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
Fiscal Year 2024-25 Staffing Allocations
End
Recommended Action:
Recommended action
Adopt a Resolution amending the Department of Health Services Department Allocation List to:
A) Extend 1.0 Full-Time Equivalent Assistant Public Health Laboratory Director - Time-Limited through June 30, 2026, in alignment with approved extended state grant;
B) Convert 1.0 Full-Time Equivalent Behavioral Health Clinical Specialist - Time-Limited to permanent ongoing in support of the Crisis Assessment, Prevention, and Education serving transition-age youth ages 16-25 who are experiencing mental health issues; and
C) Add 3.0 Full-Time Equivalent Senior Client Support Specialists - Time-Limited through December 31, 2027, to provide client navigation at the new Bridge Housing 440 Arrowood site. New positions will be financed with awarded Behavioral Health Bridge Housing grant funds and will be filled gradually as needed to support the 80-bed transitional recovery and community re-entry housing facility.
(4/5th Vote Required)
end
Executive Summary:
The County participates in the LabAspire program, a state initiative designed to train future public health lab directors, fully supported by AB107 California Future of Public Health HERO funds. The Department has recently received approval to extend the grant which fund the current Public Health Lab Director through June 30, 2026. Department management and Public Health Division leadership is seeking approval to extend 1 full time equivalent (FTE) Assistant Public Health Laboratory Director - Time-Limited through June 30, 2026, at the Sonoma County Public Health Laboratory. The grant funding for this Assistant Lab Director expires on June 30, 2026. The position extension will result in $265,144 expanded Public Health Laboratory costs and will be funded by the LabAspire grant.
Additionally, the Department is the recipient of State of California Department of Health Care Services Behavioral Health Bridge Housing funds and requires additional staffing to provide client navigation for the Bridge Housing project at 440 Arrowood Drive. The Behavioral Health Division leadership is requesting approval to add 3.0 FTE Senior Client Support Specialists (SCSS) - Time-Limited through December 31, 2027, to provide client navigation for the Behavioral Health Bridge Housing (BHBH) site. The three new positions are expected to serve 80+ clients per year and total an annual cost of $605,192 which will be funded by Behavioral Health Bridge Housing funding through December 31, 2027.
Lastly, the Department is seeking to convert 1.0 FTE Behavioral Health Clinical Specialist - Time-Limited allocation for the Crisis Assessment, Prevention, and Education (CAPE) Team to an ongoing permanent position in order to continue to serve students at Sonoma County high schools. The conversion of the existing term limited position to permanent will create an ongoing CAPE operating cost of $192,876 to be financed by Measure O.
Discussion:
Public Health Division - Public Health Laboratory - 1.0 FTE Assistant Public Health Laboratory Director - Time-Limited
The Department is seeking approval to extend 1.0 FTE Assistant Public Health Laboratory Director Time-Limited at the Sonoma County Public Health Lab (SCPHL). The Assistant Laboratory Director is funded through the California Department of Public Health LabAspire program <https://www.caphld.org/labaspire>, a state initiative designed to train future public health lab directors, fully supported by AB107 <https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202320240AB107> California Future of Public Health HERO funds.
The Department of Health Service Public Health Lab provides testing services to Sonoma, Mendocino, Lake and Humboldt counties, training and reference testing to clinical laboratories and laboratory support for diagnosis and control of communicable diseases to medical providers.
The Public Health Lab currently has 1.0 FTE Assistant Public Health Laboratory Director Time-Limited allocation funded by the LabAspire program intended to address Public Health Lab personnel shortages by increasing workforce training programs. The position oversees quality improvement efforts, efforts to maintain and improve technical excellence, day-to-day operational needs, and regulatory compliance.
Original LabAspire funding term was July 1, 2022, through June 30, 2025. On December 29, 2023, the Department was notified that the existing LabAspire award and associated funding had been extended through June 30, 2026. As such, the Department is requesting to extend this allocation through June 30, 2026, in connection with the grant extension.
Behavioral Health Division - CAPE Team (Crisis Assessment, Prevention, and Education) - 1.0 FTE Behavioral Health Clinical Specialist Time-Limited
The Department is requesting to convert 1.0 FTE Behavioral Health Clinical Specialist Time-Limited position for the CAPE Team to ongoing.
