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: Majority
Supervisorial District(s): Countywide
Title:
Title
Behavioral Health Bridge Housing and Behavioral Health Continuum Infrastructure Program Grant Awards
End
Recommended Action:
Recommended action
Adopt a budget Resolution adjusting the fiscal year 2024-2025 revised budget increasing appropriations in the amount of $2,124,241 to reflect revenue and expenditures associated with the Behavioral Health Bridge Housing Program. (4/5th vote required)
end
Executive Summary:
The Sonoma County Department of Health Services (hereinafter, “DHS” or “the Department”) will initiate expenditures for major grant programs awarded by the California Department of Health Care Services (DHCS) in FY 2024-2025. The Board had previously approved acceptance of the grant awards in July 2023, and now appropriations for expenditures are being requested based on the spending plan described below.
DHS was awarded the amount of $11,246,962 for the Behavioral Health Bridge Housing Program. Of that amount, $2,142,241 will be needed in Year 1 of this 5-year program for both one-time start-up costs (e.g., capital expenditures) and ongoing operational costs (e.g., payroll for program administration). This cash lump-sum amount was received in FY 2023-2024 and intended for spending in FY 23-24, but due to timing we still need to account for the costs already expended in FY 23-24, which are in addition to the FY 2024-2025 appropriations in the adopted budget. The FY 24-25 appropriations are separately allocated to specific contractual expenses.
DHS was awarded the amount of $18,233,680 for Round 5 of the Behavioral Health Continuum Infrastructure Program (BHCIP-R5). Of that amount, $1,536,700 will be needed in Year 1 of this 5-year program for one-time start-up costs (e.g., capital expenditures). The FY 24-25 budget already includes $16,538,319 in budget appropriation for the BHCIP-R5 project. The Sonoma Public Infrastructure department will assist DHS with these capital expenditures intended to develop pre-construction deliverables in phase 1 that include architectural engineering, blue-printing, demolition [of existing structures], and permitting.
Discussion:
Behavioral Health Bridge Housing - BHBH
The BHBH Program awarded by DHCS, will provide a total of $1.5 billion in funding to county behavioral health agencies and Tribal entities to operate bridge housing settings to address the immediate housing needs of people experiencing homelessness who have serious behavioral health conditions, including serious mental illness (SMI) and/or substance use disorder (SUD).
• $2,124,241 will be needed in Year 1 of this 5-year program for the preparatory phases of the Behavioral Health Bridge Housing (BHBH) program. The remainder of the $11,246,962 grant award, or $9,122,721, will be expended in the four subsequent years.
The non-infrastructure [preparatory] phase of the BHBH program requires an expenditure plan that starts in fiscal year 2024-2025 to be on target with grant timelines. The appropriation of $2,124,241 for the fiscal year 2024-2025 budget will cover consulting costs, renovation costs for the 71-bed facility at 440 Arrowwood, and the provision of Fixtures, Furnishings & Equipment (FF&E) at the aforesaid location. Also, a kitchen installation at another “bridge housing” location--635 Healdsburg Avenue--will be covered by this appropriation. The remainder of the $11,246,962 grant award, or $9,122,721, will be expended in the four subsequent years. 25% of funds for BHBH have been received by the Department to date.
The BHBH program will serve individuals with serious behavioral conditions, including mental illnesses with co-occurring substance use disorders, and experiencing homelessness. With the passage of Senate Bill 1338, which established the Community Assistance, Recovery & Empowerment (CARE) program, the CARE [Court] clients diagnosed with the aforesaid behavioral health problems will be prioritized in referrals to this 71-bed facility.
Please see Attachment 2 - Draft BHBH Program Plan Statement of Work, submitted on January 16, 2024 to DHCS, for more details.
Behavioral Health Continuum Infrastructure Program - BHCIP
Round 5 of BHCIP, awarded by DHCS, awarded $430 million to 33 projects including Sonoma County to improve California’s access to treatment and behavioral health infrastructure. This essential funding provides grants to construct and expand facilities providing crisis and behavioral health (mental health and substance use disorder) services to vulnerable Californians of all ages, including those who are Medi-Cal beneficiaries.
• $1,536,700 is for the preparatory phases of the Round 5 Behavioral Health Continuum Infrastructure Program (BHCIP-R5). The remainder of the $18,233,680 grant award will be expended in the four subsequent years.
