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
Behavioral Health CARE Court Staffing Allocation
End
Recommended Action:
Recommended action
A) Adopt a Resolution amending the Department Allocation List of the Department of Health Services, by adding 1.0 Full Time Equivalent Time-Limited Behavioral Health Clinician to provide CARE Court mandated services, effective August 25, 2026 through August 24, 2029.
B) Adopt a Resolution authorizing budgetary adjustments to the fiscal year 2026-2027 adopted budget, increasing appropriations in the Department of Health Services by $244,731 to reflect revenue and expenditures associated with the requested position allocations.
(4/5th Vote Required)
end
Executive Summary:
The Department of Health Services is requesting the addition of a 1.0 Full Time Equivalent (FTE) time-limited Behavioral Health Clinician to join the CARE Court program. This position will significantly enhance access to behavioral health services for individuals participating in this mandated program under SB 1338 <https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220SB1338>. While the existing CARE Court team was established to fulfill statutory requirements through care coordination and linkage to community-based treatment providers, the program currently has limited capacity to provide direct clinical services. This position will serve as a critical access point for participants by conducting timely clinical assessments, identifying behavioral health treatment needs, facilitating engagement in services, and providing short-term case management until individuals are successfully connected to ongoing outpatient care. The addition of this clinician will strengthen continuity of care, reduce delays in treatment initiation, improve participant engagement, and support the Behavioral Health Services Act Integrated Plan goals of expanding access to behavioral health services for individuals with the greatest needs.
The position will be funded with revenue received from the California Department of State Hospitals‘ Felony Incompetent to Stand Trial Growth Cap Penalty Program.
Discussion:
Sonoma County CARE Court
CARE Court, which stands for Community Assistance, Recovery, and Empowerment, launched in Sonoma County on December 1, 2024. It is a civil court process designed to provide behavioral health services while using the courts to offer increased structure and support for individuals with severe mental illness. The program allows certain people, including family members and first responders, to petition a civil court for treatment, services, and housing resources for individuals with untreated schizophrenia and other psychotic disorders.
The process works in stages: it starts with a petition, followed by a clinical evaluation to determine eligibility, and then the creation of a care plan that can include recommended treatment, medication, and housing. The person's participation and the county's delivery of services are then monitored over a year-long period via court hearings. CARE Court goals are to divert individuals from more restrictive situations (such as hospitalizations, incarcerations, and conservatorship), preserve self-determination to the greatest extent possible, and ultimately transition individuals into permanent housing.
CARE court is a mandated program under SB1338 and was implemented as required in December 2024. SB1338 requires the Department of Health Services (DHS) to perform activities to assist eligible participants engage in court ordered treatment. CARE programming and its required services are not offered by other programs in our system due to need to have specialized training and education to provide services to forensic populations. The initial CARE Court team was implemented on a smaller scale using a utilization methodology and services were limited to fulfilling the CARE Act mandate such as care coordination with community treatment providers including supportive housing, substance use treatment, mental health, primary care, and psychiatry services. In alignment with new Behavioral Health Services Act (BHSA) integrated plan requirements, this new position will create an access point for behavioral health treatment services.
The addition of a 1.0 FTE time-limited Behavioral Health Clinician to the CARE Court program will significantly enhance access to behavioral health services for individuals participating. While the existing CARE Court team was established as the program was implemented to fulfill statutory requirements through care coordination and linkage to community-based treatment providers, the program currently has limited capacity to provide direct clinical services, especially as program participation increases. This position will serve as a critical access point for participants by conducting timely clinical assessments, identifying behavioral health treatment needs, facilitating engagement in services, and providing short-term case management until individuals are successfully connected to ongoing outpatient care. Given the specialized forensic, clinical, and legal expertise required to serve the CARE Court population, these services cannot be readily absorbed by other Behavioral Health Division programs. The addition of this clinician will strengthen continuity of care, reduce delays in treatment initiation, improve participant engagement, and support the BHSA Integrated Plan goals of expanding access to behavioral health services for individuals with the greatest needs.
In addition to the above-mentioned tasks, this position will be responsible for:
• Administering psychosocial evaluations and risk assessments,
• Providing individual, family, and group psychotherapy,
• Delivery of crisis intervention and stabilization services,
• participation in treatment planning and case consultations,
• Facilitation of referrals to specialty behavioral health services and higher levels of care,
• Assisting clients in navigating complex behavioral health and social service systems,
• Engaging participants in treatment and monitoring progress toward CARE agreements or court-ordered treatment plans,
• Providing short-term case management and linkage to outpatient behavioral health, psychiatry, substance use treatment, supportive housing, and other services,
• Documenting compliance with SB 1338 requirements and support court reporting functions.
The proposed Behavioral Health Clinician position will be supported with Felony Incompetent to Stand Trial (IST) Growth Cap Penalty funds administered by the California Department of State Hospitals (DSH). These funds are generated when a county exceeds the State’s established growth cap for felony IST commitments and may only be used for DSH-approved activities intended to reduce IST commitments and improve outcomes for individuals involved in the criminal justice system.
For Fiscal Year 2023-2024, the Department of Health Services and the Probation Department jointly submitted an expenditure plan for $828,000 in available penalty funds. DSH approved the expenditure plan on April 2, 2026, and the County received confirmation on April 22, 2026, that the funds had been received and would be available for the approved projects beginning in Fiscal Year 2026-2027.
