To: County of Sonoma Board of Supervisors
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
Mobile Support Team Expansion Allocations
End
Recommended Action:
Recommended action
Adopt a personnel resolution amending the Department of Health Services allocation list, effective November 10, 2020, to add 8.00 full-time equivalent permanent positions.
end
Executive Summary:
This items seeks the approval of a personnel resolution to add eight (8.00) full-time equivalent permanent positions for the expansion of the Mobile Support Team to allow for coverage on weekends and the addition of a team to respond to the northern areas of the county, including Cloverdale and Healdsburg. During the fiscal year 2020-2021 adopted budget process, the Board of Supervisors made the decision to allocate $5,500,000 over three years from available PG&E settlement funds for the expansion of the program. Existing Behavioral Health revenue is not available to fund the Mobile Support Team Expansion unless the Department makes reductions in other Behavioral Health programs.
Note: During FY 20/21 budget hearings the Board provided 3-years of PG&E funds for the expanded Mobile Support Team positions within the DHS department. The MST positions were 8 of 18.5 positions throughout the organization funded with 3-years of PG&E funds by the Board. Appropriations were included in the approved FY 2020-21 Budget for these positons. Although the addition of the new MST positions do not have a defined funding source in future budgets, the new positions are critical to expand the hours and service area of the MST and therefore is being recommended for funding notwithstanding that the Department will need to find additional funding support in the future for the MST positions when the 3-year funding expires on June 30, 2023.
Discussion:
The County of Sonoma’s Mobile Support Team provides mobile crisis alongside law enforcement in order to assist law enforcement and community members in finding appropriate solutions to mental health crisis situations. Mobile Support Team staff consists of licensed clinicians, post-graduate clinical interns, and certified alcohol and drug abuse counselors. In addition, the Mobile Support Team adds an innovative family and peer component to the team by contracting with community organizations who provide family support and education, peer support, and a connection to other peer run services throughout the county.
The Mobile Support Team program was developed in response to the community planning process held by Sonoma County Behavioral Health to discuss use of Mental Health Services Act funds in the county. There was significant interest in the community in the coordination, collaboration, and training to law enforcement on behavioral health issues, and in providing a behavioral health presence in the field to work with law enforcement when responding to individuals experiencing a psychiatric crisis. The Mobile Support Team began in September 2012 in the cities of Santa Rosa and Windsor. In 2015, the program expanded to cover Rohnert Park, Cotati, and Petaluma, and then expanded again in 2019, to cover West County and the Sonoma Valley.
When law enforcement determines that a call is mental health and/or substance use related, the Mobile Support Team is called to respond. Staff assess the needs of the individual and family, and provide information, referrals, and assistance in connecting to treatment and other community services. Staff can write involuntary holds for psychiatric treatment if necessary, but often are able to develop plans with individuals that will allow them to remain safely in the community and access resources on a voluntary basis. Plans may involve calling in friends or family members, accessing immediate resources such as shelter beds, Adult Protective Services, Child Protective Services, detox, and making arrangements to meet with doctors, therapists, or other treatment providers the next day.
Follow-up phone calls and/or home visits by Mobile Support Team staff, as well as peer and family providers, help to ensure that people are getting connected to the treatment and services they need. These follow-up efforts can decrease the likelihood of future law enforcement contacts, and encourage people to access available supports in the community.
Currently, the Mobile Support Team is staffed by 4.00 full-time equivalent licensed and licensed eligible clinicians, 1.00 full-time equivalent Alcohol and Other Drug Services Counselors, 1.00 full-time equivalent Alcohol and Other Drug Services Specialist, 1.00 full-time equivalent Behavioral Health Clinical Specialist and 0.10 full-time equivalent of a Clinical Care Manager. County staff are also supported by contracts with community-based organizations - SOS Community Counseling, NAMI Sonoma County, and West County Community Services. These community partners provide additional clinical staffing, as well as peer and family support, as needed.
The expansion of the program will require the addition of a 0.25 Section Manager, 1.00 Health Program Manager, 0.25 Administrative Aide, 5.50 full-time equivalent Behavioral Health Clinicians, and 1.00 full-time equivalent Senior Office Assistant.
The new positions will fulfill the following roles:
- The Section Manager will provide oversight of the program budget, goals, performance, and outcomes. This position will be responsible for monitoring and contracts associated with the Mobile Support Team program. This position will also maintain collaborative working relationships with partner programs and community agencies.
- The Health Program Manager will be responsible for all aspects of the Mobile Support Team program, including hiring, training, and supervising staff, interacting with contractor and community partners. Tracking and reporting program data, ensuring shifts are adequately staffed, facilitating team meetings as well as meetings with community organizations and partners, and maintaining excellent collaborative relationships with community partners.
- The Administrative Aide will be responsible for creating reports of program data and performance outcome measures, assisting the Section Manager in managing contracts, and providing support to the Section Manager and Health Program Manager in scheduling meetings, creating agendas, and taking minutes.
