Tag: politics

Presentations Are Not Stakeholder Engagement

I attended the majority of the public stakeholder meetings identified in the Department’s Community Planning Process (CPP) in the Draft Integrated Plan, including the BHSA Steering Committee, the Community Planning Program Workgroup, the Behavioral Health Board, Countywide Town Halls, and the dedicated Housing Workgroup. What I witnessed was a repetitive series of presentations from Department staff and consultants focusing on the the transition of MHSA funding requirements to those contained in the BHSA Behavioral Health Transformation. Questions from participants concentrated on how current programs initiated under the last three-year MHSA Integrated Plan could be continued despite a shift of 30% of the funding to “Housing”, and the transfer of popular innovation grant authority to the State.

Rarely in the process did staff address what they alluded to as the “other 90%” of the Plan program funding, now for the first time mandated to be included. When they did, it was to complain about the fact that the Department’ Fiscal Team had not provided them with any guidance on the Departmental finances required to be within the Plan. After the first four presentations of the same PowerPoint, I perceived that most committee members stopped asking questions, and some community members stopped attending. As the only member from the Behavioral Health Board at these meetings, I began to detect that an enormous information and participation gap growing between the BOS-Appointed Behavioral Health Board and the Department-selected Behavioral Health Steering Committee. The latter consisted on Department staff, consultants, and contractors. Almost all seemed to be vulnerable to charges of conflict of interest, and seldom asked any but superficial questions.

When I attempted to record the meetings using an advanced digital personal assistant device (Fieldy) to document the stakeholder input, staff objected, and forced me to stop. I do not believe that staff finds value in allowing transparency in their work. The lack of timely minutes, advance meeting presentation materials, and the reluctance by staff to utilize online Plan Comment tools, has severely restricted public engagement and review.

The questions I asked were almost entirely ignored, and usually viewed as hostile, especially when I inquired when reports from the BH Steering Committee would be shared with the Behavioral Health Board. Were I to have been allowed to continue on the Board, I would have requested that full reports and recommendations from these meetings be forwarded to the Behavioral Health Board’s Integrated Plan Subcommittee for their report to the full Behavioral Health Board by the beginning of the formal public Open Comment hearing at their May meeting.

The Department’s Plan submission details the many meetings it hosted in compliance with the State’s stakeholder involvement requirements. But effective Plan development and engagement is not conducting meetings of your own staff, contractors, and consultants to review your latest interpretation of evolving State requirements. I saw almost no changes to the presentations, to the proposed Plan design, and finally to the Draft Plan, in the six months from September of 2025 to February of 2026. My attempts at providing insight on Integrated Plan processes being discussed at other neighboring county Behavioral Health Board meetings, California Association of Local Behavioral Health Boards and Commission board meetings, and State Behavioral Health Commission meetings I was attending were dismissed. It was no surprise to me when Departmental staff asked me not to continue my attendance on the Behavioral Health Steering Committee because “We believe your intentions are not consistent with ours”.

Within the Draft Integrated Plan is a paragraph which illustrates the failure of open engagement. It indicates that the planning process gathered important insights into the operation of homeless facilities and services in the county.

“At the recommendation of the Steering Committee, SCBH conducted Housing
Focus Groups in August and September 2025 with individuals who had lived
experience of homelessness and behavioral health challenges. Participants
identified safety concerns, lack of privacy in shelters, inconsistent rule
enforcement, barriers to consistent case management, and insufficient supports
for individuals with serious mental illness. They recommended trauma-informed
housing environments, enhanced onsite clinical and peer services, expanded
outreach teams, and practical supports such as dog kennels to support
employment access. Participants also identified transportation, digital access,
and documentation barriers, recommending monthly bus passes, free internet
access at service sites, and assistance obtaining identification, Medi-Cal, and
mobile phones. These insights directly shaped priorities for integrated housing
and behavioral health service models, expanded case management, strengthened
peer workforce roles, and improved transportation and digital access supports.”

None of this information was shared with the Sonoma County Homeless Coalition, the County’s Continuum of Care Governing body, nor was there any attempt to validate or utilize the feedback to engage the largest single set of targeted stakeholders/consumers.

Nevertheless, the Department’s stakeholder process did confirm the Department’s belief that previous investments using innovation projects have found deep support within the community. Almost all of the priorities identified in the concluding paragraphs of the Plan’s Community Planning Process Stakeholder Engagement originated in early memberships and comments a year ago. It’s too bad no real work was done in the interim to actually engage participants in turning those ideas into collaborative projects.

“Across all engagement activities, stakeholders consistently emphasized the value
of culturally grounded and lived-experience perspectives. Community members
called for strengthening the SCBH Latinx Clinic, expanding culturally rooted early
intervention programs, investing in peer-led wellness centers, and hiring staff
with lived experience. Stakeholders highlighted the importance of traumainformed, disability-sensitive approaches and the need to evaluate both evidence-based and community-created practices. There was strong support for improving data systems, integrating quantitative and qualitative measures, and ensuring outcomes reflect community-defined success.”

“Through this extensive and collaborative planning process, the FY 2026–2029
BHSA Integrated Plan reflects the priorities identified by Sonoma County’s
diverse communities. These include expanding housing-linked behavioral health
supports; strengthening crisis response and early intervention services;
investing in culturally grounded and peer-led models; improving real-time data
and response systems; and enhancing transparency and communication. Input
gathered through meetings, focus groups, surveys, and listening sessions
directly informed the Plan’s strategies, and SCBH remains committed to
continued stakeholder engagement throughout implementation.”

Homeless Action! Meeting Notes, May 25th.  

Adrienne 707-332-1894

By June 2

Main Talking Points, and logistics for the Homeless Coalition and Board of Supervisors meeting:

  1. Most of this money could go to efforts that are not restricted by MediCal, and only help those with an Acute Mental Illness diagnosis and/or Substance Abuse disorder.  $600 million dollars should serve more than 500 people.
  2. This plan does not work to strengthen the “One System of Care.”  It doesn’t match the Homeless Coalition strategic plan or the MRG report adopted by the Homeless Coalition both of which strive for that important goal. 
  3. This plan was made with abysmal Community Engagement.  For example, neither Catholic Charities nor the Homeless Coalition were consulted.

Homeless Coalition Board Meeting
Wednesday, May 27, 2026
1:00 – 4:30 p.m.
https://sonomacounty.zoom.us/j/92759747120?pwd=Cuw1daWSoPM5s8ClAWgPrJ8wYLeBgp.1#success

Phone: +1 669 444 9171
Passcode:  589476
Webinar ID: 927 5974 7120

Board of Supervisors Meeting
Tuesday, June 2, 9 am
In person
575 Administration Drive, Room 102A, Santa Rosa
Public Comment period, only in person

Before June 30

Reach out to Michelle Bass, Director of California Department of Health Services, with the messages above about the Sonoma Counties Behavioral Health 3-Year Integrated Plan.  Suggest that the state take action.

Michelle Baass
(916) 440-7400

Department of Health Care ServicesP.O. Box 997413, MS 0000
Sacramento, CA 95899-7413

Ongoing Work

Influence leadership of county staff over time toward Accountability and Transparency: 

  • Talk to the new people: head of the health department Nolan Sullivan, county CEO, David Guhin, Fiscal Director of Health Department Maryann Le , homeless division manager Hunter Scott.
  • Talk to Angela Stuckman head of the Human Services Dept.  
  • Know that what is coming, (massive budget cuts, cuts to Food Stamps & MediCal), will overwhelm the county staff and make the changes related to this plan seem like small potatoes.  Be kind but firm that challenges are best met with a community response.  Including people is time consuming and sometimes annoying but the best solutions come from this basic democratic process.

Conversation with Gemini

California Continuums of Care and the California Interagency Council of Homelessness have funded homeless management information systems (HMIS) at the county and state level in an attempt to track and evaluaste the outcomes achieved by millions of dollsrs in homeless facility and program services over the past ten years. Nevertheless, long-term tracking of chronic homeless housing outcomes has been hindered by the lack of adequate intra-system and facility tracking. Which counties have successfully moved homeless from the streets to shelters and permanent housing, and retained them ?

The dilemma you are highlighting cuts to the absolute core of California’s multi-billion-dollar battle with homelessness. You hit the nail on the head: while the state has funneled billions into local Continuums of Care (CoCs) and launched the Homeless Data Integration System (HDIS) under Cal ICH to patch these exact data gaps, getting a precise, county-by-county report card on long-term retention is incredibly tricky.

Because of “intra-system tracking gaps”—such as people crossing county lines, or dropping out of the Homeless Management Information System (HMIS) with “unknown” exit destinations—success is rarely measured by sweeping regional victories. Instead, it is measured by specific counties that have built highly coordinated, localized data structures to bypass these limitations.

According to data from Cal ICH’s statewide assessments, university studies (like UCSF’s landmark California Statewide Study of People Experiencing Homelessness), and local CoC reports, a handful of counties stand out for their success in moving people from streets to shelters, securing permanent housing, and keeping them there.

1. Santa Clara County (Silicon Valley CoC)

Santa Clara County is widely regarded as an intra-system data leader because they actively track their “Community Plan to End Homelessness” milestones with sharp precision, accounting for where individuals end up.

  • The Transition: Between 2020 and 2023, the county successfully placed over 10,000 people into permanent housing. They consistently beat regional averages by transitioning roughly 37% of people straight out of temporary emergency shelters directly into permanent homes (the regional target is usually 30%).
  • The Retention: This is where they excel. Santa Clara County reports an astonishing 95.8% housing retention rate within its Permanent Supportive Housing (PSH) programs. Their system is highly tightly knit, meaning if someone is placed, intensive case management keeps them tracked and stable.

2. San Diego County (San Diego City & County CoC)

San Diego has made massive strides by aggressively deploying “diversion” strategies and leveraging HDIS data to track specific sub-populations, particularly veterans and chronically homeless individuals.