The approved plan allocates $250,000 to the Department of Health Services to support a 1.0 full-time equivalent, time-limited Behavioral Health Clinician dedicated to providing specialty mental health services for participants in the CARE Court program. An additional $10,000 was approved for participant incentives intended to promote engagement throughout the CARE Court process. The remaining funds support Probation Department reentry initiatives, including $200,000 for a specialized probation caseload and $368,000 for contracted housing stabilization and supportive services.
The County anticipates expending most of the Fiscal Year 2023-2024 allocation during Fiscal Year 2026-2027. However, DSH permits unspent funds to be carried forward into future fiscal years until the approved funds are fully expended. The County must submit annual expenditure reports to DSH until all funds have been used.
An additional $2,277,000 is available through the pending Fiscal Year 2024-2025 expenditure planning process. Subject to DSH approval, a portion of that funding is anticipated to support the CARE Court Behavioral Health Clinician for up to two additional years. Recommendations for the remaining funds are being developed through the Sonoma Stepping Up workgroup and are expected to be reviewed by the County’s Safety Net department leadership by October 2026.
Because Felony IST Growth Cap Penalty funding is tied to the County’s performance under the State’s IST growth-cap requirements, the amount and continued availability of future funding are not assured. In fact, successful efforts to reduce felony IST commitments are expected to reduce future penalty amounts. Accordingly, the Behavioral Health Clinician position is recommended as time-limited rather than ongoing and will continue only for the period supported by approved and available DSH funding.
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 June 2, 2026, the Board adopted the Fiscal Years 2026-2029 Sonoma County Behavioral Health Services Act Integrated Plan.
On October 28, 2025, the Board received an informational update on Senate Bill 43 Implementation.
On March 11, 2025, the Board adopted a personnel resolution adding 3.0 Full-Time Equivalent Senior Client Support Specialists.
On November 5, 2024, the Board adopted a personnel resolution and budgetary resolution for CARE Court implementation.
Fiscal Summary
|
Expenditures |
FY 26-27 Adopted |
FY 27-28 Projected |
FY 28-29 Projected |
|
Budgeted Expenses |
|
$241,023 |
$247,504 |
|
Additional Appropriation Requested |
$244,731 |
|
|
|
Total Expenditures |
$244,731 |
$241,023 |
$247,504 |
|
Funding Sources |
|
|
|
|
General Fund/WA GF |
|
|
|
|
State/Federal |
$244,731 |
$241,023 |
$247,504 |
|
Fees/Other |
|
|
|
|
Use of Fund Balance |
|
|
|
|
General Fund Contingencies |
|
|
|
|
Total Sources |
$244,731 |
$241,023 |
$247,504 |
Narrative Explanation of Fiscal Impacts:
The fiscal impact of the proposed allocation includes salary and benefits for the addition of 1.0 FTE time-limited Behavioral Health Clinician. For FY 2026-2027, total estimated costs are $244,731, consisting of a base salary of $130,525, benefits of $79,206, ongoing overhead costs of $25,000, and one-time costs of $10,000 for computer equipment and office furniture.
For FY 2027-2028, the estimated ongoing annual cost is $241,023, and for FY 2028-2029, the estimated cost is $247,504. These projections include an assumed 3% cost-of-living adjustment (COLA) in FY 2027-2028 and FY 2028-2029.
The Department of Health Services proposes to fund these expenditures with revenue received from the California Department of State Hospitals‘ Felony Incompetent to Stand Trial Growth Cap Penalty Program.
The Felony IST growth cap penalty from the Department of State Hospitals for FY 2023-2024 was received by the County Executive’s Office earlier this year and will be used to fund FY 2026-2027 expenditures.
Felony IST funding is contingent upon the future Growth Cap Penalty, which is variable in nature. Given this, DHS requests that this allocation be approved as a time-limited, three-year allocation. The next expenditure plan, which will request an additional $2.2 million, will provide funding for two additional years.
|
Staffing Impacts: |
|
|
|
|
Position Title (Payroll Classification) |
Monthly Salary Range (A-I Step) |
Additions (Number) |
Deletions (Number) |
|
Behavioral Health Clinician - Time-Limited |
8,797.21-10,694.75 |
1.0 |
0.0 |
Narrative Explanation of Staffing Impacts (If Required):
This position will enhance the CARE Court program’s capacity by alleviating workload pressures currently borne by the Behavioral Health Clinical Specialist, whose primary responsibilities include conducting forensic evaluations and fulfilling other statutory requirements associated with CARE Court. As demand for these mandated activities has increased, the Clinical Specialist has had limited capacity to provide direct service engagement and facilitate timely access to community-based behavioral health treatment. The addition of this position will expand the program’s ability to connect participants to needed services by conducting clinical assessments, providing short-term case management and engagement, and facilitating linkage to ongoing treatment. Furthermore, the position will deliver and document billable specialty mental health services, increasing service capacity and supporting reimbursement opportunities while ensuring participants receive timely access to clinically appropriate care.
Attachments:
Attachment 1 - Budget Resolution
Attachment 2 - Personnel Resolution
Related Items “On File” with the Clerk of the Board:
None