DATE: March 5, 2024
TO: Board of Supervisors
SUBMITTED BY: Susan L. Holt, Director, Department of Behavioral Health
SUBJECT: Amendment I to Agreement with Fresno County Superintendent of Schools
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to execute First Amendment to Agreement with Fresno County Superintendent of Schools eliminating the Prevention and Outreach for Recognition strategies, effective July 1, 2024 with no change to the term of July 1, 2023 through June 30, 2025 and decreasing the maximum by $4,739,650 to a total of $74,775,612.
REPORT
There is no Net County Cost associated with the recommended action. The recommended action will eliminate the Prevention and Outreach for Recognition strategies and keep only Early Intervention services. The PEI component is funded through Mental Health Services Act (MHSA) and projections show a reduction due to state allocations. Reducing the service lines in the component will assist with fiscal sustainability and ensure services continue to be provided to youth throughout the County. This item is countywide.
ALTERNATIVE ACTION(S):
There is no viable alternative action. If the recommended action is not approved, the County Department of Behavioral Health would be at risk for fiscal sustainability for these services.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action, which decreases the maximum compensation by $4,739,650 to a total of $74,775,619, which is fully funded by MHSA and Medi-Cal Federal Financial Participation. Sufficient appropriations and estimated revenues will be included in the FY 2024-25 Recommended Budget for DBH Org 5630.
DISCUSSION:
On June 5, 2018, the Board executed agreement No. 18-208 with FCSS to expand PEI services to include the following:
• Trauma informed practices in the current PBIS schools
• PBIS training for preschools
• PEI screening and assessment and short-term treatment
• Training in suicide prevention practices
• Perinatal wellness and prevention strategies to increase mental health services to this population (0-5 years of age)
• Integration of mental health treatment staffing into the school-wide system
• Act as an access point to triage at-risk children and families into specialty mental health treatment services at the school setting
• Reducing barriers to access, by providing services to many more schools
• One Continuum of care for treatment and PEI to many more schools
• Seamless system of care that promotes a positive healthy environment
On June 20, 2023, the Board executed the supersede agreement No. 23-273 with FCSS to add the Department of Health and Care Services (DHCS) California Advancing in Medi-Cal (Cal AIM) initiative requirements. Through the partnership between FCSS and the Department, the goals of expanding mental health services, increasing awareness, reducing mental health stigma through outreach and training have been met.
However, the PEI component is funded with MHSA dollars and is a volatile funding source. County allocations are based on tax revenue in the three-year preceding cycle and allocations are forecasted to decrease. The Department has gone through a thorough review of current MHSA PEI funded programs to ensure MHSA funds are used in the most efficient and effective way. Due to meeting the goals to provide training and awareness across all of the schools within the County, the recommended action would continue only early intervention services with a focus of Medi-Cal beneficiaries. Services will be provided to all youth regardless of insurance coverage, with the intent to link youth to appropriate provider within six weeks.
OTHER REVIEWING AGENCIES:
The Behavioral Health Board was informed of the recommended action at its December 2023 meeting.
REFERENCE MATERIAL:
BAI #44, June 20, 2023
BAI #9, June 5, 2018
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Amendment I to Agreement with FCSS
CAO ANALYST:
Ronald W. Alexander, Jr.