DATE: May 21, 2024
TO: Board of Supervisors
SUBMITTED BY: Susan Holt, Director, Department of Behavioral Health
SUBJECT: Retroactive Participation Agreement with California Mental Health Services Authority for the Central Valley Suicide Prevention Hotline
RECOMMENDED ACTION(S):
TITLE
1. Approve and authorize the Chairman to execute a retroactive Participation Agreement with the California Mental Health Services Authority for Central Valley Suicide Prevention Hotline services, effective July 1, 2023 through June 30, 2024, total not to exceed $446,885; and
2. Approve and authorize the Department of Behavioral Health Director, or designee, to be the signatory and act as the Fresno County representative on behalf of the Board of Supervisors on associated California Mental Health Services Authority Central Valley Suicide Prevention Hotline related reports and forms, without modifying the maximum compensation.
REPORT
Approval of the first recommended action will assign funding to the California Mental Health Services Authority (CalMHSA) for FY 2023-24 to act as a fiscal intermediary and provide program management and oversight for the Central Valley Suicide Prevention Hotline (CVSPH) program. CVSPH will serve as the primary suicide prevention hotline for the Counties of Fresno, Tulare, Kings, Madera, Mariposa, Merced, and Stanislaus. Approval of the second recommended action will allow the Department of Behavioral Health Director, or designee, to sign related reports and forms, without modifying the maximum compensation, and act as a representative of the County. The services are funded with Mental Health Services Act (MHSA)
Prevention and Early Intervention (PEI) funds, with no increase in Net County Cost. The item is countywide.
ALTERNATIVE ACTION(S):
Should your Board not approve the first recommended action, the suicide prevention hotline services will not be provided to the County. If the second recommended action is not approved, the Department will return to the Board for all necessary reports and forms.
RETROACTIVE AGREEMENT:
The recommended agreement was received on December 22, 2023 and is retroactive to July 1, 2023. The delay in bringing the agreement before your Board on an earlier date was due to ongoing discussions on increased hotline cost to participating counties and CalMHSA’s agreement review process.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. Services are fully funded with MHSA PEI funds. The total cost to operate the suicide prevention hotline is approximately $813,211. As the main user of the suicide prevention hotline, Fresno County’s share of cost is $446,885, or 55% as identified by the call volume data. The share of cost is inclusive of the 15% administrative fee of total program funding due to CalMHSA. The participating counties are paying their agreed upon share of cost directly to CalMHSA. Sufficient appropriations and estimated revenues are included in the Department’s Org 5630 FY 2023-24 Adopted Budget. There are no pending invoices.
DISCUSSION:
On September 14, 2010, the Board executed Joint Powers Agreement (JPA) No. 10-489 to implement Statewide MHSA PEI projects through CalMHSA, pursuant to Welfare and Institutions Code, section 5897. The JPA allowed CalMHSA to increase cost efficiency for suicide prevention, student mental health initiatives, and reduction in stigma and discrimination related to mental illness. The County can choose to participate in CalMHSA activities, specifically the CVSPH.
On January 3, 2023, the Board approved a Participation Agreement (No. 23-060) with CalMHSA to act as a fiscal intermediary and provide program management and oversight for the CVSPH program. CVSPH operates a 24-hour/7 day a week accredited American Association of Suicidology hotline that serves as the primary suicide prevention hotline for the Counties of Fresno, Tulare, Kings, Madera, Mariposa, Merced and Stanislaus. CVSPH answers calls through its participation in the National Suicide Prevention Lifeline, maintains a hotline website, and provides outreach and technical assistance to the involved counties.
During the 2022-2023 fiscal year, CVSPH received 5,336 calls from the Fresno County community. These calls included 35 “talk down calls” in which callers were assisted in creating a safety plan and did not ultimately attempt self-harm, as well as 52 “active rescues” in which emergency services were activated due to self-harm activity currently taking place, resulting in a local life saved from suicide. The Participation Agreement grants CalMHSA authority to contract with Kings View Behavioral Health for services on behalf of the County. CVSPH serves as the primary suicide prevention hotline for Fresno and other participating counties.
The Agreement varies from standard County template as it was drafted by CalMHSA. The template is utilized by CalMHSA to execute Participation Agreements with different Counties and is consistent statewide. The agreement includes a limitation of liability to funds paid to CalMHSA and indemnification in favor of CalMHSA. However, the Department believes that the benefit of the contract as written outweighs any potential risks and recommends approval of the agreement.
The recommended Participation Agreement is a one-year contract with the option for early termination in which either party may withdraw from the program upon a two-month written notice. Upon cancellation, termination, or other conclusion of the Program, any funds remaining undisbursed after CalMHSA satisfies all obligations arising under the Program shall be returned to the County.
REFERENCE MATERIAL:
BAI #18, January 3, 2023
BAI #39, September 14, 2010
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Agreement with CalMHSA
CAO ANALYST:
Ron Alexander