To: County of Sonoma Board of Supervisors
Department or Agency Name(s): Department of Health Services
Staff Name and Phone Number: Nolan Sullivan 707-565-4774; Jan Cobaleda-Kegler, 707-565-5157
Vote Requirement: 4/5th
Supervisorial District(s): Countywide
Title:
Title
Fiscal Year 2025-2026 Mobile Crisis Agreements
End
Recommended Action:
Recommended action
A) Authorize the Director of Health Services, or designee, to execute five (5) funding agreements for Mobile Crisis Programs for a combined total not-to-exceed $5,984,803 through June 30, 2026, as follows:
1) An agreement with Sonoma State University, in an amount not-to-exceed $86,921.
2) An agreement with the City of Cotati, in an amount not-to-exceed $188,329.
3) An agreement with the City of Rohnert Park, in an amount not-to-exceed $1,173,436.
4) An agreement with the City of Petaluma, in an amount not-to-exceed $1,493,003.
5) An agreement with the City of Santa Rosa, in amount not-to-exceed $3,043,114.
B) Adopt a Resolution authorizing budgetary adjustments to the fiscal year 2025-2026 adopted budget, increasing appropriations in the amount of $2,060,659 to reflect revenues and expenditures associated with Mobile Crisis Service funding agreements for providers of behavioral health services. (4/5th Vote Required)
end
Executive Summary:
In response to community interest in expanded mobile crisis services, several cities within Sonoma County have established mobile crisis services that utilize behavioral health and emergency medical service teams as first responders to service calls that do not require law enforcement resources. Along with the Department of Health Services’ (hereinafter, “DHS” or “the Department”) Mobile Support Team, the City of Santa Rosa has the inRESPONSE team, and the Cities of Petaluma, Cotati, Rohnert Park and the campus of Sonoma State University have the SAFE team. The development of these teams over the past three years created opportunities for the Board of Supervisors to invest Measure O funds in mobile crisis services. This preparation positioned Sonoma County to meet the state mandate, effective December 2023, to provide 24/7 mobile crisis response services to Medi-Cal recipients.
This item requests authority to execute new funding agreements that will continue these vital services with Sonoma State University, as well as the cities of Cotati, Rohnert Park, Petaluma, and Santa Rosa for a total amount not-to-exceed $5,984,803 through June 30, 2026.
Discussion:
The Department has operated the Mobile Support Team (MST) program since 2012. The MST responds to law enforcement requests for support on calls in which individuals may be experiencing a behavioral health crisis. The 24/7 mobile crisis response system is designed to assist individuals experiencing behavioral health emergencies without involving law enforcement. Location-based teams aim to provide timely, compassionate care and reduce unnecessary emergency department visits and psychiatric hospitalizations.
Sonoma County’s Mobile Crisis System
Mobile Support Team (MST)
Operated by the Sonoma County Department of Health Services, MST is the countywide backbone of the system. The team is available 24/7 and can be reached at 1-800-746-8181. MST staff include mental health clinicians, substance use counselors, and client support specialists. They provide in-field crisis assessment, de-escalation, 5150 evaluations, safety planning, transportation, and follow-up services. MST also coordinates with other local teams listed below to ensure comprehensive coverage.
Cities Mobile Crisis Services
In response to community interest, several cities within Sonoma County committed to establishing mobile crisis services. The development of programs in Santa Rosa, Petaluma, Rohnert Park and Cotati created additional opportunities for the Board of Supervisors’ investment of Measure O funds, as well as development of other collaborative city/county efforts.
The regional programs have agreed to assist the Department with meeting the Medi-Cal 24/7 service mandated response, and funding is requested to provide adequate staffing, training, and equipment.
inRESPONSE (Santa Rosa)
The Santa Rosa Police Department established the inRESPONSE program, a partnership with Santa Rosa Fire Department, the Department of Health Services, Buckelew Programs, and Catholic Charities, which launched in January 2022. The team includes a licensed mental health clinician, paramedic, and homeless outreach specialist. They respond to mental health crises and are unarmed, working in partnership with law enforcement when necessary. The team aims to reduce police involvement in mental health emergencies.
SAFE Team (Sonoma State University, Petaluma, Rohnert Park, Cotati)
The Petaluma Specialized Access for Everyone (SAFE) program operated by Petaluma Peoples Services Center began providing mobile support services in Petaluma in July 2021.
The cities of Petaluma, Rohnert Park, and Cotati have entered into agreements with Petaluma People Services Center to operate their mobile support team programs. The Rohnert Park/Cotati SAFE Team started training on October 18, 2021, and launched operations in November 2021.
The SAFE Team provides 24/7 crisis response in these areas and to Sonoma State University students. They aim to address crisis situations without involving law enforcement, assisting individuals in accessing community support services.
