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HomeMy WebLinkAboutcfjl-progress-update-october-13,-2025-Alameda County Care First Jails Last (CFJL) Progress Update -2025 Alameda County | Board of Supervisors Health Committee -2025.10.13 Introduction Care First, Jails Last Resolution & Action •On May 25, 2021 the Alameda County Board of Supervisors (BOS) unanimously approved a CFJL Resolution described as "The fundamental goal of a 'Care First, Jails Last' policy is to develop a continuum of care that includes a full spectrum of treatment and housing, including preventative and outpatient services, inpatient acute and subacute facilities, licensed board and care homes, and other wraparound support services...in order to reduce the number of people with mental illness, substance use and co-occurring disorders in our jail."This resolution created the Care First, Jails Last Taskforce (a 25-member body made up of community representatives, agency directors or their designee, community-based providers, city-based program directors, and representatives from stakeholder groups and police agencies. •The Taskforce developed fifty-eight (58) recommendations divided into specific strategy areas, which were adopted by the Board of Supervisors in August 2024. •The BOS delegated continued planning and implementation monitoring to County's Mental Health Advisory Board (MHAB)to monitor the implementation agency recommendations created by the Taskforce, as well as to coordinate with the County's Behavioral Health Department to conduct a cost analysis, funding sources, and integrated countywide plan.2Health Committee - October 13, 2025 CFJL Historical Impacts & Intersectional Efforts Alameda County's historical commitment to advocacy and strategic change within the justice involved system. 3Health Committee - October 13, 2025 Background & Context: Overview Landscape for Countywide Planning •Alameda County has engaged in multiple coordinated analysis, fact finding, strategic planning, and foundational efforts to support justice involved individuals. •These efforts were led by county agencies as well as several stakeholder groups. •Several resulting plans have overlapping, intersectional elements, creating a comprehensive active network of partnering agencies, organizations, and community stakeholders. 4Health Committee - October 13, 2025 Context & Background Sequential Intercept Mapping (SIM) •Alameda County launched a Sequential Intercept Mapping (SIM) planning process in 2017, gathering over 100 diverse stakeholders from local government, community-based organizations, and medical/behavioral health providers to: 1)Develop a comprehensive picture of how people with mental health (MH) or substance use disorder (SUD) conditions flow through the criminal justice system within Alameda County; 2)Identify gaps, resources, and opportunities for individuals in this population; and 3)Develop and prioritize strategies to improve system- and service-level responses for individuals in the target population. •The SIM process identified unmet needs for the reentry population including mental health services, substance use disorder recovery services, and housing resources. •As a result of this local initiative, the local Alameda County Sequential Intercept Model expanded the traditional six (6)areas of system engagement to include two additional areas to focus on earlier stages of intervention and support.5Health Committee - October 13, 2025 Context & Background Sequential Intercept Mapping (SIM) - continued • Alameda County's intercept components are as follows, including two additional domains developed by interagency & community stakeholders; •Prevention: Intercept (-2) •Early Intervention: Intercept (-1) •Community Services: Intercept (0) •Law Enforcement: Intercept (1) •Initial Court Hearings/ Initial Detention: Intercept (2) •Jails/Courts: Intercept (3) •Re-Entry: Intercept (4) •Community Corrections: Intercept (5) •Ultimately, this system map enabled the county to launch more targeted strategies regarding support to those who are justice involved. 6Health Committee - October 13, 2025 Interagency & Community Planning Justice Involved Mental Health Taskforce (JIMHT) •In early 2018, Countywide SIM efforts led to the development of the Justice Involved Mental Health Taskforce (JIMHT). With approval from the Alameda County Board of Supervisors, the JIMHT was comprised of an inter-disciplinary team that involved a variety of county stakeholders and decision-makers convened to examine how Alameda County might make systemic changes to improve services for justice-involved individuals with mental illness. •JIMHT developed recommendations for policymakers to improve system-wide responses to such individuals; and •The Taskforce created an action plan to implement the recommendations of the Taskforce and circulated the information countywide for systemwide coordination. 