File #: 2022-0444   
Type: Consent Calendar Item Status: Passed
File created: 4/8/2022 In control: Health Services
On agenda: 8/30/2022 Final action: 8/30/2022
Title: Staffing Allocations - Homekey Cohort
Department or Agency Name(s): Health Services, Community Development Commission
Attachments: 1. Summary Report, 2. Attachment 1 - Personnel Resolution, 3. Attachment 2 - DHS-CDC Memorandum of Understanding, 4. Attachment 3 - IMDT Organizational Chart, 5. Attachment 4 - DHS Homelessness Division Organizational Chart

To: County of Sonoma Board of Supervisors and Board of Commissioners of the Community Development Commission

Department or Agency Name(s): Department of Health Services and Community Development Commission

Staff Name and Phone Number: Tina Rivera, 565-7876; Dave Kiff, 565-7504

Vote Requirement: Majority

Supervisorial District(s): Countywide

 

Title:

Title

Staffing Allocations - Homekey Cohort

End

 

Recommended Action:

Recommended action

A)                     Adopt a personnel resolution amending the allocation list for the Department of Health Services to add 6.00 full-time equivalent positions, and delete 1.00 full-time equivalent position, as detailed in the attached resolution, effective August 30, 2022.

B)                     Authorize the Director of Health Services, or designee, and the Executive Director of the Sonoma County Community Development Commission, or designee, to execute a memorandum of understanding facilitating payment by the Department of Health Services to the Sonoma County Community Development Commission for Housing Negotiator/Inspector support for the whole Interdepartmental Multi-Disciplinary Team in an amount not-to-exceed $438,765, including $27,000 for fiscal year 2020-2021, $238,000 for fiscal year 2021-2022 and $173,765 for fiscal year 2022-2023, for the period March 10, 2020 through June 30, 2023.

end

 

Executive Summary:

On August 31, 2021 the Board of Supervisors approved staff’s recommended action to work with cities, community-based organizations and the Continuum of Care Board on a collaborative county wide approach to supportive housing projects potentially funded by the State of California’s Project Homekey 2.0 funds and the next round of Homeless Housing Assistance and Prevention (HHAP-3) funding and to return with concepts for discussion on October 26, 2021. Due to the diverse and complicated social service, physical healthcare, and behavioral health needs of Homekey site populations, staff has identified a need to add a new team to work with the Interdepartmental Multi-Disciplinary Team (IMDT). The new team will focus on supporting the Homekey participants’ cohort. The Homekey team will develop trusting relationships and provide active assistance in accessing needed resources and supports, case management, treatment, and other appropriate services for Project Homekey participants through frequent contacts, a team approach, and a long-term commitment of support. This item recommends approval of four full-time equivalent position allocations to support implementation of a new IMDT Homekey Cohort. With these requested allocations supporting Homekey cohort, the Department of Health Services (DHS, or “the Department”) will collaborate with Sonoma County cities operating Homekey projects in Sonoma County (i.e., Rohnert Park, Santa Rosa, Petaluma, and Healdsburg).

Homekey staff will provide integrated care management to all participants residing at the County and City Homekey sites (Elderberry Commons, Mickey Zane Place, the anticipated future George’s Hideaway site, L&M Village, Labath Landing, Caritas Center, Montero Place, and Homeless Action Sonoma PSH). In addition, the Department is recommending deletion of an existing IMDT Public Health Investigator position allocation intended to provide infectious disease support, education, and prevention to the unsheltered community. This position is currently vacant and is no longer needed because adequate support in this role is provided using the IMDT expansion team Public Health Investigator.

Also, to support the IMDT’s Homeless Encampment Assistance Resource Team (HEART), staff proposes the addition of one full-time equivalent Senior Client Support Specialist allocation. This position will work to support collaborative outreach in local jurisdictions, as well as supporting collaborative efforts at non-County Homekey sites to provide IMDT case management services to residents.

In addition, one full-time equivalent Program Planning and Evaluation Analyst (PPEA) is requested to support the critical data and reporting needs of the IMDT, maximizing the Watson Care Manager Database and corresponding COGNOS 360 reporting portal. Similar to the IMDT Expansion team, this position is to be embedded within and works across the IMDT. The PPEA is a critical addition to the IMDT, as it commits staffing to oversee data quality, analysis, and reporting for all IMDT cohorts.