The CAPE Team provides clinical services to students at high schools throughout Sonoma County. These services include screening, linkage and referrals, crisis response, clinical consultation, education on mental health and substance use issues in youth, and brief clinical interventions to address mental health and substance use issues in youth. The staff on the team include Behavioral Health Clinicians, Behavioral Health Clinicians Interns, and Alcohol and Other Drug Counselors I/II. The staff require clinical supervision and consultation, as well as clinical back-up and support in the field when responding to crisis situations. The Behavioral Health Clinical Specialist provides this clinical guidance, supervision, and support to the team. In addition, the Behavioral Health Clinical Specialist provides clinical consultation to school counselors and therapists in urgent and crisis situations.
The Behavioral Health Clinical Specialist allocation is currently Time-Limited because it was tied to a time-limited grant when the position was created. The allocation was previously funded with Mental Health Student Services Act grant awarded by Mental Health Services Oversight and Accountability Commission. On April 18, 2023, the Board of Supervisors approved the CAPE program being funded by Measure O. As such, funding is available to continue this position on an ongoing, permanent basis. This would ensure the services and oversight of the program and staff are continued, in order to continue the successful work of the CAPE Team.
Behavioral Health Division - Behavioral Health Bridge Housing - 3.0 FTE Senior Client Support Specialists Time-Limited
In 2022, the State of California Department of Health Care Services established the Behavioral Health Bridge Housing (BHBH) Program, designed to provide funding to counties and Tribal entities to operate bridge housing settings to address the immediate housing and treatment needs of people experiencing homelessness who have serious behavioral health conditions, including serious mental illness and/or substance use disorder. The Department applied for BHBH Round 1 funding in May 2023 and was awarded $11,246,961. The key project funded by the BHBH grant is an 80-bed transitional recovery and community re-entry housing facility located at 440 Arrowood Drive in Santa Rosa. The location totals 25,414 square feet consisting of 43 bedrooms serving up to 80 individuals, incorporating double occupancy if appropriate. The grant submission included housing navigation services managed by DHS staff.
The Department is requesting approval to add 3.0 FTE Senior Client Support Specialist Time-Limited to provide client navigation for the Bridge Housing project at 440 Arrowood Drive through December 31, 2027. These staff will help bridge the immediate shelter and treatment needs of people experiencing serious behavioral health conditions and homelessness with a particular focus on supporting CARE Court <https://sonoma.courts.ca.gov/care-court> clients and helping clients experiencing homelessness quickly exit to permanent housing. Allocations will be funded with Behavioral Health Bridge Housing (BHBH) grant funds. Medi-Cal reimbursement may offset costs, however positions are fully funded by the BHBH grant award.
One of the requested Senior Client Support Specialists will work as a Housing Coordinator, ensuring the appropriateness of all referrals and client intakes, working in conjunction with the Felton Institute, the procured contracted operator of the facility’s 24-hour medical and clinical staff. The two other Senior Client Support Specialists will serve as Housing Navigators and will work to identify clients’ needs and potential barriers to successful tenancy with the goal of providing housing coordination, assistance, and placement after 6-12 months of residency and will maintain a caseload of 40 clients each. Average caseloads sizes for non-intensive behavioral health treatment team range from 35-40 per full time person. Staff performing housing navigation services will be responsible for having regular contact with each person on their caseload each week. Some site guests will receive a higher level of contact than others as a result of behavioral problems or symptom acuity. Regular contact is necessary to not only develop rapport but to also form and carry out a suitable discharge plans, including providing valuable care coordination services linking guests to external providers.
Prior to opening this site there are already 17 individuals waiting to be served, and more expected each month. The site is expecting full capacity at 3 months with 80 individuals housed, and with varying stays. Staff are expecting to serve 100+ individuals a year. CARE Court clients are the priority however they are only one of multiple unsheltered Behavioral Health populations served at this site, all needing case management and supportive services. Specialists will develop an individualized housing support plan; work with clients to search for housing options; assist in securing appropriate housing, including housing applications, and required documentation; assist with benefits advocacy; identify and secure available resources to assist with subsidizing rent to cover expenses such as security deposits, moving costs and adaptive aids.
The Department expects high utilization rates at the facility as a result of the mixed populations of individuals it intends to serve in our community and forecasts being at full capacity in FY 2025-2026. The Department will prioritize acceptance and placement of any individual accepted into CARE court. Other populations to be served at Arrowood include individuals who are homeless and are:
• being discharged from a correctional facility;
• stepping down from conservatorship or other long-term care facility;
• being discharged from crisis services such as Sonoma Healing Center, Crisis Stabilization Unit, or Crisis Residential Units;
• transitioning out of residential treatment placement for co-occurring disorders;
• transitioning out of foster care; and
• behavioral health clients in services and who are also unsheltered.
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.
Racial Equity:
Was this item identified as an opportunity to apply the Racial Equity Toolkit?
