The Alameda County Health Committee, chaired by Supervisor Miley and including Supervisor Lena Tan, met on April 27, 2026, to receive three informational presentations: a Housing First overview, an update on maternal, paternal, child, and adolescent health, and a report on the county's wastewater surveillance pilot. The committee also heard public comments on these items and on behavioral health budget cuts.
All right, good morning. Let's call the order of the health committee for April 27th. Supervisor present. Supervisor Miley. Present. We have a quorum. Okay, thank you. Are there any instructions we need to provide this morning? 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 remote participation, follow the teleconferencing guidelines. Post it at www.ac.org. And use the raise your hand function to speak. All right. First items and informational item. Housing first overview. Good morning, uh, supervisors. Jonathan Russell, director for Alameda County Health Housing and Homelessness Services. Here with a brief overview presentation, I believe a month or so ago. Supervisor Miley, you'd requested an overview of Housing First, so that's what we have here. Go to next slide. Brief agenda, of course, first starting what is Housing First and what isn't it? What is the evidence for it? What are state related requirements for Housing First? And then how do we here locally implement it? Next slide. So first, what is Housing First? Oh, I should also mention this slide is a combination of some slides also taken from local uh researchers. So from UCSF, you will see you can see icons in the bottom right, whether it's an AC health slide or from UCSF or from the state. So I will note that. But this is some summaries from Dr. Margot Cushell, who runs the Benioff Homelessness and Housing Initiative at UCSF, which is a preeminent researcher on homelessness that does a lot of academic studies. Um, and also in the last several years completed the largest uh study of homelessness uh ever completed of about uh 30,000 individuals, I believe were uh survey um through a process across eight counties in California. So they're a highly respected researcher. So this is a slide taken directly from a presentation in a briefing um that we both participated in several years ago with our state legislature. So what is housing first? Housing first is first and foremost an evidence-based, that is to say a research backed approach to housing people experiencing homelessness. It is fundamentally an individualized approach, which means it is focused on providing a range of models to meet individuals' unique needs, and it is very much not housing only, which is to say there's much more involved in housing first than the housing part of it. It was initially developed and continues to work uh as a model to meet the needs of people that are experiencing chronic homelessness, by which we mean long and enduring homelessness with disabling conditions as a factor and serving those with severe mental illness and substance use disorders. It's also a long-standing practice in that it was first adopted as federal policy under the George W. Bush administration based on research and studies done at the time in Los Angeles that have grown since. So, why is it important as an evidence-based approach? First, it really prioritizes where possible getting people into housing as quickly as we can without mandating certain engagements with services in order to access that housing. Also, it's important to note that housing first models include services. So services are embedded throughout the housing first approach. The distinction is they're not mandated or required in a way that compels people. It also offers a really important setting. Housing, I like to say it's an environment first approach in order to offer stability that people need in order to meaningfully engage services and wellness. It's also supported by a robust evidence base that shows its ability to provide stable housing for people, even with significant behavioral health conditions. And uh it's been very robustly used by the Veteran uh Veterans Affairs Association alongside the Department of Housing and Urban Development that year over year has led to up until this point a 50% reduction in homelessness for veterans across the country. So significant impact by the VA taking a strong housing first approach, and I'll come back to that later.