To: Sonoma County Board of Supervisors
Department or Agency Name(s): Department of Health Services
Staff Name and Phone Number: Tina Rivera 707-565-4774
Vote Requirement: Majority
Supervisorial District(s): Countywide
Title:
Title
Behavioral Health & Housing Grants Awarded to the Department of Health Services
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Recommended Action:
Recommended action
A) Adopt a resolution to authorize the Director of Health Services to execute a program funding agreement with Advocates for Human Potential, Inc. and to receive $18,233,680 in revenue to support the Behavioral Health Continuum Infrastructure Program in Sonoma County through June 30, 2027.
B) Adopt a resolution to authorize the Director of Health Services to execute a contract with Advocates for Human Potential, Inc. and to receive $11,246,961 in revenue to support the Behavioral Health Bridge Housing Program in Sonoma County through June 30, 2027.
C) Adopt a resolution to authorize the Director of Health Services to execute a standard agreement with California Interagency Council on Homelessness and to receive $4,567,130 in revenue to support the Encampment Resolution Funding.
end
Executive Summary:
The Department of Health Services (hereinafter, “DHS” or “the Department”) applied for and received grant awards for (1) Round 5 of the Behavioral Health Continuum Infrastructure Program (BHCIP) and (2) the Behavioral Health Bridge Housing Program, both from the California Department of Health Care Services (DHCS) via third-party program administrator Advocates for Human Potential, Inc. (AHP).
The Department is requesting authority to enter into two agreements with AHP to receive grant funding totaling $29,480,641 through June 30, 2027. In addition, the California Business, Consumer Services, and Housing Agency (BCSH) awarded DHS a grant of $4,567,130 authorized by SB 197 for the Encampment Resolution Funding (ERF) program.
The purpose of the awarded funds is to provide funding for crisis and behavioral health infrastructure to serve vulnerable Californians of all ages, including those who are Medi-Cal beneficiaries, and to address the immediate housing and treatment needs of people experiencing unsheltered homelessness with serious behavioral health conditions, along with the sustainability of these ongoing supports.
The County’s match for the $18 million BHCIP is 2 acres of county-owned land. It is important to note that the county will be responsible for any cost overruns as DHCS will not allow increases in project budgets.
Finally, the BHBH $11.25 million funding must be spent no later than June 30, 2027, and will be paid through reimbursement invoicing, based on achieved milestones. Staff has identified Mental Health Services Act and Intergovernmental Transfers to cash flow initial investments. The county’s progress will be reviewed annually and if progress is not on track to meet deliverables and spend its full contracted amount, DHCS reserves the right to redistribute those grant funds to other eligible county BHAs.
Discussion:
Behavioral Health Continuum Infrastructure Program (BHCIP), Round 5: Crisis and Behavioral Health Continuum $18,233,680 Award
The purpose of the “BHCIP Round 5: Crisis and Behavioral Health Continuum grant” is to provide funding for crisis and behavioral health infrastructure to serve vulnerable Californians of all ages, including those who are Medi-Cal beneficiaries. The BHCIP fund was established in 2021 by DHCS to construct, acquire, and rehabilitate real estate assets or mobile crisis infrastructure that would expand facilities dedicated to behavioral health treatment services.
In January 2023 the Department submitted an application for BHCIP Round 5: “Crisis and Behavioral Health Continuum” funding for the construction of a new 7,180 square foot facility on County-owned land in the City of Santa Rosa, adjacent to other County youth-serving facilities, including the Juvenile Detention Center and the County-run Valley of the Moon youth treatment facility. For grant application purposes the project is titled, “Sonoma County Youth Behavioral Health Treatment.” In July 2023 the Department was notified of an approved grant award in the amount of $18,233,680.