Using data from 07/01/21 through 06/06/22: 41 encampments were served with 56% in unincorporated jurisdiction and the remaining 44% in the cities. At these locations a total of 564 unsheltered people were served with 33% residing in unincorporated encampments and 67% residing in cities. The Homekey team was originally presented at a City Managers meeting with positive feedback and discussion. A follow up survey was given to local Homekey site operators with 5 respondents representing Reach for Home, West County Community Services, Committee on the Shelterless, Burbank, and Rohnert Park City. All respondents acknowledged Homekey team benefits, a desire for county providers to “come to them” rather than integrating with county teams, and a need for supporting high behavioral health, physical health, substance use disorders, and legal assistance.

Finally, this item requests approval of a memorandum of understanding (MOU) to facilitate payment by the Department of Health Services to the Sonoma County Community Development Commission for Housing Negotiator/Inspector support for the IMDT. The Housing Negotiator/Inspector was initially created on March 10, 2020 in response to the Joe Rodota Trail Encampment Emergency. An extension of the position to June 30, 2023 was recently approved by the Board on May 3, 2022. Staff assigned to the Community Development Commission will provide support to the IMDT and will be managed by the IMDT supervisor.

 

Discussion:

California has a homelessness crisis. California has an estimated 151,000 people experiencing homelessness, accounting for almost half (47 percent) of the homeless population in the United States. In the 2018 Point in Time Homeless Count, Sonoma County was among the top three suburban counties in America. Sonoma County is 77 percent higher in per capita homelessness by Continuum of Care (CoC) category than the next highest suburban county in America. The 2022 Homeless Count found a five percent increase over the 2020 count that showed 2,893 persons experienced homelessness on one night in wintertime. Like other jurisdictions throughout California, high housing costs, low vacancy rates, and displacements due to the recent wildfire disasters are contributory factors to the high rates of homelessness in Sonoma County.

Homelessness is a complex, dynamic, and all-consuming crisis for those experiencing it. Local jurisdictions like Sonoma County have provided most of the homeless assistance in our jurisdictions, relying in part on County General Fund and federal and state funding.

For the last two years, the state has made its largest one-time investments in combatting homelessness in state history. The Homeless Emergency Aid Program (HEAP) and the Homeless, Housing Assistance Program (HHAP) have in combination allocated $1.15 billion in flexible funds to local governments. Despite these investments, Sonoma County and other local jurisdictions are still faced with gaps in services, sheltering, and housing resources that are desperately needed to address the County’s homeless crisis.

Currently in Sonoma County there are approximately 3,000 individuals experiencing homelessness. Since 2011, the number of individuals experiencing homelessness in Sonoma County has been reduced by 1,500. Sonoma County, our cities, and non-profit partners have made some progress, including over the last three years successfully housing more than 3,000 individuals.

The Interdepartmental Multi-Disciplinary Team (IMDT) and ACCESS Sonoma Initiative have been a key component in the County’s response in addressing homelessness. The IMDT is a care coordination and advisory team of subject matter experts of frontline staff across multiple departments and programs that develops integrated care plans through collaborative planning of individualized goal setting for participants. The IMDT Homekey team discussed here will be a key component of the County’s response to the homelessness crisis and a critical addition to the IMDT cohorts, conducting outreach and engagement into services, supporting those on a pathway into, and residing at, the Project Homekey sites.

To date, the COVID cohort staff have provided outreach, referral, and intensive case management for all staying at the Non-Congregate Shelters (NCS) set up in response to COVID. This includes providing support in transitioning NCS guests to Project Homekey sites (Elderberry Commons and Mickey Zane Place) and providing integrated care management services to all residing there. The team has supported participants in accessing an array of services and public benefits, including Emergency Housing Vouchers (over 30 to date), the Housing Authority Waitlist Lottery and other shelter and housing options. As the NCS programs cease, the COVID cohort will likewise be ceasing operations as we transition focus to the Homekey cohort.

