Alameda County Board of Supervisors Health Committee Meeting - October 29, 2026

The Alameda County Board of Supervisors Health Committee, chaired by Supervisor Miley (participating remotely) and joined by Supervisor Tam, convened on October 29, 2026, at 21:30 boulevard. The meeting focused on three information items: the annual update from the Health Care for the Homeless Commission, the proposed second Measure W Home Together Fund capital RFP, and the new Aligned grant management platform. Public comment was received on each agenda item.

Health Care for the Homeless Commission Annual Update

• Commissioners Lara Uzman (Chair), Gloria Crowell, and Sabrina Puentes presented an overview of the commission's work. The commission oversees a $5 million federal grant (HRSA funding) for the Health Care for the Homeless (HCH) program, which has been part of Alameda County Health for over 30 years.
• The HCH program serves people experiencing homelessness countywide (unsheltered, sheltered, doubled up), with a network of direct county teams and contracted providers including Alameda Health System, Lifelong Medical Care, and others. Services include primary care, street medicine, shelter health, a mobile pharmacy (one of the first three in the U.S.), substance use disorder treatment, and overdose prevention.
• Commissioners reported that 5,200 people in Alameda County are street- or vehicle-homeless, and street health teams cover 14 zones. Shelter health teams visit 16–18 sites monthly. Between 2023 and 2025, more than 1,000 homeless individuals died prematurely.
• Key concerns raised by commissioners: The need for much closer collaboration between the HCH program, the Behavioral Health Department, and Public Health to achieve a "no wrong door" approach. Commissioners stressed that many homeless individuals have co-occurring medical, behavioral health, and substance use issues, and that current referral-based systems are insufficient.
• Supervisor Miley asked about operational impediments to collaboration. Director of Alameda County Health, Anika Chowdhury, acknowledged the need and committed to providing a future report to the committee on how to make service delivery more seamless. Supervisor Miley directed that the report include ideas such as integrated work teams.
• The commission discussed termination of the contract with Roots Community Health Clinic for street medicine in East Oakland (Zone 6). Luella Penserga, HCH Program Director, stated the decision was mutual due to Roots requesting flexibilities incompatible with the broader county model. The zone was transitioned to Alameda Health System as of July 2026.
• Regarding the mobile pharmacy, commissioners noted it is a new, promising model but is still in a soft launch phase. Efforts are ongoing to bring medications directly into the field via street medicine teams.
• Supervisor Miley asked about targeted strategies for older adults and African American men experiencing homelessness. Jonathan Russell, Director of H Housing and Homelessness Services, noted that over 50% of those housed in supportive housing are age 50 or older, and the county is expanding medically frail permanent supportive housing and homelessness prevention using shallow subsidies with a racial equity lens.
• Funding details: The HCH program receives about $5.1 million annually in federal 330(h) grant funding. This designation also allows Alameda Health System to draw higher FQHC Medi-Cal rates.
• Public comment: Joe Rose (NAMI Alameda County South) asked whether Newark is covered by street medicine. Staff confirmed it is covered by Tiburcio Vasquez Health Center.

