Sonoma County Health Comparisons

Yesterday, at the quarterly meeting of the California Association of Local Behavioral Health Boards and Commissions, the staff of the Steinberg Institute led attendees through a new set of tools for county health performance evaluation. In addition, CALBHB/C staff revealed county comparison data recently reported on Integrated Plan submissions in compliance with the implementation of Proposition One, Behavioral Health Transformation.

Here are links to some of the data discussed:

https://www.calbhbc.org/performance.html

https://www.calbhbc.org/pap.html

https://www.calbhbc.org/data-notebooks.html

https://www.capeercertification.org/certification-program-data-dashboard/

A Week of Concern

This week, I spent listening to the members of three statewide behavioral health advisory commissions conduct their regular quarterly meetings at the Embassy Suites in Burlingame, California. Some of the smartest people in the nation, representing every stakeholder group in California’s healthcare system, shared with each other their concerns about the current state of the health of the people of California, and the system intended to improve it.

It would not be an overstatement to say they have serious concerns about recent changes to the system they are charged to oversee, and about their perception of changes they can see coming soon. Though recordings of the meeting will be available in the coming weeks, I will be sharing summaries of both the Commission on Behavioral Health (COB), and the California Association of Local Behavioral Health Boards and Commissions (CALBHB/C) in this space over the weekend.

In the meantime, I’m headed off in the next couple of hours for a PET Scan to determine the extent to which cancer has attacked my body. Later on this afternoon, I’ll resume writing.

While I wait until the scan, I thought it important to post the summary of the Commission on Behavioral Health meeting yesterday:

CalNonprofits briefing on OMB Rules Impacts

This morning, staff from CalNonprofits led a 90-minute briefing for hundreds of listeners into the current status of rule changes proposed by the Federal Office of Management and Budget. Here is a summary of what was discussed.

  • Threats to Federal Grants and Nonprofits
    • Overview and Federal Funding Context
      • Public sector grants/contracts are second largest nonprofit revenue stream (~1/3 of total sector funding)
      • California is a donor state sending ~$80B more annually to Washington DC than received back
        • Subsidizes operating budgets of ~11 other states lacking state income taxes
      • May OMB proposal introduced sweeping changes across hundreds of pages governing federal fund flows
  • OMB Regulatory Proposals and Systemic Threats
    • Proposals introduce political screening into grant selection
      • Political appointees could reject proposals deemed inconsistent with vague “national interest” or agency priorities without explanation or appeals process
      • Considers organization memberships, affiliations, and activities unrelated to grant proposals
      • Discretionary funds could be withheld indefinitely if not advancing White House policy priorities
    • Mid-performance grant changes
      • Agencies could terminate/suspend grants without cause or notice, and alter terms/conditions mid-delivery without hearings
    • Restrictions on equity programming
      • Bars funding for “unlawful DEI” or immigration work despite legality upheld in court
    • Proposed SAM.gov certifications
      • Vague attestations required under penalty of civil/criminal law and perjury
  • Federal Oversight and Enforcement Trends
    • Broad federal pressure across executive actions
      • Approaching 300 executive orders and over 400 active investigations targeting nonprofits via White House, DOJ, FBI, and congressional committees
      • OMB Director Russell Vought testing Impoundment Control Act limits via executive fund halts and pocket rescissions
    • Legal and advocacy counter-offensives
      • Litigation win rate exceeds 80%; over 600 legal actions filed against unlawful administration measures
      • Nearly 500,000 public comments submitted against OMB rules
      • Bipartisan congressional action inserted a stay in the continuing resolution (CR) delaying implementation through December 11, 2026
  • California State Action and Legislative Efforts
    • California DOJ led by Attorney General Rob Bonta filed 80+ lawsuits, supported by $25M legislative funding
    • State legislation passed
      • AB 1318 (enacted October 2025): California will not recognize unilateral federal revocation of 501(c)(3) status
      • Permissive advance pay legislation authorizing up to 25% grant funds upfront to nonprofits
    • Stalled state measures
      • AB 1039 to mandate 25% advance pay vetoed/opposed by Governor Newsom over grant control concerns; targeting reintroduction under future Governor Becerra
        • Proposal to establish an Office of Nonprofit Empowerment modeled on GO-Biz stalled
    • Feasibility of state tax strike: impossible since individual citizens pay federal taxes directly, exposing residents to federal prosecution for tax evasion
  • Upcoming Deadlines and Action Items
    • December 11, 2026: Expiration of current continuing resolution and rule stay
    • November 10, 2026: National Day of Action for nonprofits
  • Key direct actions
    • Sign national opposition letter circulated by National Council of Nonprofits (~2,000 organizations signed to date)
    • Contact congressional representatives urging permanent blocks on OMB rule during the post-election lame-duck session
    • Continue applying for federal grants and documenting discriminatory or arbitrary agency actions for court records

