To: County of Sonoma Board of Supervisors
Department or Agency Name(s): Department of Health Services
Staff Name and Phone Number: Tina Rivera, 565-4774
Vote Requirement: 4/5th
Supervisorial District(s): Countywide
Title:
Title
Whole Person Care Staffing Allocation
End
Recommended Action:
Recommended action
A) Adopt a personnel resolution amending the Department of Health Services allocation list to add a 0.7 full-time equivalent Behavioral Health Clinician allocation to support the Whole Person Care team, effective December 6, 2022.
B) Adopt a resolution authorizing budgetary adjustments to the fiscal year 2022-2023 adopted budget, appropriating $81,629 to reflect revenue and expenditures associated with the requested position allocation. (4/5th vote required)
(4/5th Vote Required)
end
Executive Summary:
The Department of Health Services (DHS, or the “Department”) Whole Person Care Outpatient program will be engaging in field-based specialty mental health services for high-needs, chronically homeless individuals. The Department has identified a need to expand treatment teams for homeless adults with Serious and Persistent Mental Illness (SPMI). Department leadership recommends adding a 0.7 full-time equivalent (FTE) allocation in Behavioral Health Clinicians to achieve a total of 2.80 FTE to meet the needs of the outpatient program. The activities required in the field, specifically crisis intervention and assessment activities, necessitate three people per shift/day to provide both field interventions and office visits.
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.
Discussion:
Whole Person Care Outpatient Program Staffing - 0.7 Full-Time Equivalent Behavioral Health Clinician
The Whole Person Care (WPC) pilot, established in December of 2017, ended December 31, 2021. The new state program known as Enhanced Care Management (ECM) is replacing this program in collaboration with Partnership HealthPlan of California (PHC). Therefore, the Department will continue the WPC program as an ECM provider. The County will also serve as a provider of Community Supports - wraparound services for individuals enrolled in the ECM/Whole Person Care program - serving beneficiaries who have a serious mental illness and are homeless or at risk of homelessness. As part of the evolution of these programs, Sonoma County Behavioral Health has identified a need to continue homeless outreach efforts and expand treatment teams.
The Department is requesting an increase of 0.7 full-time equivalent (FTE) Behavioral Health Clinician, for a total of 2.8 FTE. The Whole Person Care outpatient program will conduct outreach, intake assessments and provide mental health treatment to a primary focus population of homeless adults with Serious and Persistent Mental Illness (SPMI). The current staffing level is 2.1 FTE (1 full-time FTE position, and two part-time FTE positions utilizing 1.1 FTE), which results in 2 people on shift per day. This is an insufficient level of staffing for an outpatient program given the types of activities required in the field, specifically, crisis intervention and assessment activities, which necessitate two staff for safety purposes, leaving no clinical team member in the program building to address walk-ins or other in-program needs that might occur during the time the team is in the field. The addition of 0.7 FTE will result in three people on shift per day, which is the appropriate level of staffing to provide both field interventions and office visits.
The increased staffing costs for the first year (current FY 22-23) will be funded through Mental Health Services Act (MHSA) Fund Balance, and subsequent ongoing costs will be financed from the leveraged Federal Financial Participation funds available through the Mental Health Plan Medi-Cal claiming processes as a result of services delivered by these positions.
Fiscal year 2022-2023 budget adjustments in the amount of $81,629 to support the requested Whole Person Care allocation are included in the attached budget resolution.
Strategic Plan:
N/A
Prior Board Actions:
None
Fiscal Summary
|
Expenditures |
FY 22-23 Adopted |
FY 23-24 Projected |
FY 24-25 Projected |
|
Budgeted Expenses |
|
$129,309 |
$135,775 |
|
Additional Appropriation Requested |
$81,629 |
|
|
|
Total Expenditures |
$81,629 |
$129,309 |
$135,775 |
|
Funding Sources |
|
|
|
|
General Fund/WA GF |
|
|
|
|
State/Federal |
|
$129,309 |
$135,775 |
|
Fees/Other |
|
|
|
|
Use of Fund Balance |
$81,629 |
|
|
|
Contingencies |
|
|
|
|
Total Sources |
$81,629 |
$129,309 |
$135,775 |
Narrative Explanation of Fiscal Impacts:
The proposed 0.7 FTE of Behavioral Health Clinician will be funded by 1 revenue source initially: Mental Health Services Act (MHSA) - Community Services & Support (CSS). Ongoing costs for the WPC Behavioral Health Clinician will be funded through Mental Health Services Act (MHSA) fund balance for the first year, and subsequently financed from the leveraged Federal Financial Participation (FFP) funds that the position will draw down through the Mental Health Plan Medi-Cal claiming procedures. FFP funds are recorded in the department/sub-section/program in which the funds are reimbursing. Appropriations for the position will be added to the FY 22-23 budget via the attached budget resolution. Appropriations for future years will be included in the appropriate year budget.
|
Staffing Impacts: |
|
|
|
|
Position Title (Payroll Classification) |
Monthly Salary Range (A-I Step) |
Additions (Number) |
Deletions (Number) |
|
Behavioral Health Clinician |
3905 |
0.70 |
0.0 |
|
|
|
|
|
Narrative Explanation of Staffing Impacts (If Required):
The Department will work with the Human Resources Department, as necessary, to fill the position.
Attachments:
Attachment 1 - Personnel Resolution
Attachment 2 - Budget Resolution
Related Items “On File” with the Clerk of the Board:
None