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File #: 2019-0242   
Type: Consent Calendar Item Status: Agenda Ready
File created: 2/20/2019 In control: Health Services
On agenda: 9/24/2019 Final action:
Title: Crisis Counseling and Suicide Prevention Services
Department or Agency Name(s): Health Services
Attachments: 1. Summary Report

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: Majority

Supervisorial District(s): Countywide

 

Title:

Title

Crisis Counseling and Suicide Prevention Services

End

 

Recommended Action:

Recommended action

A) Authorize the Director of Health Services to execute agreements with two partner organizations to provide crisis counseling services for the period October 1, 2019 through September 30, 2020 with a total amount not to exceed $720,536.

B) Authorize the Department of Health Services to adjust their fiscal year 2019-2020 budget through the first quarter consolidated budget adjustments process to reflect receipt of a $1,000,000 state funding allocation.

end

 

Executive Summary:

In response to the Sonoma Complex Fires of October 2017, the County of Sonoma implemented a crisis counseling program through which several partner organizations provided counseling services to fire survivors, including targeted outreach and intervention to highly-impacted survivors who were in the process of re-homing and at risk of developing Post Traumatic Stress Disorder. In the winter of 2019, floods in Sonoma County further exacerbated stress impacts on survivors and the surrounding community. Program counselors assisted with emotional recovery efforts related to the floods as well. The program, which was in operation through June 30, 2019, was funded with Federal Emergency Management Agency funding of $5,501,379 and Kaiser Foundation Hospital funding of $1,000,000. Given the scale of destruction and the prolonged impact on the many people affected by the fires and floods, the Department is seeing a continued need for services in the community.

Given this continued need, the Sonoma County Board of Supervisors requested funding from the state, and as a result, the Department of Health Services received a $1,000,000 allocation to fund priority behavioral health services. This funding will be used for the following: 1) continuation of crisis counseling services through the re-branded program “HOPE Sonoma” (HOPE - Helping, Outreach, Possibilities, Empowerment) and 2) suicide prevention campaign and counseling services. Both programs will focus on highly-impacted survivors of the Sonoma Complex Fires and 2019 floods. In addition, unspent funding of $482,867 from a Kaiser Foundation Hospital Fund for Community Benefit Programs at the East Bay Community Foundation grant is available for the continuation of crisis counseling services through HOPE Sonoma.

This item requests approval to execute agreements with two partner organizations for the continuation of crisis counseling services for Sonoma County residents through the HOPE Sonoma program. Agreements with West County Community Services and Brief and Strategic Integrated Counseling Services, LLC, each in the amount of $360,268, for a total of $720,536, will provide for program services through September 30, 2020.

Health Services plans to release a request for proposals for suicide prevention services and will return to the Board following completion of the competitive procurement process to request approval of an agreement or agreements for these services. Remaining funding of $762,331 is available for suicide prevention services and County staff and expenses required to manage the programs.

This item also requests approval for Health Services to adjust their fiscal year 2019-2020 budget through the first quarter consolidated budget adjustments process to reflect receipt of a $1,000,000 state funding allocation.

 

Discussion:

HOPE Sonoma Crisis Counseling Services

In response to the Sonoma Complex Fires of October 2017, the County of Sonoma implemented a crisis counseling program through which several partner organizations provided counseling services to fire survivors, including targeted outreach and intervention to highly-impacted survivors who were in the process of re-homing and at risk of developing Post Traumatic Stress Disorder. In the winter of 2019, flooding in Sonoma County further exacerbated stress impacts on survivors, as many people who had been displaced by the fires relocated to West County, where they were once again displaced by the floods. Counselors responded to this growing need and delivered services at the Local Area Assistance Center, with continuing outreach and engagement to flood survivors in the following months. The program, which was in operation through June 30, 2019, was funded with Federal Emergency Management Agency funding of $5,501,379 and Kaiser Foundation Hospital funding of $517,133. During the last month of the program, over 1,000 client contacts were made, with many of these clients being first-time utilizers of services. Given the scale of destruction and the prolonged impact on the many people affected by the fires, the Department is seeing a continued need for services in the community.

Given the continued need for crisis counseling services, the Sonoma County Board of Supervisors requested $1,000,000 in disaster funding from the state to provide critical behavioral health services to community members that continue to struggle through the rebuild process. The state responded by providing funding in the amount requested to fund priority behavioral health services. This funding will be used for the following: 1) continuation of crisis counseling services through the re-branded program “HOPE Sonoma” (HOPE - Helping, Outreach, Possibilities, Empowerment) and 2) suicide prevention campaign and counseling services. Both programs will focus on highly-impacted survivors of the Sonoma Complex Fires. In addition, unspent funding of $482,867 from a Kaiser Foundation Hospital Fund for Community Benefit Programs at the East Bay Community Foundation grant is available for the continuation of crisis counseling services through HOPE Sonoma. The original grant from Kaiser was for $1,000,000 through September 30, 2019. An extension to the Kaiser grant was requested and approved by Kaiser on September 9, 2019, with a new grant term end date of June 30, 2020.

