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
Behavioral Health Delegated Authority - MHBG/SABG Supplemental Funding Services Agreements
End
Recommended Action:
Recommended action
A) Authorize the Director of Health Services, or designee, to execute agreements and amendments for Mental Health and Substance Use Disorder Services, funded by Community Mental Health Services Block Grant and Substance Abuse Prevention and Treatment Block Grant Supplemental funding, in an amount not to exceed $3,172,240 through June 30, 2025, including $1,407,407 in fiscal year 2021-2022.
B) Adopt a resolution authorizing budgetary adjustments to the fiscal year 2021-2022 adopted budget to reflect additional revenue and expenditures related to receipt of Community Mental Health Services Block Grant and Substance Abuse Prevention and Treatment Block Grant Supplemental funding in the amount of $1,407,407.
(4/5th Vote Required)
end
Executive Summary:
In July 2021, the California Department of Health Care Services (DHCS) contacted Sonoma County Department of Health Services (DHS) with information that the annual Substance Abuse Prevention and Treatment Block Grant (SABG) and Community Mental Health Services Block Grant (MHBG) would be increased with supplemental funds from Coronavirus Response and Relief Supplemental Appropriations Act (CRRSAA) and American Rescue Plan Act (ARPA). CRRSAA funding is available from July 1, 2021 through December 31, 2022 and ARPA funding is available from September 1, 2021 through June 30, 2025.
The funds were sorted in activity categories. The SABG allocations included $1,374,945.01 in CRRSAA funding and $1,212,755.96 in ARPA funding. The MHBG allocations included $453,157.00 in CRRSAA funding and $870,194.00 in ARPA funding. Of the $3,911,052 awarded to DHS, $738,812 is set aside for staff and services and supplies. Given the activity and time limitations associated with the funds, DHS applied with the primary intent of increasing existing services and activities approved in the original funding agreements for SABG and MHBG. DHCS has approved DHS applications for supplemental funds. This report provides details on planned expenditures utilizing the MHBG and SABG supplemental funding.
This item also requests approval of a budget resolution. The fiscal year 2021-2022 budget adjustment is required for only that portion of supplemental funding planned for contracted services.
Discussion:
SABG Supplemental Funding
On November 19, 2021 the California Department of Health Care Services (DHCS) notified DHS of an award of SABG supplemental funding in the amount of $2,587,700.97, including $1,374,945.01 in CRRSAA funding and $1,212,755.96 in ARPA funding. SABG funding categories and associated amounts are as follows:
|
Funding Category |
CRRSAA Amount ($) 7/1/21 - 12/31/22 |
ARPA Amount ($) 9/1/21 - 6/30/25 |
|
Primary Prevention Set-Aside |
$639,564.52 |
$529,591.58 |
|
Friday Night Live Set-Aside |
$50,000.00 |
$100,000.00 |
|
Perinatal Set-Aside |
$102,345.85 |
- |
|
Adolescent/Youth Set-Aside |
$129,975.00 |
- |
|
Recovery Housing Support |
$453,059.64 |
- |
|
Discretionary Allocation |
- |
$583,164.38 |
|
Total Allocation |
$1,374,945.01 |
$1,212,755.96 |
The Department plans to enter into services agreements with a number of providers for the provision of substance use disorder services funded with SABG supplemental funding. Provided below are planned expenditures for each funding category and funding source. Planned expenditures for contracted services funded with SABG supplemental funding total $2,244,015.22, including $1,187,272.58 for fiscal year 2021-2022. Additional information related to the services agreements is provided in Attachment 1. Some agreements will provide services for multiple programs so in Attachment 1 the agreements are condensed to consultant/contractor total amount.
SABG Coronavirus Response and Relief Supplemental Appropriations Act (CRRSAA) Funded Services
Primary Prevention Set Aside - The SABG regulation defines “Primary Prevention Programs” as those programs “directed at individuals who have not been determined to require treatment for substance abuse” (45 CFR 96.121), and “a comprehensive prevention program which includes a broad array of prevention strategies directed at individuals not identified to be in need of treatment” (45 CFR 96.125). Primary prevention includes strategies, programs, and initiatives which reduce both direct and indirect adverse personal, social, health, and economic consequences resulting from problematic Alcohol and Other Drug (AOD) availability, manufacture, distribution, promotion, sales, and use. The desired result of primary prevention is to promote safe and healthy behaviors and environments for individuals, families, and communities. The Department plans to contract for the following in support of the Primary Prevention Set Aside Funding Category:
1) Social Changery ($400,000) - Expand prevention outreach services including the following: a) Full Tik Tok campaign, Media Buys, Media Trainings for FNL youth, and [Cannabis] Decoded campaign expansion and b) implement Crushing the Curve campaign (mental health/COVID/substance use prevention for youth).
