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: 4/5th
Supervisorial District(s): Countywide
Title:
Title
Community Care Expansion Preservation Program Grant
End
Recommended Action:
Recommended action
A) Authorize the Director of Health Services, or designee, to execute a funding agreement with Advocates for Human Potential, Inc. to receive $728,439 in revenue to support the Community Care Expansion Program in Sonoma County through January 30, 2027.
B) Adopt a budget resolution adjusting the Department of Health Services fiscal year 2023-2024 final budget by $42,841 to support the Community Care Expansion Program Operating Subsidy Payment Grant Award. (4/5th vote required)
(4/5th Vote Required)
end
Executive Summary:
The Department of Health Services (hereinafter, “DHS” or “the Department”) applied for and received a grant for Community Care Expansion Program from the California Department of Social Services (“CDSS”) via third-party program administrator Advocates for Human Potential, Inc.
The purpose of the Community Care Expansion Program is to preserve and avoid the closure of licensed residential adult and senior care facilities that serve applicants and recipients of Supplemental Security Income/State Supplementary Payment and Cash Assistance Program for Immigrants, with a priority for individuals experiencing or at risk of homelessness.
This item requests authorization to execute the Community Care Expansion Preservation Projects Program Funding Agreement with Advocates for Human Potential, Inc., in the amount of $728,439 through January 30, 2027.
This item also includes a request for approval of a budget adjustment to the fiscal year 2023-2024 adopted budget to increase revenues and expenditures associated with the Community Care Expansion Program Grant agreement by $42,841 in the Department of Health Services.
Discussion:
California has a shortage of adult and senior care facilities (e.g., Adult Residential Facilities and Residential Care Facilities for the Elderly) that accept individuals receiving or applying for Supplemental Security Income/State Supplementary Payment (SSI/SSP) or Cash Assistance Program for Immigrants (CAPI). It has also seen a decline in the number of SSI/SSP recipients residing in adult and senior care facilities.
The California Department of Health Care Services (DHCS) and the CDSS launched two new programs intended to expand the infrastructure of and address historic gaps in the behavioral health and long-term care continuum serving seniors, people with disabilities, and people with behavioral health needs. These new programs are the Behavioral Health Continuum Infrastructure Program and the Community Care Expansion Program. The Community Care Expansion program was established by Assembly Bill (AB) 172 (Chapter 696, Statutes of 2021) to fund capital projects and promote the sustainability of residential adult and senior care facilities and to address historic gaps in the long-term care continuum.
The Behavioral Health Continuum Infrastructure Program and the Community Care Expansion programs represent the largest provision of resources for behavioral health and social services infrastructure in the state’s history totaling over $3 billion combined. Together, Behavioral Health Continuum Infrastructure Program and the Community Care Expansion afford counties, tribal entities, nonprofits, and for for-profit organizations the ability to expand and preserve infrastructure around the entire continuum of care for individuals to meet growing demand for services and support across the life span.
The purpose of the Community Care Expansion program is to preserve and avoid the closure of licensed residential adult and senior care facilities that serve applicants and recipients of Supplemental Security Income/State Supplementary Payment and Cash Assistance Program for Immigrants, with a priority for individuals experiencing or at risk of homelessness.
The CDSS contracted with Advocates for Human Potential, Inc., a consulting and research firm focused on improving health and human services systems, to serve as the third-party administrator for the Community Care Expansion program.
The Department submitted an application for funding for operational subsidies. On April 6, 2023, the Department received confirmation of an award in the amount of $344,613 in Operational Subsidies Payment funds from the fiscal year 2022-2023 budget appropriations. In addition, Sonoma County was awarded $383,826 in additional operational subsidies payment funds from the remaining fiscal year 2021-2022 appropriation, bringing the total award to $728,439.
Implementation Plan
Sonoma County engagement with community stakeholders regarding the Community Care Expansion Preservation OSB funds is planned in three primary phases: 1) Identify and engage key stakeholders to inform the outreach plan; 2) Convene a Community Care Expansion Preservation stakeholder workgroup to inform evaluation criteria; and 3) Identify and include key stakeholders as participants on the selection review panel.
Phase 1: Inform the Outreach Plan
Sonoma County identified the following entities as primary stakeholders:
• Department of Health Services (DHS): Behavioral Health Division (lead entity on project)
• Human Services Department (HSD): Adult & Aging Division
• Senior Advocacy Services: Ombudsman Program
• Community Care Licensing Regional Office
• HomeFirst: Coordinated Entry
Direct engagement of these entities was completed by end of January 2023. The resulting shared contact lists for potentially eligible facilities will maximize the opportunity for outreach.
Phase 2: Evaluation Criteria Workgroup
Sonoma County will utilize the existing Behavioral Health Quality Improvement Committee (QIC) to recruit and convene a workgroup to inform evaluation criteria for the request for proposal (RFP) process. The QIC is comprised of County Behavioral Health Program Leadership, Community Based Organizations (including licensed residential facility operators), Partnering Health Agencies (including tribal health agencies), Ethnic Services Inclusion and Training Leadership, Peer Providers/Advocates, and Family Members/Advocates. Utilizing an equity lens, the workgroup will review and inform the prioritization criteria and ranking structure for the RFP. Recruitment for this workgroup will commence in August 2023, with anticipated final report out to QIC in September 2023.
Phase 3: RFP Selection Review Panel
Sonoma County plans to include key stakeholders as subject matter experts (SME) on the RFP Selection Review Panel as follows:
• Behavioral Health Division leadership (SME for adult residential programs for behavioral health populations)
• Ombudsman Program (SME for senior care facilities)
• HomeFirst Coordinated Entry Program (SME for homeless services continuum)
• Peer Recovery Program Leadership (SME for lived experience with behavioral health issues)
Direct engagement of these entities should commence in fiscal year 2023-2024.
Continued Engagement
As a standard part of the contracting process, Sonoma County assigns a primary contract liaison to each contractor/recipient of funds to provide technical assistance and support. The Contract Liaisons will function as a primary avenue for feedback and troubleshooting issues that arise over the course of the implementation. Additionally, Sonoma County will be sending quarterly updates to the QIC and to lead stakeholders over the course of the implementation.
References:
Assembly Bill (AB) 172 (Chapter 696, Statutes of 2021) - <https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220AB172>
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:
None
Fiscal Summary
|
Expenditures |
FY 23-24 Adopted |
FY 24-25 Projected |
FY 25-26 Projected |
|
Budgeted Expenses |
$685,598 |
|
|
|
Additional Appropriation Requested |
$42,841 |
|
|
|
Total Expenditures |
$728,439 |
0 |
0 |
|
Funding Sources |
|
|
|
|
General Fund/WA GF |
|
|
|
|
State/Federal |
$728,439 |
|
|
|
Fees/Other |
|
|
|
|
Use of Fund Balance |
|
|
|
|
Contingencies |
|
|
|
|
Total Sources |
$728,439 |
0 |
0 |
Narrative Explanation of Fiscal Impacts:
DHCS and CDSS jointly awarded DHS the amount of $728,439 for use from 07/01/2023 through 01/30/2027. DHS already budgeted $685,598 in FY 2023-2024 and will need additional appropriation for the augmentation of $42,841. Any funds not utilized in FY 2023-2024 will be rolled-over into subsequent fiscal years.
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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 - Program Funding Agreement with Advocates for Human Potential, Inc.
Attachment 2 - Budget Resolution
Related Items “On File” with the Clerk of the Board:
None