The chart below shows the historical Measure O investment in mobile crisis by jurisdiction:
|
City/Jurisdiction |
FY 22-23 |
FY 23-24 |
FY 24-25 |
Total to Date |
|
*Santa Rosa |
$ 85,887.00 |
$ 514,440.00 |
$ 1,450,000.00 |
$ 2,050,327.00 |
|
Petaluma |
$ 428,000.00 |
$ 500,000.00 |
$ 1,137,072.00 |
$ 2,065,072.00 |
|
Cotati |
$ 68,480.00 |
$ 60,000.00 |
$ 136,449.00 |
$ 264,929.00 |
|
Rohnert Park |
$ 359,520.00 |
$ 410,000.00 |
$ 921,028.00 |
$ 1,690,548.00 |
|
SSU |
$ - |
$ 30,000.00 |
$ 79,595.00 |
$ 109,595.00 |
|
|
|
|
Total to-date |
$ 6,180,471.00 |
The current-year request from both SAFE and inRESPONSE reflects the increased costs required for both programs to meet a 24/7 Medi-Cal response, including maintaining the correct staffing component to meet response requirements, increased navigation and follow-up requirements, and higher operational needs.
The Department is seeking authority to execute five funding agreements totaling $5,984,803 for fiscal year 2025-2026 for the 24/7 mobile crisis services. The breakdown is as follows:
|
City |
FY 25-26 Contract |
|
Santa Rosa (inRESPONSE) |
$3,043,114 |
|
Rohnert Park (SAFE) |
$1,173,436 |
|
Cotati (SAFE) |
$188,329 |
|
Petaluma (SAFE) |
$1,493,003 |
|
Sonoma State University (SAFE) |
$86,921 |
|
Total Request |
$5,984,803 |
Lastly, the Department is requesting a budget resolution be adopted, increasing the Department’s appropriations for fiscal year 2025-2026 in the amount of $2,060,659 to reflect revenues and expenditures associated with these funding agreements.
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: Create a “no wrong door” approach where clients who need services across multiple departments and programs are able to access the array of services needed regardless of where they enter the system.
Racial Equity:
Was this item identified as an opportunity to apply the Racial Equity Toolkit?
No
Prior Board Actions:
On December 12, 2023, the Board received an update on the mobile crisis team regional plan submitted to the California Department of Health Care Services on October 31, 2023.
On May 16, 2023, the Board received an update on mobile crisis teams in Sonoma County; authorized the Director of Health Services to execute funding agreements with Sonoma State University and the cities of Cotati, Rohnert Park, Petaluma, and Santa Rosa for continued support of mobile crisis services for a total amount not-to-exceed $1,514,440 through June 30, 2024; and directed staff to continue current program evaluation, and work with city and community-based organization partners to develop regional model for on-going Measure O funding that incorporates existing mobile crisis teams and integrates requirements of the California Department of Health Care Services Medi-Cal Mobile Crisis Unit benefit.
On September 20, 2022, the Board authorized the Director of Health Services to execute a revenue agreement with Advocates for Human Potential, Inc. (state contractor) to accept revenue to support local mobile support team programs in the amount of $2,498,898.69, including $1,929,788.69 for infrastructure through June 30, 2025 and $569,120 for limited direct services through February 14, 2023, and to execute amendments and modifications to said agreement and authorized the Director of Health Services to execute funding agreements with the cities of Cotati, Rohnert Park, Petaluma, and Santa Rosa for a total amount not-to-exceed $2,248,787 through June 30, 2025.
On October 26, 2021, the Board accepted the staff report on Mobile Support Team (MST)/CAHOOTS Programs; allocated a one-time investment of $428,000 to Cotati/Rohnert Park and Petaluma each and $85,887 to Santa Rosa to assist those jurisdictions in developing their MST program for a total of $941,887, and authorize the Interim Director of Health Services to enter into funding agreements with the jurisdictions; and directed staff to lead a collaborative evaluation in January - December 2022 of all mobile crisis support programs using evaluation criteria suggested, and determine path forward for most sustainable and successful model to adapt and scale countywide.
Fiscal Summary
|
Expenditures |
FY 25-26 Adopted |
FY26-27 Projected |
FY 27-28 Projected |
|
Budgeted Expenses |
$3,924,144 |
|
|
|
Additional Appropriation Requested |
$2,060,659 |
|
|
|
Total Expenditures |
$5,984,803 |
|
|
|
Funding Sources |
|
|
|
|
General Fund/WA GF |
|
|
|
|
State/Federal |
$5,984,803 |
|
|
|
Fees/Other |
|
|
|
|
Use of Fund Balance |
|
|
|
|
General Fund Contingencies |
|
|
|
|
Total Sources |
$5,984,803 |
|
|
Narrative Explanation of Fiscal Impacts:
Funding for the agreements with Sonoma State University and the cities of Cotati, Rohnert Park, Petaluma, and Santa Rosa to continue mobile crisis services, totaling an amount not-to-exceed $5,984,803 through June 30, 2026, will be funded through Measure O funds allocated to Crisis Services.
The FY 2025-2026 Adopted Budget allocates $3,924,144 for these contracts. An additional $2,060,659 in appropriations is requested to fully fund the agreements and support ongoing service delivery. This request accounts for increased costs associated with meeting 24/7 Medi-Cal response requirements, including adequate staffing, enhanced navigation and follow-up services, and greater operational demands.
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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):
None
Attachments:
Attachment 1 - Budget Resolution
Related Items “On File” with the Clerk of the Board:
None