DATE: September 25, 2018
TO: Board of Supervisors
SUBMITTED BY: Dawan Utecht, Director, Department of Behavioral Health
SUBJECT: Agreement with Community Health Improvement Partners
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to execute an Agreement with Community Health Improvement Partners, for Room and Board housing services for the Department of Behavioral Health, effective October 1, 2018 through June 30, 2023, which includes an approximate three-year base contract and two optional one-year extensions, total not to exceed $1,900,000.
REPORT
Approval of the recommended action will allow the Department of Behavioral Health (Department) to contract with Community Health Improvement Partnership (CHIP), to develop and implement an Independent Living Association (ILA) program for Fresno County. The ILA is a quality improvement program designed to expand the number of high quality independent living homes (room and boards) for individuals in need of housing who are seeking services of the Department. CHIP will provide all aspects of the ILA program and will work closely with room and board operators and the Department. The ILA program was developed through the Department’s community planning stakeholder process and will be included in the FY 2018-19 MHSA Annual Update, with no increase in Net County Cost.
ALTERNATIVE ACTION(S):
There is no viable alternative action. Should your Board opt not to approve the recommended action, it would eliminate the potential for increased capacity of independent living homes (room and boards) for homeless individuals seeking services provided by the Department. The 2017 MHSA Three-Year Plan clearly demonstrates the need for increased housing inventory and housing options for homeless or at risk of homelessness for individuals seeking Department services.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. The recommended agreement maximum for the remainder of FY 2018-19 is $333,333. As a new County contractor, startup funds in the amount of $70,000 have been requested by CHIP for startup costs related to office lease, automation equipment and staffing. Requested startup funds will not increase the recommended Agreement maximum and repayment of startup funds to the County will be included within CHIP’s monthly invoicing during the initial 12-month agreement period. The maximum compensation for the recommended agreement ($1,900,000) will initially be financed with Realignment funds and will be funded with MSHA funds for the remaining term of the agreement. Sufficient appropriations and estimated revenues are included in the Department’s Org 5630 FY 2018-19 Adopted Budget and will be included in future budget requests for the duration of the Agreement term.
DISCUSSION:
During the 2017 MHSA Three-Year Plan community program planning process, feedback from stakeholders clearly demonstrated the need for increased housing capacity and housing options for individuals living with a serious mental illness who utilize Department services. Further, the Department’s Housing Inventory and Needs Assessment identified a lack of available housing inventory for individuals utilizing Department services. The research also provided the Department with several recommendations to increase capacity of safe, stable affordable housing. The recommended Agreement aligns with the Housing Inventory and Needs Assessment recommendations by encouraging and supporting local room and board owners (operators) to improve the quality of their housing as well as expand their operations.
Recognizing the urgent need for quality housing for individuals seeking Department services, “Independent Living Associations (ILAs),” also referred to as unlicensed “room and boards” have been identified as a type of housing inventory that could hold promise in addressing this need. ILAs are privately owned homes that provide housing for extremely low-income individuals living with a severe mental illness or other disabling health condition. ILA’s serve residents that do not require medication management, are able to function without supervision and live independently. At times, operators of this type of housing may not understand or follow existing laws and regulations related to the operation of room and board housing. For this reason, the Department has established engaging operators of room and boards to be a part of a professional association that supports meeting quality housing standards and connects operators to available resources as an overall program goal of the recommended Agreement.
The process of engaging room and board operators will be accomplished with the assistance/guidance of the contractor (Community Health Improvement Partnership - CHIP). Working directly with room and board operators, CHIP will provide extensive hands-on training, resources and advocacy, leading to inclusion and membership of room and board operators within the ILA; a room and board quality improvement program. Room and board operators will gain membership to the ILA after successful completion of required training, passage of the ILA membership criteria and upon site visit approval by the ILA Peer Review and Accountability Team (PRAT), comprised of Contractor staff, individuals seeking Department services, family members, ILA tenants, and other community partners interested in supporting the Fresno ILA. Membership in the ILA demonstrates properties have been peer-reviewed and adherence to ILA improved quality housing standards. Recognition as an ILA member provides potential tenants, family members and the community with knowledge the ILA meets a higher standard of quality housing.
The County of Fresno Purchasing Manual stipulates that services which have been competitively bid by another agency may be procured via purchasing cooperatives. With concurrence of the County of Fresno Purchasing Division and County Counsel, the Department is requesting to procure the services of CHIP for operation of the ILA program, which was competitively bid and awarded by Alameda County, enabling the County of Fresno to leverage the pricing, terms and conditions from the Alameda County contract to Fresno County’s advantage.
The ILA is designed to expand housing opportunities for individuals seeking services provided by the Department. Key components of the program will include:
● Create a web-based ILA Website/Directory designed to provide individuals and family members with quality information about available, local independent living options;
● Create a system of oversight, support, coordination and ongoing quality improvement for ILA homes and operators;
● Improve the quality of life for ILA residents by improving quality housing standards;
● Increase the available inventory of ILA homes;
● To improve health outcomes for ILA residents by improving coordination/connection to critical services;
● To create sustainable housing solutions for ILA residents living in healthy, local, stable homes;
● To create positive partnerships between ILA members and community partners including code enforcement, Community Care Licensing, law enforcement and emergency responders;
● To create interventions for ILA residents that reduce utilization of Fresno County services and have ongoing support from community partners;
● Website/Directory to go live on or before June 30, 2019;
● By January 2020, CHIP will have produced an ILA standards and membership guide for Fresno County;
● By January 2021, CHIP will have at a minimum 20 ILA member homes;
With your Board’s approval, the recommended agreement would allow CHIP to provide technical assistance to room and board operators and the Department to create a sustainable ILA quality improvement program for Fresno County. The ILA would expand the number of high quality ILAs as well as develop core quality ILA building standards and improvements for extremely low-income individuals seeking Department services. The recommended agreement provides for termination due to non-allocation of funds upon giving a 30-day advance written notice to CHIP and provides for termination without cause by MHS, the Department Director, or designee, upon giving a 60-day advance written notice to terminate.
OTHER REVIEWING AGENCIES:
The Behavioral Health Board was made aware of the recommended agreement during the February 2018 meeting.
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Agreement
CAO ANALYST:
Ronald Alexander