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13 the most frequently reported health condition among survey respondents was psychiatric or emotional conditions (39%), followed by post-traumatic stress disorder (30%) and drug or alcohol abuse (30%). California’s Department of Health Care Services (DHCS) recently conducted a needs assessment for behavioral health care services statewide and surveyed consumers and family member on needed housing supports. Many of the comments corresponded closely to the Alameda County CRE report findings. Unmet needs cited as priorities included: • Additional housing capacity, due to low vacancy rates and lack of affordability • Additional permanent supportive housing options for adults that provide wraparound behavioral health services, such as recovery services and access to supports, such as adult Full- Service Partnerships that provide intensive services and supports and coordinate access to housing, education, and employment for people with severe mental illness • Additional capacity in longer-term adult residential facilities, sober living and recovery residences • Address barriers to building or siting housing for individuals living with mental health issues and individuals living with SUD, and housing provider unwilling to accept behavioral health clients 32 People Impacted by Criminal Justice System Involvement Focus groups of people with lived expertise of homelessness convened to inform Alameda County’s original Homeless System Model discussed how incarceration impacted their ability to find and keep housing. While incarceration is a barrier to housing and employment for anyone, the well-documented mass incarceration of Black, Latinx, and other people of color means that incarceration is a barrier to housing disproportionately impacting people of color. Focus group participants also highlighted the impact of structural racism in systems such as mass incarceration, and how involvement in these systems makes it difficult to increase income.33 Currently, the Probation Department receives direct funding for RRH and transitional housing programs for people in reentry. In May 2020, the Alameda County Board of Supervisors directed the Alameda County Health Care Services Agency/ Behavioral Health Department to develop a plan to reduce the number of incarcerated individuals with behavioral health conditions within the jail. The multi-year plan, estimated to cost $50 million, includes extensive stakeholder engagement, internal County Department research and consultation. One primary area of focus is to strengthen connections between and across sectors to close any gaps and improve post-release service participation. Strategies include expansion of access to urgent care and crisis services, expansion of forensic linkage programs, and development of a TAY full-service partnership. The plan will prioritize the care of “high utilizers” of county behavioral health and county forensic services to ensure that justice involved people are connected to appropriate treatment and facilities, and increase short term, permanent housing and board and care facilities. 32 State of California Department of Health Care Services, Assessing the Continuum of Care for Behavioral Health Services in California Data, Stakeholder Perspectives, and Implications January 10th, 2022 33 Oakland-Berkeley-Alameda County Continuum of Care. Centering Racial Equity in Homeless System Design. January 2021. https://everyonehome.org/centering-racial-equity/