DATE: May 6, 2025
TO: Board of Supervisors
SUBMITTED BY: Susan L. Holt, Director, Department of Behavioral Health
SUBJECT: Retroactive Amendment V to Agreement with Fresno County Superintendent of Schools - All 4 Youth Wellness Centers
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to execute retroactive Amendment V to Agreement with Fresno County Superintendent of Schools to allow expansion of school-based mental health and prevention and early intervention services, and reallocate $73,844 from FY 2023-24 to subsequent grant years, effective September 1, 2024, extending the term by one year from January 1, 2026 through December 31, 2027, and increasing the compensation maximum by $750,000 to a total of $8,369,403.
REPORT
There is no increase in Net County Cost associated with the recommended action. Approval of the recommended action will utilize the newly awarded grant funds from Mental Health Services Oversight and Accountability Commission (MHSOAC) to purchase mobile mental health units, hire a Quality Improvement and Sustainability (QIS) Coordinator, and reallocate funds from Grant Year (GY) 2023-24 to GY 2024-25 and GY 2025-26 to cover additional costs for unexpected repairs to the Wellness Centers due to routine wear. This item is countywide.
ALTERNATIVE ACTION(S):
Should your Board not approve the recommended action, the additional awarded grant funds would not be implemented to expand services, and the unspent funds from the prior year would not carryover to allow for unexpected repairs the existing Wellness Centers.
RETROACTIVE AGREEMENT(S):
The recommended agreement is retroactive to September 1, 2024. Annually MHSOAC requests a budget modification to the state agreement to properly reallocate any unspent funds to future grant years. Final approved budget modification was received November 4, 2024. The newly awarded grant funds were approved by your Board on December 17, 2024. The approved budget modification and new grant funds were used to develop the budgets in this Amendment. This item was brought before the board at the earliest date possible in accordance with internal Department review, contractor review and budget modification, and board agenda item review timelines.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. Approval of the recommended action will reallocate $73,844 in unspent funds from GY 2023-24 to GY 2024-25 and GY 2025-26 and increase the agreement maximum compensation by $750,000 to $8,369,403 which is funded by an additional Mental Health Student Services Act (MHSSA) grant. Sufficient appropriations and estimated revenues are included in the Department of Behavioral Health Org 5630 FY 2024-25 Adopted Budget and will be included in subsequent budget requests throughout the duration of the term of the Agreement.
DISCUSSION:
On June 5, 2018, your Board approved Agreement No. 18-308 with Fresno County Superintendent of Schools (FCSS) to provide Mental Health Services Act specialty mental health services and prevention and early intervention services to individuals aged 0-22 and their families, at school sites throughout the County. The goal of this integrated expanded treatment program (collectively referred to as the “All 4 Youth” Program) is to provide one school-based integrated system of care for the behavioral health needs of youth and their families. Services include individual and group therapy, intensive case management, rehabilitation, medication support, and other related mental health services.
In July 2019, the Governor signed Senate Bill 75 (Statutes of 2019, Chapter 75), which created the MHSSA to establish a mental health partnership between county mental health or behavioral health departments and local educational entities for the purpose of increasing access to mental health services in locations that are easily accessible to students and their families.
On December 12, 2019, the Request for Application (RFA) was released from the MHSOAC. The Department and the local education agency, FCSS, collaborated to develop a proposal.
On March 24, 2020, your Board approved the retroactive MHSSA grant application submission to the MHSOAC for the competitive grant opportunity for supplemental funds to the All 4 Youth Program.
On April 23, 2020, the MHSOAC announced the selection of the County as one of the counties awarded with the MHSSA grant.
On August 4, 2020, your Board approved Agreement No. 20-283 (State Agreement 19MHSOAC052) with the MHSOAC to receive competitive grant funds to be passed through to the local education agency and partner, FCSS, to implement the submitted proposal.
On April 13, 2021, your Board approved Agreement No. No. 21-111 with FCSS to implement the Wellness Center program to fund capital investments and expansion of the prevention and early intervention component in the All 4 Youth Program with the establishment of four Wellness Centers that are strategically placed throughout the County to increase mental health awareness and access.
