DATE: October 6, 2026
TO: Board of Supervisors
SUBMITTED BY: Susan L. Holt, Director, Department of Behavioral Health
SUBJECT: Amendment No. 1 to Agreement No. D-26-363 with DHCS for FY 2026-27 PATH Grant Funds
RECOMMENDED ACTION(S):
TITLE
1. Approve and ratify the Department of Behavioral Health Director’s previous submission of Amendment No. 1 to the Application/Agreement (No. D-26-363) with the California Department of Health Care Services for the Projects for Assistance in Transition from Homelessness Grant, effective upon execution, with no change to the terms or grant amount ($439,203); and
2. Approve and authorize the Director of Behavioral Health, or their designee, to sign associated grant documents and execute any necessary budget change requests to adjust individual program budget line items without changing the scope or maximum funding amount.
REPORT
There is no increase in Net County Cost associated with the recommended actions, which will authorize the submission of Amendment No. 1 to the Application/Agreement No. D-26-363 with the California Department of Health Care Services (DHCS) for the FY 2026-27 Projects for Assistance in Transition from Homelessness (PATH) Grant to remove all references to “permanent supportive housing”, which was submitted by the Department of Behavioral Health Director (DBH Director) on July 1, 2026, ratify the approved Amendment No. 1 as the agreement to receive PATH funds from DHCS, and allow the DBH Director to submit budget change requests to DHCS to reallocate PATH grant funds within the program budget as necessary without changing the scope or max funding amount This item is countywide.
ALTERNATIVE ACTION(S):
If the recommended actions are not approved, PATH grant funds may be forfeited and services to adults experiencing homelessness and serious mental illness (SMI) and/or co-occurring disorders would be impacted and may result in a higher cost to the County.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The PATH grant allocation for FY 2026-27 is $329,402 and requires a county match of funds on a three to one ratio, or $109,801, which will be funded with Behavioral Health Services Act (BHSA) funds, for a total PATH program budget of $439,203. Sufficient appropriations and estimated revenues are included in the Department’s Org 5630 FY 2026-27 Recommended Budget and will be included in future budget requests.
DISCUSSION:
The Stewart B. McKinney Homeless Assistance Amendments Act of 1990 established the Federal PATH grants administered by the Substance Abuse and Mental Health Services Administration (SAMHSA). DHCS functions as a pass-through entity and direct services are administered through the Department. Since 1990, the Department has applied for grant funding annually to address the needs of individuals with an SMI and with co-occurring substance use disorders who are experiencing or at risk of homelessness.
The FY 2026-27 PATH grant will fund a Mobile Outreach program, which will be operated using County staffing. This will enable the Department to provide services directly to persons served experiencing homelessness with an SMI residing in encampments throughout the geographical metro Fresno area, which may include County islands located within the metropolitan areas of Fresno. The Mobile Outreach program will operate in the rural areas of Fresno County on an as-needed basis, via request and in coordination with the County Administrative Office - Office of Housing and Homelessness. The funding for these services will combine PATH, Opioid Settlement Funds (OSF), and Behavioral Health Services Act (BHSA) into one Mobile Outreach program staffed by Fresno County DBH employees.
The PATH grant application submitted to DHCS by the DBH Director on April 13, 2026, and the award letter, together, are also considered the agreement with DHCS. Historically, the Department Director has signed the application and agreement on behalf of the Board due to the short turn around needed to submit the application and the Board will either ratify and approve of the PATH grant application submittal, or the Chairman would re-sign the PATH grant application/agreement to be re-submitted to DHCS.
On June 30, 2026, your Board approved and ratified the DBH Director’s previous submittal of the PATH grant application to DHCS.
On July 1, 2026, DHCS notified staff to remove all instances of the words “permanent housing” and “permanent supportive housing” from the application program narrative, as it did not align with SAMSHA priorities. County staff notified DHCS that the Fresno County Board of Supervisors already approved and ratified the prior PATH Application/Agreement No. D-26-363 at the June 30, 2026, meeting, so this new request from DHCS to change the program narrative would need to be re-approved and ratified by the Fresno County Board of Supervisors as Amendment No. 1 to Agreement No. D-26-363, in order to affect the requested change to the program narrative. County staff revised the program narrative by removing “Permanent Supportive Housing” and “Permanent Housing” language and provided the updated application to DHCS on the same day, July 1, 2026. DHCS also provided the County with a final approved and revised application on the same day, July 1, 2026, for Board approval and ratification.
Approval of the recommended actions will approve and ratify the DBH Director’s previous submittal of Amendment No. 1 to the Application/Agreement No. D-26-363 with DHCS for PATH grant funds and align the program narrative with SAMHSA priorities, and delegate authority to the DBH Director, or their designee, to sign associated grant documents and execute any necessary budget change requests to adjust individual program budget line items without changing the scope or max funding amount.
OTHER REVIEWING AGENCIES:
The Behavioral Health Board was informed of the recommended amendment during the September meeting.
REFERENCE MATERIAL:
BAI #41, June 30, 2026
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Amendment 1 to Agreement with DHCS for PATH funds
CAO ANALYST:
Dylan McCully