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: Majority
Supervisorial District(s): Countywide
Title:
Title
Measure O Behavioral Health and Homelessness Community Solution Agreements
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Recommended Action:
Recommended action
A) Authorize the Director of Health Services, or designee, to execute agreements as detailed in Attachment 1 with organizations selected funding as a result of the Measure O Behavioral Health and Homelessness Community Solutions Notice of Funding Availability for up to three-year terms and for a total not to exceed $4,200,000.
B) Authorize the Director of Health Services, or designee, to execute agreements as detailed in Attachment 1 with organizations selected for Homeless Housing, Assistance and Prevention funding as a result of the Measure O Behavioral Health and Homelessness Community Solutions Notice of Funding Availability for up to two-year terms and for a total not to exceed $1,400,000.
C) Authorize the Director of Health Services, or designee, to execute modifications to the agreements in this Board Item which do not significantly change the scopes of service and/or to increase the total not-to-exceed amount in order to address increased service needs, subject to available funding and review and approval by County Counsel.
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Executive Summary:
Consistent with the 12/10/2024 Measure O Update <https://bit.ly/3F1oAh6> where $2 million for Behavioral Health & Homelessness Community Solutions and $2.2 million for Youth Alcohol & Drug Services, combined with $1.4 million state funding, on September 23, 2024, staff released the Measure O Behavioral Health and Homelessness Community Solutions Notice of Funding Availability (NOFA). A total of 60 proposals were received by the deadline for submission. A five-member Community Advisory Panel, comprised of community members representing behavioral health and homeless services, different geographic regions, and historically marginalized communities, developed a set of recommendations based on established criteria. These recommendations were provided to the Department of Health Services Interim Director for consideration and final selection.
The Department of Health Services Interim Director is requesting Board approval to award and execute 1 or 3-year agreements based on recommendations made by the Community Advisory Panel and the Interim Director as listed in Attachment 1. The following funding will be utilized:
• Measure O Funding with three-year terms ($4,200,000 total)
• Homeless Housing, Assistance and Prevention (HHAP) funds allocated to the County with one-year terms ($1,400,000)
Discussion:
Measure O Background
In June of 2018, the need for expanded access to behavioral health and homelessness services reached a crisis level in Sonoma County. The wildfires of 2017 exacerbated an already strained health care delivery system, decimated over five percent of the County’s housing stock, and increased the need for trauma-informed behavioral health services. Further compounding the crisis, the COVID-19 pandemic caused new challenges and obstacles throughout the County. While more and more residents needed treatment, budget shortfalls forced drastic reductions to services. These increasing needs demanded additional revenue to support the most vulnerable residents of Sonoma County, leading to the development of Measure O.
In November 2020, Sonoma County voters passed Measure O to provide essential funding for mental health and homelessness services. Measure O is a one-quarter cent sales tax for 10 years, passed with over 2/3 of the vote, that generates approximately $30 million each year to help protect essential mental health and homelessness services. The Measure O Sales Tax Ordinance identified five categories of services to be funded with the sales tax revenue (see pages 5-6 of Attachment 2):
1. Behavioral Health Facilities
2. Emergency Psychiatric/Crisis Services
3. Mental Health and Substance Use Disorder Outpatient Services
4. Behavioral Health Homeless/Care Coordination
5. Transitional <https://bit.ly/3F3geWe> and Permanent Supportive Housing <https://bit.ly/3DlZF7A>/Supportive Housing Pool
In May 2023, in partnership with the Board of Supervisors, DHS sponsored a Community Forum on Mental Health funded by Measure O, in partnership with the Sonoma County Board of Supervisors. The forum brought together service providers from across the County for a community conversation discussing crisis services, suicide prevention, substance use disorder treatment services, workforce development, and more.
