To: County of Sonoma Board of Supervisors
Department or Agency Name(s): Department of Health Services
Staff Name and Phone Number: Nolan Sullivan 707-565-7901, Jan Cobaleda-Kegler, 707-565-5157
Vote Requirement: Majority
Supervisorial District(s): Countywide
Title:
Title
Crisis Residential Services - Agreement for Crisis Residential Unit Operations
End
Recommended Action:
Recommended action
A) Authorize the Director of Health Services, or designee, to execute an agreement with Progress Foundation, for the operation of a Crisis Residential Unit for a term of January 1, 2026 through December 31, 2028, in an amount not to exceed $4,627,272, with two one-year options to extend at $1,542,424 for Fiscal Year 2028-2029 and $764,873 for a portion of Fiscal Year 2029-2030, for a total possible not to exceed amount of $6,934,569, subject to review and approval by County Counsel.
B) Authorize the Director of Health Services, or designee, to execute modifications to the agreement which address changes in service needs, payment or reimbursement methodologies, subject to available funding as well as review and approval by County Counsel.
end
Executive Summary:
The Sonoma County Department of Health Services has completed a Request for Proposals process to identify a qualified provider to operate a licensed ten bed Crisis Residential Unit for adults experiencing an acute mental health crisis. The Crisis Residential Unit will support the County’s crisis care continuum by reducing unnecessary hospitalizations and providing timely, trauma-informed, and culturally responsive care.
Following a competitive Request for Proposals process, Progress Foundation was selected as the provider. This contract will establish a facility to serve individuals aged eighteen and older in acute psychiatric distress, offering stabilization and transition planning in a supportive, home-like environment.
Discussion:
Crisis Residential Treatment (CRT) is a required service that must be offered as part of the Mental Health Plan for Sonoma County’s Department of Health Services (hereinafter “DHS” or “the Department”), for adults aged eighteen years and older who are ambulatory and meet the medical necessity criteria to receive treatment in a Social Rehabilitation Program setting. CRT programs serve individuals experiencing an acute crisis in the least restrictive, most supportive environment possible.
CRT programs reduce unnecessary stays in psychiatric hospitals, reduce the number and expense of emergency room visits, and divert inappropriate incarcerations while producing the same, or superior outcomes to those of institutionalized care. The safe, accepting environment nurtures the individual’s process of personal growth and is essential to individuals as they work through crises at their own pace. The residential setting will be a part of a continuum of care with links to community resource centers and supports that ease the transition into independent living. CRT programs serve the crisis continuum by helping to divert clients away from psychiatric hospitalization or local emergency departments, and/or provides clinically safe step-downs from a recent psychiatric hospitalization or episode at the Crisis Stabilization Unit (CSU). It differs from the CSU-services as CRT program provides services that last up to thirty days and are providing in a residential setting whereas the CSU provides stabilization services up to twenty-four hours. Individuals may be referred for CRT program services by the CSU or coordinated by the Hospital Liaison Team after recent psychiatric hospitalization.
CRT is a positive, temporary alternative for people experiencing an acute psychiatric episode or intense emotional distress who might otherwise face voluntary or involuntary commitment. Programs must provide crisis stabilization, medication monitoring, and evaluation to determine the need for the type and intensity of additional services within a framework of peer support and trauma-informed approaches to recovery planning.
The Department issued a Request for Proposals (RFP) on May 14, 2025, to solicit proposals for Crisis Residential Services.
The RFP outlined that the selected provider must:
• Include treatment for co-occurring disorders based on either harm-reduction or abstinence-based approach to wellness and recovery.
• Operate under a flexible, social rehabilitation model that adapts to the needs of the client at the time.
• Emphasize mastery of daily living skills and social development using a strength-based approach that supports recovery and wellness in home-like environments.
• Prioritize the well-being of the residents and not schedule services for the convenience of the facility or arbitrarily assign systemic requirements for the sole purpose of consistency and efficiency.
A pre-bid conference was held on May 29, 2025, and the County received two proposals by the deadline on June 25, 2025. An evaluation panel reviewed and scored the submissions in accordance with published criteria.
The selected contractor, Progress Foundation, will operate a 10-bed licensed CRU, providing 24/7 services to adults in crisis. The CRU model supports clients through crisis stabilization, medication monitoring, and discharge planning with strong community linkages.
The contractor is responsible for securing a licensed site that meets Social Rehabilitation Program and Crisis Residential Treatment standards. No facility will be provided by the County. Progress Foundation’s Crisis Residential Treatment facility is already open and operational and is located at 3400 Montgomery Drive in Santa Rosa. Their program is open all year long with qualified teams of counselors who provide services twenty-four hours per day. One-to-one counseling, crisis intervention, skill-building, and twice daily therapeutic groups are part of the program structure to support individuals in their path to recovery and wellness.
All referrals are initiated through Sonoma County Behavioral Health.
Key goals for the CRU include:
• Reducing unnecessary psychiatric inpatient utilization
• Supporting 85% of enrolled clients in stepping down to less restrictive settings
• Ensuring 90% of enrolled clients do not require hospitalization during stay
• Maintaining an average length of stay of eight to fourteen days (maximum thirty)
This work aligns with the County’s behavioral health strategy and expands its capacity for community-based crisis response.
Strategic Plan:
This item directly supports the County’s Five-year Strategic Plan and is aligned with the following pillar, goal, and objective.
Pillar: Healthy and Safe Communities
Goal: Goal 1: Expand integrated system of care to address gaps in services to the County’s most vulnerable.
Objective: Objective 3: Create a “no wrong door” approach where clients who need services across multiple departments and programs are able to access the array of services needed regardless of where they enter the system.
Racial Equity:
Was this item identified as an opportunity to apply the Racial Equity Toolkit?
No
Prior Board Actions:
None
Fiscal Summary
|
Expenditures |
FY 25-26 Adopted |
FY26-27 Projected |
FY 27-28 Projected |
|
Budgeted Expenses |
764,873 |
1,542,424 |
1,542,424 |
|
Additional Appropriation Requested |
|
|
|
|
Total Expenditures |
$764,873 |
$1,542,424 |
$1,542,424 |
|
Funding Sources |
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General Fund/WA GF |
|
|
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State/Federal |
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Fees/Other |
764,873 |
1,542,424 |
1,542,424 |
|
Use of Fund Balance |
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General Fund Contingencies |
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Total Sources |
$764,873 |
$1,542,424 |
$1,542,424 |
Narrative Explanation of Fiscal Impacts:
The Fiscal Year 2025-2026 Adopted Budget includes $764,873 to support this agreement. The remaining contract amounts will be budgeted as follows: $1,542,424 in Fiscal Year 2026-2027, $1,542,424 in Fiscal Year 2027-2028, and $777,551 in fiscal year 2028-2029, for a total contract amount of $4,627,272. These expenditures will be funded through Measure O section 2c - Residential Crisis Services.
The two optional one-year contract extensions would require the following appropriations: $1,542,424 for Fiscal Year 2028-2029 and $764,873 for Fiscal Year 2029-2030. These amounts will be requested through the annual recommended budget process or consolidated budget adjustments, as appropriate.
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Staffing Impacts: |
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Position Title (Payroll Classification) |
Monthly Salary Range (A-I Step) |
Additions (Number) |
Deletions (Number) |
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Narrative Explanation of Staffing Impacts (If Required):
None
Attachments:
Attachment 1 - Draft Agreement
Related Items “On File” with the Clerk of the Board:
None