Here is a link to the full recording: https://www.youtube.com/watch?v=fXATeWq7JUo

And the Resources presented in the Webinar: Resources:

CalNonprofits CA Nonprofit Equity Initiative

NCN Call to Action: Comment Guide

NCN Executive Orders Affecting Charitable Nonprofits

NCN OMB Uniform Guidance

NCN Letter Sign On: Oppose Sweeping Changes to Federal Grantmaking

The Impacts of the Recent Executive Orders on Nonprofits

A Nonprofit Checklist: Conducting a Risk Assessment for Federal Funding

CalNonprofits Advocacy Tools

CDBHI-Funded Grant to Support Transition Age Youth on Behavioral Health Boards and Commissions

Building on California’s requirement that consumers and stakeholders are included in state and local program advisory boards and commissions, HEAPA hopes to improve California’s medical and behavioral population health outcomes among transition age youth by supporting their appointment to county behavioral health boards and commissions. Like CDPH, HEAPA believes that Californian’s deserve a system of health care in which prevention and care work in tandem, and are grounded in the experience of consumers.

HEAPA believes that a recently-successful statewide event, the National Lived Experience Leadership Conference in September of 2026 in San Jose, has identified it a core of TAY leaders which it believes can successfully accomplish the applications’s goals. The program application’s goals are to assist local governing behavioral health boards and commissions to identify, recruit, and support the appointment and retention of transition age youth (those 18 to 25-year olds) who meet their otherwise eligibility requirements. Funding will include salaries and organizational administration; stipends for TAY in planning, research, and recruitment of participants; and conference and communication costs. Expected budget is $250,000/year for two years. Trying to figure out what nonprofit should apply.

Also trying to decide if the project’s goals should be broadened to include the growing group of lived-experience consumers who are currently advising a few of the homeless continuum of care boards in California’s counties. And why shouldn’t TAY and Lived Experience representatives be recruited and supported for the separate substance use advisory councils in some of California’s counties which have not included that responsibility in their behavioral health boards. And what about First Five Commissions, or Maternal Child and Adolescent Health Advisory Boards?

California Dept of Public Health Behavioral Health Inititive RFP

Today, the California Department of Public Health produced an online webinar explaining how its long-awaited participation in Prop One’s Behavioral Health Transformation would occur. Two thousand two hundred people attended the two and a half hour webinar, listening to how California proposes to use $30 million over two years to impact population-based prevention. Soliciting applications by November 6th from 501© (3) organizations which propose to support health promotion, universal prevention, and selective prevention directed to a population or subgroup, Applicants must explain how their proposed approach meets the RFA requirements, reflects or responds to the community, supports an eligible population-based prevention pathway, and connects to measurable outcomes. Thirty to forty grants of between $400,000 to $1,000,000 over the period from Feb 1, 2027 to April 30, 2029 are expected to be allocated.”

One attendee asked: “If my proposal includes activities for both individuals age 25 and under and adults age 60+, could you fund only the younger age group’s activities, or would including the 60+ activities make the entire proposal ineligible or less competitive?”

Answer: “The requirement that at least 51% of applicable prevention funds serve people 25 years of age or younger applies across the overall CDBHI portfolio. It is not an eligibility requirement, minimum budget percentage, or scoring preference for each individual application unless otherwise stated in the RFA. Applicants should accurately describe the populations that will benefit from their proposed activities and the portion of the project expected to serve children and youth.”