The preparatory phases of BHCIP-R5 require an expenditure plan that starts in fiscal year 2024-2025 for construction to be completed on-time and the facility be operational by the end of the period of performance on June 30, 2028. The additional appropriation of $1,536,700 covers architectural construction drawings, structural engineering, civil engineering, permitting, legal due diligence, and other developmental costs. Appropriations and funds not expended in the current fiscal year will be rolled over to subsequent years.
The BHCIP [Round-5] facility will be divided into two residential wings, separate from one another to provide services to two separate residential populations. One wing will include eight beds for residential substance use disorder treatment for children and youth ages 12 to 18. This unit will include a separate dining room and multi-purpose space, two staff offices and one group meeting room. Separate all-gender ADA restrooms and showers will be included in this wing. A second wing in the facility will house six beds for crisis residential behavioral health treatment for children and youth ages 12 to 18. This wing will also include a separate dining room and multi-purpose space, two staff offices and one group meeting room. Separate all-gender ADA restrooms and showers will also be located in this wing. The main area of the facility will include an industrial kitchen that will service the dining rooms in both wings. There will also be a separate all-gender ADA restroom for use by kitchen and other staff.
In addition to the two residential treatment wings, the facility will include a separate section for the delivery of outpatient substance use disorder services for youth and young adults ages 12-25. This portion of the facility will include the following: six individual offices for one-on-one interviewing and counseling, two larger rooms for group treatment, and one room for family counseling. This section will also include one all-gender ADA restroom for staff and another for use by clients.
Please see Attachment 3 - BHCIP-R5 Application Budget and Attachment 4 - Program Funding Agreement for BHCIP-R5 for more details.
Strategic Plan:
N/A
Racial Equity:
Was this item identified as an opportunity to apply the Racial Equity Toolkit?
No
Prior Board Actions:
On July 18, 2023, the Board A) Adopted a resolution to authorize the Director of Health Services to execute a program funding agreement with Advocates for Human Potential, Inc. and to receive $18,233,680 in revenue to support the Behavioral Health Continuum Infrastructure Program in Sonoma County through June 30, 2027; B) Adopted a resolution to authorize the Director of Health Services to execute a contract with Advocates for Human Potential, Inc. and to receive $11,246,961 in revenue to support the Behavioral Health Bridge Housing Program in Sonoma County through June 30, 2027; and C) Adopted a resolution to authorize the Director of Health Services to execute a standard agreement with California Interagency Council on Homelessness and to receive $4,567,130 in revenue to support the Encampment Resolution Funding.
Fiscal Summary
|
Expenditures |
FY24-25 Adopted |
FY25-26 Adopted |
FY26-27 Projected |
|
Budgeted Expenses |
$22,785,280 |
$1,523,708 |
$1,523,707 |
|
Additional Appropriation Requested |
$2,124,241 |
|
|
|
Total Expenditures |
$24,909,521 |
$1,523,708 |
$1,523,707 |
|
Funding Sources |
|
|
|
|
General Fund/WA GF |
|
|
|
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State/Federal |
$24,909,521 |
$1,523,708 |
$1,523,708 |
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Fees/Other |
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Use of Fund Balance |
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|
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General Fund Contingencies |
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|
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Total Sources |
$24,909,521 |
$1,523,708 |
$1,523,707 |
Narrative Explanation of Fiscal Impacts:
Additional appropriations for the BHBH grant program in year 1 (FY 24-25) is requested in the amount of $2,124,241. $6,246,961 in appropriations for BHBH contracts is already programmed in the FY 24-25 budget. Also, $16,538,319 is programmed in the FY 24-25 budget for BHCIP Round 5. Current appropriation of $6.2 million for BHBH and $16.5 million for BHCIP-Round 5 total $22,785,280. The additional $2.1 million being requested brings total expenditures between these two large projects to $24,909,521 in year 1.
DHCS already advanced DHS a lump-sum cash deposit of $2,124,241 for the BHBH program in order to assist with start-up costs. Thus, DHS is requesting this specific amount in additional appropriations for BHBH.
By the successful completion of the two projects, a total of $29,480,642 will have been spent.
• $11,246,962 for BHBH
• $18,233,680 for BHCIP-R5
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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 - Budget Resolution
Attachment 2 - Draft BHBH Program Plan Statement of Work
Attachment 3 - BCHIP-R5 Application Budget
Attachment 4 - Program Funding Agreement for BHCIP-R5
Related Items “On File” with the Clerk of the Board:
None