DATE: October 17, 2017
TO: Board of Supervisors
SUBMITTED BY: Dawan Utecht, Director, Department of Behavioral Health
David Pomaville, Director, Department of Public Health
SUBJECT: Retroactive State Application / Agreement for Substance Abuse and Mental Health Services Administration Community Mental Health Services Block Grant
RECOMMENDED ACTIONS:
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 detention facilities, effective July 1, 2017 through June 30, 2018 ($2,012,097); and,
2. Approve and authorize the Director of the Department of Behavioral Health, or designee, to be the signatory on behalf of the Board of Supervisors on associated grant agreement documents, expenditure forms and reports.
REPORT
The Department of Behavioral Health (DBH) submitted a placeholder application, signed by the Department 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). The Application / Agreement was released by DHCS on July 20, 2017 with a submission date of August 25, 2017. Approval of the first recommended action will allow DBH to resubmit the Application / Agreement replacing the placeholder. The grant allows counties to fund dual diagnosis mental health services in detention facilities for adults with serious mental illness (SMI) and juveniles with severe emotional disturbance (SED). Dual diagnosis is when an individual suffers from both mental illness and substance abuse.
The second recommended action would allow the DBH Director to sign grant documents, expenditure forms, and reports on behalf of your Board. The grant allows funding for DBH and the Department of Public Health (DPH) for detention facility services, with no increase in Net County Cost.
ALTERNATIVE ACTION(S):
If your Board chooses not to approve the recommended actions, the Departments will not receive the grant funds for mental health and substance use disorder treatment to individuals in adult and juvenile detention facilities. Additionally, DBH would also 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, 2017. DHCS released notice of the FY 2017-18 SAMHSA MHBG application via electronic mail to the County on July 20, 2017 with a submission deadline of August 25, 2017. The period to prepare and review the recommended Application / Agreement did not allow presentation to your Board on an earlier date.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The County is eligible for FY 2017-18 SAMHSA MHBG non-competitive grant funds in the amount of $2,012,097. The total grant funding ($2,012,097) includes a base allocation of $1,593,198 and dual diagnosis set-aside funds of $418,899. The base allocation increased by $138,232 (or 9.5%) from the FY 2016-17 allocation. The grant does not require a County match and program expenses are 100% offset with these Federal funds. Sufficient appropriations and estimated revenues are included in the DPH Org 5620 ($1,672,097) and DBH Org 5630 ($340,000) FY 2017-18 Adopted Budgets.
DISCUSSION:
The County has received the SAMHSA MHBG funding since 1993, to provide mental health services to dual diagnosed adults and juveniles in detention facilities. The funds are allocated to county mental health departments for community mental health services for a specific target population. The base and dual diagnosis set-aside funding target population is SMI adults as well as SED children and adolescents.
The recommended Application / Agreement will enable the County to receive funds to partially fund the adult Jail Psychiatric Services (JPS) program operated by the County’s comprehensive medical and behavioral health care provider. In FY 2016-17, JPS provided 2,773 unique inmates with mental health services. Of those inmates served, 729 unique inmates were provided with dual diagnosed services. DPH, as the lead department over the comprehensive medical and behavioral health care provider program, estimates that 3,258 unique inmates will receive mental health services and 792 of these will receive specialized dual diagnosed services in FY 2017-18.
The recommended Application / Agreement also includes funding of $300,000 for the contracted mental health service provider to serve SED juveniles with mental health and substance use disorders who are in custody or have recently been released from the Juvenile Justice Campus (JJC) and were overseen by DBH. The remaining funding amounts of $10,000 and $30,000 support the cost of facility services at the JJC and fund DBH’s staff time for administrative activities and periodic grant related expenditure reporting, respectively.
In total 66 unique juveniles were served in FY 2016-17 and each reached the six-month marker after completion of the program. In FY 2017-18 it is anticipated that 72 unique juveniles will be served, and of those, outcome data is projected as follows:
(1) 92% or 66 juveniles will be drug free six months after completion;
(2) 97% or 69 will have no new convictions during first six months after completion; and,
(3) 97% or 69 juveniles will attend school, work, or engaged in a vocational program six months after completion.
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 August 25, 2017 deadline. Your Board’s approval will allow DBH to submit an updated Application / Agreement to replace the placeholder. The recommended Application / Agreement contains language that allows the DBH Director, or designee, to sign grant documents, expenditure forms, and reports on behalf of your Board over the term of the agreement.
OTHER REVIEWING AGENCIES:
The Behavioral Health Board members were notified of the SAMHSA MHBG grant funding at the August 16, 2017 meeting.
REFERENCE MATERIAL:
BAI #31, June 21, 2016, Agreement No. 16-362
BAI #29, October 13, 2015, Agreement No. 15-506
BAI #65, July 15, 2014, Agreement No. 14-407 and Amendment I to Agreement No. 14-407
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Application / Agreement with DHCS
CAO ANALYST:
Sonia De La Rosa