DATE: January 21, 2020
TO: Board of Supervisors
SUBMITTED BY: Jean M. Rousseau, County Administrative Officer
Dawan Utecht, Director, Department of Behavioral Health
David Pomaville, Director, Department of Public Health
Delfino Neira, Director, Department of Social Services
SUBJECT: Retroactive Letter of Interest & Approval of Resolution Related to One-Time Funding to Initiate Whole Person Care-Like Pilot Capacity
RECOMMENDED ACTIONs:
TITLE
1. Retroactively approve and authorize the County Administrative Officer to serve as the primary contact for Fresno County related to the one-time funding opportunity, and submittal of a Letter of Interest on December 10, 2019, to the Department of Health Care Services to initiate Whole Person Care-Like Pilot capacity; and,
2. Approve and authorize the Chairman to execute a Resolution as requested by the California Department of Health Care Services, indicating the County’s intent to utilize the one-time funding available through the 2019-20 Governor’s budget to initiate Whole Person Care-Like Pilot capacity in the amount of $894,377.
REPORT
Approval of the recommended actions will allow the County Administrative Office and Departments of Behavioral Health, Public Health and Social Services to apply to the California Department of Health Care Services (DHCS) for Whole Person Like-Pilot capacity funding.
The funding opportunity was made possible by the 2019-20 Governor’s Budget and will utilize the funds for administrative and programmatic activities specific to high-risk populations. Counties were notified of the funding opportunity on October 18, 2019, see Attachment A. To receive the funding, the proposed retroactive Letter of Interest was submitted on December 10, 2019, see Attachment B. In addition, the required resolution must be submitted to DHCS no later than January 31, 2020, see Attachment C. While the specific utilization of the funding opportunity has yet to be determined, the Departments are engaging with key stakeholders in planning for use of the funds; these one-time funds will be directed towards administrative and programmatic activities. This item is countywide.
ALTERNATIVE ACTION:
There is no viable alternative action. Should your Board opt not to approve the recommended actions, the Departments would not pursue the funding opportunity.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The one-time funding made available by the 2019-20 Governor’s Budget will be in the amount of $894,377 for the County. DHCS notified counties by January 2, 2020 of funding awards. The recommended resolution represents formal acceptance to be submitted to DHCS, and the funds will be fully processed and released by DHCS to approved counties no later than March 31, 2020. The final date of funding availability for encumbrance or expenditure is June 30, 2025, and the Department of Behavioral Health will be required to submit a final report to DHCS within 90 days after the full expenditure of funding (September 30, 2025). The one-time State General Fund allocation with multi-year spending authority will be deposited into a newly established Special Revenue Fund; at this time, it is not anticipated that funding would be expended in FY 2019-20. Sufficient appropriations and estimated revenues will be included in the Department of Behavioral Health Org 5360’ future budget requests for the duration of this program.
DISCUSSION:
The 2019-20 Governor’s budget includes a one-time augmentation of $20 million from the Mental Health Services Fund for counties that do not operate Whole Person Care Pilots. The funding will allow counties to develop and implement essential programs and infrastructure to focus on coordinating physical health, behavioral health and critical social services for persons who are homeless or at risk of becoming homeless and who are have serious mental illness with or without substance use disorder and/or who have a chronic physical health condition.
DHCS derived county allocations using the Federal Housing and Urban Development (HUD) Point-in-Time (PIT) count numbers from 2017, cost of living using the HUD Fair Market Rate Efficiency amount for each county area, and prevalence of individuals who are mentally ill and are experiencing homelessness from the HUD PIT Severely Mentally Ill subpopulation count numbers from 2017.
In order to receive the one-time funds, the County must delegate a single organization that will serve as the primary contact for the County. On December 10, 2019, a Letter of Interest was submitted to DHCS identifying the County Administrative Officer. In addition, the letter stated that the participating community partners would include the County Departments of Behavioral Health, Public Health, and Social Services, as well as hospitals, federally qualified health centers, and representatives of the Fresno Madera Continuum of Care and Multi-Agency Access Program. In addition, the target population was identified as individuals who are experiencing homelessness who have mental illness and/or two or more chronic health conditions.
With your Board’s approval, the recommended actions will adopt a resolution approving the County’s participation in the funding opportunity and retroactively authorize the County Administrative Officer to serve as the primary contact for the County, as well as the entity to submit the requisite Letter of Interest to confirm the County’s intention of using the funds appropriately as per the 2019-20 Governor’s budget.
OTHER REVIEWING AGENCIES:
Due to the accelerated deadline to submit the required letter and resolution, the Behavioral Health Board will be made aware of the DHCS one-time funding opportunity during the January 15, 2020 meeting.
ATTACHMENTS INCLUDED AND/OR ON FILE:
Attachment A - C
On file with Clerk - Resolution
CAO ANALYST:
Sonia M. De La Rosa