Participants were able to provide a myriad of creative solutions to address concerns about the availability and connectivity of services in the County. Along with feedback from the Mental Health Board, the Mental Health Services Act steering committee, and other community surveys and feedback, the following six categories of needed local innovation in the behavioral health field were identified:
1. Service Navigation
2. Staffing Shortages
3. Education/Training & Upstream Approaches
4. Peer Support
5. Individual & Family Counseling
6. Cultural Competence
Homeless Housing, Assistance, and Prevention (HHAP) Background
HHAP <https://bit.ly/41Hrpgf> is a block grant provided by the State of California Interagency Council on Homelessness (ICH) to both counties and continuums of care (CoCs) to support best practices and interventions in homelessness services. HHAP funding is based on annual results of the Homeless Point in Time Count, among other factors. Funding is not ongoing and is granted year-to-year as one-time funds. Each round of HHAP has different expenditure deadlines. To date, five rounds of HHAP have been provided to CoCs and counties. Sonoma County’s CoC is currently known as Homeless Coalition. A portion of the NOFA is funded by the County’s HHAP Round 1 and Round 4 awards.
HHAP Project Categories
Eligible projects for HHAP funding include:
a) Permanent supportive housing
b) Rapid Rehousing
c) Emergency Shelter/Interim Housing (both congregate and non-congregate shelter)
d) Street Outreach
e) Capital expenses for permanent supportive housing or enhancing existing emergency shelter projects for privacy
f) Operating subsidies for permanent supportive housing and rapid rehousing
HHAP funds include a requirement to provide a minimum of 10% of total funds for projects serving transitional age youth (TAY), defined by the funder as ages 18-24.
HHAP funds are administered in compliance with Emergency Solutions Grant <https://bit.ly/4inGxVy> (ESG) standards and projects are monitored by the Ending Homelessness Team in the Homelessness Services Division of the County DHS.
Combined Funding Approach
In addition to the work funded by Measure O and the community needs expressed during the 2023 Community Forum on Mental Health, DHS has identified additional funding and goal areas for community funding utilizing available HHAP funds. DHS combined these funding sources into the NOFA to expand opportunities for local partners to provide services in the related areas of need.
Total funding available for Measure O projects is $4,200,000. Total funding available for HHAP Youth Homeless projects is $700,000. Total funding available for HHAP General Homeless projects is $700,000. The total available funding through is NOFA is $5.6 million.
Measure O Behavioral Health and Homelessness Community Solutions Notice of Funding Availability
On September 23, 2024, a Measure O Behavioral Health and Homelessness Community Solutions NOFA was released. DHS invited community-based organizations (CBOs) and local government partners to apply to provide Behavioral Health and Homelessness programming to the residents of Sonoma County in order to address one or more of the defined areas of need. A maximum award amount was set at $500,000. Proposals were due on November 12, 2024.
All proposals were scored, based on a set of established criteria, by a five-member Community Advisory Panel comprised of community members representing behavioral health and homeless services, different geographic regions, and historically marginalized communities. The scoring criteria included: Program Planning/Ability to Achieve Objectives; Cost; Monitoring and Evaluation; Leverage; Sustainability; Cultural Competency; References/Past Performance; and Completeness (see Attachment 5). After multiple consensus meetings, recommendations were provided to the Department of Health Services Interim Director for consideration and final funding recommendations.
Contracts funded through this NOFA will have terms of either one or three years depending on project and funding source.
Recommended Proposals
Thirteen funding recommendations are presented today for Board consideration. A detailed list of proposals recommended for funding, including the geographical area served, is included in Attachment 1. A complete list of applications received is included in Attachment 4.
The below proposals are being recommended for full or partial funding:
Measure O Funded Proposals with a three-year term - ($4,200,000)
1) Aldea Inc dba Aldea Children & Family Services ($500,000) - Supportive Outreach and Access to Resources (SOAR)
2) Aldea Inc dba Aldea Children & Family Services ($294,280) - Substance Use Prevention Services for Adolescents
3) Alliance Medical Center ($500,000) - Northern Sonoma Behavioral Health Pipeline Project
4) Catholic Charities ($499,567) - Expand Mental Health Programming
5) California Parenting Institute dba Child Parent Institute ($499,167) - Supporting Student and Family Well Being through School Based Services
6) Jewish Community Free Clinic ($420,000) - Mental Health Program Expansion to include Children and Youth;
7) Santa Rosa Community Health Centers ($486,986) - Street Medicine
8) West County Health Center ($500,000) - Enhancing the Substance Use Disorder/Mental Health Continuum of Care for Geographically-Isolated Residents in West County
9) YWCA Sonoma County ($500,000) - Specialized Counseling Services for children and youth
HHAP Funded Proposals with a one-year term - ($1,400,000)
1) Committee on the Shelter less ($350,000) - Family Rapid Rehousing
2) Home First ($350,000) - Rapid Rehousing in Sonoma Valley
3) Community Support Network ($444,286.50) - Integrated Recovery Transitional Age Youth (TAY) Housing Program
4) TLC Child & Family Services ($255,713.50) - Rapid Rehousing for Transitional Age Youth (TAY)
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 2: Establish equitable and data-driven distribution of services
Objective: Objective 3: Increase investment in programs that treat underlying causes of homelessness, including substance abuse, mental illness, poverty, and lack of affordable housing.