2) TBD - Prevention Activities Coordinator ($80,000) - Expand prevention events and services coordination by implementing and coordinating additional events and services.
3) Child Parent Institute ($150,000) - Expand prevention services - parent education in alcohol and opioid use prevention to LatinX community.
4) Mulholland Research & Evaluation Services ($6,900) - Evaluate prevention services per SABG requirements.
Friday Night Live Set Aside - Friday Night Live builds partnerships for positive and healthy youth development which engage youth as active leaders and resources in their communities. The primary focus of Friday Night Live programs is to form youth-adult partnerships with young people, to provide programs rich in opportunities and support, so young people will be less likely to engage in problem behaviors, more likely to achieve in school, and more likely to attend higher education or secure a full-time job. The Department plans to contract for the following in support of the Friday Night Live Set Aside Funding Category:
1) Northern California Center for Well-Being (CWB) ($25,000) - Expand services to increase recruitment and expand program.
2) Cotati-Rohnert Park Unified School District ($25,000) - Expand services to increase recruitment and expand program.
Adolescent/Youth Set Aside - Adolescent/Youth activities can include, but are not limited to: outreach, screening, initial and continuing assessment, diagnosis, counseling, and family interventions and support systems. The Department plans to contract for the following in support of the Adolescent/Youth Set Aside Funding Category:
1) Drug Abuse Alternatives Center ($53,060) - Expand youth services including the following: a) Adolescent Treatment Program (ATP) Outpatient with counseling and family intervention service and b) early intervention with students in schools and conduct outreach.
2) Mulholland Research & Evaluation Services ($35,000) - Conduct an Adolescent Treatment Continuum of Care Assessment.
Perinatal Set Aside - Perinatal activities focus on substance use services for pregnant and parenting women and can include, but are not limited to: screening and assessment, case management, aftercare, and residential treatment. The Department plans to contract for the following in support of the Perinatal Set Aside Funding Category:
1) Drug Abuse Alternatives Center ($25,000) - Expand Perinatal Intensive Outpatient Treatment (IOT): Case management and aftercare services.
2) Women’s Recovery Services ($40,168) - Increase availability of residential beds.
3) California Human Development ($35,364) - Increase availability of residential and aftercare services.
Recovery Housing Support Set Aside - Recovery Housing Support activities can include residential treatment and room and board (within specified guidelines). The Department plans to contract for the following in support of the Recovery Housing Support Set Aside Funding Category:
1) Drug Abuse Alternatives Center ($151,019) - Expand transitional housing in Rohnert Park: 6 beds total.
2) Women’s Recovery Services ($151,020) - Expand transitional housing: 11 beds total, monthly Sober Living Environment (SLE) rate.
3) California Human Development ($151,020) - Expand Hope Village transitional housing - $700 per room/bed a month
SABG American Rescue Plan Act (ARPA) Funded Services
Primary Prevention Set Aside. The Department plans to contract for the following in support of the Primary Prevention Set Aside Funding Category:
1) SUD Prevention Speakers Bureau ($100,000) - Establish school and community-based educational events.
2) Panaptic ($237,000) - Expand IMPACT Prevention Program services.
3) Mulholland Research and Evaluation Services ($2,700) - Expand evaluation services to address new activities.
4) Contractor TBD ($89,891.58) - Prevention Activities Coordinator for management of additional prevention activities.
5) Mike Bates and TBD Contractor ($100,000 total) - Expand responsible beverage service training; increase bilingual responsible beverage service trainers’ services.
Friday Night Live Set Aside. The Department plans to contract for the following in support of the Friday Night Live Set Aside Funding Category:
1) Contractor TBD ($25,000) - Coordinator services.
2) Contractor TBD ($75,000) - Provider services.
Discretionary Set Aside - Discretionary activities can include, but are not limited to: providing increased access for those in need of SUD treatment services, improving IT infrastructure, and identifying the needs and gaps of the County’s SUD services continuum. The Department plans to contract for the following in support of the Discretionary Set Aside Funding Category:
1) Drug Abuse Alternatives Center ($207,517) - Expand availability of residential services.
2) Hilltop Recovery Services ($50,320) - Expand availability of residential services.
3) Buckelew Programs ($28,035) - Expand availability of residential services.
