DATE: January 24, 2023
TO: Board of Supervisors
SUBMITTED BY: Susan L. Holt, Director of Behavioral Health
SUBJECT: Amendment to Forensic Continuum of Care Agreement to Add Whole Person Care-Like Navigation and Linkage Services
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to execute First Amendment to Agreement with Turning Point of Central California, Inc. to add a navigation and linkage component, effective January 24, 2023 with no change to the term of July 1, 2022 through June 30, 2027 and increasing the maximum by $894,377 to a total of $27,577,272.
REPORT
The FY 2019-20 Governor’s Budget initiated Whole Person Care-Like (WPCL) capacity with the intent of utilizing the funds for administrative and programmatic activities to high-risk populations. Approval of the recommended action will allow the Department of Behavioral Health to provide navigation services to Penal Code (P.C.) 1203 probationers that would benefit from a program that coordinates chronic physical health, behavioral health, and social services in a person-centered manner with the goal of improved health and well-being. The services are funded by WPCL funding, with no Net County Cost. This item is countywide.
ALTERNATIVE ACTION(S):
There is no viable alternative action. If your Board does not approve the recommended action, the County would not be able utilize the WPCL grant funds to pursue navigation and linkage services for individuals released from jail with chronic needs.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. Approval of the recommended amendment will increase the maximum compensation by $894,377, to a total of $27,577,272. Services will be funded by WPCL one-time funding. Sufficient appropriations and estimated revenues are included in the Department’s Org 5630 FY 2022-23 Adopted Budget and will be included in subsequent budget requests for the duration of this program. Total expenditures are based on actual services provided.
DISCUSSION:
The need for a Whole Person Care approach arose due to unmet social, behavioral health, and health needs within vulnerable populations, and from the existing fragmentation of organization and financing of current health and human services systems. 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 have a mental illness with or without substance use disorder and/or who have a chronic physical health condition.
On January 21, 2020, your Board retroactively approved the submission of a Letter of Interest dated December 10, 2019, in order to receive the Whole Person Care-like Pilot one-time funds.
On June 21, 2022, your Board approved Agreement No. 22-264 with Turning Point of Central California, Inc. (Turning Point) to deliver specialty mental health and substance use disorder outpatient treatment (OP), Full Service Partnership (FSP) and Assertive Community Treatment (ACT) services. This continuum of care targets justice-involved populations, specifically adult prison transfers and persons on pre-trial probation per California Assembly Bill (AB) 109: 2011 Public Safety Realignment (Chapter 15, Statutes of 2011), persons on mental health diversion through AB 1810: Mental Health Diversion Chapter 34, Statutes of 2018, and those who have been found misdemeanor incompetent to stand trial (MIST) under Senate Bill (SB) 317 Chapter 599, Statutes of 2021. The Board was advised at this time that Turning Point would work with the County to include services to incorporate WPCL pilot funding.
With your Board’s approval, the recommended amendment will support the creation of a navigation and linkage system to meet the chronic physical health, behavioral health, social, and housing needs of individuals reintegrating into the community after incarceration. The pilot program will target individuals who are 18 years or older being released from Fresno County Jail on PC 1203 probation who have a mental health diagnosis and chronic physical health condition, are homeless or at-risk of homelessness, have a term of formal probation or Mandatory Supervision upon release, and have a scheduled release date within 60-90 days of referral. The provider shall collaborate with the County to develop workflows on pre-release coordination and learn about the target population’s service needs. They will capture data driven outcomes (tracking recidivism, post-release housing status, timeliness of linkages, emergency department use, hospitalizations, education and vocation, Medi-Cal, improved health outcomes, cost per person served compared to cost savings avoiding return to jail/hospital/etc.) with the goal of successful system navigation/linkage and will assist with structured program evaluation.
OTHER REVIEWING AGENCIES:
The Behavioral Health Board was made aware of the recommended amendment at its November 2022 meeting.
REFERENCE MATERIAL:
BAI #44, June 21, 2022
BAI # 25, January 21, 2020
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Amendment to Agreement No. 22-264 with Turning Point
CAO ANALYST:
Ron Alexander