then I know the agency uh is struggling and working with the providers around the the bigger prevention piece, and we've got to get that that solved.

I think the board's gonna want that.

Uh I'm pretty confident of that.

So we need to keep working on that.

And we, you know, we just had the meeting on that last week, um, the CPAC meeting.

So um we we've got to get that you know managed.

Uh and if once again, if the agency can't come up with all of the resources necessary to address that, you need to do what you can do and then let the board know what else needs to be done so we in turn can decide whether or not we want to utilize um and get the county administrator to look at additional resources uh to provide that bridge.

Yeah, because I don't want to I don't want to not consider that.

So even if everybody's not gonna end up homeless that's getting mental health services, um, we need to look at you know both groups, you know, and be capable of accommodating both groups of mental health um clients.

Yeah.

And then there's been this whole controversy around housing first.

Are we still using a housing first model?

We are uh our our programs uh follow the state, the state's guidance uh and requirements uh around prioritizing uh housing first.

And I think what what does that mean exactly?

Yeah, great it's a great question.

And I think part of the controversy, frankly, and some of the some of the discussions in different settings um are uh evidence of a really a lack of comprehension of what we mean by housing first as opposed to an issue with the model.

So housing first is a is a uh it's it's an evidence-based practice that prioritizes getting people into permanent stable housing as quickly as possible, as opposed to requiring a lot of barriers or performance for achievements in different program areas before accessing housing.

Now, in a system like ours where we have very, very limited permanent housing resources to share uh with people, that does not mean uh that people don't go to shelter before they go to housing, but that we are oriented towards seeking to wrap the services around someone in as permanent and stable an environment as possible and try to get them into those settings as quickly as possible.

It does not mean that we don't provide intensive services, so it's housing first, not housing only.

Uh, in some ways, many of our projects uh by focusing on housing first, they do so from different vantage points.

So, for example, shelters uh can be housing focused or housing first oriented in their principles by seeking to support people to get into housing as quickly as possible, but very often they are not the ones providing that permanent housing.

So they're really seeking to reduce barriers to help people get uh the documents they need to access housing, whereas a permanent housing provider that is moving people directly into housing, for example, would be approaching housing first from another perspective, which is someone is now in housing, let's continue to wrap the permanent supports around them to help them stay housed.

So it's a it's a principle and it's an evidence-based practice.

We apply it across our system, uh, but it has more direct and indirect applications depending on the program type.

Okay.

Still a little fuzzy around it, but I think I'll take that response for now.

Yeah.

One one other thing that I wanted to share, supervisor, because we we've talked about it before.

Um, is that while we can, as Jonathan's saying, you know, housing first is sort of an overall concept and principle that we apply to all of our programs.

Um, with some of the changes that are happening as a part of HR1, for example, with work requirements, does now open up opportunities for us to look at workforce programs that may be connected to housing, which we've not necessarily been able to do before.

Um, so there are you know some some shifts, but generally we would still uh hold that you know it's housing that solves homelessness for someone not housing.

So we'd be happy to we don't want to put too many barriers in front of it.

Yeah, and to your to your question, supervisor.

Uh I'd be happy to bring a more detailed um presentation of the elements of housing first, uh, how it applies and the outcomes in our community if you'd like at a future a future meeting.

Sure, that'd be good.

That should be enlightening for all of us because yeah, it keeps coming up and it's just kind of um I'm trying to understand the the controversy associated with it.

Okay.

Um and then this the provider pool that we're looking at at the uh um establishing in the future.

This provider pool is basically around services, it's not around any capital.

Right.

That's good it's not about building um new um or you know, opening up new shelters, providing new housing, uh anything like that.

It's all about services.

That's my understanding, Jonathan.

Do you want to clarify anything about shelters in particular?

Yeah, it is for services and primarily operation, operational funding for, but it also will to your second question.

The answer would be yes.

It is also for new services.

So for example, we used uh the vendor pool process, the existing vendor pool to uh procure the initial investment for 300 additional interim housing beds, the new shelter beds that we are opening now that was our first uh expansion investment with Measure W months ago.

We use the vendor pool to do that.

So those are new shelters that are opening.

They are in leased properties, um, but they are providing that we're providing the operational funding.

So it can be for new projects, it's primarily funding the operations, whereas, for example, the capital procurement we did, of which there will be another round, that was jointly with the community development agency where they would lead the procurement for money to acquire uh or rehab properties, uh, and we would lead the the uh procurements for services or expanded operations at new sites.

So could the new vendor pool could be an entity apply that wants to open up a new shelter to provide or expand the shelter operation and have more beds.

Would that qualify correct?

Correct.

We we we go to the vendor pool looking to expand uh shelters, uh shelter beds at an existing or new sites.

We could utilize the vendor pool to identify uh providers that would uh have those resources available.

That's correct.

Okay.

Also offline, could uh Jonathan, could you talk to my office about um first Presbyterian church in the unincorporated area?

Uh because I've been hearing some um feedback on possibly let's say not um uh not utilizing them in the future.

Something came up in one of my meetings with CDA, and I'm just uh I just need to understand what's going on there.

Yes, happy to.

I think there may have been some confusion whereas we don't uh imagine a transition there, but happy to talk to your office and CDA more about that.

Okay, I think I think those are all the questions I had.

Supervisor Tam, do you have any other questions or comments?

No, thank you.

Okay, well thanks.

It's been very enlightening.

Um let's see if we have any public speakers on this item.

We have no speakers on this item.

Okay, very good.

Do we have any public speakers on non agendized items today?

We have no speakers for public comment.

All right, very nice.

Okay, so the March 23rd meeting of the health committee is adjourned, and our next meeting, I believe, is April.

April, April 13th.

All right.

We are adjourned.