DATE: November 7, 2023
TO: Board of Supervisors
SUBMITTED BY: Susan L. Holt, Director, Department of Behavioral Health
John Zanoni, Sheriff-Coroner-Public Administrator
Kirk Haynes, Chief Probation Officer
SUBJECT: Retroactive Grant Applications with the California Department of Health Care Services
RECOMMENDED ACTION(S):
TITLE
1. Retroactively approve and authorize the Department of Behavioral Health, Sheriff-Coroner-Public Administrator and Probation’s previous submittals of a grant application to the California Department of Health Care Services for the Providing Access and Transforming Health Justice-Involved Capacity Building Program Round 3 Grant related to the implementation of the Statewide California Advancing and Innovating Medi-Cal Initiative; and
2. Receive award letter and authorize the Director of Behavioral Health or designee, the Sheriff-Coroner-Public Administrator or designee, and Chief Probation Officer or designee, to electronically sign and submit the Acknowledgement of Grant Terms and Conditions form, and execute any documents necessary with DHCS to accept and collect the grant in the amount of
a. Sheriff-Coroner-Public Administrator: $5,000,000
b. Probation: $2,500,000
c. Department of Behavioral Health: $1,984,121
REPORT
Approval of the recommended action will authorize the retroactive submission of a grant application to the California Department of Health Care Services (DHCS) through the California Advancing & Innovating Medi-Cal (CalAIM) Initiative for the Providing Access and Transforming Health Supports (PATH) Round 3 for funding to support the planning and implementation of the provision of targeted pre-release Medi-Cal services to individuals in state prisons, county jails, and youth correctional facilities who meet the eligibility criteria as outlined in the CalAIM Section 1115 Demonstration approval. This item is countywide.
It should be noted that the Departments received the application from DHCS on May 1, 2023. In order to meet the application deadline of July 31, 2023, the Department of Behavioral Health (DBH) submitted the application on July 27, 2023, the Sheriff’s Office and Probation submitted the application on July 31, 2023, contingent upon your Board’s approval.
ALTERNATIVE ACTION(S):
There is no alternative action. If your Board does not approve the recommended action, the submitted grant application will be withdrawn from consideration for funding resulting in loss of additional funding to invest in staffing, collaborative planning and implementation of targeted pre-released Medi-Cal services.
RETROACTIVE AGREEMENT:
The application period opened on May 1, 2023 with a deadline of July 31, 2023. During the application period the Sheriff’s Office, Probation and DBH discussed possible funding implementations for staffing, technical support, and training to better coordinate linkage efforts. The discussions, along with receiving assistance from DHCS and Funding Administrator Public Consulting Group, LLC and review of the application resulted in submission of the application on July 27, 2023 by DBH and July 31, 2023 by the Sheriff’s Office and Probation.
On August 7, 2023 DBH was notified of approval of the application and the award amount. Probation was notified on August 11, 2023 and the Sheriff’s Office on August 16, 2023.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. If awarded, the grant will provide the Sheriff’s Office $5,000,000, Probation up to $2,500,000 and DBH $1,984,121 over a three-year period (FYs 2023-24 to 2025-26) in accordance with the milestone requirements included in the DHCS provided Program Guide. This award will be part of PATH Round 3 Funding. There is no match requirement associated with the funding. Once the funds are established, DBH, Sheriff and Probation will bring to your Board a separate budget resolution for approval.
DISCUSSION:
California became the first state in the nation to offer a targeted set of Medicaid (Medi-Cal) services to youth and adults in state prisons, county jails and youth detention and commitment facilities for up to 90 days prior to release. Currently, Medi-Cal services are generally available only after release from incarceration. Through a federal Medicaid 1115 demonstration waiver, the DHCS will establish a coordinated community reentry process that will assist people leaving incarceration to connect to the physical and behavioral health care services they need upon release.
The PATH Justice-Involved Funding consists of Round 1, Round 2, and Round 3. Round 1 and 2 of the funding targeted correctional agencies to support collaborative planning with county departments of social services to identify processes, protocols and IT system modifications necessary to support implementation of pre-release services. The application period for Round 1 opened in April 2022 with a deadline of July 31, 2022. On April 11, 2023, your Board retroactively approved the Sheriff’s Office previous submittal of the Round 1 grant application that was submitted to DHCS on July 20, 2022, and authorized the Sheriff’s Office to sign any initial award documents and other required documents that are necessary to accept and collect the awarded revenue of $150,000, which was divided between Sheriff’s Office ($100,000) and Probation ($50,000). This award letter was approved by DHCS on August 5, 2022. The application period for Round 2 opened on November 10, 2022 with a deadline of March 31, 2023. On March 30, 2023, the Department of Social Services (DSS), also on behalf of Sheriff’s Office and Probation, submitted an application to DHCS for Round 2, where funding was approved on July 17, 2023, in the amount of $1,002,290 for Sheriff’s and $73,631 for Probation. On October 10, 2023, your Board approved the previous submittal of the Round 2 grant application for DSS, Sheriff’s Office and Probation.
Round 3 of the PATH Justice-Involved Funding provides planning and implementation grants to behavioral health agencies to establish behavioral health linkages for community reentry services as required by AB 133. This funding will support the departments in planning of the implementation behavioral health linkages as required by AB 133. PATH funds will be available to support investments in personnel, capacity, and/or IT systems that are needed for collaborative planning and implementation in order to effectuate pre-release service processes. These PATH capacity building funds are available to qualified entities and will be distributed based on how entities meet certain performance milestones.
The application period opened on May 1, 2023 with a deadline of July 31, 2023. During the application period the Sheriff’s Office, Probation and DBH discussed possible funding implementations for staffing, technical support, and training to better coordinate linkage efforts. The discussions, along with receiving assistance from DHCS and Funding Administrator Public Consulting Group, LLC and review of the application resulted in submission of the application on July 27, 2023 by DBH and July 31, 2023 by the Sheriff’s Office and Probation.
On August 7, 2023 DBH was notified of approval of the application and the award amount. Probation was notified on August 11, 2023 and the Sheriff’s Office on August 16, 2023.
Section II of the Terms and Conditions note that the County will agree to hold the Third Party Administrator harmless for any claims relating to the receipt of grant funds.
OTHER REVIEWING AGENCIES:
The Behavioral Health Board was notified of the grant at its August 2023 meeting.
REFERENCE MATERIALS:
BAI#70, October 10, 2023
BAI #23, April 11, 2023
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - DHCS Grant Application
On file with Clerk - DHCS Award Letter
On file with Clerk - DHCS Terms and Conditions
CAO ANALYST:
Ron Alexander