Joint Health & Public Protection Committee Meeting – July 29, 2026

The Alameda County Board of Supervisors convened a special joint meeting of the Health and Public Protection Committee on July 29, 2026, from 10:00 a.m. to approximately 1:00 p.m. The meeting featured three informational items: a progress report from the Behavioral Health Advisory Board (BHAB) on Care First Jails Last (CFJL) implementation, an update on the state’s CARE Act (Care Court) in Alameda County, and an update on Senate Bill 43 (SB 43) implementation. Supervisors Elisa Márquez (Chair), Nate Miley, and Lena Tam were present. Public comment was taken after each presentation.

Consent Calendar

• No consent calendar items were on the agenda.

Public Comments & Testimony

Item I – Care First Jails Last:

• Merle Lustig (resident/taxpayer) expressed full support for the BHAB's recommendations, particularly continued funding for pretrial release services, calling it a major success.
• John Lindsay Poland (American Friends Service Committee) urged braided funding to increase licensed boarding care beds, noting a net loss of 198 beds since 2021.
• Richard Spiegelman (Interfaith Coalition for Justice in Our Jails) emphasized the need to renew Wendy Ware’s contract for jail data analysis and to appoint a CFJL implementation director.
• A speaker (unidentified) urged the Board to require a serious study on reducing jail operating costs to capture savings from the declining jail population.
• Sherry Novick praised the CFJL report’s recognition of changing needs over time and called for county investment in licensed board and care homes.
• Elay Dream Hillman (NUHW) supported renewing Wendy Ware’s contract and stressed that mental health care is health care, urging full provision of Kaiser mental health benefits.
• Margot Dashiel highlighted the need for county support of licensed board and care homes as a housing strategy.
• Moni (no affiliation given) praised the report’s four concrete recommendations: fund mental health diversion court, pretrial services, board and care development, and data analysis via Wendy Ware.
• Tony Velgia and Alison Monroe (FASME) urged the county to look at best practices in board and cares, noting that some people cannot be supported by family forever.
• Ann Foley shared a personal story contrasting a positive 2007 Berkeley crisis response with a 2026 incident where police ignored her AB form, leading to her partner’s jail booking.
• Kathleen Secora requested a comprehensive independent assessment of unmet needs for licensed board and cares, warning that closures lead to homelessness.
• A speaker (SHCLA) supported a CFJL implementation director in the County Administrator’s Office, noting that SHCLA’s budget had been slashed despite being cited in CFJL recommendations.

Item II – Care Court Update:

• Alison Monroe (FASME) acknowledged Care Court’s benefits but argued that some people are too ill to engage voluntarily, supporting SB 1016 to clarify that WIC 5200 can exit Care Court to conservatorship; she disagreed with BH’s assessment that 5150s are sufficient.
• Monty Hancock asked about structural lessons from case-by-case approaches, permanent supportive housing for graduates, and whether the sheriff’s internal capacity building means Wendy Ware will not be used.

Item III – SB 43 Implementation:

• Alison Monroe (FASME) expressed disappointment that SB 43 has helped very few people and suggested police abdication of 5150s as a factor; she stated that behavioral health directors resist expanding the system for the seriously mentally ill.
• Brian Bloom (citizen) responded to Supervisor Miley’s question about capacity for treatment over objections. He inferred from John George’s 72% discharge rate (only 28% admitted) that the county lacks capacity; he called for an honest assessment.

General Public Comment:

• John Lindsay Poland urged the Board to require the CAO to publish financial information on savings from the declining jail population, noting the sheriff’s office underspent its budget last year despite $52 million in overtime.