HOPE Sonoma will provide services to all who request them, with the anticipated need 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.

Health Services plans to execute agreements with two partner organizations for the continuation of crisis counseling program services for Sonoma County residents through HOPE Sonoma. Agreements with West County Community Services and Brief and Strategic Integrated Counseling Services (BASICS, LLC), each in the amount of $360,268, for a total of $720,536, will provide for program services through September 30, 2020. Given the specialized training and community networking involved with this program, the availability of the previous crisis counseling program team leads to facilitate the re-launch is a key deciding factor in selecting partner organizations. Two of the previous leads are available for the project (one of which has moved to a new organization, BASICS, LLC). West County Community Services will focus on the West-North-Central areas of the County and BASICS will focus on the South-Sonoma-Central areas. Through these agreements, HOPE Sonoma seeks to make 20,000 service contacts, with special attention given to target populations at higher risk for developing serious stress reactions, particularly high impact survivors in the re-homing/re-building process. Services will have an emphasis on individual/family encounters and group counseling, while also providing public education and brief supportive services. (The previous crisis counseling program, which ended on June 30, 2019, completed over 90,000 service contacts during the life of the program.) HOPE Sonoma will continue to have bilingual service capability.

Suicide Prevention Services

During post-disaster recovery period, it is not uncommon for grief and trauma responses to contribute to increased suicide risk. The World Health Organization has identified suicide as a major but preventable global public health issue. In 2017, 14 out of every 100,000 Americans died by suicide, according to a new analysis released by the Centers for Disease Control and Prevention’s National Center for Health Statistics. That represents a 33 percent increase since 1999, and the highest age-adjusted suicide rate recorded in the United States since 1942.

Suicide is the eighth leading cause of death and the fourth leading cause of premature death in Sonoma County. Locally, more individuals die from suicide than motor vehicle collisions (209 vs. 129 deaths, respectively, from 2015-2017). Sonoma County age-adjusted death rates from suicide are typically higher than California rates but lower than national rates. The Sonoma County three-year average age-adjusted suicide death rate for 2015 through 2017 was 12.3 per 100,000 people per year as compared to 10.4 per 100,000 people annually in California.

Health Services plans to release a request for proposals for suicide prevention services and will return to the Board following completion of the competitive procurement process to request approval of an agreement or agreements for these services. Funding of approximately $744,174 is available for suicide prevention services.

Additional Information

In addition to contracted program services, funding of approximately $18,157 will be used to fund County staff and expenses required to manage the new programs. Grant funding for crisis counseling and suicide prevention services related to the Sonoma Complex Fires, including funding from the Federal Emergency Management Agency, Kaiser, and the new $1,000,000 allocation from the state, now totals $7,501,379.

This item also requests approval for Health Services to adjust their fiscal year 2019-2020 budget through the first quarter consolidated budget adjustments process to reflect receipt of a $1,000,000 state funding allocation.

 

Prior Board Actions:

On July 23, 2019 the Board received an update on collaborative efforts to address suicide prevention from Health Services.

On April 16, 2019 the Board 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 $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.

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 and 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.

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

 Expenditures

FY 19-20 Adopted

FY 20-21 Projected

FY 21-22 Projected

Budgeted Expenses

482,867

 

 

Additional Appropriation Requested

1,000,000

 

 

Total Expenditures

1,482,867

0

0

Funding Sources

 

 

 

General Fund/WA GF

 

 

 

State/Federal

1,000,000

 

 

Fees/Other

482,867

 

 

Use of Fund Balance

 

 

 

Contingencies

 

 

 

Total Sources

1,482,867

0

0

 

Narrative Explanation of Fiscal Impacts:

Total funding of $1,482,867 will be spent as follows: crisis counseling services - $720,536; suicide prevention services - $744,174; and County staff - $18,157 (amounts are approximate). Funds not spent by the end of fiscal year 2019-2020 will be rolled over to fiscal year 2020-2021.

Health Services will request an adjustment to their fiscal year 2019-2020 budget through the first quarter consolidated budget adjustments process to reflect receipt of a $1,000,000 state funding allocation. Funding of $482,867 from the Kaiser Foundation Hospital Fund is included in the fiscal year 2019-2020 budget.

 

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:

None

 

Related Items “On File” with the Clerk of the Board:

None