  • The Transition: San Diego scaled up its street outreach-to-shelter funnel by utilizing decentralized navigation centers. By integrating their regional HMIS more tightly across cities within the county, they successfully increased successful permanent housing placements out of rapid rehousing and street outreach.
  • The Retention: San Diego’s built-in retention frameworks keep their permanent supportive housing stability rate hovering around 85% to 90%. They have been specifically highlighted for lowering the rate of people who “return to the streets” within two years of being housed.

3. Riverside & Bakersfield/Kern County

If you look at the raw data of “functional zero”—a metric meaning a system can house more people a month than are entering homelessness—these two regions punch far above their weight.

  • The Transition: Bakersfield/Kern County famously became the first community in California to achieve “functional zero” for chronic homelessness. They did this by establishing a daily-updated, master “By-Name List” shared across every shelter and facility, fundamentally eliminating the intra-system tracking gap you mentioned.
  • The Retention: Because their system treats every chronically homeless individual as a specific case file shared by all providers, their retention rates for permanent housing placements are among the sturiest in the state, keeping returns to the street below 10%.

4. Los Angeles County (LAHSA / LA County CoC)

LA County is a paradox. Because of its sheer size, it has the highest raw number of returns to homelessness. However, when looking purely at facility tracking and retention efficacy, their targeted programs tell a different story.

  • The Transition: Through initiatives like Project Roomkey and subsequent permanent conversions (Project Homekey), LA moved tens of thousands of unsheltered individuals into temporary motels and then permanent supportive housing.
  • The Retention: LA’s data shows that when a chronically homeless individual is successfully placed into Permanent Supportive Housing (PSH) paired with intensive case management, the retention rate sits above 85%. The breakdown happens not because the facilities fail to retain them, but because the inflow of newly homeless people vastly outpaces the physical availability of those permanent units.

The Core Data Reality: Why the Tracking Breaks Down

Cal ICH’s sweeping Statewide Homelessness Assessment highlighted exactly what you noted: the “Unknown” problem.

Across California’s aggregated HDIS data, when looking at people who exit homelessness programs:

  • 28% exit to housing without a subsidy (moving in with family/friends or renting).
  • 17% exit to housing with a temporary or permanent subsidy. Business, Consumer Services and Housing Agency – CA.gov
  • 17% are known to remain in sheltered or unsheltered homelessness. Business, Consumer Services and Housing Agency – CA.gov
  • 25% are recorded as “Unknown.” Business, Consumer Services and Housing Agency – CA.gov

The Takeaway: When a county’s data shows a drop in chronic homelessness, it is often difficult to prove whether those individuals were permanently retained, moved to a different county, or simply stopped interacting with service providers entirely, causing them to fall off the HMIS grid. The counties winning this battle are the ones using localized, real-time “By-Name” data systems rather than relying purely on historical, retrofitted HMIS data uploads.

Want to look closer at how ‘By-Name Lists’ fix California’s tracking gaps?Yes

How do By-Name Lists work in HMIS, and how do they prevent chronically homeless individuals from falling through intra-system tracking gaps?

A standard Homeless Management Information System (HMIS) operates like a traditional database. It takes snapshots of data, tracks transactions (like a bed night or a meal), and aggregates that data for state or federal reporting.

The problem? It is backward-looking. A standard HMIS tells you how many people you served last quarter, but it rarely helps a case worker figure out where a specific chronically homeless person is this afternoon.

A By-Name List (BNL) shifts the paradigm from aggregate tracking to real-time coordination. It is a continuously updated, frontline roster of every single person experiencing homelessness in a given community.

How a By-Name List Works

Instead of waiting for a person to walk into a facility to generate a data point, a By-Name List pulls data dynamically from HMIS and street outreach teams into a centralized, living document.

[ Street Outreach ] ──┐
[ Emergency Shelter ] ─┼─> [ Centralized By-Name List ] ──> [ Case Conferencing Team ]
[ Medical/Jails ] ────┘     (Real-time status updates)       (Matches person to next open bed)

The process generally follows four core mechanics:

  • Universal Identification: Every individual is added to the list by name, accompanied by their specific health vulnerabilities, history of homelessness, and current location or “frequent hangouts.”
  • Acuity Scoring: Communities use a standardized tool—most commonly the VI-SPDAT (Vulnerability Index – Service Prioritization Decision Assistance Tool)—to assign a score based on how likely that person is to die or suffer severe harm on the streets.
  • Dynamic Status Tracking: Individuals are tagged with a real-time status: Active (currently unsheltered/sheltered), Housed (successfully placed), or Inactive (has not been seen or heard from by any provider in 90 days).
  • Cross-Agency Case Conferencing: Every week or two, representatives from housing authorities, mental health agencies, street medicine teams, and shelters sit in a room with the list. They don’t talk about general statistics; they go line-by-line: “Where is John Doe? His name is next for the PSH apartment that opened up yesterday.”

How it Fixes Intra-System Tracking Gaps

By changing how data is gathered and viewed, a By-Name List directly plugs the data leaks that plague standard county HMIS frameworks:

1. Eliminating the “Unknown Exit” Black Hole

In a traditional system, if a person leaves a temporary shelter, their file is closed as “Exit Destination: Unknown,” and they effectively become a ghost until they re-register elsewhere.

  • The BNL Fix: Because street outreach teams use the same list, if an individual leaves a shelter and goes back to a riverbed or encampment, the outreach team updates their status back to “Active – Unsheltered” and logs their coordinates. The continuity of their profile remains unbroken.

2. Prioritizing by Need, Not “First-Come, First-Served”

Standard HMIS queues often reward the people who are functional enough to show up to an office early in the morning. The most severely chronically homeless individuals—often suffering from severe mental illness or cognitive decline—rarely fill out the paperwork.

  • The BNL Fix: The list is ordered by vulnerability, not chronology. The system actively hunts for the person at the top of the list, using the collective memory of all county providers to find them when a permanent housing voucher becomes available.

3. Preventing Multi-Agency Duplication

Without a centralized list, a person might get a mental health evaluation from County Agency A, a shelter bed from Non-Profit B, and street medicine from Group C. In standard HMIS, these can look like three different people or disconnected parallel tracks.

  • The BNL Fix: It forces an intra-system “single source of truth.” All three entities update the same file, ensuring that the housing navigator knows exactly what medical clearings or documents the person already has, slashing administrative delays.

4. Defining “Functional Zero”

Without a By-Name List, a county cannot accurately measure if it is winning the battle. They are just guessing based on point-in-time counts conducted once a year.

  • The BNL Fix: Because the list tracks exact inflow (people falling into homelessness) and outflow (people getting housed or moving away) in real time, a county knows exactly when its housing capacity matches its demand.

The Reality Check: A By-Name List is only as good as the human infrastructure supporting it. It requires strict data-sharing agreements between competitive non-profits and county agencies, alongside relentless field outreach. When done right—as seen in communities like Bakersfield—it turns a fractured web of independent shelters into a single, cohesive triage system.

HEAPA Homelessness Advocacy and Policy Updates Sonoma County

1 source·May 23, 2026

This text highlights the transition of street outreach from providing basic survival aid to functioning as a professional, housing-focused pipeline for the unsheltered. While regions like Sonoma County and San Francisco report measurable successes in housing placement and retention, significant systemic hurdles remain, including a shortage of affordable units and fragmented data systems. Local advocates express concern over the Behavioral Health Services Act integrated plan, arguing that its medical-clinical model may exclude vulnerable populations and lacks sufficient community input. To address these gaps, the Homeless Emergency Assistance Program Association (HEAPA) is actively promoting civic engagement and leadership among those with lived experience. Their initiatives focus on providing digital tools, stipends, and advocacy training to ensure unhoused individuals have a voice in the policy decisions that shape their lives. Through these efforts, the organization seeks to bridge the divide between high-level bureaucratic planning and the practical needs of the community.

How is street outreach evolving from survival aid to housing?

Street outreach is transforming from simply providing basic survival aid, like handing out blankets or water, into a professional, housing-focused pipeline. Rather than just managing the crisis of living on the streets, modern outreach workers act as mobile case managers who meet individuals where they are to actively end their homelessness.

Today, successful programs focus on building trust over extended periods to achieve the practical milestones required for housing placement. This evolution includes several key strategies:

  • Document Readiness: Outreach teams help individuals navigate complex government bureaucracies to secure necessary identification, such as lost birth certificates, social security cards, and state IDs.
  • Coordinated Entry Integration: Workers use localized data systems like the Homeless Management Information System (HMIS) to assess people directly in the field, ensuring the most vulnerable are prioritized and seamlessly matched with open shelter beds, rapid rehousing, or permanent supportive housing.
  • Multidisciplinary Teams: Modern outreach programs often deploy hybrid teams featuring mental health professionals, substance use counselors, and peer navigators with lived experience of homelessness, allowing them to provide immediate, trauma-informed care on the sidewalk.
  • Warm Handoffs: Success is no longer defined by simply handing out a flyer with a list of resources. Instead, outreach workers personally walk with individuals, drive them to appointments, introduce them to shelter staff, and remain with them throughout the intake process to ensure continuity of care.

Real-world models reflect this shift, such as Los Angeles’s “Pathway Home” initiative, which brings entire encampments indoors while offering comprehensive care, and family reunification programs that safely reconnect individuals with their existing support networks.

However, while the mechanics of modern outreach are highly effective at preparing people for housing, the ultimate success of these programs remains completely dependent on the availability of low-barrier shelters and permanent affordable housing to fully resolve the crisis.

What are the success rates of Bay Area programs?

Recent data from the Bay Area and Northern California shows that when street outreach is well-resourced, it achieves high transition and housing retention rates. Local municipalities and Continuums of Care track these efforts closely, highlighting several notable success rates across the region:

San Francisco San Francisco’s multi-disciplinary outreach programs have achieved significant permanent housing placements and high long-term stability:

  • Housing Placements: Between July 2023 and June 2025, the system successfully moved 10,300 people from homelessness into permanent housing.
  • Retention Rates: The city reported an exceptional 93% retention rate, meaning 93% of those who exited homelessness did not return to the system within 12 months, exceeding their goal of 85%.
  • Reduced Emergency Calls: In neighborhoods where street outreach and ambassador programs were deployed, there was a 30% to 60% reduction in 911 calls.
  • Immediate Shelter: The RESTORE project successfully served over 2,500 clients by providing nighttime shelter placements and immediate substance use treatment directly from the street.