7Health Committee - October 13, 2025 Interagency & Community Planning Cross-Agency Coordination and Strategic Planning & Accountability •In May 2020, the Alameda County Board of Supervisors directed Alameda County Behavioral Health Department (ACBHD) to create a plan to specifically reduce the number of incarcerated individuals with behavioral health conditions. The "Forensic System Redesign Plan"(also referred to as the 'Forensic Plan') that was developed incorporated recommendations from the JIMHT and synthesized local requirements,behavioral health priorities, costs to the Alameda County system; and input from multiple community stakeholders to develop a comprehensive list of programs, strategies, and financial resources needed to implement this system change. •Alameda County Reimagine Adult Justice Initiative (September 2021) •Alameda County Youth Justice Report (August 2023) 8Health Committee - October 13, 2025 System Results System Changes & Impact •Creation of Navigation Centers •Expansion of Services •Increased Interagency Coordination •Capital Expansion & Facility Projects •Increased Quality and Results-Based Accountability 9Health Committee - October 13, 2025 CFJL Progress & Implementation Alameda County Departmental & Agency Updates 10Health Committee - October 13, 2025 Strategy Area 1: African American Resource Center 1A – African American Resource Center (GSA) : •GSA's request to award the Design/Build Entity contract is posted on the October 14,2025, Board Agenda. •African American Health and Wellness Council will present to the Health Committee in November. 11Health Committee - October 13, 2025 Strategy Area 2: Collaboration & Case Management 2C – Safe Landing (ACSO/GSA): •SRJ Lobby: GSA has completed installation of the furniture in the lobby and rekeying the large closet for storage of the contractor's belongings. •SRJ Parking Lot Trailer: The best place to engage residents exiting SRJ is immediately upon release inside the lobby space established for Safe Landing Center services. Coordination between Safe Landing Center service and transportation contracts will be addressed in future RFPs for these services with the managing agencies (ACH and Probation). 12Health Committee - October 13, 2025 Strategy Area 3: Community-Based Support, Outreach and Education 3L – First Episode Psychosis Program (AC Health / ACBHD): •Alameda County's Behavioral Health Department (ACBHD) remains committed to further expansion of the First Episode Psychosis Program. The department has funded many programs who support this population, and one specific contractor (Felton Institute). This element will continue pursuant to state required guidelines associated with the Behavioral Health Services Act (BHSA) •The implementation of the First Episode Psychosis Program will meet all BHSA requirements established by the Department of Health Care Services (DHCS) that will enable county behavioral health departments, such as ACBHD, ensure its current, and expanded contracted programs, meet evidence-based standards associated with program models, including consideration of individuals up to 30 years of age. •To ensure program integrity, ACBHD will also participate in all Fidelity reviews designed to monitor alignment with quality, program requirements, and outcome measures established by the State/ its delegates. 13Health Committee - October 13, 2025 Strategy Area 4: Crisis Services & Treatment Beds 4D / 4E – Psychiatric Beds (AC Health / ACBHD): Part 1 •ACBHD has shared completed assessments with the Mental Health Advisory Committee's (MHAB) CFJL Taskforce ad hoc committee on May 6, 2025, May 7, 2025, and June 10, 2025. These assessment materials were used to supplement an additional formal statewide assessment of psychiatric bed capacity completed by the RAND Corporation, in partnership with the State of California and the California Mental Health Services Authority (CalMHSA) to serve as an estimate in psychiatric bed need from 2021 to 2026. •Its findings suggested that Alameda County, included in the "San Francisco Bay Area" in its entirety, should minimally increase its psychiatric bed capacity by 2.1% to meet the expected need. 14Health Committee - October 13, 2025 Strategy Area 4: Crisis Services & Treatment Beds 4D / 4E – Psychiatric