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Home My WebLink Aboutcfjl-presentation-july-23,-2026-Alameda County Behavioral Health Advisory Board (BHAB) Care First, Jails Last (CFJL) Ad Hoc Committee Implementation Report Board of Supervisors Joint Health and Public Protection Committees (July 23, 2026) Presented by: Behavioral Health Advisory Board CFJL Ad Hoc Committee Care First, Jails Last PREVALENCE OF MENTAL ILLNESS IN THE JAIL * “SMI reflects that AFBH has determined that a client (any client LOC 1-4) has a qualifying SMI mental health diagnosis.” May 2025 June 2026 Jail Population 1,439 1,226 (-15%) Level of Care (LOC) 2 – 4 350 348 Seriously Mentally Ill (“SMI”)*76 113 (+49%) Source: Santa Rita Jail Weekly Update (See: https://www.alamedacountysheriff.org/about-us/public-documents/-folder-96)2 2 RACIAL/ETHNIC COMPOSITION OF AFBH POPULATION Source: AFBH Update presented to BOS Public Protection Committee on November 20, 2025 3 3 Serious Mental Illness at Santa Rita Jail 4 4 Source: Santa Rita Jail Weekly Update (see: https://www.alamedacountysheriff.org/about-us/public-documents/-folder-96) Question: Why is the number of seriously mentally ill people incarcerated at the jail increasing? Answer: Alameda County continues to under-invest in the kinds of community-based treatment programs that have a proven track record of keeping people living with mental illness and/or substance abuse out of jail. Serious Mental Illness at Santa Rita Jail (Cont’d) 5 5 IMPLEMENTATION MONITORING Progress to Date 6 6 Progress: •Broad agreement that FSPs with “ACT Fidelity” lead to successful outcomes. •“FSP Assessment” showing that Alameda County needs 1400 FSP slots (16 years of age and older). Obstacles: •County is funding 1155 FSP slots (16 years of age and older) in FY ‘26/’27. Request for Board Action: •Fund the additional FSP slots that are necessary to fulfill the unmet need ($20k/FSP slot* with 245 slots = roughly $5M). • Increase utilization rates (i.e., are all the slots filled and if not, why not?). Increase the Number of Full-Service Partnerships (“FSPs”) to Meet the Needs of Alameda County (Rec. 2A) *Source: ACH Board Letter (Attachment No. 16) from BOS Agenda on June 2, 2026 7 7 Provide Sufficient Number of Clinicians in the Court-Based Diversion Programs (Rec. 5C) Progress: •Excellent partnership with Superior Court and Office of Collaborative Courts. •Unprecedented levels of participation in the Mental Health Diversion Court. Obstacles: •Urgent need for assigned clinicians in Mental Health Diversion Court. •Longstanding grants to the Office of Collaborative Courts no longer available. Request for Board Action: •Staff Mental Health Diversion Court without further delay (County cost = <$1M). •Sustain funding for the Office of Collaborative Courts (County cost = $200k). 8 8 Progress: •Early Access and Stabilization Services (“EASS”) Program at the jail. •Pilot program is transitioning to a Permanent IST Diversion Program. •Understanding that in many cases, diversion is preferable to competency restoration. Obstacles: •Relevant parties have yet to sign the contract regarding the program plan. Request for Board Action: •Determine the timeline for the creation of the 88 residential treatment beds. •Determine why the contract has yet to be finalized. 9 Incompetent to Stand Trial (“IST”) Diversion Program (Rec. 5D) Progress: •Successful collaboration between Court, Probation, and BOSS providing case management and supportive services to an increasing number of people on pretrial or release. Obstacles: •Funding through the Community Corrections Partnership (CCP) (AB 109 funds) ends in December 2026. Request for Board Action: •Require Probation Department to provide a program update and plan going forward. •Fully fund the Pretrial Services Program to serve the needs of the rapidly growing pretrial population. 10 Fund Pre-Trial Release Services (Rec. 5B) IMPLEMENTATION MONITORING Summary 11 11 1.Provide funding for the additional 245 FSP slots to bring the total to 1400. •Annual cost of approximately $20k per slot (county cost) for a total of ~$5M 2.Staff Mental Health Diversion Court with two (2) licensed clinicians and two (2) Public Defender Social Workers. •Annual cost of <$1M 3.Sustainability funding for the Office of Collaborative Courts. •Annual cost of $200k for FY ‘26/’27 4.Dedicated forensic treatment beds necessary for the IST Diversion Program. •Annual cost to be determined 5.Provide funding for the Pretrial Release Program •Projected annual cost of $8.5M from the CCP (AB 109) funds. 12 Short-Term Goals or “Low Hanging Fruit” 6.The Reimagining Adult Justice Initiative advanced data and analysis of the jail population with work by Wendy Ware. 7.Wendy Ware’s analysis of data from Santa Rita Jail established systems that can be built upon to include the behavioral health treatment needs of the jail population. 