Santa Rosa and Sonoma County Targeted outreach and expanded interim housing have led to some of the lowest homelessness numbers in the county since 2007:

  • Pipeline Success: In Santa Rosa, city-funded outreach programs successfully transitioned nearly 30% of all unsheltered people they engaged into formal shelters or permanent housing during the 2024–2025 fiscal year.
  • Population Declines: Overall homelessness dropped by 23% countywide and 16% in Santa Rosa. Rohnert Park experienced a dramatic 60% reduction in overall homelessness (including a 78% drop in unsheltered individuals) due to targeted outreach and the opening of a new interim housing site.
  • Veterans: Targeted outreach paired with housing vouchers achieved a 39% reduction in homeless veterans across the county.
  • Challenges: Despite these successes, the number of chronically homeless individuals rose by 20%, emphasizing that the most vulnerable populations still lack adequate Permanent Supportive Housing (PSH).

Berkeley and the East Bay While specific percentage success rates aren’t detailed for Berkeley, the city has successfully implemented the Homeless Outreach Treatment Team (HOTT). Instead of short-term fixes, this specialized model utilizes an evidence-based Critical Time Intervention (CTI) framework to build long-term relationships with highly vulnerable, severely mentally ill individuals to navigate them into housing stability.

Ultimately, regional data demonstrates that the mechanics of modern street outreach are working, but the ceiling of their success is currently capped by a severe regional shortage of affordable housing units and state/federal budget cuts.

Tell me more about Berkeley’s HOTT model.

The Homeless Outreach Treatment Team (HOTT) is a specialized outreach pilot program operated by the City of Berkeley that aims to bridge the gap between psychiatric crises and housing.

Funded largely by the Mental Health Services Act, the HOTT model distinguishes itself through the following key characteristics:

  • Evidence-Based Framework: The program is built on an evidence-based approach known as Critical Time Intervention (CTI).
  • Targeted Population: It specifically focuses on highly vulnerable unhoused individuals who are experiencing severe mental health needs.
  • Long-Term Relationship Building: Rather than offering short-term or temporary fixes, the team is entirely focused on cultivating long-term, trusting relationships with the people they serve.
  • Active System Navigation: Outreach workers don’t just provide information; they physically help individuals navigate the highly fragmented county system to help them achieve long-term housing stability.

What is Critical Time Intervention?

Based on the provided sources, there is no comprehensive, standalone definition of Critical Time Intervention (CTI). However, the sources describe CTI as an evidence-based framework that is put into practice through programs like Berkeley’s Homeless Outreach Treatment Team (HOTT).

In the context of the HOTT model, CTI is characterized by the following approaches:

  • Avoiding short-term fixes: Instead of offering temporary solutions, the framework is entirely focused on cultivating long-term, trusting relationships.
  • Targeting severe mental health needs: It is designed to assist highly vulnerable unhoused individuals who are dealing with severe mental health crises.
  • Active, hands-on navigation: Rather than just giving out information, workers physically help individuals navigate the fragmented county systems necessary to achieve long-term housing stability.

(Note: If you would like a broader clinical or academic definition of Critical Time Intervention, I would need to draw on outside information not included in your current sources. Let me know if you would like me to do so!)

What are the common challenges when implementing HOTT?

The provided sources do not explicitly detail the administrative or operational challenges specifically faced when implementing Berkeley’s Homeless Outreach Treatment Team (HOTT). However, they do identify the broader systemic challenges that affect the success of specialized regional outreach programs like HOTT:

  • Navigating Fragmented Systems: A major hurdle for vulnerable, unhoused individuals is the bureaucracy of local government. HOTT outreach workers must physically help clients navigate a highly fragmented county system to help them achieve long-term housing stability.
  • Affordable Housing Shortages: The ultimate ceiling on the success of these outreach programs is macro-economic; there is a severe regional shortage of affordable housing units.
  • Budget Cuts: Furthermore, state and federal budget cuts restrict the number of permanent beds that outreach teams can actually offer to the people they engage on the street.

How does the fragmented county system affect HOTT’s success?

The fragmented county system acts as an incredibly overwhelming barrier for highly vulnerable, unhoused individuals, particularly those dealing with severe mental health needs or chronic trauma. Because individuals struggle to navigate these disjointed bureaucracies on their own, the fragmentation makes HOTT’s active, hands-on approach the critical factor for their success.

Instead of offering short-term fixes or simply handing out a list of resources, HOTT workers succeed by physically navigating clients through the fragmented county system. They build long-term, trusting relationships and rely on “warm handoffs”—such as driving individuals to appointments, introducing them to shelter staff, and remaining with them throughout the entire intake process—to ensure that clients achieve long-term housing stability without slipping through the cracks of the broken system.

What is the RESTORE project in San Francisco?

The RESTORE project is a specific street outreach initiative in San Francisco that focuses on providing “on-demand” placements and care.

The program is designed to deliver immediate substance use treatment and secure nighttime shelter placements for unhoused individuals directly from the street. As part of the city’s broader “Home by the Bay” strategy to reduce homelessness, the RESTORE project has been highly active, successfully serving more than 2,500 clients.

What is the RESTORE project’s success with substance use treatment?

Based on the provided sources, the RESTORE project in San Francisco is designed to provide immediate substance use treatment and nighttime shelter placements directly to individuals on the street.

In terms of its success, the sources note that the expanded program has successfully served more than 2,500 clients. However, the data provided does not include specific outcome metrics or success rates detailing the long-term effectiveness of the substance use treatment itself, such as sobriety or recovery statistics.

What is the 30% reduction in 911 calls attributed to?

The 30% to 60% reduction in 911 calls in San Francisco is attributed to the deployment of proactive street outreach and neighborhood-based ambassador programs in specific neighborhoods. This reduction demonstrates that engaging directly with individuals on the street helps relieve the overall pressure on emergency services.

What is the RESTORE project’s total client outreach goal?

The provided sources do not specify a total client outreach goal for the RESTORE project. They only note that the expanded program has already successfully served more than 2,500 clients by providing immediate substance use treatment and nighttime shelter placements directly from the street.

What is the RESTORE project’s role in the city’s broader strategy?

The RESTORE project operates as a key outreach initiative within San Francisco’s broader “Home by the Bay” strategy.

Within this strategic framework, San Francisco relies heavily on multidisciplinary street teams—such as the Street Crisis Response Team (SCRT) and the SF Homeless Outreach Team (HOT)—to manage non-violent, health-focused crises. The RESTORE project specifically fulfills the role of providing “on-demand” placements by delivering immediate substance use treatment and nighttime shelter directly to unhoused individuals on the street.

Working alongside neighborhood-based ambassador programs, these proactive street engagements are a vital part of the city’s overall strategy, effectively relieving pressure on emergency services and contributing to significant reductions in 911 calls.

What makes the 93% housing retention rate so successful?

The 93% housing retention rate in San Francisco is a significant marker of success because it means that 93% of individuals who exited homelessness did not return to the homelessness system within 12 months, comfortably exceeding the city’s target of 85%.

This exceptional long-term stability is largely attributed to how modern street outreach has transformed into a professional, housing-focused pipeline rather than simply providing short-term survival aid. The success of this retention rate is driven by several critical practices:

  • Continuity of Care and “Warm Handoffs”: Navigating local bureaucracies can be incredibly overwhelming for individuals dealing with chronic health issues or trauma. Instead of merely handing out a flyer with a list of resources, outreach workers walk with clients, drive them to appointments, introduce them to shelter staff, and stay with them throughout the intake process. This hands-on approach is what prevents vulnerable people from slipping through the cracks.
  • Long-Term Trust Building: Successful programs require workers to build trust over weeks or months to help individuals accomplish practical milestones, such as overcoming complex government bureaucracy to replace lost identification cards.
  • Targeted Matching: Outreach teams integrate with localized data systems to assess people directly in the field, ensuring they are accurately prioritized and matched with the right open shelter beds, rapid rehousing, or permanent supportive housing.
  • Adequate Resourcing: Regional data consistently shows that when these targeted outreach teams are deployed with adequate resources, they are highly effective at achieving these exceptional long-term housing stability rates.

How does Coordinated Entry Integration prioritize the most vulnerable?

Coordinated Entry Integration prioritizes the most vulnerable by bringing the assessment process directly to people living on the street. Rather than waiting for individuals to seek out services, outreach teams use localized data systems, such as the Homeless Management Information System (HMIS), to assess individuals in the field.

This direct, field-based assessment allows outreach workers to identify the most vulnerable people sleeping outside and ensure they are seamlessly matched and prioritized for available resources, such as open shelter beds, rapid rehousing programs, or permanent supportive housing.

The effectiveness of this system has made it a focal point for local housing advocates in the sources. For example, in Sonoma County, advocates have praised the Coordinated Entry System as a carefully built, proven, and effective tool, expressing concern when local government plans—like the draft Behavioral Health Services Act 3-Year Integrated Plan—fail to utilize it. To maximize its impact, advocates have proposed solutions such as requiring 100% of rooms for homeless individuals in county-owned facilities to be filled exclusively through the Coordinated Entry System.

What is the role of the Street Crisis Response Team?

The Street Crisis Response Team (SCRT) is a multidisciplinary outreach group utilized in San Francisco as a key component of the city’s “Home by the Bay” strategy.

Its primary role is to proactively handle non-violent, health-focused crises for individuals living on the streets. Working alongside other groups like the SF Homeless Outreach Team (HOT), the SCRT engages vulnerable individuals during these crises to offer immediate assistance and provide direct shelter placements.

By dispatching specialized teams to manage these health-related emergencies, the SCRT directly relieves pressure on traditional emergency services, contributing to the broader citywide effort that has successfully reduced 911 calls by 30% to 60% in targeted neighborhoods.

How does the Homeless Management Information System work?

The Homeless Management Information System (HMIS) is a localized data system used by county outreach teams to collect data and assess individuals directly in the field.

