DATE:
May 19, 2026
28
TO:
Board of Supervisors
SUBJECT
Title
A NEW HEALTHCARE PARTNERSHIP TO DELIVER HOMELESS SERVICES AND SAVE MILLIONS IN COUNTY TAXPAYER DOLLARS (DISTRICTS: ALL)
Body
OVERVIEW
This item is part of a broader effort by the County to identify every reasonable efficiency, cost-saving opportunity, and new revenue source before any service reductions are considered. This effort has already produced millions in ongoing savings through modernizing County communications technology, centralizing space management, and right-sizing our vehicle fleet.
For decades, local governments have paid for homeless outreach while the healthcare system paid for the downstream consequences, including emergency room visits and crisis care. The California Advancing and Innovating Medi-Cal (CalAIM) initiative, California's landmark Medi-Cal reform, begins to change that equation. For the first time, the healthcare system will pay for housing-focused services that help people move off the streets and stay stably housed, including housing navigation, security deposit assistance, and housing tenancy sustaining services.
These are services the County is already delivering. The County's Office of Homeless Solutions (OHS) is a team of social workers, analysts, and specialists who conduct homeless outreach, case management, and housing referrals across the region. Since launching in 2021, OHS has spearheaded outreach and street case management in the unincorporated communities and regionwide in partnership with the local cities through OHS Regional Homeless Services. OHS also implemented the County's safe parking programs at three locations and is advancing the County's first emergency shelter, the Troy Street sleeping cabins. OHS also advanced multiple programs for seniors, youth, people with disabilities, LGBTQ+ and justice involved individuals and is administering the State's HomeSafe and Encampment Resolution grants.
An estimated 90% of OHS clients are Medi-...
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