Noting that the funding required applicants to utilize “Community-Defined Evidence Practices”, an attendee asked “For the Community-Defined Evidence requirement, what evidence is sufficient for an existing community-based practice that has not previously been formally identified or evaluated as a CDEP? In particular, what documentation of lived experience, participant feedback, community use, and practice adaptation would reviewers consider persuasive?”

Answer: “The CDEP practice list is non-exhaustive, and a practice is not ineligible solely because it is not listed. Applicants proposing an unlisted practice must demonstrate that it satisfies the applicable CDEP and population-based prevention requirements. The RFA states that effectiveness may be demonstrated through real-world experience, sustained community use, cultural knowledge, community consensus, practice-based evidence, local evaluation, and community-defined measures of success. Applicants may also reference the Final CDEP Resource Guide for additional information on CDEPs.”

Continuing to press the funders, the attendee continued “How should applicants demonstrate community-defined evidence for an emerging practice that builds on years of lived experience, trusted relationships, and community-led activities but has not yet been formally evaluated?”

Answer: “Applicants may propose an eligible community-defined evidence practice or evidence-based practice that satisfies the requirements described in the RFA. Applicants may also reference the Final CDEP Resource Guide for additional guidance. Inclusion of a model in a resource guide or illustrative list should not be interpreted as automatic approval of a proposed project. Applicants must explain how the proposed approach meets the RFA requirements, reflects or responds to the community, supports an eligible population-based prevention pathway, and connects to measurable outcomes.”

On evaluating outcomes, an attendee asked “Will there any specific metrics that will be used to measure/quantify outreach/engagement and recruitment activities?”

Answer: “Awardees will participate in the statewide CDBHI evaluation and collaborate with CIBHS, CDPH, and designated evaluation partners. Statewide evaluation requirements will be developed in consultation with funded organizations. Awardees will provide input on evaluation methods and community-defined measures of success, collect required demographic, geographic, reach, output, outcome, and fiscal data, and use approved or locally appropriate measures where authorized. Additional statewide evaluation guidance may be issued.”

On developing a budget, an attendee asked: “When submitting our proposal,  how do we    structure  the budget request in support of the project,  in a way that  reflects other possible funding avenues for the project?”

Answer: “Allowability depends on whether a cost is reasonable, necessary, allocable to the proposed project, adequately documented, consistent with the approved scope and budget, and otherwise permitted by the RFA. CIBHS cannot pre-approve a fact-specific cost through the question-and-answer process. Applicants should clearly identify and justify proposed costs in the required budget and budget narrative. Final costs remain subject to application review, budget negotiation, CDPH approval, and the executed subaward agreement.”

On the question of sustaining the projects, an attendee asked: “For programs that will remain primarily philanthropically supported after the grant period, what level of sustainability planning does CDPH expect? Is a diversified fundraising strategy considered sufficient, or are applicants expected to identify committed post-grant funding sources at the time of application?”

Answer: “Please reference the RFA §C.12 Sustainability Statement (RFA p. 20) Applicants are required to provide a sustainability statement describing how the benefits of the proposed project can continue beyond the award period. The statement may address community capacity, partnerships, prevention practices, staff or community knowledge, data and evaluation tools, organizational systems, infrastructure, future funding, and integration of effective activities into ongoing programs.”

On who can be served: “For programs that will remain primarily philanthropically supported after the grant period, what level of sustainability planning does CDPH expect? Is a diversified fundraising strategy considered sufficient, or are applicants expected to identify committed post-grant funding sources at the time of application?”

Answer: “Please reference the RFA §C.12 Sustainability Statement (RFA p. 20) Applicants are required to provide a sustainability statement describing how the benefits of the proposed project can continue beyond the award period. The statement may address community capacity, partnerships, prevention practices, staff or community knowledge, data and evaluation tools, organizational systems, infrastructure, future funding, and integration of effective activities into ongoing programs.

On whether immigrants can be served: “Can we apply specifically to serve immigrant and refugee communities as our priority population under this funding opportunity?”

