DATE: June 22, 2021
TO: Board of Supervisors
SUBMITTED BY: Dawan Utecht, Director, Department of Behavioral Health
SUBJECT: Retroactive State Application / Agreement for Substance Abuse and Mental Health Services Administration Community Mental Health Services Block Grant
RECOMMENDED ACTION(S):
TITLE
1. Approve and authorize the Chairman to execute a retroactive Application / Agreement with the California Department of Health Care Services for Substance Abuse and Mental Health Services Administration Community Mental Health Services Block Grant funds for dual diagnosis mental health services in licensed residential board and care facilities, effective July 1, 2020 through June 30, 2021 ($5,000,000); and,
2. Approve and authorize the Director of the Department of Behavioral Health, or designee, as signatory on behalf of the Board of Supervisors on associated grant agreement documents, expenditure forms and reports, with no change to the compensation amount or term.
REPORT
On July 31, 2020, the Department of Behavioral Health submitted a placeholder application, signed by the Director due to the short turnaround period, for the California Department of Health Care Services (DHCS) annual Federal Substance Abuse and Mental Health Services Administration (SAMHSA) Community Mental Health Services Block Grant (MHBG). Approval of the recommended actions will allow the Department to resubmit the application / agreement replacing the placeholder for licensed residential board and care facility placement funds for adults with serious mental illness (SMI), with no county match. The recommended actions will allow the Director to sign grant documents, expenditure forms, and reports on behalf of your Board, without changing the maximum or term. This item is countywide.
ALTERNATIVE ACTION(S):
If the recommended actions are not approved, the Department will not receive grant funds to assist in placement of adults with mental health and substance use disorder treatment needs into transitional residential board and care facilities. Additionally, the Department will have to return to your Board for signature on all necessary grant reports and forms for submittal to DHCS.
RETROACTIVE AGREEMENT:
The recommended application / agreement is retroactive to July 1, 2020. DHCS released notice of the FY 2020-21 SAMHSA MHBG application via electronic mail to the Department on April 10, 2020 with a submission deadline of July 31, 2020. The Department was not able to present the recommended application / agreement to your Board on an earlier date due to the State taking longer than anticipated to review the application, provide feedback to the Department, and then finally to provide formal approval after the Department provided clarification and additional information.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The recommended application / agreement will fund transitional residential board and care services in the amount of $5,000,000. The Department is eligible for FY 2020-21 grant funds in the amount of $2,474,787. The funding includes a base allocation of $2,249,807. The total allocation decreased by $49,395 (or 2%) from the FY 2019-20 allocation. The Department is allowed up to 10% for administrative costs ($224,980). This funding does not require a match and program expenses are 100% offset with these federal funds and Mental Health Realignment ($2,525,213). Sufficient appropriations and estimated revenues were included in the Department’s Org 5630 FY 2020-21 Adopted Budget.
DISCUSSION:
The SAMHSA MHBG funds are allocated to county mental health departments to be used for community mental health services for adults with SMI and/or children and adolescents with serious emotional disturbance (SED). Since 1993, the Department has received the funds to provide mental health services to dual diagnosed adults and juveniles in detention facilities. On December 12, 2018, DHCS confirmed direction from SAMHSA that funding services to detained individuals did not meet the requirement for a community health setting.
On September 10, 2019, the Board approved Agreement No. 19-438 with DHCS to receive MHBG funds to partially fund Transitional Residential Services Program (TRSP) and Specialized Transitional Residential Services Program (STRSP) services as operated by providers under existing Agreement No. 17-377 with twenty (20) licensed transitional residential facilities, approved by the Board on July 11, 2017.
The recommended application / agreement will enable the Department to continue supporting the transition of adults with SMI from locked and/or higher-level of care services to less restrictive facilities and more appropriate level of care. The facilities include transitional board and care, specialized level of care services, and/or other certified/licensed facilities. In FY 2019-20, 151 adults were placed in TRSP and STRSP facilities with an average length of stay of 207 days. In FY 2020-21, the Department has already placed 262 adults in TRSP and STRSP facilities with an average length of stay of 207 days. The grant will also fund the Department’s staff time for administrative activities and periodic grant related expenditure reporting.
The DHCS approval process is contingent upon allocated federal funding. The recommended application / agreement will act as the final agreement; the placeholder was submitted to meet the July 31, 2020 deadline. The recommended application / agreement contains language that allows the Director, or designee, to sign grant documents, expenditure forms, and reports on behalf of your Board over the term.
OTHER REVIEWING AGENCIES:
The Behavioral Health Board was notified of the SAMHSA MHBG Application/Agreement at the June 2021 meeting.
REFERENCE MATERIAL:
BAI #34, September 10, 2019
BAI #38, July 11, 2017
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Agreement with DHCS
CAO ANALYST:
Sonia M. De La Rosa