Beds (AC Health / ACBHD):Part 2 •Based upon these results and gap analysis contained its own countywide assessments,ACBHD sought and secured over $170M in Behavioral Health Continuum Infrastructure Program (BHCIP) capital grants awarded to Community Based Organizations to build treatment facilities countywide. Of these grant awards, Alameda County will see an increase of an estimated addition of (+83) locked Sub-Acute Beds, (+20) locked Acute Gero- Psychiatric beds, and (+20) locked Acute Medical-Psychiatric beds upon completion of the construction projects. These additional beds well-exceed the estimated need (+2.1%) for all Bay Area counties (combined). •The addition of planned Adult Residential Treatment (+16 Beds), Substance Use Treatment (+150), Crisis Residential Treatment & Stabilization (+32 and +8 beds, respectively), Medical Detoxification (+10), and new Sobering and Outpatient Services (expected to serve 100 and 50 clients, annually, respectively) is anticipated to be a great resource to the greater Alameda County community. •Construction for these facilities is estimated to be completed by 2029. 15Health Committee - October 13, 2025 Strategy Area 5: Diversion (5A) Enhanced CBO Partner Support and Oversight •In 2024, The Uncuffed Project was selected as CBO provider for the CARES Navigation Center. •the Training and overseeing current CBO at West Oakland facility located at 3425 Market Street Increased Law Enforcement Outreach and Training •Spring 2025, the District Attorney's Office conducted training and outreach to law enforcement partners, including: •Emeryville PD •Berkeley PD •BART PD •MACRO •Oakland PD •Alameda PD •ACSO Improved Facility and Infrastructure •The CARES Navigation Center has gone mobile, with the addition of a passenger van. •In 2025, the DA's Office developed training materials, and brochures for use by community members and law enforcement partners. •Purchased new respite furniture for guests. •Intake improvements have been well received by law enforcement, with many noting that it is a more streamlined process. Increased Referrals •The CARES Navigation Center has seen a significant increase in referrals since first quarter 2025. CARES NAVIGATION CENTER: Complete Overhaul and Reengagement Underway 17Health Committee - October 13, 2025 Strategy Area 5: Diversion (5A) Current Mental Health Courts: (all numbers are estimates): Mental Health Diversion •220+ current participants (170+ felonies), 50+ pending •NO ASSIGNED CLINICAL STAFF Behavioral Health Court •40 current participants (mostly misdemeanors), 10+ pending •3 clinicians, 1 care coordinator through ACBH Drug Court and Re-Entry Court •84 current participants •4 clinicians through Office of Collaborative Courts Military Diversion/ Veteran’s Treatment Court •20 in Veteran’s Court, 100 in Military Diversion •2 clinicians through the VA Incompetent to Stand Trial •DATA PENDING, 2 clinicians assigned to misdemeanor IST court Family Treatment Courts (Reunification Courts) •75 current participants •4 clinicians through Office of Collaborative Courts 18Health Committee - October 13, 2025 Strategy Area 5: Diversion (5C) 5c – Expand Court-Based Diversion Programs (Probation) •CBO – Funded Program (serving 2,000 individuals annually) •$3M approved by the Community Corrections Partnership on 7/21/2025 •Scope of work drafted by Probation and reviewed by the Court •Scope sent to a pool of identified providers on 9/8/2025, due 10/3/2025 •Mandatory Pre-Bid Meeting conducted via Teams on 9/12/2025 •Pretrial vendor interviews scheduled for October 9, 2025 (in-person), with representation from ACPD, ACSO, DA, and PD on the selection panel •Currently on target for January 1, 2026 launch 19Health Committee - October 13, 2025 Strategy Area 5: Diversion (5C) 5c – Expand Court-Based Diversion Programs (District Attorney /Probation / Public Defender / Courts) •"Coordinate efforts to identify key performance and outcome metrics, share current data- gathering practices, and create a plan for cross-agency collaboration in collaborative and diversion courts" •Mental Health Diversion Court •The Office of Collaborative Courts collect and report on data for many grants and contracts. Data is analyzed by the justice partners in court-specific workgroups for program improvement •DA, PD, and the Collaborative Courts have begun meeting to identify key performance and outcome metrics across the collaborative court programs. 