Answer: “Applicants must clearly identify the proposed population, describe the relevant strengths, needs, risks, disparities, and barriers, and explain how the community informed the proposed approach. CIBHS cannot determine through an individual question whether a proposed population or project will qualify or be selected.”

For more information regarding all webinar materials and upcoming engagements, please go to CDPH’s BHSA Partner and Community Engagement webpage: https://www.cdph.ca.gov/Programs/OPP/Pages/Engagement.aspx. https://www.cibhs.org/projects/cdbhi/#RFA-Application-Materials. Today’s recording and materials will be shared afterwards and posted to the CDPH Partner and Community Engagement webpage: https://www.cdph.ca.gov/Programs/OPP/Pages/Engagement.aspx.

Here is the announcement of the RFP on the California Department of Public Health’s website: https://www.cibhs.org/wp-content/uploads/2026/09/01.-CDBHI_RFA_14Sep26.pdf

SAVS Executive Director View on Point in Time Count

Sonoma County’s Point in Time Count for 2026

I often feel this is an undercount and, due to Federal guidelines, they don’t consider the many people who are couch surfing or 1 week away from losing their housing – people who might be called “At Risk of Homelessness”.   With that said. . .

Seventeen things that jumped out at me about homeless people in Sonoma County:

  1. Total number of homeless people (1951) – the same as last year
  2. Less than 1/2 have shelter – also the same
  3. 45% homeless before age 25.
  4. 15% part of the LGBTIQ community
  5. 21% been in foster care
  6. 31% BIPOC (Latinx, Native American and other non-white identities)
  7. 90% housed in Sonoma County when they lost their homes
  8. Most common reason for homelessness: Lost Job
  9. Most common reason keeping people from housing:  No job, High rent
  10. 16% employed.  59% looking for work
  11. 31% spent 1 or more nights in some kind of jail in the last year
  12. 30% physical disability; 20% traumatic brain injury
  13. 49% live with psychiatric or emotional condition
  14. 75% live with a disability
  15. Number of families (42) decreased.  All are in shelter
  16. Number of unaccompanied children and young people under 25 (168) rose.  74% not sheltered.
  17. Number of people who are homeless for a year or more continues to rise.

There’s a lot to be said about each one of these statistics and the report gives you more about each one.   

My personal focus today is this:

1) The number of unaccompanied children and young people under 25 ~ 74% are unsheltered.

There were 11 unaccompanied children experiencing homelessness, and 157 transition age youth.  The county and research group made a huge effort to reach these young people. Special youth teams canvassed specific areas where youth and young adults were known to hang out. As a result, we have these alarming numbers.  Most of us in the homeless service community do not know where to find these folks and they rarely show up at our offices and day centers.  They simply don’t hang out with the older homeless people.  It’s likely many of the 21% of homeless people who came from a foster home are part of this young people’s group.  Young people are at a crucial time in their lives.  Finding homes and jobs now could mean decades of productive happy life.  Social Advocates for Youth (SAY) closed in early 2024.  This report makes is clear that our community has not picked up the slack.

2) The number of LGBTIQ homeless people – 15% 

These are my people, my community.  We don’t know how many overlap with the category of “under 25” who I just talked about.  But, it’s likely many do, given that 29% said their reason for homelessness was family and/or domestic violence.  It’s not a big leap to say that these folks were kicked out of their homes due to their sexual identity and the homophobia of their parents or foster parents.  “Positive Images” explicitly welcomes these people into their agency services and does what it can.

31% of Sonoma County’s homeless people are BIPOC!! 75% live with a disability!!  What the heck!?!?  

Why is there not an outcry from every single person in Sonoma County?

https://content.govdelivery.com/attachments/CASONOMA/2026/09/24/file_attachments/3792291/Sonoma%20County%20Homeless%20Point-in-Time%20Count%20Report%202026.pdf

Adrienne

Entrusting Land for Public Purposes

I realized this week that I’ve been in the land trust business almost all my life. Beginning with populating common use trails to surf spots along the Southern California coast in high school, and continuing on to become a nonprofit manager specializing in acquiring land and properties for childcare, housing, parklands, schools, and coastal access, I have learned how to use trust for public good.