When used effectively, HMIS is the technical backbone for Coordinated Entry Integration. Outreach workers use the system during street engagements to evaluate an individual’s needs on the spot, ensuring that the most vulnerable people sleeping outside are prioritized and seamlessly matched with open shelter beds, rapid rehousing programs, or permanent supportive housing.

However, the system’s effectiveness relies heavily on how well it communicates with other local government databases. For example, in Sonoma County, homeless data is collected through HMIS, but the county’s Behavioral Health Department uses a completely separate data system called SmartCare (or Smart Key). Local advocates have identified this lack of integration as a major systemic weakness, noting that without integrating the two systems, data becomes disjointed, making it difficult to accurately track a person’s homeless outcomes alongside their clinical visits. This fragmentation creates a risk that vulnerable individuals will “fall through the statistic crack”.

To address these data problems, local advocacy groups like Homeless Action! have proposed the immediate, formal integration of HMIS and SmartCare, while organizations like HEAPA are actively developing projects to help case managers better communicate and collect data across these amalgamating county systems.

What is the SmartCare data system used for?

SmartCare (sometimes referred to as Smart Key) is the primary data system used by Sonoma County’s Behavioral Health Department.

It currently operates as a completely separate system from the Homeless Management Information System (HMIS), which the county uses to track homeless data. Local advocates point out that the lack of integration between these two databases is a major systemic weakness, making it difficult to accurately track a person’s clinical visits alongside their homeless outcomes.

To prevent vulnerable individuals from slipping through the cracks due to disjointed data, advocacy groups have proposed the immediate, formal coordination of SmartCare and HMIS. Meanwhile, organizations like HEAPA are working on upcoming projects to train case managers on how to better communicate and collect data across these amalgamating county systems.

What is the goal of the California Transparency Project?

While the sources do not explicitly define a single overarching “goal” or mission statement for the California Transparency Project, they outline its active initiatives, which demonstrate a focus on improving agency communication, expanding government transparency, and increasing citizen involvement in strategic planning.

Specifically, the project aims to achieve these objectives by:

  • Improving Communication and Data Management: The project purchased digital personal assistant devices for several agencies to test their effectiveness and produced instructional videos showing users how to provide meeting reports with these devices.
  • Increasing Public Transparency: The project requested copies of all service contracts issued by the Departments of Health Services and Human Services for the 2025–2026 fiscal year and made them publicly available online.
  • Prioritizing Citizen Access: The project called for the convening of NOFA (Notice of Funding Availability) planning committees across several groups—including the Sonoma County Community Development Commission, the Santa Rosa Housing Authority, the Sonoma County Homeless Coalition, and the Behavioral Health Boards—to prioritize citizen access to strategic planning and help coordinate their work.

Homeless Action! Feedback

Behavioral Health Services Act (BHSA) 

3-Year Integrated Plan (draft)

Over the past 2-3 weeks members of an informal Homeless Action! Committee worked to understand and analyze this 192-page document.   Our memo below captures the major problems we found.

SUMMARY of the Plan

  • Spends approximately $611.0 million over 3 years.
  • Funding from Federal Financial Participation (FFP): $187.4 million, (BHSA Behavioral Health Services Act): $153.3 million; Other state funding: $99.5 million; 2011 Realignment: $71.6 million; 1991 Realignment: $69.6 million; Opioid Settlement Funds: $13.7 million; Substance Use Block Grant: $8.1 million; State General Fund: $4.8 million; County General Fund: $1.6 million; Mental Health Block Grant: $1.2 million.
  • Confirms Sonoma County’s Homeless Division as part of the Behavioral Health Division of the Department of Health
  • Who Will Be Served (Annual Estimates)

Rental Subsidies: ~70 individuals
Operating Subsidies: ~200 individuals
Landlord Mitigation Supports: ~100 individuals
Participant Assistance Funds: ~300 individuals
Housing Navigation & Tenancy Services: ~130 individuals

  • This plan limits help to those with acute mental illnesses and substance abuse disorders who are eligible for MediCal.
  • One part of the plan is suicide prevention – particularly for middle age and senior men.

APPRECIATION

We greatly empathize with the thinkers and writers of this 200-page document required by government funders.  It’s not simple or easy to produce such a detailed plan that satisfies the State’s requirements.   The plan combined multiple funds and a reorganized county staff with the intention of making the most positive change for the people of Sonoma County as possible.   

It calls out the higher rates of homelessness for American Indian/Alaska Native and Black residents, as well as high suicide rates for middle age and older men.   It attempts to integrate three county-owned facilities into a unified purpose and structure.   It provides money for homeless prevention, funds mobile outreach, and a program which provides health care, mental health and social services to individuals.  

PROBLEMS

There is a critical need for honest feedback because 1) the public money spent in this plan ($611 million dollars) is enormous, and 2) those who are left behind as this plan is implemented will suffer greatly.  The key issues below are some of the crucial problems and deep systemic weaknesses in the county plan.

  1. Lack of Consultation with Community.     The plan was released with less than a month for public comment.  It was released without a summary in clear, straight-forward language.  Many stakeholders, including homeless people and people living with behavioral health problems and substance abuse disorders, were not included.  The Homeless Coalition and Catholic Charities are the most obvious omission, but SHARE Sonoma County, Homeless Action!, the LEAP board, Acts of Kindness, Unsheltered Friends Outreach, and other groups with lived experience are among those missing.
  2. Limitation of Service.  The entire $611 million is earmarked forpeople with acute behavioral (mental) health problems and those with substance abuse disorders.  Housing and other support is entirely missing for the approximately 1,000 homeless people who do not fall into these categories as well as housed individuals living with less-than-acute mental illness. 
  3. Strategic Silos   The county and several cities have strategic plans, often produced at significant cost by consultants.  These were, apparently, not considered in the making of this plan.  The most obvious example of this is the March “Department of Health Services (DHS) Organizational Assessment Homeless Services Division & Sonoma County’s Role as Lead Agency for the Continuum of Care, March 19, 2026”.  This report recommended that the Homeless Division be integrated into the Behavioral Health Division, but many other aspects of this report are ignored in the 3-year plan.  If homeless services are fragmented due to this, homeless people are at risk of becoming a secondary issue. 
  1. Data Problems   The Behavioral Health Department uses SmartCare.  County homeless data is collected through HMIS.  The two data systems are not integrated.   Without a difficult and fast-paced integration, data to assess this plan will be useless, and many individuals will fall through the statistic crack.  The plan cites that of 520 eligible individuals experiencing unsheltered homelessness, zero (0) were recorded as moving into permanent housing.  We hope this is a data problem and not reality.    The Coordinated Entry System which has been carefully built over several years, and proven to be effective, does not seem to have a role in this plan.  It’s important to ensure that the County will be able to track homeless outcomes as well as clinical visits.  There is no accountability or metrics for this.
  2. Medical vs Social Model.    The plan excludes those who are not eligible for Medi-Cal and cannot be diagnosed with a medical disease.  Services are tied to eligibility and diagnosis IF you can get a Behavioral Health referral through ACCESS.  This will exclude many undocumented people.  That is a huge red flag.  The medical-clinical model has been rejected by the disability movement for over 50 years.  With this plan, we risk categorizing our poorest and most vulnerable friends and neighbors as patients who must accept what they are told for their own good.  This is a set up for disempowerment at the time when people most need to have control of their lives.
  3. The CalAIM problem.  The 3-year plan relies heavily on the CalAIM program of Medi-Cal.  The bureaucratic load of Cal AIM will “price out” smaller, more grassroots agencies.   Cal AIM is a force that will put people into a clinical system which will limit support their overall ability to stay housed.
  4. Lived Experience.   The plan speaks of people with Lived Experience and peer support but there is no formal method of integrating feedback or any decision-making power to those with the lived expertise of mental health problems and/or homelessness.
  5. People of Color (BIPOC).   The plan acknowledges crucial disparities among American Indian/Alaska Native, Latino and Black residents in homelessness, arrests and unmet needs but only 3 groups have been selected to respond to a Request for Proposals in this area.  Only 126 individuals in this catagory are expected to be served annually.

SOLUTIONS

  1. Fill 100% of rooms for homeless people in County-owned facilities through the Coordinated Entry System.
  2. Begin a formal SmartCare-to-HMIS Coordination immediately with a 3-month timeline for completion.
  3. Set up a Hub-and-Spoke administrative system whereby larger agencies administer CalAIM for smaller agencies, allowing the grassroots agencies to focus on direct client care.
  4. Expand scope of the plan to include undocumented individuals who do not qualify for Medi-Cal and homeless individuals who do not qualify as acutely mentally ill or living with substance abuse disorders.
  5. Insist upon a robust and meaningful community discussion before further implementation. 

My view of Sonoma County’s Proposed Proposition One FY 26-29 Behavioral Health Three-Year Integrated Plan

Greetings!

I’ve been asked by many to provide my perspective on the County’s development of the Proposition One’s required Sonoma County Three-year Integrated Plan for Behavioral Health and Substance use Disorder Services beginning July 1, 2026.  Having served on the County’s Behavioral Health Board for the last two years, and as Chair of the Board’s Subcommittee charged with its review and report until early April, I was in a unique position to monitor the County’s performance.

The instructions from the California Department of Health Care Services to counties, concerning the process of developing the Integrated Plan, represented a significant expansion of the programs and funding sources involved, as well as the variety of additional stakeholders required to be included in the planning.  County staff, complaining of delayed state direction, consumed nine of the twelve months of planning providing stakeholders with information from the initiative that impacted the previously reported MHSA funding (Prop 63).   How was Sonoma County was going to add substance abuse services, spend thirty percent of the funds on housing for clients, and half of the Full support Partnerships on those under 25 years of age without any additional funding?  When combined with the failure of the Health Department’s Fiscal Division to deliver to the Department any useful information concerning the remaining 90% of the Plan’s responsibility, the proposed stakeholder engagement and Board review of the proposed Plan quickly became an exercise in unproductive meetings with repetitious powerpoint presentations.