- The Behavioral Health Clinicians will respond to requests for Mobile Support Team services, respond to calls in the field, conduct clinical and risk assessments of individuals, gather collateral information as available, make informed clinical decisions about the best response, connect clients to needed resources and services, write involuntary holds if needed, partner with law enforcement and other community members in providing excellent services to clients, maintain accurate and timely clinical documentation of services, and provide follow-up support to clients as direction by the Clinical Specialist and/or Health Program Manager.
- The Senior Office Assistant will be responsible for making paper charts, as needed, filing, faxing, and managing the flow of paperwork necessary for the efficient and effective functioning of the team, ordering supplies for the team, answering the phone and directing calls as appropriate, and providing other clerical support to the team as needed.
Currently the Mobile Support Team staff work from 1 pm to 9 pm, Monday through Friday, and cover the areas of Windsor, Santa Rosa, Rohnert Park, Cotati, Petaluma, Penngrove, Sonoma Valley, and the West County. The expansion of these services will allow an additional team to be added to cover the areas of Healdsburg and Cloverdale. In addition, Saturday and Sunday eight-hour shifts will be added.
The current goals of the Mobile Support Team are to provide interventions to individuals experiencing a psychiatric crisis in order to find solutions to the crisis that are person- and family-centered, provide safety, and result in the least restrictive alternative possible. Staff strive to reduce the number of people going to jail or hospital, and to connect individuals and family members to treatment and support services in the community.
With this expansion, the Mobile Support Team will expand our geographical coverage areas, and the hours and days we are available to respond to calls. We will also begin to add the ability to respond to calls without law enforcement. This will allow law enforcement to direct its resources and time on other matters of community safety, and will allow us to respond to situations prior to the need rising to a level of needing law enforcement intervention. This earlier intervention should result in more significant reductions in jail and hospital visits, and greater likelihood of getting individuals connected to community treatment and support resources.
The Emergency Medical Services Ad Hoc Committee established by the Board of Supervisors will be assessing the best models for crisis response including opportunities to partner with emergency medical providers. Under the direction of the Emergency Medical Services Ad Hoc Committee, the department will convene community partners including law enforcement and other first responders to identify approaches and models to strengthen our mobile crisis service models. The Department will provide the information and feedback from the community to the Emergency Medical Services Ad Hoc Committee for consideration.
Prior Board Actions:
N/A
Fiscal Summary
|
Expenditures |
FY 20-21 Adopted |
FY 21-22 Projected |
FY 22-23 Projected |
|
Budgeted Expenses |
1,500,000 |
2,000,000 |
2,000,000 |
|
Additional Appropriation Requested |
|
|
|
|
Total Expenditures |
1,500,000 |
2,000,000 |
2,000,000 |
|
Funding Sources |
|
|
|
|
General Fund/WA GF |
|
|
|
|
State/Federal |
|
|
|
|
Fees/Other |
1,500,000 |
2,000,000 |
2,000,000 |
|
Use of Fund Balance |
|
|
|
|
Contingencies |
|
|
|
|
Total Sources |
1,500,000 |
2,000,000 |
2,000,000 |
Narrative Explanation of Fiscal Impacts:
During the FY 20-21 adopted budget process, the Board of Supervisors made the decision to allocate $5,500,000 one-time discretionary funding over three years for the expansion of the program. This breaks down to $1,500,000 for FY 20-21, $2,000,000 for FY 21-22, and $2,000,000 for FY 22-23. The existing Mobile Support Team program is currently funded through a state grant, Mental Health Medi-Cal Administrative Activities reimbursement, and funding through the Mental Health Services Act.
Funding allocation from the state grant is capped and the Mental Health Service Act funds are not available unless the Department makes reductions in other Behavioral Health programs funded with the Mental Health Service Act funds.
The Mental Health Medi-Cal Administrative Activities reimbursement for the Mobile Support Team Expansion program is unknown at this time. Once the Mobile Support Team Expansion program is fully implemented, we anticipate that the Mobile Support Team Expansion program will leverage minimal federal dollars through outreach, as it not considered a mental health treatment. The Department will include the additional Mental Health Medi-Cal Administrative Activities reimbursement in its revenue appropriations when sufficient information is available to arrive at a reasonable estimate.
|
Staffing Impacts: |
|
|
|
|
Position Title (Payroll Classification) |
Monthly Salary Range (A-I Step) |
Additions (Number) |
Deletions (Number) |
|
Administrative Aide |
4,713 - 5,729 |
0.25 |
0.0 |
|
Behavioral Health Clinician |
6,481 - 7,877 |
5.50 |
0.0 |
|
Health Program Manager |
7,341 - 8,924 |
1.00 |
0.0 |
|
Section Manager |
9,921 - 12,057 |
0.25 |
0.0 |
|
Senior Office Assistant |
3,738 - 4,541 |
1.00 |
0.0 |
Narrative Explanation of Staffing Impacts (If Required):
These are all new positions and the Department will work with the Human Resources Department to begin the recruitment process for the positions listed in this item as soon as the position allocations become effective.
Attachments:
Personnel Resolution
Related Items “On File” with the Clerk of the Board:
None