The proposed Homekey Cohort, consisting of four staff from Health Services, will perform a critical role in supporting the County Project Homekey Participants (Mickey Zane Place, Elderberry Commons, George’s Hideaway), as well as at non-County Homekey sites including, but not limited to, Rohnert Park, Petaluma, and Healdsburg. The new Homekey Cohort will combine qualified County expertise with city contacts to approach high-level behavioral health and case management needs via a region-wide team, supporting the County and City Homekey sites. This multidisciplinary intervention will offer collaborative case management, peer support, access to care, and supplementary community services and supports. This wraparound service approach is key to improving health outcomes and housing stability for homeless individuals and families. The Homekey Cohort will be housed in the new Homelessness Services Division at Health Services as approved by the Board in June 2022 and will report to the IMDT Health Program Manager, who will report to the Division Director. The Homelessness Division Organization Chart can be found on Attachment 4.

The Homekey cohort, similar to HEART and other IMDT cohorts, will include social workers, substance abuse counselors, employment specialists, outreach workers, family coordinators, and others. This cohort will coordinate and liaise with city contacts and community providers. The goal of the cohort will be the development of trusting relationships, active assistance in accessing needed resources and supports, case management, treatment, and other appropriate services for Homekey participants through frequent contacts, a team approach, and a long-term commitment of support as needed. This Homekey team will coordinate the care plans and service goals for Homekey cohort participants. As Homekey focuses on sheltering Sonoma County’s vulnerable homeless population, this cohort will engage with those receiving housing at these sites, stabilizing individuals, linking them to vital resources that address their mental health, addictive disorder, employment, food and benefit needs creating cost efficiencies for larger systems such as emergency rooms and criminal justice systems.

In addition to the Homekey cohort, the Department is requesting the addition of one full-time equivalent Senior Client Support Specialist to work in close partnership with local jurisdictions in encampment outreach coordination, as well as connect IMDT support at non-County Homekey sites. The Department plans to enter into an MOU with the jurisdictions to confirm the relationship and role this position will take, as well as reporting, supervision, and other such aspects of the collaborative relationship to support Countywide Homekey programs.

In connection to the Homekey cohort, the Department is proposing deletion of one full-time equivalent Public Health Investigator allocation, which is currently vacant. Deletion of this allocation will offset costs associated with the requested Homekey cohort allocations.

Finally, the requested full-time equivalent Program Planning and Evaluation Analyst allocation will report to the Homelessness Services Division Director of Health Services. This position will provide supportive research, planning, program development, program monitoring, and outcome analysis for all ACCESS Sonoma’s current and future cohorts, grants, contracts, and other assignments designated by the Homelessness Services Division Director. This position will also support the health program managers (Homeless Encampment Assistance and Resource Team, and the IMDT Expansion Team) with developing program policies and procedures to ensure effective implementation of new and existing programs.

Position Funding Information:

Position

Cohort/ Unit

FTEs

FY 22-23 Cost ($)*

HHAP Round 1 & 2

Measure O

Behavioral Health Clinician

Homekey

1.00

$214,742

$214,742

$0

Alcohol and Other Drug Counselor II

Homekey

1.00

$188,788

$5,255

$183,533

Senior Client Support Specialist

Homekey

1.00

$176,093

$0

$176,093

Senior Office Assistant

Homekey

1.00

$152,440

$12,065

$140,375

Program Planning and Evaluation Analyst

IMDT Data

1.00

$214,481

$0

$214,481

Senior Client Support Specialist

IMDT HEART

1.00

$171,344

$0

$171,344

Public Health Investigator

IMDT HEART

(1.0)

($164,280)

$0

($164,280)

 

 

6.00

$953,608

$232,062

$721,546

* FY 22-23 costs are comprised of salary, benefits, and costs associated with labor.