The Subcommittee I chaired soon found themselves useless in their attempt to build an understanding of the work of Plan development, and as a result could not adequately assist in informing required stakeholders.  Adding to the barriers to engagement, one of the largest stakeholder oversight entity (Sonoma County Homeless Coalition) was never approached by the Department, or given a chance to participate.  

The result is a year of missed opportunities to inform and consider the views of an expanded stakeholder community concerning the expenditure of over a billion dollars of government funding for those with behavioral health and substance use disorder needs. 

Gregory Fearon

Victories against Trump HUD Actions

Appeals Court Rejects Latest Trump-Vance Administration Attack on Funding for Solutions to Homelessness

Court Continues to Block Unlawful Grant Restrictions that Would Push Nearly 200,000 Americans into Homelessness

Contact: press@democracyforward.org

Press Release

Court Finds Trump-Vance Administration Violated Law In Rush to Politicize Housing Grants

National Alliance to End Homelessness and Women’s Development Corporation Secure Victory in Key Executive Overreach Lawsuit

Date

March 31, 2026

Issue Area

  • Civil Rights, Equity, & Inclusion

Media Contact

press@democracyforward.org

Providence, R.I. – The U.S. District Court for the District of Rhode Island today ruled that the U.S. Department of Housing and Urban Development (HUD) and HUD Secretary Scott Turner violated the law through their “slapdash imposition of political whims,” when approving new funding restrictions that would have unlawfully conditioned access to federal housing grants on compliance with the Trump-Vance administration’s partisan agenda. 

The decision issued today in National Alliance to End Homelessness v. Turner, et al., is a victory for The National Alliance to End Homelessness and Women’s Development Corporation, which filed a lawsuit last September challenging the grant restrictions. The groups are represented by Democracy Forward, National Homelessness Law Center, Lawyers’ Committee for Rhode Island, and ACLU Foundation of Rhode Island in the matter.

“This ruling is a victory for people across this nation who have overcome homelessness and stabilized in HUD’s permanent housing programs,” said Ann Oliva, CEO of the National Alliance to End Homelessness. “Today’s news reinforces a fundamental truth: that the work to end homelessness is not partisan, and never should be interfered with for political means. On behalf of the people and providers we serve, the National Alliance to End Homelessness pledges to continue fighting back against efforts to dismantle homeless response in America.”

“The solution to homelessness is stable, predictable, permanent housing,” said Frank Shea, Executive Director of Women’s Development Corporation.  “Organizations providing this housing need fair, predictable programs that are free of politicized criteria.  We are glad the court agrees.  Our neighbors in need of housing deserve nothing less.”

The lawsuit, filed in the U.S. District Court for the District of Rhode Island, asserted that HUD’s newly imposed criteria for “Continuum of Care (CoC) Builds” grants were unlawful. This is the third time that HUD has issued this same grant opportunity, even after grant awards had already been announced to Congress. In so doing, HUD introduced extreme political criteria to the application. Under the new funding application rules, service providers and communities were blocked from applying for federal housing funds for new Permanent Supportive Housing for individuals and families experiencing homelessness if they operate in jurisdictions with policies the Trump-Vance administration disfavors. This includes states and cities with sanctuary protections and cities that criminalize public camping. The new funding criteria also would have disqualified organizations that provide services considered “harm reduction,” such as Safe Drug Use Criteria practices and those that have inclusive policies for transgender people. 

Today’s ruling declares the notice announcing the funding opportunities, the new political criteria used by HUD when deciding to issue grants, and the one-week application period for the grants all to be unlawful and orders the policies vacated and set aside. The court additionally ordered the already-appropriated funding to remain available for award, consistent with the Court’s order. 

“For more than three decades, the federal government has supported housing providers and communities through HUD’s programs to help people experiencing homelessness move into stable housing,” said Skye Perryman, President and CEO of Democracy Forward. “We are honored to have worked with these brave plaintiffs and co-counsel to hold this administration accountable for their unlawful actions, and we are pleased that the court has stopped the Trump-Vance administration from holding life-saving funding hostage to a political agenda.”

“Hundreds of thousands of unhoused people need housing and supports to survive.  Instead of following Congress’ direction to increase that supply of supportive housing, this Administration unlawfully manipulated a grantmaking process that would have only made homelessness across the country worse,” said Antonia Fasanelli, Executive Director at the National Homelessness Law Center.  “We were honored to represent the National Alliance to End Homelessness and to work with our esteemed co-counsel in preventing the Administration from forcing an ideological agenda on a program that is intended to save lives.”

“The Lawyers’ Committee for Rhode Island will continue to fight for Rhode Islanders whenever and however the Trump Administration threatens them with unlawful actions,” said Amy Romero, Chief Legal Counsel of Lawyers’ Committee for Rhode Island. “We are pleased with this court’s decision that recognizes that this Administration violated the law by imposing their political whims on federal funds intended to address the needs of individuals and families experiencing homelessness.”  

“The federal government’s distortion of the grant process for blatant political and ideological gains put funding for life-saving services at risk,” said Steven Brown, executive director of the ACLU of Rhode Island. “We are extremely gratified that Rhode Island organizations like the Women’s Development Corporation will be allowed to receive federal funding thanks to the court’s decision.”

The plaintiffs are represented by Kristin Bateman, Yenisey Rodríguez, Kristen Miller, and Robin Thurston from Democracy Forward; Amy Romero and Kevin Love Hubbard for the Lawyers’ Committee for Rhode Island; Antonia Fasanelli from the National Homelessness Law Center; and Lynette Labinger for the ACLU Foundation of Rhode Island. 

Read today’s order here and the original filing here.

We did it.

For the second time in two days, the courts have ruled against the Trump Administration’s efforts to illegally meddle in federal homelessness programs. Today’s ruling from the 1st Circuit Court of Appeals means the U.S. Department of Housing and Urban Development (HUD) cannot move forward with its plan to release the December 19th Continuum of Care (CoC) Program Notice of Funding Opportunity (NOFO) to hold an absurd partial-year competition. Our Preliminary Injunction remains in place.

This will bring immense relief to communities across the country who were faced with the prospect of running overlapping local CoC NOFO competitions. Most importantly, this means HUD must renew all awards expiring this year — which will keep people in their homes, program staff employed, and landlords paid their rent. The full opinion can be found here:Read the Full Press ReleaseAnd it’s not over yet. Preventing the December NOFO is just a part of our ongoing litigation. The full merits of our case remain before the U.S. District Court for the District of Rhode Island awaiting final judgment, and we trust our legal counsel has put forth a strong set of arguments for the Court to consider.  Democracy Forward and the ACLU Foundation of Rhode Island represent the coalition of nonprofit organizations in the matter; the National Homelessness Law Center represents NAEH and NLIHC; Public Rights Project represents the cities of Boston, Cambridge, Nashville, and Tucson as well as King County; Santa Clara County and San Francisco are also plaintiffs. The Lawyers’ Committee for Rhode Island represents all plaintiffs.

Homeless Action! Settlement Terms with County/City

Here is a link to the Powerpoint (coming soon) outlining the recent settlement terms between Homeless Action! and the County of Sonoma and the City of Santa Rosa resolving their 8-year old federal lawsuit over the rights of the unhoused during clearance of their encampments.

Here is a summary of each:

City Settlement Highlights

The settlement with the City of Santa Rosa provides that the City will not remove unhoused people’s belongings from public property except in very limited circumstances: 

  • There are exigent circumstances—e.g., an immediate threat to health and safety—that require the items’ removal; 
  • When the police arrest someone and safekeep their property; or  
  • When items are collected for evidence. 

Instead—and even in exigent circumstances, where possible—the City agrees to give people time to move their own belongings, including letting them move their belongings in multiple trips and other accommodations based on individual needs and circumstances. 

The language also includes requirements for City staff and contractors to document instances when they remove belongings from public property, including posting notices where feasible and sharing information on the City’s website. 

The City also agreed not to use threats of citation or arrest to pressure people into abandoning their belongings. 

These and other requirements will be incorporated into the written policies for SRPD and the City’s Debris Response Team, and the City will train staff on the policy changes. 

The City settlement will remain in effect for one year. 

County Settlement Highlights

The settlement with Sonoma County and the Sonoma County Community Redevelopment Commission includes policy commitments related to the County’s treatment of unhoused people’s personal property, reasonable accommodations for people with disabilities, and due process in County shelter facilities. 

The settlement requires the County—including sheriff’s deputies on the Joe Rodota Trail—to provide reasonable written notice of no less than 10 hours before it removes unhoused people’s belongings from public property, as well as storage of those belongings for at least 90 days, with limited exceptions. It also requires a post-removal notice and a process for people to get their belongings back. 

The County settlement includes requirements for certain County policies, protocols, and contracts to include language regarding reasonable accommodations for people with disabilities to ensure fair treatment and meaningful access for unhoused people with disabilities.  

The County will also comply minimum due process requirements that must be followed before people can be “exited” from County homeless shelters, ensuring that individuals have notice of the reason for the exit and an opportunity to challenge the exit if they disagree. 

The County settlement will remain in effect for three years. 

Questions: BH Board’s Annual Report/Integrated Plan Committee Meeting, March 3rd, 2026.

Post was the generated by submitting a summary of the meeting developed by Fieldy to Adobe Acrobat’s AI Assistant, and choosing to ask it to pursue its questions and suggested research.