Racial Equity:
Was this item identified as an opportunity to apply the Racial Equity Toolkit?
No
Prior Board Actions:
On December 10, 2024, the Board received an informational update on the status of Measure O. The update covered fiscal year 2023-2024 expenditures by category; estimated fund balance for fiscal year 2024-2025 and fiscal year 2025-2026; and provided a review of outcomes and numbers served from last fiscal year.
On November 5, 2024, the Board approved the Re-appointments of Edward Sheffield, Betzy Chavez, Shannon McEntee, Gregory Fearon, Shirlee Zane, Ben Ford, and Kevin McDonnell to the Measure O Citizens’ Oversight Committee for a term beginning December 7, 2024, and ending December 7, 2027.
On February 27, 2024, the Board received the Measure O Annual Report for Fiscal Year 2022-2023 as approved by the Citizen’s Oversight Committee for Measure O.
On April 18, 2023, the Board A) Received the Measure O Annual Report for Fiscal Year 2021-2022 as approved by the Citizen’s Oversight Committee for Measure O; B) Adopted a personnel resolution amending the allocation list for the Department of Health Services to add 4.00 full-time equivalent positions for the Measure O-funded Behavioral Health School Partnership as detailed in the attached resolution, effective April 18, 2023; and C) Adopted a resolution authorizing budgetary adjustments to the fiscal year 2022-2023 adopted budget, programming $250,502 in Measure O fund balance to support the requested position allocations.
On May 24, 2022, the Board received the Measure O Annual Report for Fiscal Year 2020-2021 as approved by the Citizen’s Oversight Committee for Measure O.
Fiscal Summary
|
Expenditures |
FY24-25 Adopted |
FY25-26 Projected |
FY26-27 Projected |
|
Budgeted Expenses |
$287,643 |
$2,829,408 |
$1,738,552 |
|
Additional Appropriation Requested |
|
|
|
|
Total Expenditures |
$287,643 |
$2,829,408 |
$1,738,552 |
|
Funding Sources |
|
|
|
|
General Fund/WA GF |
|
|
|
|
State/Federal |
$287,643 |
$2,829,408 |
$1,738,552 |
|
Fees/Other |
|
|
|
|
Use of Fund Balance |
|
|
|
|
General Fund Contingencies |
|
|
|
|
Total Sources |
$287,643 |
$2,829,408 |
$1,738,552 |
Narrative Explanation of Fiscal Impacts:
A total of $257,643 from HHAP Round 1 funds and $30,000 from Measure O funds are included in the FY 24-25 Adopted Budget. These funds will be allocated to support $257,643 of the $444,287 Integrated Recovery Transitional Age Youth Housing (TAY) one-year agreement, as well as $30,000 of the West County Health Center agreement.
All remaining NOFA-recommended agreements will be executed in FY 25-26 and will be funded by a combination of HHAP Round 4 and Measure O. The total remaining appropriations of $5,342,357 will be included in the regular budgeting cycles (dependent on term of agreement) for FY 25-26, FY 26-27 and FY 27-28 as follows:
• $4,200,000 from Measure O funds
• $257,643 from HHAP Round 1 and $1,142,357 from HHAP Round 5
A detailed breakdown by contractor and funding amount is provided in Attachment 1.
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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 - Funding Recommendations
Attachment 2 - Measure O Behavioral Health and Homelessness Community Solutions NOFA
Attachment 3 - Sample Agreement from NOFA
Attachment 4 - Applications Received List
Attachment 5 - Scoring Criteria and Qualitative Scoring Guide
Attachment 6 - Presentation
Related Items “On File” with the Clerk of the Board:
None