In addition to the aforementioned staffing, this item requests approval of a memorandum of understanding to facilitate payment by the Department of Health Services to the Sonoma County Community Development Commission (CDC) for Housing Negotiator/Inspector support for the Interdepartmental Multi-Disciplinary Team. Leased Housing Negotiator-Inspector Staff from the Community Development Commission are assigned to and provide support to the IMDT and will be managed by the IMDT supervisor. The proposed MOU memorializes that agreement and details reimbursement, reporting, and supervision for the roles. The MOU would affirm the Housing Negotiator/Inspector support for the IMDT and Health Services’ reimbursement to CDC in an amount not-to-exceed $438,765, including $27,000 for fiscal year 2020-2021, $238,000 for fiscal year 2021-2022, and $173,765 for fiscal year 2022-2023. MOU funding reflects current and prior Housing Negotiator/Inspector staff under the IMDT in fiscal year 2020-2021 and fiscal year 2021-2022, as well as continuation of funding for IMDT-Expansion Navigation staff during fiscal year 2022-2023.

This report recommends 1) approval to add four new Homekey Cohort position allocations, 2) approval of a Program Planning and Evaluation Analyst position allocation, 3) approval to delete an existing Public Health Investigator position allocation, 4) approval of a Senior Client Support Specialist position allocation under HEART and 5) approval of a memorandum of understanding facilitating payment by Health Services to the Community Development Commission for IMDT Housing Negotiator/Inspector support.

 

Strategic Plan:

Implementation of this item will assist in achieving several goals and objectives of the Healthy and Safe Communities pillar of the Strategic Plan. Sonoma County has utilized the ACCESS Sonoma’s Interdepartmental Multi-Disciplinary Team (IMDT) technology, infrastructure, and its specialized cohorts of staff to effectively respond to and support those experiencing homelessness, conducting outreach, engagement and case management. This investment to support our impacted community is designed to, and proven effective at, streamlining access, improving service integration, and bolstering opportunities for coordination of care. In addition, this item will provide for new and innovative responses to homelessness, addressing gaps in services that have not supported the most vulnerable or otherwise un-inclined to accept traditional shelter services. The work presented below reflects both existing and potential for future expanded efforts of the IMDT. The IMDT is poised to implement these efforts, continuing progress in attaining the goals and objectives of the plan.

This item directly support the County’s Five-year Strategic Plan and is aligned with the following pillar, goal, and objective.

Pillar: Healthy and Safe Communities

Goal: Goal 1: Expand integrated system of care to address gaps in services to the County’s most vulnerable.

Objective: Objective 3: Create a “no wrong door” approach where clients who need services across multiple departments and programs are able to access the array of services needed regardless of where they enter the system.

 

Pillar: Healthy and Safe Communities

Goal: Goal 4: Reduce the County’s overall homeless population by 10% each year by enhancing services through improved coordination and collaboration.

Objective: Objective 3: Increase investment in programs that treat underlying causes of homelessness, including substance abuse, mental illness, poverty, and lack of affordable housing.

 

Prior Board Actions:

On May 24, 2022 the Board A) Received staff recommendation to move the Community Development Commission’s (CDC) Ending Homelessness team to the Department of Health Services (DHS) under a new Homelessness Services Division, and direct staff to return during the June budget hearings with more financial details for consideration of the proposed reorganization; and B) Received an update on the implementation of recommendations presented in the April 20, 2021 consultant report: Improving Integration & Outcomes to Benefit County Residents: Assessment of Housing and Homeless Services and Programs.

On May 3, 2022 the Board adopted a personnel resolution amending the allocation lists for the departments of Health Services and Human Services, and the Sonoma County Community Development Commission to extend 10.00 full-time equivalent time-limited positions for the HEART Expansion Team to June 30, 2023, as detailed in the attached resolution, effective May 3, 2022.

On December 7, 2021 the Board authorized staff to enter into agreements to award the recommended funding levels to the recommended recipients who proposed projects within the recent Notice of Funding Availability for24/7 Safe Parking Locations and/or Indoor Outdoor Non-Congregate Shelters; and directed staff to return back to the Board with an update as to these projects.

On October 26, 2021 the Board A) Adopted resolution approving the Supportive Services Funding Framework and Early Capital Match for Project Homekey’s Round 2 (and if applicable Round 3); B) Adopted a resolution authorizing staff to apply for a George’s Hideaway project (located at 18084 Highway116 west of Guerneville) under Project Homekey-2; C) Approved the use of Measure O funding up to $500,000 to establish a Project Homekey Cohort under the County’s ACCESS Program to provide high-level behavioral health and other services to clients served in Project Homekey facilities; and D) Directed staff to study further and determine an operational partner for a Project Homekey-2 Redwood Inn project (located at 1670 Santa Rosa Avenue in unincorporated Santa Rosa) that may include an element for Transition Aged Youth (TAY). This may include a 5-year master leasing opportunity.