The proposed Sonoma County Youth Behavioral Health Treatment facility is to include two residential wings, separate from one another to provide services to two separate populations. One wing is to include eight beds for residential substance use disorder treatment for children and youth ages 12 to 18. A second wing in the facility will house six beds for crisis residential behavioral health treatment for children and youth ages 12 to 18. In addition to the two residential treatment wings, the facility will include a separate section for the delivery of outpatient substance use disorder services for youth and young adults ages 12-25.
This project is currently in the design development phase, with completion of the project expected by September 2025. The Department will return to your Board with an Item outlining the project for approval in the Fall/Winter of 2023.
The County of Sonoma currently has no facilities available to provide either residential substance use disorder treatment or crisis residential behavioral health treatment for children and youth ages 12 to 18 and their families. Children and youth and their families in need of these services currently need to be referred to programs located beyond the county or even the Northern California region. The proposed project will enable the expansion of substance use disorder residential service capacity by 8 beds, and crisis residential behavioral health capacity by 6 beds. The proposed project will also include space for outpatient substance use disorder services for youth and young adults ages 12-25. The County currently lacks the facility space to accommodate these services. It is estimated that the addition of this treatment space will expand service capacity by 600 children, youth, and family members per year for outpatient treatment, and will provide additional capacity for 300 children and youth ages 12 to 18 and their families who will be served in the residential treatment programs. Access for these 900 youth and their families will significantly improve services not only Sonoma County but also the San Francisco Bay Area and the greater Northern California Region.
Behavioral Health Bridge Housing (BHBH) Program: $11,246,961 award
The BHBH Program was established in 2022 to address the immediate housing and treatment needs of people experiencing unsheltered homelessness with serious behavioral health conditions, along with the sustainability of these ongoing supports. The BHBH Program enables DHCS, through county and tribal partners, to meaningfully contribute to the implementation of the California Interagency Council on Homelessness and will be implemented in alignment with the Community, Assistance, Recovery and Empowerment (CARE) Court, which prioritizes BHBH resources for CARE Court participants. A total of $1.5 billion in funding to county behavioral health agencies and Tribal entities will be made available through the BHBH Program.
In May 2023, the Department submitted an application for BHBH Program funding to fund the acquisition of bridge housing to support the target population of individuals with serious behavioral health conditions, including serious mental illness and/or substance use disorder, who are experiencing homelessness. In July 2023 the Department was notified of an approved grant award in the amount of $11,246,961.
With the passage of Senate Bill 1338, which established the Community Assistance, Recovery, and Empowerment (CARE) Program, the target population will be prioritized for appropriate bridge housing funding. The County’s CARE Court Program implementation, as prescribed by Legislation, is set for December 1, 2024. Once CARE Court Program activities begin, the target population will be prioritized for bridge housing and supports funded through this program as required.
The State of California has provided significant capital funding to create opportunities for housing and treatment settings, including programs such as Project Homekey. The Department will seek to leverage BHBH Program funding to serve as a complement to these Homekey investments. The Department will use existing settings, such as Mickey Zane Place, as well as create a master lease where the Department will provide supports to individuals struggling with mental illness and substance use disorders and those who are experiencing homelessness with substance use disorder and/or serious mental illness. These properties will enable the conversion into bridge housing more quickly with tenant improvements and rehabilitation as opposed to embarking on new capital projects.
The Department is proposing to master lease a site with an option to purchase. This site will provide 71 transitional recovery and community re-entry housing beds for those suffering with mental illness and substance use disorders who are experiencing homelessness. Sonoma County will partner with Marin County, providing them with 20 units of housing, establishing a regional partnership while providing priority bridge housing for CARE Court participants in both jurisdictions.
The Department will also leverage our existing HomeKey Round 1 site, Mickey Zane Place located in Santa Rosa, California, providing transitional housing for individuals experiencing homelessness with behavioral health conditions. This site has 44 units. The Department will also leverage 25 proposed tiny homes for transitional housing development via a Homekey Round 3 proposal. These sites will provide regional housing capacity desperately needed within our region.