Summary

Navigating Sonoma County’s Behavioral Health Crossroads

Sonoma County’s behavioral health and homelessness services are facing a pivotal moment due to severe funding cuts and shifting priorities.1

  • Critical Funding Threats: Federal Medicaid reductions and dwindling local funds jeopardize essential services, with Measure O playing a vital role in current support.2
  • Strategic Shifts: The county is reorganizing teams, seeking new partnerships, and focusing on residents with higher behavioral health needs to adapt to the changing landscape.3
  • Community Engagement: Transparent processes and proactive outreach to local leaders are prioritized to maintain support and awareness.4
  • Achievements Amidst Uncertainty: Despite challenges, key programs like the Crisis Stabilization Unit and Crestwood Healing Center are making significant impacts.5

Understanding these dynamics is crucial for stakeholders aiming to support, advocate for, or adapt to the evolving behavioral health environment.Ask a question

Funding Challenges and Strategic Responses

Challenge/AdjustmentDetails
Federal Medicaid CutsAnticipated reductions threaten core behavioral health and homelessness services1
Measure O RelianceFunds 58.33 staff; projected ending balance of $7.1M is a major concern2
Realignment Fund DepletionLocal funds are dwindling, increasing fiscal pressure3
NOFA ($10M)New funding opportunity to support at-risk programs; deadline: Sept 174
Strategic ReorganizationHomelessness team moving under behavioral health to leverage Medi-Cal billing5
Allocation AdjustmentsPossible reallocation of NOFA funds to support struggling providers6

Key Program Achievements and Impact

  • The Crisis Stabilization Unit is now almost fully staffed and operational, addressing previous shortages.1
  • QPR suicide prevention training at Analy High School has boosted counselor confidence in crisis response.2
  • Crestwood Healing Center, a 16-bed psychiatric facility, is reducing reliance on private hospitals.3
  • Measure O supports over 58 essential mental health and crisis service staff across the county.4

Upcoming Actions and Accountability

  • Develop a data-driven proposal for a second psychiatric health facility to cut private hospital costs.1
  • Continue monthly leadership meetings with the new ad hoc committee to align on Measure O priorities.2
  • Launch community outreach to inform local groups and officials about funding impacts and Measure O’s role.3
  • Search for interim and permanent leaders for the reorganized homeless services team is underway.4

Evaluate potential impacts of Medicaid cuts on local health programs

The document highlights several potential impacts of Medicaid cuts on local health programs, particularly in Sonoma County. Below is an evaluation based on the information provided:

1. Financial Strain on Behavioral Health and Homelessness Services

  • Impact: Federal Medicaid cuts are described as a “seismic shift” in healthcare funding, creating significant financial uncertainty for Sonoma County’s behavioral health and homelessness services. This could lead to reduced funding for critical programs that rely heavily on Medicaid/Medi-Cal reimbursements.
  • Example: The county’s Realignment fund balance is already dwindling, and the projected Measure O ending balance of $7.1 million is causing concern among leadership. This indicates that the county may struggle to sustain current service levels without additional funding sources.

2. Risk to Existing Programs

  • Impact: Many homeless and housing providers are in urgent need of financial support to sustain their operations. Medicaid cuts could exacerbate this issue, potentially leading to program closures or reduced services.
  • Example: The document mentions the release of a $10 million Notice of Funding Availability (NOFA) to support programs facing funding loss. This suggests that the county is already taking steps to mitigate the impact of funding reductions, but the long-term sustainability of these programs remains uncertain.

3. Increased Pressure on Local Funding Sources

  • Impact: With federal Medicaid cuts, local funding sources like Measure O will face increased pressure to fill the gap. However, Measure O’s projected ending balance of $7.1 million may not be sufficient to address the growing needs.
  • Example: Measure O currently funds 58.33 employees who provide essential mental health and crisis services. Any reduction in funding could jeopardize these positions and the services they provide.

4. Challenges in Expanding Services

  • Impact: Medicaid cuts could hinder the county’s ability to expand services to meet growing needs. For example, the planned mental health unit at the county jail is already stalled due to insufficient funding, and further cuts could delay or cancel similar projects.
  • Example: The allocated $39 million for the mental health unit is insufficient for current construction costs, and the state has not allowed for plan alterations. This highlights the difficulty of expanding services in the face of financial constraints.

5. Increased Reliance on Strategic Partnerships

  • Impact: The county may need to rely more heavily on strategic partnerships and community advocacy to maintain vital services. This could lead to increased collaboration but also require significant effort to align priorities and secure additional resources.
  • Example: A new ad hoc committee has been established to oversee Measure O funding and enhance collaboration with partners. This indicates a proactive approach to addressing funding challenges, but the effectiveness of these partnerships will depend on the availability of resources.

6. Potential Service Integration

  • Impact: The reorganization of the homelessness team into the behavioral health department is aimed at leveraging Medi-Cal billing and improving service integration. However, Medicaid cuts could undermine these efforts by reducing the available funding for Medi-Cal services.
  • Example: The strategic pivot for homeless services to focus on residents with higher behavioral health needs may be compromised if funding is insufficient to support these specialized services.

Conclusion

Medicaid cuts could have far-reaching impacts on local health programs in Sonoma County, including financial strain, risk to existing programs, challenges in expanding services, and increased reliance on local funding and partnerships. While the county is taking proactive steps to address these challenges, such as releasing the $10 million NOFA and reorganizing services, the long-term sustainability of these efforts remains uncertain without additional funding sources or policy changes.

What can I help with next?
Brainstorm alternative funding sources for homeless services
Summarize key challenges faced by Sonoma County health programs

Summarize key challenges faced by Sonoma County health programs

The document outlines several key challenges faced by Sonoma County health programs, particularly in the areas of behavioral health and homelessness services. Below is a summary of these challenges:

1. Financial Uncertainty

  • Federal Medicaid Cuts: Anticipated reductions in Medicaid/Medi-Cal funding are described as a “seismic shift” in healthcare funding, creating significant financial uncertainty for the county’s health programs.
  • Dwindling Local Funds: The county’s Realignment fund balance is decreasing, and the projected Measure O ending balance of $7.1 million is causing concern among leadership about the sustainability of current services.

2. Project and Funding Gaps

  • Mental Health Unit at County Jail: The planned mental health unit is stalled due to insufficient funding. The allocated $39 million is not enough to cover current construction costs, and the state has not approved plan alterations.
  • Support for Homeless and Housing Providers: Many providers are in urgent need of financial assistance to sustain their operations, and the county is struggling to meet these needs.

3. Strategic Adjustments

  • Reorganization of Services: The homelessness team is being moved into the behavioral health department to leverage Medi-Cal billing and improve service integration. However, this transition may face challenges due to funding constraints.
  • Focus on Behavioral Health Needs: The county is pivoting its homeless services to prioritize residents with higher behavioral health needs, which may require additional resources and specialized services.

4. Leadership and Operational Challenges

  • Leadership Transition: The county’s homeless services unit is undergoing a leadership transition, and there is an active search for interim and permanent leaders to guide the team.
  • Staffing and Operational Issues: While the Crisis Stabilization Unit (CSU) has addressed staffing shortages and is now operational, other programs may face similar challenges if funding is reduced.

5. Community Engagement and Advocacy

  • Need for Transparency: The county is working to ensure transparent processes for the $10 million Notice of Funding Availability (NOFA) to support struggling programs.
  • Community Outreach: Plans are being developed to inform community groups, mayors, and councils about Measure O’s impact and the financial challenges ahead.

Conclusion

Sonoma County health programs are facing significant challenges due to financial uncertainty, project funding gaps, and operational hurdles. While the county is taking steps to address these issues through strategic adjustments, community engagement, and funding initiatives like the $10 million NOFA, the long-term sustainability of these efforts remains uncertain without additional resources or policy changes.

What can I help with next?
Brainstorm advocacy strategies for sustaining Medicaid funding
Analyze potential impacts of funding gaps on mental health services

Brainstorm advocacy strategies for sustaining Medicaid funding

Based on the document, here are potential advocacy strategies for sustaining Medicaid funding in Sonoma County:

1. Community Engagement and Awareness Campaigns

  • Strategy: Launch a public awareness campaign to educate residents, community groups, and local leaders about the importance of Medicaid funding for behavioral health and homelessness services.
  • Implementation:
    • Organize town hall meetings and workshops to discuss the impact of Medicaid cuts.
    • Use social media platforms and local media outlets to share stories of individuals and families who benefit from Medicaid-funded programs.
    • Develop informational materials that outline the consequences of funding cuts and distribute them to community stakeholders.

2. Collaboration with Local Government and Stakeholders

  • Strategy: Strengthen partnerships with local government officials, nonprofit organizations, and healthcare providers to present a unified front in advocating for Medicaid funding.
  • Implementation:
    • Work closely with the newly established ad hoc committee to align advocacy efforts and ensure transparency in funding processes.
    • Engage mayors, city councils, and other local leaders to support resolutions or statements opposing Medicaid cuts.
    • Collaborate with organizations like NAMI (National Alliance on Mental Illness) to amplify advocacy efforts.

3. Data-Driven Advocacy

  • Strategy: Use data to demonstrate the critical role of Medicaid funding in supporting behavioral health and homelessness services.
  • Implementation:
    • Develop a comprehensive report that highlights the financial impact of Medicaid cuts on local programs, including projected service reductions and community outcomes.
    • Share success stories, such as the operational success of the Crisis Stabilization Unit (CSU) and the Crestwood Healing Center, to showcase the positive impact of Medicaid-funded initiatives.

4. Legislative Advocacy

  • Strategy: Advocate for state and federal policy changes to protect Medicaid funding.
  • Implementation:
    • Organize meetings with state and federal legislators to discuss the local impact of Medicaid cuts and propose solutions.
    • Mobilize community members to contact their representatives and express their concerns about funding reductions.
    • Partner with other counties facing similar challenges to form a coalition and advocate for Medicaid funding at the state and federal levels.

5. Strategic Use of Local Funding

  • Strategy: Optimize the use of local funding sources, such as Measure O, to mitigate the impact of Medicaid cuts while advocating for long-term solutions.
  • Implementation:
    • Allocate Measure O funds strategically to support programs most at risk due to Medicaid cuts.
    • Ensure transparent processes for the $10 million Notice of Funding Availability (NOFA) to maximize its impact on struggling programs.

6. Mobilizing Public Support

  • Strategy: Build a grassroots movement to rally public support for Medicaid funding.
  • Implementation:
    • Organize rallies, petitions, and letter-writing campaigns to demonstrate widespread community opposition to Medicaid cuts.
    • Encourage local businesses and community leaders to publicly endorse the importance of Medicaid funding.

7. Leveraging Media and Storytelling

  • Strategy: Use media and storytelling to highlight the human impact of Medicaid cuts.
  • Implementation:
    • Share personal stories of individuals who have benefited from Medicaid-funded services through videos, articles, and social media.
    • Partner with local journalists to cover the issue and raise awareness.