No
Prior Board Actions:
On January 28, 2025, the Board of Supervisors authorized the Director of Health Services, or designee, to execute an agreement with Felton Institute to provide Bridge Housing supportive services and site management at 440 Arrowood Drive, Santa Rosa, for an initial term from date of execution and ending June 30, 2027 in an amount not to exceed $5,038,810 and to execute up to two (2) additional one-year renewal options for a maximum five-year agreement value of $9,274,590l; authorized a modification to the agreement with Felton Institute to increase the total not-to-exceed amount up to $500,000 in order to address increased service needs or other contractual amendments; authorized a Memorandum of Understanding with the County of Marin Department of Health and Human Services with a three-year term ending December 31, 2027, for the dedicated use of 20 beds at 440 Arrowood Drive, Santa Rosa; and adopted a Resolution authorizing budgetary adjustments to the Department of Health Services Fiscal Year 2024-2025 Adopted Budget by increasing revenue appropriations by $140,000 to offset budgeted expenditures.
On June 14, 2024, the Board of Supervisors adopted a Concurrent Resolution adopting the Fiscal Year 2024-2025 Budget and Position Allocation Listing.
On April 18, 2023, the Board of Supervisors adopted a resolution amending the allocation list for the Department of Health Services to add 4.0 full-time equivalent positions for the Measure O-funded Behavioral Health School Partnership as detailed in the attached resolution, effective April 18, 2023.
Fiscal Summary
|
Expenditures |
FY24-25 Adopted |
FY25-26 Projected |
FY26-27 Projected |
|
Budgeted Expenses |
$423,497 |
$1,126,676 |
884,778 |
|
Additional Appropriation Requested |
|
|
|
|
Total Expenditures |
$423,497 |
$1,126,676 |
$884,778 |
|
Funding Sources |
|
|
|
|
General Fund/WA GF |
|
|
|
|
State/Federal |
$423,497 |
$1,126,676 |
$884,778 |
|
Fees/Other |
|
|
|
|
Use of Fund Balance |
|
|
|
|
General Fund Contingencies |
|
|
|
|
Total Sources |
$423,497 |
$1,126,676 |
$884,778 |
Narrative Explanation of Fiscal Impacts:
Costs associated with the current 1.0 FTE Assistant Public Health Laboratory Director Time-Limited and the 1.0 FTE Time-Limited Behavioral Health Clinical Specialist allocations are already included in the FY 2024-2025 budget. Future fiscal year recommended budget processes will include the Assistant Public Health Laboratory Director Time-Limited allocations funded by the LabAspire grant, terming at the conclusion of the grant.
The budget process will also include the conversion of the Behavioral Health Clinical Specialist Time-Limited allocation to ongoing which will be funded by Measure O, for the CAPE program.
The 3.0 FTE Senior Client Support Specialist Time Limited allocations will be funded through the Behavioral Health Bridge Housing Grant (BHBH) through December 31, 2027. The total approved grant was $11,246,961, of which $9,749,786 is committed to readying the site and financing the site services contract with Felton Institute (approved by the Board on 1/28/2025) which leaves $1,497,175 available for the added positions. The positions are in the BHBH funding plan. Grant funds will be collected on a reimbursement basis through the life of the grant. Future salaries and benefits will be included in the annual budget process.
|
Staffing Impacts: |
|
|
|
|
Position Title (Payroll Classification) |
Monthly Salary Range (A-I Step) |
Additions (Number) |
Deletions (Number) |
|
Assistant Public Health Laboratory Director |
$9,779.90-$11,886.15 |
0.0 |
0.0 |
|
Behavioral Health Clinical Specialist |
$8,797.21-$10,694.75 |
0.0 |
0.0 |
|
Senior Client Support Specialist |
$6,664.87-$8,101.50 |
3.0 |
0.0 |
Narrative Explanation of Staffing Impacts (If Required):
The extension of the Assistant Public Health Laboratory Director allocation is necessary to support the Public Health Laboratory Director with additional supervisory/management support to the laboratory during the public health laboratory’s transition to the new facility in 2026.
The Behavioral Health Clinical Specialist will convert an existing Time-Limited allocation to ongoing. There will be no staffing impacts.
The Senior Client Support Specialist request will increase the FTE of the department by 3.0 for a Time-Limited manner, allowing for greater program coverage and access to services for both Mental Health and Substance Use Disorder Services at 440 Arrowood. Existing staff will not be impacted.
Attachments:
Attachment 1 - Personnel Resolution
Related Items “On File” with the Clerk of the Board:
None