MHBG Supplemental Funding
On December 13, 2021 the California Department of Health Care Services (DHCS) notified DHS of an award of MHBG supplemental funding in the amount of $1,323,351, including $453,157 in CRRSAA funding and $870,194 in ARPA funding. MHBG funding categories and associated amounts are as follows:
|
Funding CategoryCRRSAA Amount ($) 7/1/21 - 12/31/22ARPA Amount ($) 9/1/21 - 6/30/25 |
|
|
|
First Episode Psychosis Set-Aside |
$344,785.00 |
$595,539.00 |
|
Crisis Stabilization |
$54,993.00 |
- |
|
Early Intervention |
$53,379.00 |
- |
|
Discretionary/Base Allocation |
- |
$223,244.00 |
|
General Crisis Services |
- |
$51,411.00 |
|
Total Allocation |
$453,157.00 |
$870,194.00 |
The Department plans to enter into services agreements with a number of providers for the provision of mental health services funded with MHBG supplemental funding. Provided below are planned expenditures for each funding category and funding source. Planned expenditures for contracted services funded with MHBG supplemental funding total $928,224.00, including $220,134.00 for fiscal year 2021-2022. The balance will be contracted during FYs 22-25. Additional information related to the services agreements is provided in Attachment 1.
MHBG Services Funded By Both Coronavirus Response and Relief Supplemental Appropriations Act (CRRSAA) and American Rescue Plan Act (ARPA) Funding
First Episode Psychosis Set Aside - The First Episode Psychosis Set Aside is used for individuals who have early serious mental illness, including a first episode psychosis, regardless of the age of the individual at onset. The Department plans to contract for the following in support of the First Episode Psychosis Set Aside Funding Category:
1) Aldea Children and Family Services ($928,224) - Expand first episode psychosis program services.
The Department contracts for mental health and substance use disorder treatment services as part of the Department of Health Services treatment system. Planned contracts include the estimated client need for the contract term. In some instances, the needs of clients dictate a pattern of contract utilization that is other than what was originally planned. The ability to maximize funding between contracts (within the overall budget authority granted by the Board) increases opportunities to provide for the varying needs of clients with the most appropriate and effective level of care.
MHBG/SABG Funding for Department of Health Services Staff
In addition to contracted services, the Department is considering options for staffing associated with MHBG/SABG supplemental funding and other non-personnel items. The Department will return to the Board as appropriate to request staffing allocations.
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.
Prior Board Actions:
The Department requests authority to accept funding allocations from state and federal agencies. Most recently, on June 8, 2021, the Board adopted a resolution delegating authority to the Director of Health Services, or designee, to accept funding allocations for the County of Sonoma and execute revenue agreements, amendments, and related documents received in fiscal year 2021-2022 as necessary to receive revenue from state and federal agencies.
Fiscal Summary
|
Expenditures |
FY 21-22 Adopted |
FY 22-23 Projected |
FY 23-24 Projected |
|
Budgeted Expenses |
|
$1,403,531 |
$405,051 |
|
Additional Appropriation Requested |
$1,407,407 |
|
|
|
Total Expenditures |
$1,407,407 |
$1,403,531 |
$405,051 |
|
Funding Sources |
|
|
|
|
General Fund/WA GF |
|
|
|
|
State/Federal |
$1,407,407 |
$1,403,531 |
$405,051 |
|
Fees/Other |
|
|
|
|
Use of Fund Balance |
|
|
|
|
Contingencies |
|
|
|
|
Total Sources |
$1,407,407 |
$1,403,531 |
$405,051 |
Narrative Explanation of Fiscal Impacts:
Appropriations for proposed services agreements in the amount of $1,407,407 will be added to the FY 2021-2022 budget via the attached resolution. The Department is considering options for staffing associated with MHBG/SABG supplemental funding and other non-personnel items totaling $288,587 this fiscal year and will present these plans with a later Board Item to add this amount as revenue and expenditures appropriations during the consolidated budget adjustments process. Appropriations for future year revenue and expenditures will be included in the appropriate year budgets.
|
Staffing Impacts: |
|
|
|
|
Position Title (Payroll Classification) |
Monthly Salary Range (A-I Step) |
Additions (Number) |
Deletions (Number) |
|
|
|
|
|
|
|
|
|
|
Narrative Explanation of Staffing Impacts (If Required):
N/A
Attachments:
Attachment 1 - List of Contracts
Attachment 2 - Budget Resolution
Related Items “On File” with the Clerk of the Board:
None