To: County of Sonoma Board of Supervisors
Department or Agency Name(s): Department of Health Services
Staff Name and Phone Number: Jennifer Solito, 707-565-4774
Vote Requirement: 4/5th
Supervisorial District(s): Countywide
Title:
Title
Department of Health Services Behavioral Health Agreement with East Bay Agency for Children
End
Recommended Action:
Recommended action
A) Authorize the Director of Health Services, or designee, to execute the first amendment to an agreement with East Bay Agency for Children for Trauma Informed Systems Training, increasing the not-to-exceed amount from $19,100 to 144,100, including up to $109,100 in FY 2024-25 and $35,000 in FY 2025-26, and extending the term through June 30, 2026, including authority to execute modifications thereto which do not significantly change the scope of service in order to address increased service needs for the period of July 1, 2024 through June 30, 2026, subject to available funding and review and approval by County Counsel.
B) Adopt a Resolution authorizing budgetary adjustments to the Department of Health Services fiscal year 2024-2025 adopted budget, increasing appropriations in the amount of $90,000, to reflect revenues and expenditures associated with the East Bay Agency for Children agreement.
(4/5ths Vote Required)
end
Executive Summary:
Trauma-Informed Care, in terms of direct-service work, is an evidence-based practice that requires trauma-informed systems-level changes. An organization cannot meet the definition of providing trauma-informed care to clients unless it does the internal organizational work to be trauma-informed in its work with staff. East Bay Agency for Children (EBAC) provides Trauma-Informed Systems implementation training and support. The Sonoma County Department of Health Services (hereinafter, “DHS”) requests authority to modify the current agreement with EBAC to support Behavioral Health Division staff in furthering a trauma-informed, equitable workplace where employees and clients can thrive. After working with EBAC on a FY 2023-2024 Trauma Transformed program, DHS has decided to expand the scope of services so that EBAC could continue their work on Trauma-Informed Systems implementation for DHS. This implementation project is intended to provide knowledge and skills to current employees, who will, at the end of the agreement period, be able to continue the framework in the future without additional coaching from EBAC.
Additionally, DHS is requesting the Board to adopt a resolution increasing fiscal year 2024-2025 appropriations by $90,000 using Mental Health Services Act (MHSA) funds to support the expenses associated with the agreement with EBAC.
Discussion:
DHS, its Behavioral Health Division staff, and its network of contracted agencies providing Medi-Cal mental health treatment have experienced waves of both direct and secondary/vicarious trauma since 2017, with wildfires, floods, potential lay-offs, the COVID-19 pandemic, and other community-wide events, in addition to the vicarious trauma experienced by staff working with clients experiencing these traumas and mental health challenges. Through discussions with staff regarding morale and observations of the way the division reacts to change, BHD leadership saw the signs that the division was a traumatized system. To improve staff well-being, division resiliency, and client outcomes, DHS would like to implement a trauma-informed project that will transform the way staff perceive and respond to each other as well as the community. The MHSA funding that will be used for this request is designated specifically to support behavioral health workforce education and for this reason, the project will be limited to the Behavioral Health Division staff and its network of contracted agencies.
Trauma-Informed Care, in terms of direct-service work, is an evidence-based practice that requires trauma-informed systems-level changes. An organization cannot meet the U.S. Department of Health and Human Services Substance Abuse and Mental Health Services Agency (SAMSHA) practice of providing trauma-informed care to clients unless it does the internal organizational work to be trauma-informed in its work with staff. The EBAC facilitators and trainers bring specialized knowledge not just in trauma-informed care, but in trauma-informed organizational development. The EBAC training is a key strategy DHS is implementing to improve staff retention, and working toward creating and maintaining a workplace where employees feel valued, supported, and heard.
DHS began working with EBAC in fiscal year 2023-2024 on their Trauma Transformed program, which includes contracted services for two all-staff trainings, an organizational assessment and write-up of findings, a leadership orientation session, a "Trauma Informed Leadership Team" facilitation for champions in the division to dive into the work of organizational change, and multiple sessions for a "Leadership Learning Collaborative" to support management-level staff with the culture and organizational change. After holding the two all-staff trainings, the leadership orientation session, and beginning the process of the organizational assessment, it became clear that two cohorts for the "Leadership Learning Collaborative," were needed in order to provide appropriate and adequate support to management through this process, so that they can best support their staff.
DHS leadership has received extremely positive feedback from both management and staff about EBAC’s approach and framework. As such, DHS would like to expand the scope of services with EBAC to continue their work on the Trauma-Informed Systems implementation for the DHS Behavioral Health Division. EBAC will provide on-demand training and reflection spaces, continue facilitation and planning work with the Trauma Informed Leadership Team, lead another round of management training, and offer multiple opportunities for leadership and equity training and coaching. This implementation project is intended to provide knowledge and skills to current employees, who will then be able to continue the framework in the future at DHS without additional coaching from EBAC.
EBAC's Trauma Transformed program (<https://www.ebac.org/services/trauma.asp>) is unique in that it focuses not just on trauma-informed care for clients, but also works with the organization to shift organizational structure and culture. The Behavioral Health division’s trauma-informed project will include a self-paced Trauma-Informed Systems 101 training on EBAC's learning management system with two facilitated "reflection cafes" to help deepen learning; continued facilitation of the established Trauma-Informed Leadership Team; another cohort of the Leadership Learning Community for new managers; facilitating "Principles into Practice" to help current and emerging leaders implement the trauma-informed systems principles they have learned; facilitating Emerging Leaders of Color and White Accountability Group spaces to develop equitable leadership and workplace culture; one-on-one leadership coaching with management staff; and continued support with trauma-informed systems implementation.
DHS has a current fiscal year 2024-2025 contract with EBAC in the amount of $19,100, from July 1, 2024 to June 30, 2025 for training and consultation regarding Trauma-Informed Systems work, which includes working with DHS leadership and staff regarding organizational culture change. A Single Source Waiver was pursued for this first amendment to the agreement and was approved by the Purchasing Agent on October 2, 2024. The request today is to add a total of $125,000, for a new not to exceed total of $144,100, and to extend the term date through June 30, 2026.
Strategic Plan:
N/A
Racial Equity:
Was this item identified as an opportunity to apply the Racial Equity Toolkit?
No
Prior Board Actions:
None
Fiscal Summary
|
Expenditures |
FY24-25 Adopted |
FY25-26 Projected |
FY26-27 Projected |
|
Budgeted Expenses |
$19,100 |
$35,000 |
|
|
Additional Appropriation Requested |
$90,000 |
|
|
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Total Expenditures |
$109,100 |
$35,000 |
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Funding Sources |
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General Fund/WA GF |
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State/Federal |
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Fees/Other |
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Use of Fund Balance |
$109,100 |
$35,000 |
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General Fund Contingencies |
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Total Sources |
$109,100 |
$35,000 |
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Narrative Explanation of Fiscal Impacts:
DHS is requesting additional appropriations for FY 2024-2025 in the amount of $90,000; $35,000 will be added to the FY 2025-2026 budget through the annual budget process. This agreement amendment will be funded with Mental Health Services Act funds using the Workforce Education and Training component.
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Staffing Impacts: None |
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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 - Budget Resolution
Attachment 2 -Agreement Amendment
Related Items “On File” with the Clerk of the Board:
None