To: Board of Supervisors of Sonoma County
Department or Agency Name(s): Department of Health Services
Staff Name and Phone Number: Wendy Wheelwright, 565-4868
Vote Requirement: 4/5th
Supervisorial District(s): Countywide
Title:
Title
Crisis Counseling Program
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Recommended Actions:
Recommended action
A) Authorize the Director of Health Services to execute amendments to agreements with four partner organizations to support an extension of Crisis Counseling Assistance and Training Program services in Sonoma County, increasing each contract by $268,766 resulting in a new total not-to-exceed amount of $1,486,201 per contract, for a new combined total amount of $5,944,804 through June 30, 2019.
B) Adopt a resolution adjusting the fiscal year 2018-2019 final budget by increasing revenues and expenditures in the Department of Health Services by $1,135,535 to reflect receipt of California Department of Health Care Services revenue and associated expenditures. (4/5 vote required)
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Executive Summary:
In response to the Sonoma Complex Fires, the California Department of Health Care Services awarded two grants to the County of Sonoma to implement the Crisis Counseling Assistance and Training Program, with a total combined grant funding amount of $4,365,844. In addition, Kaiser Foundation Hospital Fund for Community Benefit Programs at the East Bay Community Foundation provided funding of $1,000,000 for the Program. This funding is being used to fund crisis counseling services through partner organizations, as well as to fund County staff and expenses required to manage the project. The Program is currently funded into April 2019.
Given the scale of destruction and the prolonged impact on many people affected by the fires, the Department is seeing a continued need for services in the community. Given this continued need, the Department worked with the California Department of Health Care Services to apply for a three-month extension of the Crisis Counseling Assistance and Training Program. In response, the Department has been awarded an additional $1,135,535 for the Program. The additional funding allows the Department to provide targeted outreach and intervention to highly-impacted survivors as they begin re-homing, and help mitigate the risk of developing Post-Traumatic Stress Disorder.
This item requests approval to execute amendments to agreements with four partner organizations to support an extension of Crisis Counseling Assistance and Training Program services in Sonoma County. Agreements with Council on Aging, Goodwill Industries of the Redwood Empire, Petaluma People Services Center, and West County Community Services will each be increased by $268,766, a total of $1,075,064, for the continued provision of Program services.
This item also requests approval of an adjustment to the fiscal year 2018-2019 final budget to increase revenues and expenditures in the Department of Health Services by $1,135,535 to reflect receipt of California Department of Health Care Services revenue and associated expenditures.
Discussion:
The Federal Emergency Management Agency’s Crisis Counseling Assistance and Training Program provides short-term disaster relief grants to states after a presidential major disaster declaration to support community-based outreach, counseling, and other mental health services to survivors of disasters. In response to the Sonoma Complex Fires, the California Department of Health Care Services awarded two grants to the County of Sonoma to implement the Crisis Counseling Assistance and Training Program, with a total combined grant funding amount of $4,365,844. In addition, Kaiser Foundation Hospital Fund for Community Benefit Programs at the East Bay Community Foundation provided funding of $1,000,000 for the Program. This funding is being used to fund crisis counseling services through partner organizations, as well as to fund County staff and expenses required to manage the Program.
Federal funding for the Crisis Counseling Assistance and Training Program was set to end January 29, 2019. With the additional funding from Kaiser, the Program is currently funded into April 2019. Given the scale of destruction and the prolonged impact on many people affected by the fires, the Department is seeing a continued need for services in the community. The Program is currently averaging over 3000 client contacts per month, and many of the clients are first time utilizers of these services. The Program continues to provide services to all who request them, with the need currently being greatest among those most directly impacted by the fires (people who lost homes, loved ones, pets). Many still addressing direct impacts from the fires experience a delayed reaction as a result of having to maintain a focus on activities such as the rebuilding process, and up to this point have not had time to seek emotional support services. For many, the build-up of emotions over time has become overwhelming. Increasing numbers of people are experiencing Post-Traumatic Stress Disorder symptoms.
Based upon the continuing need for services, the Department worked with the California Department of Health Care Services to apply for a three-month extension of the Crisis Counseling Assistance and Training Program (also known as HOPE - Helping, Outreach, Possibilities, Empowerment). In response, the Department has been awarded an additional $1,135,535 for the Program. The additional funding allows the Department to provide targeted outreach and intervention to highly-impacted survivors (those with a higher degree and proximity of loss who are at greater risk of developing Post-Traumatic Stress Disorder) as they begin re-homing, and help mitigate the risk of developing Post-Traumatic Stress Disorder.
Though the original population to be served by the Crisis Counseling Assistance and Training Program is anyone emotionally impacted by the fires, the definition of fire survivor is broad and encompasses the entire county. Given that residents of West county are now both fire survivors and flood survivors, the Department requested and received permission from the state and federal funding agencies to provide counseling services to individuals impacted by the recent floods at the Local Assistance Center established as a result of the floods. Crisis counseling teams continue to provide services to flood survivors and will do so until the program ends.
A majority of the new funding will fund amendments to agreements with four partner organizations to support an extension of Crisis Counseling Assistance and Training Program services in Sonoma County. Agreements with Council on Aging, Goodwill Industries of the Redwood Empire, Petaluma People Services Center, and West County Community Services will each be increased by $268,766, a total of $1,075,064, for the continued provision of Program services. Through these agreements, special attention has been given to target populations at higher risk for developing serious stress reactions including children and youth, parents and other caregivers, people with prior trauma, people with mental illness, people with a history of substance abuse, people with disabilities, the Latino community, and older adults. The Department has made services available in all areas of the County with teams dedicated to each region or area.