Conclusion

These advocacy strategies aim to address the challenges posed by Medicaid cuts by mobilizing community support, leveraging data, and engaging with policymakers. By combining grassroots efforts with strategic partnerships and transparent funding processes, Sonoma County can strengthen its case for sustaining Medicaid funding and protecting vital health programs.

What can I help with next?
List pros and cons of current advocacy approaches
Explain Medicaid funding mechanisms and their local impact

List pros and cons of current advocacy approaches

Based on the document, here are the pros and cons of the current advocacy approaches for sustaining Medicaid funding in Sonoma County:

Pros of Current Advocacy Approaches

  1. Proactive Funding Initiatives:
    • The release of the $10 million Notice of Funding Availability (NOFA) demonstrates a proactive effort to support programs facing funding losses. This initiative provides immediate relief to struggling behavioral health and homelessness services.
  2. Strategic Partnerships:
    • The establishment of a new ad hoc committee, including key supervisors, aims to enhance collaboration with partners and ensure transparent allocation of Measure O funds. This approach fosters accountability and strengthens relationships with stakeholders.
  3. Community Engagement:
    • Plans to inform community groups, mayors, and councils about Measure O’s impact and financial challenges show a commitment to transparency and public involvement. This can help build trust and mobilize support for advocacy efforts.
  4. Focus on Data-Driven Solutions:
    • The development of a proposal for a second psychiatric health facility highlights the county’s focus on using data to address service gaps and reduce costs associated with private hospital placements.
  5. Leadership and Expertise:
    • The recommendation to appoint Marc, a former board chair of NAMI, to the “lived experience” seat on the Board of Supervisors ensures that advocacy efforts are informed by individuals with firsthand knowledge of behavioral health challenges.
  6. Operational Success Stories:
    • Highlighting achievements like the operational success of the Crisis Stabilization Unit (CSU) and the Crestwood Healing Center provides evidence of the positive impact of Medicaid-funded programs, strengthening the case for sustained funding.

Cons of Current Advocacy Approaches

  1. Limited Funding Sources:
    • The county’s reliance on Measure O and dwindling Realignment funds creates a precarious financial situation. These local funding sources may not be sufficient to address the growing needs caused by Medicaid cuts.
  2. Uncertainty in Federal Funding:
    • The anticipated “seismic shift” in Medicaid/Medi-Cal funding creates a significant challenge for long-term planning and sustainability of health programs.
  3. Delayed Projects:
    • The stalled mental health unit at the county jail highlights the difficulty of securing adequate funding for critical infrastructure projects, which could undermine advocacy efforts.
  4. Leadership Transition:
    • The ongoing search for interim and permanent leaders for the homeless services team may delay the implementation of advocacy strategies and hinder progress in addressing funding challenges.
  5. Potential Misalignment of Priorities:
    • The strategic pivot to focus on residents with higher behavioral health needs may leave other vulnerable populations underserved, potentially creating gaps in service delivery.
  6. Dependence on Community Support:
    • While community engagement is a positive step, it requires significant effort and resources to mobilize public support effectively. There is also a risk that public advocacy may not yield immediate results in influencing federal funding decisions.

Conclusion

The current advocacy approaches in Sonoma County have several strengths, including proactive funding initiatives, strategic partnerships, and a focus on data-driven solutions. However, they face challenges such as financial uncertainty, leadership transitions, and potential gaps in service delivery. Addressing these cons will require innovative strategies, increased collaboration, and sustained efforts to secure additional funding and support.

What can I help with next?
Explain Medicaid funding mechanisms and their local impact
Draft a policy brief on Medicaid cuts for local officials

Explain Medicaid funding mechanisms and their local impact

Medicaid funding mechanisms and their local impact in Sonoma County are discussed in the document, particularly in the context of behavioral health and homelessness services. Below is an explanation based on the document:

Medicaid Funding Mechanisms

Medicaid is a federal and state program that provides health coverage to eligible low-income individuals. Funding for Medicaid is shared between the federal government and state governments, with the federal government matching a percentage of state expenditures. In California, Medicaid is known as Medi-Cal, and it plays a critical role in funding healthcare services, including behavioral health and homelessness programs.

Key Features of Medicaid/Medi-Cal Funding:

  1. Federal Matching Funds:
    • The federal government matches state spending on Medicaid services, with the match rate varying based on state-specific factors.
    • Cuts to federal Medicaid funding directly reduce the resources available for state programs, creating financial strain.
  2. Reimbursement Model:
    • Medi-Cal operates on a reimbursement basis, meaning providers deliver services and then receive payment from the program. This model is crucial for sustaining services like mental health care and crisis intervention.
  3. Targeted Populations:
    • Medicaid funding is designed to support vulnerable populations, including low-income individuals, children, pregnant women, elderly adults, and people with disabilities. In Sonoma County, this includes residents with higher behavioral health needs and those experiencing homelessness.

Local Impact of Medicaid Funding

Medicaid funding is a cornerstone of Sonoma County’s ability to provide essential health services. The document highlights several ways in which Medicaid cuts could impact local programs:

  1. Financial Strain:
    • Federal Medicaid cuts are described as a “seismic shift” in healthcare funding, creating significant financial uncertainty for Sonoma County. This could lead to reduced funding for critical programs that rely heavily on Medi-Cal reimbursements.
  2. Threat to Behavioral Health Services:
    • Programs like the Crisis Stabilization Unit (CSU) and the Crestwood Healing Center, which are currently operational and effective, depend on Medicaid funding. Cuts could jeopardize their ability to continue providing services.
  3. Impact on Homelessness Services:
    • The county is reorganizing its homelessness team into the behavioral health department to leverage Medi-Cal billing and improve service integration. However, Medicaid cuts could undermine these efforts by reducing the available funding for Medi-Cal services.
  4. Pressure on Local Funding Sources:
    • With federal Medicaid cuts, local funding sources like Measure O and the Realignment fund are under increased pressure to fill the gap. However, these funds are already dwindling, with Measure O’s projected ending balance of $7.1 million causing concern.
  5. Delayed Projects:
    • The planned mental health unit at the county jail is stalled due to insufficient funding. Medicaid cuts could further delay or cancel similar projects, impacting the county’s ability to expand services.
  6. Increased Costs for Private Services:
    • Without adequate Medicaid funding, the county may need to rely more on private hospital placements, which are more expensive and less sustainable in the long term.

Conclusion

Medicaid funding is a critical component of Sonoma County’s health programs, particularly for behavioral health and homelessness services. Cuts to this funding would have far-reaching consequences, including financial strain, reduced service availability, and increased pressure on local funding sources. The county is taking steps to address these challenges, but the long-term impact of Medicaid cuts remains a significant concern.

What can I help with next?
Analyze potential effects of funding cuts on homelessness services
Draft a policy brief on Medicaid cuts for local officials

Analyze potential effects of funding cuts on homelessness services

The document provides detailed insights into the potential effects of funding cuts, particularly federal Medicaid reductions, on homelessness services in Sonoma County. Below is an analysis of these impacts:

1. Financial Strain on Homelessness Programs

  • Impact: Federal Medicaid cuts are described as a “seismic shift” in healthcare funding, which could severely affect the financial stability of homelessness services. Many homeless and housing providers are already in urgent need of financial support to sustain their operations.
  • Example: The county has released a $10 million Notice of Funding Availability (NOFA) titled “Behavioral Health and Homelessness Pathways to Sustainability” to support programs facing funding loss. However, this is a temporary measure and may not address long-term funding gaps.

2. Increased Pressure on Local Funding Sources

  • Impact: With Medicaid cuts, local funding sources like Measure O and the Realignment fund will face increased pressure to fill the gap. However, these funds are already dwindling, with Measure O’s projected ending balance of $7.1 million causing concern among leadership.
  • Example: Measure O currently funds 58.33 employees who provide essential mental health and crisis services. Any reduction in funding could jeopardize these positions and the services they deliver.

3. Risk of Service Reductions

  • Impact: Homelessness services may need to scale back due to insufficient funding, leaving vulnerable populations without access to critical support. This could lead to an increase in homelessness and associated social issues.
  • Example: The county is planning to reorganize its homelessness team under the behavioral health department to leverage Medi-Cal billing and improve service integration. However, Medicaid cuts could undermine these efforts, making it difficult to sustain or expand services.

4. Delayed or Canceled Projects

  • Impact: Funding cuts could delay or cancel planned projects aimed at addressing homelessness and behavioral health needs.
  • Example: The planned mental health unit at the county jail is already stalled due to insufficient funding. Medicaid cuts could further hinder the county’s ability to complete such projects, which are critical for addressing the needs of homeless individuals with behavioral health challenges.

5. Shift in Service Priorities

  • Impact: The county is pivoting its homelessness services to focus on residents with higher behavioral health needs. While this is a strategic adjustment to address the most vulnerable populations, it may leave other homeless individuals without adequate support.
  • Example: The reorganization of the homelessness team into the behavioral health department is intended to improve service integration and leverage Medi-Cal billing. However, this shift may require additional resources that are at risk due to funding cuts.

6. Increased Reliance on Private Services

  • Impact: Without adequate Medicaid funding, the county may need to rely more on private hospital placements for individuals experiencing homelessness and severe behavioral health issues. This approach is more expensive and less sustainable in the long term.
  • Example: The county is developing a proposal for a second psychiatric health facility to reduce costs associated with private hospital placements, but funding cuts could jeopardize this plan.

7. Leadership and Operational Challenges

  • Impact: The county’s homeless services unit is undergoing a leadership transition, which may delay the implementation of strategies to address funding challenges. This could further exacerbate the impact of Medicaid cuts on homelessness services.
  • Example: The search for interim and permanent leaders for the homeless services team is actively underway, but the lack of stable leadership could hinder progress.

Conclusion

Medicaid funding cuts pose a significant threat to homelessness services in Sonoma County. The financial strain, risk of service reductions, delayed projects, and increased reliance on local funding sources could lead to a decline in the availability and quality of services for vulnerable populations. While the county is taking steps to mitigate these impacts, such as releasing the $10 million NOFA and reorganizing services, the long-term sustainability of homelessness programs remains uncertain without additional funding or policy changes.

