DATE: March 19, 2024
TO: Board of Supervisors
SUBMITTED BY: Susan L. Holt, Director, Department of Behavioral Health
SUBJECT: Budget Resolution Amendments
RECOMMENDED ACTION(S):
TITLE
1. Adopt Budget Resolution increasing the FY 2023-24 appropriations for the Providing Access and Transforming Health Program Fund 0041, Subclass 17131, PATH Justice-Involved Reentry Org 1083 in the amount of $14,000 for the implementation of behavioral health linkages for incarcerated individuals (4/5 vote);
2. Adopt Budget Resolution increasing the FY 2023-24 appropriations for the Behavioral Health Bridge Housing Program Fund 0041, Subclass 17132, BH Bridge Housing Grant Org 1084 in the amount of $8,792,105 for the immediate sustainable housing needs of people experiencing homelessness (4/5 vote);
3. Adopt Budget Resolution increasing the FY 2023-24 appropriations for the Crisis Care Mobile Units Program, Fund 0041, subclass 17133, Crisis Care Mobile Units Grant Org 1085 in the amount of $204,356 to implement and expand mobile crisis services (4/5 vote);
4. Adopt Budget Resolution increasing the FY 2023-24 appropriations for Local Health and Welfare Trust, Fund 0135, Subclass 13045, 1991 Realignment - Behavioral Health Org 5245 in the amount of $10,962,630 (4/5 vote);
5. Adopt Budget Resolution increasing the FY 2023-24 appropriations for Local Revenue Fund 0271, Subclass 13030, BH Realignment - Managed Care Org 5636 in the amount of $2,472,694 (4/5 vote);
6. Adopt Budget Resolution increasing the FY 2023-24 appropriations for Local Revenue Fund, Fund 0271, Subclass 13030, BH Realignment - EPSDT Org 5637 in the amount of $3,370,162 (4/5 vote); and
7. Adopt Budget Resolutions increasing the FY 2023-24 appropriations and estimated revenues for Department of Behavioral Health Org 5630 in the amount of $25,815,947 (4/5 vote).
REPORT
There is no increase in Net County Cost associated with the recommended actions, which will authorize the Department of Behavioral Health to bring in grant funding made available this fiscal year for specialty mental health and homelessness programs as well as unbudgeted Realignment revenues. This item is countywide.
ALTERNATIVE ACTION(S):
If the recommended actions are not approved, the Department would not be able to utilize funding for behavioral health justice-involved, homelessness, and mobile support programs.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The recommended actions one through six will increase FY 2023-24 special revenue fund appropriations as follows:
PATH Justice-Involved Reentry Org 1083 $ 14,000
BH Bridge Housing (BHBH) Grant Org 1084 $ 8,792,105
Crisis Care Mobile Units Grant Org 1085 $ 204,356
1991 Realign-Behavioral Health Org 5245 $10,962,630
BH Realignment - Managed Care Org 5636 $ 2,472,694
BH Realignment - EPSDT Org 5637 $ 3,370,162
Recommended action number seven will increase FY 2023-24 appropriations and estimated revenues for the Department of Behavioral Health Org 5630 ($25,815,947) using available revenues from the Orgs listed above.
DISCUSSION:
On November 7, 2023, your Board approved the Department of Behavioral Health’s application for the Providing Access and Transforming Health (PATH) Justice-Involved Capacity Building program relating to the implementation of the Statewide California Advancing and Innovating Medi-Cal Initiative. The PATH funds help implement behavioral health linkages for incarcerated individuals at the County Detention Facilities and the Juvenile Justice Campus (JJC).
On November 28, 2023, your Board approved Agreements 23-626 and 23-627 for Behavioral Health Bridge Housing (BHBH) grant funding for immediate sustainable housing needs of people experiencing homelessness. BHBH funds are provided under Assembly Bill 179 to operate bridge housing settings for individuals who have serious behavioral health conditions, including serious mental illness (SMI) and/or substance use disorder (SUD). When your Board approved the above agreements, the Department did not have a Special Revenue Fund (SRF) set up to accommodate the receipt of the grant funds. With this resolution, the Department will have established the proper spending authority to utilize the grant funds as they are received to the SRF which is now in place.
On January 23, 2024, your Board approved Agreements 24-039, 24-040, and 24-041 allowing the Department to adhere to new Department of Health Care Services (DHCS) mandated Medi-Cal Mobile Crisis Benefit Services. Crisis Care Mobile Units grant funds are utilized to implement and expand services to individuals experiencing behavioral health crises, including mental health crises, substance uses crises, or co-occurring mental health and substance use crises to individuals 25 and younger. These mandated changes have shifted the budgetary needs of the program such that the Department requires a budget resolution to account for the anticipated spending.
Approval of recommended actions one through three will increase FY 2023-24 appropriations to PATH, BHBH and CCMU grant Special Revenue Funds respectively. While approval of recommended actions four through six will increase FY 2023-24 appropriations for 1991 Behavioral Health Realignment as well as 2011 Behavioral Health Realignment for Managed Care and EPSDT, accounting for realignment growth. Recommended action number seven will authorize the transfer of Special Revenue Funds into the General Fund to cover the expenses of the Behavioral Health programs described above.
REFERENCE MATERIAL:
BAI #29, January 23, 2024
BAI #48, November 28, 2023
BAI #44, November 7, 2023
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Budget Resolution (Org 1083)
On file with Clerk - Budget Resolution (Org 1084)
On file with Clerk - Budget Resolution (Org 1085)
On file with Clerk - Budget Resolution (Org 5245)
On file with Clerk - Budget Resolution (Org 5636)
On file with Clerk - Budget Resolution (Org 5637)
On file with Clerk - Budget Resolution (Org 5630 from Org 1083)
On file with Clerk - Budget Resolution (Org 5630 from Org 1084)
On file with Clerk - Budget Resolution (Org 5630 from Org 1085)
On file with Clerk - Budget Resolution (Org 5630 from Org 5245)
On file with Clerk - Budget Resolution (Org 5630 from Org 5636)
On file with Clerk - Budget Resolution (Org 5630 from Org 5637)
CAO ANALYST:
Ronald W. Alexander, Jr.