To: County of Sonoma Board of Supervisors
Department or Agency Name(s): Department of Health Services
Staff Name and Phone Number: Tina Rivera, 707-565-4774
Vote Requirement: 4/5th
Supervisorial District(s): Countywide
Title:
Title
Behavioral Health Access Screening Teams Staffing Allocations
End
Recommended Action:
Recommended action
A) Adopt a personnel resolution amending the Department of Health Services’ allocation list to add 2.50 full-time equivalent Behavioral Health Clinician allocations to support the Access Screening Team effective February 28, 2023.
B) Adopt a resolution authorizing budgetary adjustments to the fiscal year 2022-2023 adopted budget, programming $224,126 in Mental Health Services Act Community Support Services Fund balance to support the requested position allocations. (4/5th vote required)
(4/5th Vote Required)
end
Executive Summary:
The Department of Health Services (hereinafter, “DHS” or “the Department”) Access Screening Teams are responsible for receiving and triaging all initial requests for services within the behavioral health system of care. Current staffing level is 1.50 full-time equivalent (FTE) staff (one full-time position and one part-time position). At this level of staffing, there are gaps in coverage for walk-in clients. The addition of 2.50 FTE staff will provide sufficient coverage for business hours and anticipated increased demand. One of the new positions will be dedicated to the Youth Access Team. The other 1.50 FTE positions will augment the Adult Access Team with dual Mental Health and Substance Use Recovery expertise.
This increase in staffing will position Behavioral Health to meet its state mandates regarding timely access to services and prepare the Access Teams to take on the increased volume anticipated with CalAIM changes and participation in the Drug Medi-Cal Organized Delivery System (DMC-ODS) waiver.
This item also requests approval of a resolution authorizing budgetary adjustments to the fiscal year 2022-2023 adopted budget, programming Mental Health Services Act (MHSA) Community Support Services fund balance for the first-year cost. Future ongoing increased staffing costs will be financed with a mix of Federal Financial Participation funds and Mental Health Services Act Community Support Services funding.
Discussion:
The DHS Access Screening Teams are responsible for receiving and triaging all initial requests for services within the behavioral health system of care. Current staffing level is 1.50 FTE staff (one full-time position and one part-time position). At this level of staffing, there are gaps in coverage for walk-in clients. In addition, current staffing is insufficient to meet Dept of Health. The addition of 2.50 FTE staff will provide for sufficient coverage for business hours and anticipated increased demand. One of the new positions will be dedicated to the Youth Access Team. The other 1.50 FTE positions will augment the Adult Access Team with dual Mental Health and Substance Use Recovery expertise.
This increase in staffing will position Behavioral Health to meet its state mandates regarding timely access to services and prepare the Access Teams to take on the increased volume anticipated with CalAIM changes and participation in the Drug Medi-Cal Organized Delivery System (DMC-ODS) waiver.
This item also requests approval of a resolution authorizing budgetary adjustments to the fiscal year 2022-2023 adopted budget, programming Mental Health Services Act (MHSA) fund balance for the first-year cost. Future ongoing increased staffing costs will be financed with Medicaid Federal Financial Participation funds
Improving timely access to services is a statewide mandate and is a high departmental priority. Increasing the FTE to these programs will maximize efficiencies in screening team coverage and improve timely access to services for vulnerable community members. This is a long-term, on-going objective that cannot be filled with a consultant or outside contractor. The cost of onboarding a temporary or outsourced consultant is too significant to justify not using County staff persons/positions. In 2021, California Mental Health Services Authority attempted to competitively procure a 24-hour per day, 7-day per week access and screening service for multiple counties. They did not receive a financially viable response.
This item also requests approval of a resolution authorizing budgetary adjustments to the fiscal year 2022-2023 adopted budget, programming Mental Health Services Act (MHSA) Community Support Services fund balance for the first-year cost. Future ongoing increased staffing costs will be financed with a mix of Federal Financial Participation funds and Mental Health Services Act Community Support Services 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 2: Identify gaps in the Safety Net system of services and identify areas where departments can address those gaps directly and seek guidance from the Board when additional resources and/or policy direction is needed.
Strategic Plan Alignment - Appropriately staffing Behavioral Health programs and aligning staff requirements with available funding supports the County's goal of a Safe, Healthy, and Caring Community by ensuring that the County's most vulnerable population has access to behavioral health services. In addition to alignment with the County's Strategic Plan, Behavioral Health programs support the Department's Strategic Plan goal of ensuring that individuals have access high quality and coordinated services for health, recovery, and wellbeing by strengthening the behavioral health infrastructure.
Prior Board Actions:
N/A.
Fiscal Summary
|
Expenditures |
FY 22-23 Adopted |
FY 23-24 Projected |
FY 24-25 Projected |
|
Budgeted Expenses |
|
$461,817 |
$484,908 |
|
Additional Appropriation Requested |
$224,126 |
|
|
|
Total Expenditures |
$224,126 |
$461,817 |
$484,908 |
|
Funding Sources |
|
|
|
|
General Fund/WA GF |
|
|
|
|
State/Federal |
$224,126 |
$461,817 |
$484,908 |
|
Fees/Other |
|
|
|
|
Use of Fund Balance |
|
|
|
|
Contingencies |
|
|
|
|
Total Sources |
$224,126 |
$461,817 |
$484,908 |
Narrative Explanation of Fiscal Impacts:
Year one expenditures of $224,126 will be funded via use of Mental Health Services Community Support Services funding. Current estimated fund balance net of known obligations (including the above $224,126) for Community Support Services as of June 30, 2023 is $21.4 million. The ongoing costs for the Screening Team Behavioral Health Clinicians will be funded through the Department’s Mental Health Services Act Community Support Services revenues and the leveraged federal financial participation dollars that the positions will draw down through the Mental Health Plan Medi-Cal claiming process. Also, future participation in the Drug Medi-Cal Organized Delivery System Waiver (DMC-ODS) will provide additional funding. The cost of additional computers, chairs, set-up of desks, etc. is estimated at $10,000.
|
Staffing Impacts: |
|
|
|
|
Position Title (Payroll Classification) |
Monthly Salary Range (A-I Step) |
Additions (Number) |
Deletions (Number) |
|
Behavioral Health Clinician |
6,792 - 8,255 |
2.50 |
0.0 |
|
|
|
|
|
Narrative Explanation of Staffing Impacts (If Required):
Once approved, the Department will coordinate with County Human Resources to process recruitments. It is anticipated that the process will be initiated within a one-month timeframe following approval.
Attachments:
Attachment 1 - Personnel Resolution
Attachment 2 - Budget Resolution
Related Items “On File” with the Clerk of the Board:
None