Measure W Home Together Fund and Proposed Second RFP

• Jeanette Rodriguez (Deputy Director, Housing) and Michelle Stirrett (Housing Director, HCD) presented plans for a second capital RFP using Measure W funds. The first RFP of $56 million funded 10 new construction projects (~300 units), most in Oakland. The second RFP will be approximately $119 million, targeting about 700 units.
• The RFP has two pots: (1) Acquisition/Rehabilitation: estimated $180,000 per unit (plus operating funding) for converting existing buildings (hotels, motels, etc.) into homeless housing. (2) Preservation: about $40,000 per unit for rehabilitating existing supportive housing units that are 20+ years old and in need of capital improvements. Both pots include operating subsidies for a 10-year term to cover the gap between tenant rents and operating costs.
• Staff highlighted a partnership with the City of Oakland: approximately $6 million in operating subsidies freed up from two Oakland projects (one secured project-based vouchers, another may not proceed) will be kept in Oakland for the city to identify additional units in its Measure U round, potentially adding 50–60 units.
• The RFP will be released in January 2027, with proposals due by March 2027 and board commitments expected in late spring 2027.
• Discussion: Supervisor Miley asked whether the RFP includes tax-defaulted properties, faith-based properties, or school district properties. Staff clarified it excludes vacant land (new construction was covered in the first RFP) but includes existing buildings acquired for conversion. Supervisor Miley urged coordination with Oakland Unified School District on underutilized properties. He also asked about junk fees; Michelle Stirrett confirmed that county regulatory agreements do not allow junk fees and that monitoring is done by an asset management team.
• Supervisor Tam emphasized that acquisition/rehab likely yields more units per dollar than new construction, and asked about leveraging Prop 1 state bonds if passed. Staff stated they are aligning the RFP to position projects for state funding applications in spring 2027.
• Public comment: Caleb Smith (City of Oakland Housing Community Development) expressed gratitude for the county investment and stressed the need for geographic balance within the RFP. Liz Varela (Building Futures) supported the preservation funding, noting her 52-unit PSH project for domestic violence survivors needs rehab. Chris Van Giesen (Boss Homes) asked about flexibility to produce more housing for less cost, to which staff responded this RFP is not for modular new construction. Berkeley Mayor Adina Ishi criticized the county for poor communication with cities regarding Measure W fund release dates and the Home Together plan, and urged closer city-county collaboration. Staff acknowledged and committed to improving communication.

Aligned Shared Platform for Grant Management

• Michelle Stirrett and Dylan Sweeney presented a new Salesforce-based data management platform called "Aligned" (also referred to as "a line"). The platform replaces the legacy City Data Services system (built in 2012) which became unresponsive after being sold. Aligned was built in-house with consultant support and has been operational for three months.
• The system handles contract management, asset management, performance management, and public reporting for HCD’s portfolio of over 156 affordable housing projects (8,000 units) and 200+ service contracts. Partners (CBOs) can submit applications, invoices, and reports online via a self-service portal. Staff can track funding sources, expenditures, and performance metrics in real time.
• Aligned enables tracing of funds from source through procurement, award, and expenditure, and can produce live dashboards (e.g., Measure A1 reporting at measure-a1.acgov.org). It also tracks project occupancy, inspections, and financial records. Future phases aim to integrate federal reporting and support interdepartmental/interjurisdictional collaboration.
• Staff reported that other County departments (Healthy Homes, Economic Development) are interested, and cities (Oakland, San Mateo County) have expressed interest in potentially using the platform for a fee to cover costs.
• A contract amendment for the next phase (increasing features) will come to the Board in January 2027.
• Discussion: Supervisor Miley asked about data accuracy and auditing. Staff explained that program managers review all reports before payments, and the system does not automate human oversight. He urged expansion to other county agencies to create a unified data system. Supervisor Tam asked about tenant protection monitoring; staff noted that while not currently included, it could be built in the future. He also confirmed the platform will track Measure W capital funds and essential county services funds. Staff affirmed that performance dashboards will show progress toward the 10X goals and that expenditure data from all cities is being collected for the first time.
• No public comments on this item.

Key Outcomes

• The committee directed Anika Chowdhury to return at a future meeting with a report on how to make service delivery across health, behavioral health, and homelessness systems more seamless ("no wrong door").
• Staff will proceed with drafting the second Measure W capital RFP ($119 million) for release in January 2027, with board commitments in late spring. The partnership with the City of Oakland for $6 million in operating subsidies was endorsed.
• The committee expressed strong support for the Aligned platform and encouraged its expansion to other county departments and potential external partners (on a fee basis). The next contract amendment will be presented in January 2027.
• The committee acknowledged public comments and committed to improving communication with cities on Measure W implementation.