On August 31, 2021 the Board A) Directed staff to work with interested cities and community-based organizations as well as pursue county-led projects in partnership with local service providers through a Letter of Intent (LOI) process to be released on September 13, 2021 and to return to your Board with a recommendation and proposals to use up to $2M to assist in the funding for one or more overnight or 24/7 Safe Parking proposals and/or Indoor-Outdoor non-congregate shelter proposals. The Board recommended that staff present summaries of the proposals to the Continuum of Care (CoC) Board for consultation and input in advance of returning to the Board of Supervisors; and B) Directed staff to work with cities, community-based organizations and the Continuum of Care Board on a collaborative county wide approach to supportive housing projects potentially funded by the State of California’s Project Homekey 2.0 funds and the next round of Homeless Housing Assistance and Prevention (HHAP-3) funding and to return with concepts for discussion.

On March 10, 2020 the Board of Supervisors and Board of Commissioners of the Community Development Commission approved a number of actions including A) approved staff’s recommendation to expand the ACCESS Sonoma County Initiative to add a permanent Intensive Care Team to respond to homeless encampments and B) adopted a resolution amending the allocation list for the departments of Health Services and Human Services, and the Community Development Commission adding 10.00 full-time limited term equivalent positions effective March 10, 2020 and ending on June 30, 2022.

 

Fiscal Summary

 Expenditures

FY 22-23 Adopted

FY 23-24 Projected

FY 24-25 Projected

Budgeted Expenses

 

$982,220

$1,011,700

Additional Appropriation Requested

$953,608

 

 

Total Expenditures

$953,608

$982,220

$1,011,700

Funding Sources

 

 

 

General Fund/WA GF

 

 

 

State/Federal

$276,398

$284,700

$293,300

Fees/Other

 

 

 

Use of Fund Balance

$677,210

$697,500

$718,500

Contingencies

 

 

 

Total Sources

$953,608

$982,220

$1,011,700

 

Narrative Explanation of Fiscal Impacts:

Funding for the requested position extensions and new positions for salary, benefits, and staff associated costs are $953,608 for FY 2022-23 and going forward with COLA. Of the $953,608, $232,062 will be funded by the Homeless Housing, Assistance and Prevention Grant (HHAP) award received on 08/27/2020; and $721,546 will be funded by Measure O. Appropriations for the positions will be added during 1st Quarter Budget Adjustments.

The appropriations for the position associated with the CDC MOU was included in the 5/3/2022 board item titled “Interdepartmental Multi-Disciplinary Team Staffing Extensions” and was included in the department’s supplemental FY 2022-23 budget request.

 

Staffing Impacts:

 

 

 

Position Title (Payroll Classification)

Monthly Salary Range (A-I Step)

Additions (Number)

Deletions (Number)

Behavioral Health Clinician

$6,791.84 - $8,254.56

1.00

0.0

AODS Counselor II

$5,765.67 - $7,009.24

1.00

0.0

Senior Client Support Specialist

$5,186.49 - $6,304.84

2.00

0.0

Senior Office Assistant

$3,916.83 - $4,760.37

1.00

0.0

Public Health Investigator

$4,991.70 - $6,068.30

0.0

-1.00

Program Planning and Evaluation Analyst

$6,572.69 - $7,988.45

1.00

0.0

 

Narrative Explanation of Staffing Impacts (If Required):

If new positions are approved, the Department will work with Human Resources to fill the new positions. The proposed deletion is for a currently vacant Public Health Investigator (PHI) allocation. IMDT has two existing PHI staff and feels that these roles cover the needs in that regard, supporting the deletion and shift resources to Homekey cohort.

 

Attachments:

Attachment 1 - Personnel Resolution

Attachment 2 - DHS-CDC Memorandum of Understanding

Attachment 3 - IMDT Organizational Chart

Attachment 4 - Homelessness Division Organizational Chart

 

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

None