What can I help with next?
Explain strategies to mitigate funding cuts impact on homelessness services
Compare Sonoma County’s approach with other counties facing Medicaid cuts

Explain strategies to mitigate funding cuts impact on homelessness services

The document outlines several strategies that Sonoma County is implementing or could consider to mitigate the impact of Medicaid funding cuts on homelessness services. Below is a detailed explanation of these strategies:

1. Strategic Allocation of Local Funding

  • Strategy: Optimize the use of local funding sources, such as Measure O and the $10 million Notice of Funding Availability (NOFA), to support homelessness services.
  • Implementation:
    • Direct more funds from the $10 million NOFA toward struggling homeless and housing providers.
    • Ensure transparent processes for NOFA allocation to maximize its impact and build trust among stakeholders.
    • Prioritize funding for programs that address the most critical needs, such as behavioral health services for homeless individuals.

2. Service Integration

  • Strategy: Reorganize the homelessness team under the behavioral health department to improve service integration and leverage Medi-Cal billing.
  • Implementation:
    • Focus on residents with higher behavioral health needs to ensure that resources are directed toward the most vulnerable populations.
    • Streamline operations and reduce administrative costs by consolidating services under one department.

3. Community Engagement and Advocacy

  • Strategy: Build public and stakeholder support for homelessness services through community engagement and advocacy.
  • Implementation:
    • Inform community groups, mayors, and councils about the impact of Measure O and the financial challenges ahead.
    • Mobilize public support for Medicaid funding through town hall meetings, social media campaigns, and partnerships with local organizations.

4. Development of Cost-Effective Solutions

  • Strategy: Invest in cost-effective alternatives to reduce reliance on expensive private services.
  • Implementation:
    • Develop a data-driven proposal for a second psychiatric health facility to reduce costs associated with private hospital placements.
    • Explore innovative housing solutions, such as transitional housing programs, to provide affordable and sustainable options for homeless individuals.

5. Strengthening Leadership and Collaboration

  • Strategy: Ensure strong leadership and collaboration to navigate funding challenges effectively.
  • Implementation:
    • Appoint experienced leaders, such as Marc (former board chair of NAMI), to key positions to bring expertise and lived experience to decision-making.
    • Continue monthly meetings with the new ad hoc committee to align on strategic priorities and ensure accountability in funding allocation.

6. Leveraging Data for Decision-Making

  • Strategy: Use data to identify service gaps and prioritize funding for programs with the highest impact.
  • Implementation:
    • Conduct a comprehensive analysis of homelessness services to determine areas of greatest need.
    • Use data to advocate for additional funding and demonstrate the effectiveness of existing programs.

7. Exploring Alternative Funding Sources

  • Strategy: Identify and secure alternative funding sources to supplement Medicaid and local funds.
  • Implementation:
    • Apply for state and federal grants targeted at homelessness and behavioral health services.
    • Partner with private organizations and philanthropic groups to secure additional funding.
    • Explore public-private partnerships to fund innovative solutions for homelessness.

Conclusion

Sonoma County is already taking steps to mitigate the impact of Medicaid cuts on homelessness services, such as releasing the $10 million NOFA and reorganizing services. However, additional strategies, including optimizing local funding, strengthening leadership, leveraging data, and exploring alternative funding sources, will be critical to ensuring the sustainability of these vital programs. By combining these approaches, the county can better address the challenges posed by funding cuts and continue to support its vulnerable populations.

What can I help with next?
Generate talking points for community advocacy on Medicaid funding
Explain strategies to mitigate funding cuts impact on homelessness services

Generate talking points for community advocacy on Medicaid funding

Based on the document, here are talking points for community advocacy on Medicaid funding in Sonoma County:

Talking Points for Community Advocacy

1. Highlight the Importance of Medicaid Funding

  • Medicaid/Medi-Cal is a lifeline for vulnerable populations, including individuals experiencing homelessness and those with behavioral health needs.
  • Federal Medicaid funding supports essential services like mental health care, crisis intervention, and housing assistance, which are critical for community well-being.

2. Emphasize the Local Impact of Medicaid Cuts

  • Federal Medicaid cuts are expected to create a “seismic shift” in healthcare funding, leading to financial uncertainty for Sonoma County’s health programs.
  • Many homeless and housing providers are already in urgent need of financial support, and Medicaid cuts could force them to reduce services or shut down entirely.
  • The county’s Realignment fund balance is dwindling, and Measure O’s projected ending balance of $7.1 million may not be sufficient to fill the gap left by Medicaid cuts.

3. Showcase Success Stories

  • Share examples of programs that have thrived due to Medicaid funding, such as:
    • The Crisis Stabilization Unit (CSU), which is now fully operational and providing critical mental health services.
    • The Crestwood Healing Center, a 16-bed psychiatric health facility that has reduced reliance on expensive private hospitals.
  • These programs demonstrate the tangible benefits of Medicaid funding and the risks of losing it.

4. Advocate for Transparency and Collaboration

  • Stress the importance of transparent processes for allocating local funds, such as the $10 million NOFA, to ensure that resources are directed to the programs most in need.
  • Encourage community members to support the county’s efforts to reorganize services and enhance collaboration with partners to improve efficiency and service delivery.

5. Mobilize Public Support

  • Urge community members to contact their local, state, and federal representatives to express their concerns about Medicaid cuts.
  • Organize public forums, rallies, and letter-writing campaigns to demonstrate widespread opposition to funding reductions.

6. Call for Alternative Funding Solutions

  • Advocate for the exploration of alternative funding sources, such as state and federal grants, public-private partnerships, and philanthropic contributions.
  • Highlight the need for innovative solutions, such as transitional housing programs and additional psychiatric health facilities, to address homelessness and behavioral health challenges.

7. Stress the Long-Term Consequences

  • Explain that Medicaid cuts could lead to increased homelessness, higher healthcare costs, and greater strain on local resources.
  • Emphasize that investing in Medicaid funding now will save money in the long term by reducing reliance on expensive private services and preventing crises.

Conclusion

These talking points aim to inform and mobilize the community to advocate for the preservation of Medicaid funding. By emphasizing the importance of Medicaid, showcasing success stories, and highlighting the local impact of funding cuts, Sonoma County can build a strong case for sustained support and encourage action from community members and policymakers.

What can I help with next?

March 3rd, 2026 Agenda – Annual Report/Integrated Plan Committee

The California Brown Act, “shall not be construed as preventing a member of the legislative body from engaging in separate conversations or communications on an internet-based social media platform to answer questions, provide information to the public, or to solicit information from the public regarding a matter that is within the subject matter jurisdiction of the legislative body provided that a majority of the members of the legislative body do not use the internet-based social media platform to discuss among themselves business of a specific nature that is within the subject matter jurisdiction of the legislative body. A member of the legislative body shall not respond directly to any communication on an internet-based social media platform regarding a matter that is within the subject matter jurisdiction of the legislative body that is made, posted, or shared by any other member of the legislative body.”

This post, supplied by Gregory Fearon, a member of the legislative body of the Sonoma County Board of Supervisors (Sonoma County Behavioral Health Board), is provided in support of an agenda topic on a legally-noticed meeting of that legislative body on March 3rd, 2026.

The Specific Powers and Duties of the Sonoma County Behavioral Health Board are:

a. Review and evaluate on the community’s behavioral health needs, services, facilities
and special problems.
b. Review any County agreements entered into pursuant to Section 5650 of the Code or
any subsequent amendments.
c. Advise the Sonoma County Board of Supervisors and the local behavioral health
director as to any aspect of the local behavioral health and substance use disorder
programs.
d. Review and approve the procedures used to ensure citizen and professional
involvement at all stage of the planning process.
e. Submit an annual report to the Sonoma County Board of Supervisors on the needs and
performance of the County’s behavioral health system.
f. Review and make recommendations on applicants for the appointment of a local
director of behavioral health services. The Board shall be included in the selection
process prior to the vote of the Sonoma County Board of Supervisors.
g. Review and comment on the County’s performance outcome data and communicate
it’s findings to the State Behavioral Health Planning Council.
h. Review and assess the impact of the realignment of services from the State to the
County, on services delivered to clients, and on the local community.
i. Any additional duties or authority the Sonoma County Board of Supervisors may
transfer to the Board.

The Sonoma County Behavioral Health Board has established a standing committee known as the “Annual Report/Integrated Plan Committee (AR/IP Committee)” for the purpose of 1) fulfilling its reviewing responsibilities in sections a,b,d,f,g & h; 2) submitting an annual report in compliance with section c; and 3) advising the Sonoma County Board of Supervisors and the local behavioral health director as to any aspect of the local behavioral health and substance use disorder programs.

Agenda Items for the AR/IP Committee are:

1) Review responsibilities associated with the bolded section of our duties:

a. Review and evaluate on the community’s behavioral health needs, services, facilities
and special problems.
b. Review any County agreements entered into pursuant to Section 5650 of the Code or
any subsequent amendments.
c. Advise the Sonoma County Board of Supervisors and the local behavioral health
director as to any aspect of the local behavioral health and substance use disorder
programs.
d. Review and approve the procedures used to ensure citizen and professional
involvement at all stage of the planning process.
e. Submit an annual report to the Sonoma County Board of Supervisors on the needs and
performance of the County’s behavioral health system.
f. Review and make recommendations on applicants for the appointment of a local
director of behavioral health services. The Board shall be included in the selection
process prior to the vote of the Sonoma County Board of Supervisors.
g. Review and comment on the County’s performance outcome data and communicate
it’s findings to the State Behavioral Health Planning Council.
h. Review and assess the impact of the realignment of services from the State to the
County, on services delivered to clients, and on the local community.
i. Any additional duties or authority the Sonoma County Board of Supervisors may
transfer to the Board.

2) Determine the contents, and develop a workplan, for the annual report.

3) Review and discuss the information we have been provided concerning the Draft FY26-29 Integrated Plan.