That’s important to note because we seldom call it establishing land trusts. Lately, that term is popular, often sounding like a magical elixir to our current housing crisis. This post is intended to provide the broader perspective on how land control and access has facilitated positive public purposes.

Let’s start with a recent decision by the Sonoma County Board of Supervisors to grant $1.4 million from its Agricultural and Open Space District funds to the Camp Meeker Recreation and Park District to undertake a seven-year development for public access of a 371acre Camp Meeker Forest Preserve next door to the housing development in western Sonoma County. While the purchase of land to preserve agriculture and open space has long been the focus of the Board of Supervisors use of these funds, it has only recently begun to award funding to prepare its properties for public access. It came to my attention because I have been a board member for twenty years of Stewards of the Coast and Redwoods, a nonprofit which obtained a contract from the California Resources Department ten years ago to operate two local state parks when they were threatened to be closed during tough budget times. The actions of the Board of Supervisors is entrusting the Camp Meeker Recreation District with land control and adaptation for needed public purposes.

In many other ways over the past sixty years, land has been entrusted to community groups (mostly nonprofit organizations) to use for public good. Recognizing the existence of under-utilized land and buildings in colleges, I became active in the development of child care programs on campuses, alternative food services, and community gardens. Leaving college, I continued combining public resources, land and buildings, to further the aims of a wide variety of social needs. Once California linked housing development along its coast with property owner cooperative access, offers to dedicate trail land parcels became possible with local land trusts and with a statewide nonprofit which I chaired for many years. Property tax relief for nonprofit-owned parcels being used for public purposes became possible. Public bodies declared surplus land parcels which they transferred to nonprofit low income housing developers. Childcare and charter schools were given long-term leases from public school districts. In the last ten years, California has purchased thousands of poorly performing hotels for use as homeless transitional and permanent supportive housing.

The use of land in trust with those serving the common good has taken many forms, and served many purposes. Let’s hope that we can continue to combine and create together these valuable resources for many years to come.

Good Government

Last night, the Sonoma County Behavioral Health Board asked themselves if they were doing all they could to insure that high quality, needed behavioral health services were being delivered in Sonoma County. Questioning the pace and strategies of the Board in fulfilling its duties, Jason Reid reported his frustration over not knowing enough about county programs to effectively advise the County Board of Supervisors. It became clear from the discussion which followed that Jason was not alone in his concerns. After many suggestions, Jason agreed to assume the chairmanship of the Site Visit Committee, and invited continued ideas into effective research.

Court Wants Specific Cases for Digital Summaries

On August 18th, the Sonoma County Presiding Court Judge responded to our request to allow digital recording of mental health diversion court hearings by requesting to know which specific case hearings we were seeking to record. Denying our request for a general approval of all hearings, the Court instead asked for requests for each individual hearing. On Monday, August 24th, we will comply by transmitting to the Presiding Court Judge individual requests for every hearing scheduled before Superior Court Judges Karlene Navarro and David Kim between Monday and September 3rd. We’ve downloaded the schedule for Courtroom 64 where the cases are heard, will submit requests to the Presiding Judge for each appearance, and will be contacting the nearly 100 individuals who will be attending. Our goals include demonstrating to both the Court and the participants the value of easily producing written summaries of the hearing using the digital recording devices currently being marketed and worn in meetings.

How AI-Enhanced Meeting Summary and Podcasting Software Provides Community Education Capabilities to your Staff

Last week, I attended a monthly meeting of the Sonoma County Maternal Child and Adolescent Health Advisory Board. Most of the meeting was consumed with a report on the the latest guideline changes to WIC: USDA’s Special Supplemental Nutrition Program for Women, Infant, and Children. I wore the Fieldy necklace we’ve been distributing to community organizers within our California Transparency Project. After the meeting, I sent the two-page summary of what was discussed to my laptop, had it reviewed by a podcast generation feature on Adobe Acrobat, turned it into an MP3 and placed it into a video using GarageBand and IMovie, and uploaded it into a YouTube Video.

In another example of elevating what is discussed in public meetings to produce broadcast -quality public education, check out some work we did a few weeks ago to publicize two issues of concern to a community homeless advocacy group.