8.Jail data analysis has relied on short-term commitment by a single supervisor. Request for Board Action: •Renew contract for jail data analysis, ensuring inclusion of data on those in Santa Rita with behavioral needs (Estimated cost of $100k to $200k per year). 13 Short-Term Goals or “Low Hanging Fruit” (Cont’d) 14 Source: Homeless & Housing (PSH cost); 2026 County Budget documents; ACBH (Sub-Acute Care costs); Indigo Project (FSP cost); Horizon Treatment Services (SUD cost) Relative Annual, Per Person, Costs of Incarceration atSanta Rita Jail vs. Community Based Treatment IMPLEMENTATION MONITORING Housing Recommendation for the Care First, Jails Last Population 15 15 Progress: • Unmet need estimated to be 2,000 to 5,000 individuals. • Estimation of cost per household has been determined. • Measure W funds for staffing to implement Home Together Plan. Obstacles: • County homeless has not prioritized housing for individuals with high behavioral health needs or who are justice-involved. • County has not identified housing subsidy recipients who are both justice-involved and SMI. Request for Board Action: • Direct Home Together Plan managers to identify and prioritize individuals with SMI and justice-involvement as beneficiaries of deep housing subsidies. 16 Increase Deep Housing Subsidies (Rec. 7E & 7F) Progress: •Existing licensed Board & Cares (B&Cs) meet a crucial need in the care continuum. •State money (California’s Community Care Expansion (CCE)) supported improvements at 12-15 existing B&Cs. Obstacles: •B&Cs fall between policy stools (housing and behavioral health). •Low reimbursement rates and rising costs force B&Cs to close, leading to loss of 198 beds since 2021. •Restricted access to B&Cs excludes residents with SMI and leaves beds open. •Supportive Housing Community Land Alliance (SCHLA) has tenuous financial support to expand B&Cs. Request for Board Action: •Urge AC Health and H&H to pursue braided funding to increase B&C support. •AC Health Commission needs assessment of B&Cs. 17 Increase Licensed Board & Cares (Rec. 7I & 7O) Progress: •The County is in a housing emergency that deeply impacts poor people with SMI, SUD. •$26.6M saved from suspended construction of Mental Health Services Unit at Santa Rita Jail should be dedicated to permanent supportive housing. Obstacles: •Have not been able to determine why the county has not implemented this recommendation. •According to CAO, these funds remained unearmarked in Capital Improvement Projects fund. Request for Board Action: •Request CAO and GSA to identify funds in Capital Improvement Projects (CIP) fund that could be used for permanent supportive housing. •Identify needs for permanent supportive housing as unfunded infrastructure need in CIP. 18 Reallocate SRJ MH Program Services Unit Funds to Permanent Supportive Housing (Rec. 6C) Progress: •CAO provided to BHAB unpublished data on Babu Settlement costs in September 2025. Obstacles: •Difficulty achieving transparency required by recommendation. •Only two meetings of CAO with BHAB since October. Request for Board Action: •Direct the CAO to work with BHAB and implement recommendation. •Funding Needed: None for CAO reports. Estimated $100k-$200k for jail data analysis. 19 Transparent Reporting on Funds (Rec. 6A) Through State grants (BHCIP, CCE, etc.), the county will significantly increase its treatment bed capacity by 2028 throughout the continuum of behavioral health care: •Crisis Residential Treatment Beds •Crisis Stabilization Beds •SUD Residential Treatment Beds •Sobering Center Beds •Adult Residential Treatment Beds •Sub-Acute Treatment Beds Request for Board Action: • Transparent, public-facing, and accountable monitoring of how these new treatment beds are utilized. • Sustainable funding of necessary operating costs. •Assessment of system impacts and expected reductions in incarceration and institutionalization. 20 Monitor Utilization and Efficacy of the Unprecedented Expansion of Treatment Beds 21 Establish a “CFJL Implementation Director” to Ensure Recommendations are Implemented •The biggest threat to achieving CFJL goals is not the lack of political will or insufficient funding – it is the fragmented nature of county government. • Building a continuum of care to realize the goals of the CFJL Resolution requires seamless integration across multiple highly siloed county systems. •Currently no single agency or executive has systemic authority to compel data sharing, standardize metrics, and align inter-agency spending priorities. Without a centralized champion, there is a serious risk of fragmented programming, operational redundancies, and fiscal inefficiencies. 23 22 CFJL Ad Hoc Committee Members: Brian Bloom BHAB Chair (District 4) Terry Land BHAB Vice Chair (District 1) Juliet Leftwich BHAB Member (District 5) Viveca Bradley Margot Dashiell Alice Feller Kari Malkki Alison Monroe Tash Nguyen John Lindsay-Poland Katy Polony Myrna Schwartz Kathleen Sikora THANK YOU. QUESTIONS? Alameda County Behavioral Health Advisory Board Care First, Jails Last CFJL Ad Hoc Committee to the BHAB 23 23