On August 24, 2021, your Board approved Amendment I to Agreement No 20-283 (State Agreement 19MHSOAC052) with the MHSOAC, to move unspent funds to subsequent grant years and extend the term by one year from September 1, 2024 through August 31, 2025 with no change to the compensation maximum. Additionally, your Board also approved Amendment I to Agreement No. 21-111 with FCSS, to extend the term by one year from September 1, 2024 through August 31, 2025 with no change to the compensation maximum.
On April 18, 2022, the MHSOAC released a Request for Application for additional grant funding. Fresno County and FCSS worked collaboratively to develop and submit a proposal for two additional Wellness Centers and associated costs totaling $3,101,751.
On July 6, 2022, the MHSOAC announced the selection of the County as one of the counties awarded additional MHSSA funding in the amount of $1,619,403.
On March 14, 2023, your Board approved Amendment II to Agreement No 20-283 (State Agreement 19MHSOAC052) with the MHSOAC to reallocate unspent funds to subsequent grant years. Additionally, your Board approved Amendment II to Agreement No. 21-111 with FCSS, to expand services by building a new wellness center and extend the term by sixteen months from September 1, 2025 through December 31, 2026
On July 18, 2023, your Board retroactively approved Amendment III to Agreement No. 21-111 with FCSS, to reallocated unspent funds from previous Fiscal Year on to current and future years.
On May 7, 2024, your Board retroactively approved Amendment IV to Agreement No. 21-111 with FCSS, to reallocated unspent funds from GY 2022-23 to current and future years.
On May 16, 2024, the MHSOAC released a Request for Application for additional grant funding. Fresno County and FCSS worked collaboratively to develop and submit a proposal for marginalized and vulnerable youth, sustainability, other priorities, and associated costs totaling $1,250,000.
On August 12, 2024, the MHSOAC announced the selection of the County of Fresno as one of the counties awarded the additional MHSSA funding totaling $750,000. The County of Fresno was awarded for Other Priorities in the amount of $300,000 and Quality Improvement and Sustainability in the amount of $450,000 totaling $750,000.
On December 17, 2024, your Board approved the retroactive MHSSA grant application submission to the MHSOAC for the competitive grant opportunity for additional funds to the All 4 Youth Program. Your Board also approved Agreement No. 24-665 (State Agreement 24MHSOAC049) and Agreement No. 24-666 (State Agreement 24MHSOAC009) with the MHSOAC to receive additional grant funds to be passed through to FCSS to purchase mobile mental health units to serve rural areas of Fresno County and hire a Quality Improvement and Sustainability (QIS) Coordinator to lead quality improvement and sustainability plans for the All 4 Youth program.
Approval of the recommended action will extend the term of the agreement, reallocate unspent grant funds to future grant years, and expand school-based mental health and prevention and early intervention services in the current All 4 Youth Program. The funds would be used to purchase a mobile mental health unit and a passenger van. The mobile unit would serve Fresno County’s most high-need rural areas located in the Northern County boundary, which include the underserved students and families in Sierra Unified School District. The passenger van will serve all areas of Fresno County to address the county’s significant transportation needs by transporting families to medical appointments, basic services, and other activities that support mental health. The QIS Coordinator will conduct research to identify potential sources of funding that can be used to sustain All 4 Youth’s work and help develop a long-term sustainability strategy for Fresno County to access these identified sources of funding. Additionally, the Cultural Competency section will be revised to meet current requirements.
REFERENCE MATERIAL:
BAI #40, December 17, 2024
BAI #29, May 7, 2024
BAI #37, July 18, 2023
BAI #26, March 14, 2023
BAI #28, August 24, 2021
BAI #35, April 13, 2021
BAI #32, August 4, 2020
BAI #32, March 24, 2020
BAI #9, June 5, 2018
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Amendment V to Agreement with FCSS
CAO ANALYST:
Ronald Alexander