In addition to contracted program services, funding of $60,471 will be used to fund County staff and expenses required to manage the project through June 30, 2019. Grant funding for crisis counseling services, including funding from both the Federal Emergency Management Agency and Kaiser, is anticipated to total $6,501,379.
It is interesting to note that this is the first time the Federal Emergency Management Agency has granted an extension of a Crisis Counseling Assistance and Training Program for a wildfire. Past extensions have been limited to the events of September 11, 2001 and responses to larger hurricanes.
This item also requests approval of an adjustment to the fiscal year 2018-2019 final budget to increase revenues and expenditures in the Department of Health Services by $1,135,535 to reflect receipt of California Department of Health Care Services revenue and associated expenditures.
Crisis Counseling Assistance and Training Program Outcomes
In October 2017, during the initial phase of the program, 22 Sonoma County Behavioral Health staff were trained in the Crisis Counseling Assistance and Training Program model. This training included specialized behavioral health disaster intervention training. Since expansion to contracted services in March 2018, 43 additional contractor staff have received specialized training. Program outcomes are as follows (data current to December 31, 2018):
Individual Contacts (counseling contacts lasting 15 minutes or more)
- During the initial phase at the Local Area Assistance Center - 637
- From January through December 2018 in wider community - 1,536 Contacts (1,985 individuals)
Groups and Public Education Events (town halls, support groups, etc.)
- Total participants - 30,443
- During initial phase (October to December) - 26,002
- From January through December 2018 - 7,119
Brief Contacts (supportive contact lasting 15 minutes or less)
- Total in-person brief supportive contact (at shelters, tabling events, resource fairs, site and school re-entry, neighborhood events) - 40,549; including Immediate Services Program - 20,031 and Regular Services Program - 20,518
- Total telephone contacts by crisis counselors - 2,227; including Immediate Services Program - 1,375 and Regular Services Program - 2,092
- Hotline contacts - 3 (Immediate Services Program) and 36 (Regular Services Program)
- Total E-mail contacts - 1,930; including 8 (Immediate Service Program); 1,922 (Regular Services Program)
- Total community networking and coalition building contacts - 3,689; including Immediate Services Program - 410 and Regular Services Program - 3,279
Materials Distributed (brochures, tip sheets, resource guides, etc.)
- Total materials handed to people in-person - 29,713; including Immediate Services Program - 3,390 and Regular Services Program - 26,323
- Total materials mailed or left at people’s homes - 240; including Immediate Services Program - 26 and Regular Services Program - 214
- Total materials left in public places - 6,572; including Immediate Services Program - 402 and Regular Services Program - 6,170
- Total materials distributed by mass media (radio, TV, internet) - 278; including Immediate Services Program - 200 and Regular Services Program - 78
- Total materials distributed by social media/networking - 301; including Immediate Services Program - 128 and Regular Services Program - 173
The Federal Emergency Management Agency target for the Crisis Counseling Program is 9,677 contacts for each phase (Immediate and Regular). The Program team exceeded the first phase target considerably and also exceeded the second phase target as of July 31, 2018.
Prior Board Actions:
On September 11, 2018 the Board 1) approved a grant agreement with Kaiser Foundation Hospital Fund for Community Benefit Programs at the East Bay Community Foundation to accept $1,000,000 in revenue to support the Crisis Counseling Program for the period January 1, 2019 through September 30, 2019; 2) approved amendments to agreements with four partner organizations to support an extension of Crisis Counseling Assistance and Training Program services in Sonoma County, increasing each contract by $243,269 resulting in a new total not-to-exceed amount of $1,217,435 per contract, for a new combined total amount of $4,869,740 through June 30, 2019; and 3) adopted a resolution adjusting the fiscal year 2018-2019 final budget by increasing revenues and expenditures in the Department of Health Services by $1,000,000 to reflect receipt of Kaiser Foundation Hospital Fund for Community Benefit Programs at the East Bay Community Foundation grant revenue and associated expenditures.
On June 5, 2018 the Board approved amendments to agreements with four partner organizations to support implementation of the Crisis Counseling Assistance and Training Program - Immediate and Regular Services Programs in Sonoma County, increasing each contract by $178,006 resulting in a new total not-to-exceed amount of $974,166 per contract, for a new combined total amount of $3,896,664 through January 29, 2019.
On March 13, 2018 the Board approved agreements with four partner organizations to support implementation of the Crisis Counseling Assistance and Training Program - Immediate and Regular Services Programs in Sonoma County for the period March 13, 2018 through December 31, 2018 with a total amount not to exceed $3,184,640.
Fiscal Summary
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Expenditures |
FY 18-19 Adopted |
FY19-20 Projected |
FY 20-21 Projected |
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Budgeted Expenses |
0 |
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Additional Appropriation Requested |
1,135,535 |
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Total Expenditures |
1,135,535 |
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Funding Sources |
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General Fund/WA GF |
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State/Federal |
1,135,535 |
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Fees/Other |
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Use of Fund Balance |
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Contingencies |
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Total Sources |
1,135,535 |
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Narrative Explanation of Fiscal Impacts:
Revenues and expenditures of $1,135,535 will be added to the fiscal year 2018-2019 budget via the attached budgetary adjustment resolution.
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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:
Budget Resolution
Related Items “On File” with the Clerk of the Board:
None