20Health Committee - October 13, 2025 Strategy Area 7: Housing & Residential Facilities 7B – Coordinated Entry (CE) Access at Santa Rita Jail (H&H): •Implementation of a Forensic Access Point to provide both in-reach services within institutional settings (including the County’s Santa Rita Jail) and mobile access point services at the CARE Court. •Goal to ensure any Alameda County resident who is unsheltered can be linked to the full array of existing and new housing and services available in the Continuum of Care. •As partnerships develop with additional programs serving forensic and re-entry populations, the mobile access point may expand service locations •Bay Area Community Services (BACS) selected through a procurement process. •BACS is currently providing CE services at Care Court and preparations for in-reach at Santa Rita Jail are in process. 22Health Committee - October 13, 2025 Strategy Area 7: Housing & Residential Facilities 7E / 7F – Housing Subsidies for Justice Involved (H&H / CDA): •H&H launched a procurement and selected a provider (Abode Services) who will operate a new Flexible Housing Subsidy Pool, which will serve to greatly expand the availability of long-term rental assistance for individuals prioritized for housing across the county. •In conjunction with expanded BHSA investment through BHD, and the forthcoming Transitional Rent Community Support through Alameda Alliance and Kaiser, (launching Jan 2026), these partners have jointly agreed to prioritize the behavioral health population of focus for the Flex Pool. •The current Coordinated Entry Housing Queue for Alameda County (4,000+ of the mostly highly prioritized individuals experiencing homelessness across the county) includes more than 85% of individuals who report Serious Mental Illness, Substance Use Disorder, or both. •During Year One of operations, projected to sustain 1,000 units and expand to increase an additional 250 permanent housing units. 23Health Committee - October 13, 2025 Strategy Area 7: Housing & Residential Facilities •7I / 7J / 7O – Licensed Board and Care (H&H): • Current Licensed Board and Care/Housing Support Program (HSP) contracted facilities:21 sites and 350 beds •Sites in Berkeley, Oakland, San Leandro, Hayward and Fremont •Tiered patch rates (formerly 1-3),with additional Tier 4 rates for higher acuity clients •Biennial procurement to expand additional bed portfolio released through General Services Agency •Implemented in January 2025: Expansion of 40 Auxiliary beds within Behavioral Health Bridge Housing •Beginning January 2026: addition of 3 new licensed sites within HSP •Capital Acquisition Fund (H&H): •Future planning for (two) Clinic Spaces to serve people experiencing homelessness low barrier clinics designed to serve high needs 24Health Committee - October 13, 2025 Strategy Area 7: Housing & Residential Facilities 7D – Housing Discrimination - Fair Chance (CDA / HCD): •Yim v. Seattle lawsuit was settled in August 2025, and BOS has requested that the Fair Chance Ordinance be updated and brought to them for review. 7I / 7J / 7M/7O – More Housing for People with SMI/SUD •Portion of MA1 interest to go towards revolving loan fund for purchase of Board and Care facilities. •MW Capital funding to be released for additional Permanent Supportive Housing funds this fall. 25Health Committee - October 13, 2025 Data Needs: Ask from the MHAB on 5/22 to Joint Health & Public Protection Committee: "Give direction to the District Attorney’s Office,Superior Court,Public Defender’s Office and Behavioral Health Department to coordinate in compiling data on outcomes of each collaborative court and the Mental Health Court" •The Office of Collaborative Courts has been consulting with the MHAB on possible data points/outcomes for reporting. •Coordinate in compiling data on outcomes of each collaborative court and the Mental Health Court, regarding: •DA and Office of Collaborative Courts are meeting regularly to reconcile data between our offices •DA, PD, and Office of Collaborative Courts are currently planning an annual report for distribution. •Meaningful metrics will include information used to analyze program strengths, challenges, and opportunities for improvement. 26Health Committee - October 13, 2025 Next Steps •Strengthen participation with the Alameda County Mental Health Advisory Board, CFJL Taskforce Ad-Hoc Committee regarding departmental progress and implementation. •Identify key performance and outcome metrics and data-sharing practices to reinforce cross-agency collaboration. •Further refine agency/departmental implementation plans to incorporate updated program and financial information. 27Health Committee - October 13, 2025 Questions 28Health Committee - October 13, 2025