To: Board of Supervisors of Sonoma County
Department or Agency Name(s): Department of Health Services
Staff Name and Phone Number: Barbie Robinson, 565-7876
Vote Requirement: Majority
Supervisorial District(s): Countywide
Title:
Title
Behavioral Health Crisis Stabilization Unit Staffing Allocations
End
Recommended Action:
Recommended action
Adopt a personnel resolution effective April 21, 2020 adding 4.00 full-time equivalent Behavioral Health Clinician allocations within the Department of Health Services.
end
Executive Summary:
The Department of Health Services operates a Crisis Stabilization Unit that provides critical mental health services including client assistance, crisis intervention, crisis stabilization, crisis residential treatment, and rehabilitative mental health services. The Crisis Stabilization Unit serves anyone in the County who is experiencing a behavioral health crisis. There are currently 12 beds within the Crisis Stabilization Unit, a number insufficient to meet the needs of a community as large as Sonoma County. Hospital emergency rooms are experiencing delays in transferring Medi-Cal recipients to the Crisis Stabilization Unit, and recipients are experiencing delay in receiving the care they need. In addition, law enforcement is being diverted from the Crisis Stabilization Unit to hospital emergency rooms more frequently, adding to the delay in care and congestion in the system. With the addition of the requested 4.00 full-time equivalent Behavioral Health Clinicians, the Crisis Stabilization Unit will be able to increase the number of beds to 16, allowing the County to more effectively meet the needs of the community.
Discussion:
The County currently operates a Crisis Stabilization Unit that provides critical mental health services including client assistance, crisis intervention, crisis stabilization, crisis residential treatment, and rehabilitative mental health services. The Crisis Stabilization Unit serves anyone in the County who is experiencing a behavioral health crisis. Due to financial constraints, the number of beds available at the Crisis Stabilization Unit dropped from 20 to 16 in July 2018 and from 16 to 12 in July 2019. The current number of beds within the Crisis Stabilization Unit is insufficient to meet the needs of a community as large as Sonoma County. Hospital emergency rooms are experiencing delays in transferring Medi-Cal recipients to the Crisis Stabilization Unit, and recipients are experiencing delay in receiving the care they need. In addition, law enforcement is being diverted from the Crisis Stabilization Unit to hospital emergency rooms more frequently, adding to the delay in care and congestion in the system.
With the addition of the requested 4.00 full-time equivalent Behavioral Health Clinicians, the Crisis Stabilization Unit will be able to increase the number of beds to 16, allowing the County to more effectively meet the needs of the community. The increased bed count will help to reduce the delays being experienced by hospital emergency rooms in transferring Medi-Cal recipients to the Crisis Stabilization Unit and will allow recipients to more quickly receive the care they need. In addition, the additional staff and associated increased bed count will enhance the Crisis Stabilization Unit’s capacity to accept individuals being brought in by law enforcement, thereby reducing the burden on local area hospital emergency rooms. Proper care being provided in a timely manner to individuals experiencing a mental health crisis will result in earlier stabilization and may allow for the utilization of less restrictive options for follow-on care. A reduction in costly acute inpatient hospitalizations is anticipated.
Additional staff will also increase the speed of assessing and discharging clients, which will result in a reduction in overstays and potentially increased revenue, and will result in a safer facility for staff and clients.
Primary Duties/Responsibilities of the Additional Behavioral Health Clinician
Behavioral Health Clinicians in the Crisis Stabilization Unit perform a variety of clinical functions including, but are not limited to, the following: clinical assessments; referral, case management, crisis intervention and stabilization, psychiatric evaluation, medication monitoring and support, rehabilitation, provide motivational counseling, and therapy. In addition, Behavioral Health Clinicians participate in in-service training, attend team/staff meetings and work on various committees and/or workgroups. These positions are considered critical in the County's Specialty Mental Health system of care, specifically the ability for the Department to properly assess the needs of those (primarily Medi-Cal beneficiaries) attempting to access the services offered by the Sonoma County Behavioral Health Division.
Prior Board Actions:
None
Fiscal Summary
|
Expenditures |
FY 19-20 Adopted |
FY 20-21 Projected |
FY 21-22 Projected |
|
Budgeted Expenses |
|
659,258 |
718,284 |
|
Additional Appropriation Requested |
178,652 |
|
|
|
Total Expenditures |
178,652 |
659,258 |
718,284 |
|
Funding Sources |
|
|
|
|
General Fund/WA GF |
|
|
|
|
State/Federal |
178,652 |
659,258 |
718,284 |
|
Fees/Other |
|
|
|
|
Use of Fund Balance |
|
|
|
|
Contingencies |
|
|
|
|
Total Sources |
178,652 |
659,258 |
718,284 |
Narrative Explanation of Fiscal Impacts:
Funds for these positions will be use of 1991 Mental Health Realignment, Medi-Cal Federal Financial Participation for additional billable service units. Additionally the Department will explore other funding opportunities. There are no additional FTE space needs or ISD costs as Crisis Stabilization Unit staff work in shifts and share resources.
|
Staffing Impacts: |
|
|
|
|
Position Title (Payroll Classification) |
Monthly Salary Range (A-I Step) |
Additions (Number) |
Deletions (Number) |
|
Behavioral Health Clinician |
6,290.93 - 7,645.82 |
4.00 |
0 |
|
|
|
|
|
Narrative Explanation of Staffing Impacts (If Required):
Requested staffing is intended to address staff deficiencies identified above. If approved, the Department of Health Services will work with Human Resources to fill these positions.
Attachments:
Personnel resolution
Related Items “On File” with the Clerk of the Board:
None