Discussion Items

Item I – Care First Jails Last: BHAB 2026 Update

• Brian Bloom (BHAB Chair) presented a detailed report, calling it a “call to action.” Key points:
  • Jail population continues to decline (1,214 as of the night before, a 50% reduction from 10 years ago).
  • However, the number of people with serious mental illness (SMI) in jail increased from 76 in 2023 to 113 in June 2024, and was 124 as of the night before.
  • Racial disparities persist: 33% of the forensic behavioral health population is African American, vs. 9-10% of the county population.
  • Low-hanging fruit: fully fund 1,400 FSP slots (needed per county assessment; current funding covers only ~1,155); staff the mental health diversion court (only treatment court without clinicians); provide $200,000 for collaborative courts; develop a permanent IST diversion program; and continue funding the pretrial release program (rearrest rate dropped from 44% to 18% with services).
  • Renew Wendy Ware’s contract to add behavioral health needs assessment to jail data.
• Recommended creating a CFJL implementation director (or “czar”) with authority across agencies.
• Supervisor Tam noted that savings from jail population reduction are constrained by staffing and legal issues; she asked about FSP assessment timing (completed spring/summer 2025) and bed counts at John George (69 licensed, 89 certified) and Villa Fairmont (90 beds).
• Supervisor Miley suggested discussing CFJL implementation at the Board’s August retreat.
• Sheriff’s Captain Charles Joe stated the sheriff’s office is building internal capacity for jail data analysis, including behavioral health tracking.

Item II – Care Court Update

• Dr. Karyn Tribble (ACBH Director) and Ardavan Davaran (Indigo Project) provided the update. Key data:
  • 339 petitions filed since December 2024; 317 met prima facie; 317 ordered for investigation; approximately 120 have agreed to CARE Act services, most enrolled in the BACS FSP.
  • Demographics: 68% male, 32% female; 42% African American, 27% white.
  • Average time from petition to FSP enrollment decreased from 99 days (first 13 months) to 52 days (last 6 months).
  • Outreach and engagement improved due to push notifications from jail and John George.
  • 130 CARE respondents have been housed through bridge housing (300+ interim beds, 210 hotel/motel nights per month, 40 licensed facility beds, 55 rental vouchers).
• Juan Tizon (Director of Forensic Services) reported that 34% of incarcerated individuals are in therapeutic housing; 121 individuals identified as SMI are supported by re-entry team, including CARE Court referrals.
• Regarding WIC 5200, ACBH stated it is not used in conjunction with CARE Court; no other California county is actively using it; they believe 5150 and existing treatment courts are more effective.
• Supervisor Tam asked about the decline in 5150s; Dr. Tribble attributed it to increased use of prevention and less restrictive alternatives, such as CARE Court, AOT, and community conservatorship.

Item III – SB 43 Implementation Update

• Dr. Tribble and Deputy Director Vanessa Baker presented. Key points:
  • SB 43 broadened grave disability to include severe substance use disorder and inability to provide for medical care/personal safety.
  • County preparation included stakeholder engagement, training, and designation of providers. As of the meeting, 174 individuals and 21 facilities were designated to initiate SB 43 holds (level 1 and level 2).
  • County-operated clinics initiated zero SB 43-based 5150s; a “handful” (fewer than 5) were initiated at medical facilities in two districts.
  • The number of 5150s in Alameda County dropped from ~8,100 in 2023 to ~3,934 in 2024 (a 45% decline). Dr. Tribble explained this is likely due to expanded voluntary services, CARE Court, and preventive programs.
  • The county is developing a data report to analyze SB 43 holds further and is monitoring the impact of extended holds (up to 60 days with board-approved 5270 and 5121 authorities).
  • A 40-bed geriatric med-psych unit (ages 55+) is expected to open in 2028 under Alameda Health System, pending state approval for revised scope.
• Supervisor Tam stressed the need for early communication with Hayward regarding the concentration of new BCHIP-funded facilities there, and suggested a public education campaign.

Key Outcomes

• No formal votes were taken, as all items were informational. However, the following commitments and directives emerged:
  • Supervisor Miley proposed discussing CFJL implementation at the Board’s August retreat.
  • Supervisor Marquez affirmed her commitment to working on pretrial release funding, noting the contract expires in December and she co-authored the initial letter; she called for a one-year evaluation and a bridge plan.
  • The Sheriff’s Office indicated it is building internal data capacity and will incorporate behavioral health metrics, though no commitment was made to renew Wendy Ware’s contract.
  • BHAB’s requests for a CFJL implementation director, full FSP funding (1,400 slots), and licensure of more boarding care beds were placed on the record for future consideration.
  • The Behavioral Health Department committed to ongoing data analysis on SB 43 impacts and to seek board approval for future level one facilities (receiving centers) as BCHIP projects come online.
  • Supervisor Tam flagged the need for a collaborative outreach plan with Hayward regarding new behavioral health facilities.