These bridge housing sites will transition individuals out of homelessness into a stable living environment in advance of further placement into permanent housing. This program will serve as a link between the homeless shelter system and long-term housing options. Financed with the received awards the Department will include an array of supportive services that will be provided on site at the bridge housing units. For those experiencing homelessness, the stability provided by this bridge housing program along with supportive services, increases the likelihood that an individual will be able to move into permanent housing and not fall back into homelessness.
Encampment Resolution Funding Program Round 2: $4,567,130 award
Senate Bill 197, enacting changes to the Budget Act of 2023, authorizes the allocation of $4,567,130 to DHS for administration of the Encampment Resolution Funding (ERF) program [round 2], which is available to eligible cities, counties, and Continuum of Care (CoC) entities. ERF-2-R is intended for the wellness and safety of people experiencing homelessness in encampments by providing services and supports that address their immediate physical and mental wellness.
Funding Details
This item includes Authorizing Resolutions with the grant agreements as follows: 1) BHCIP Round 5: Crisis and Behavioral Health Continuum grant in the amount of $18,233,680; 2) BHBH grant in the amount of $11,246,961; and 3) the ERF grant in the amount of $4,567,130. The cost of delivery of services to participants at these sites will be supported by Medi-Cal reimbursement, with supplemental funds provided by Measure O, a voter approved sales tax dedicated to funding behavioral health services in Sonoma County and Mental Health Services Act funding. Along with our partnership with Marin County, which includes 20 beds related to the Behavioral Health Bridge Housing grant, depending upon their expressed need, the County of Sonoma may also contract with neighboring counties in the region to provide services for residents of those counties who are in need. Included with this item are award letters, proposed grant budgets as well as requirements from the funding sources. Staff will return to the Board with recommendations, information on the projects, and use of the grant funding.
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: Increase investment in programs that treat underlying causes of homelessness, including substance abuse, mental illness, poverty, and lack of affordable housing.
Racial Equity:
Was this item identified as an opportunity to apply the Racial Equity Toolkit?
No
Prior Board Actions:
6/12/2023 - Adopt a resolution for a joint application to participate in Project Homekey 3
Fiscal Summary
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Expenditures |
FY 23-24 Adopted |
FY 24-25 Projected |
FY 25-26 Projected |
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Budgeted Expenses |
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Additional Appropriation Requested |
$34,047,771 |
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Total Expenditures |
$34,047,771 |
0 |
0 |
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Funding Sources |
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General Fund/WA GF |
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State/Federal |
$34,047,771 |
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Fees/Other |
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Use of Fund Balance |
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Contingencies |
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Total Sources |
$34,047,771 |
0 |
0 |
Narrative Explanation of Fiscal Impacts:
Funding from DHCS is being provided via two grants with third-party program administrator Advocates for Human Potential, Inc. (AHP). The BHCIP Round 5 grant amount is $18,233,680 and the BHBH grant amount is $11,246,961, for a total of $29,480,641 through June 30, 2027. Funding from BCSH in the amount of $4,567,130 has also been awarded to DHS for FY 2023-2024 for the ERF-2-R program. Total funds in this board item total $34,047,771 for FY 2023-2024. Any funds not utilized in FY 2023-2024 will be rolled over into subsequent fiscal years.
DHS will bring budget appropriations via Consolidated Budget Adjustments in Quarter 1 of FY 23-24.
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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):
N/A
Attachments:
Attachment 1 - Authorizing Resolution - BHCIP
Attachment 2 - Authorizing Resolution - BHBH
Attachment 3 - Authorizing Resolution - ERF-2-R
Attachment 4 - Behavioral Health Bridge Housing Program Budget Narrative
Attachment 5 - BHBH Budget Template (Overview)
Attachment 6 - BHCIP Budget Template
Attachment 7 - ERF-2-R Award Letter
Attachment 8 - BHCIP July 31 Deadline
Related Items “On File” with the Clerk of the Board:
None