DATE: July 11, 2017
TO: Board of Supervisors
SUBMITTED BY: Dawan Utecht, Director, Department of Behavioral Health
SUBJECT: Retroactive State Application / Agreement for Federal Stewart B. McKinney Homeless Block Grant, through McKinney Projects for Assistance in Transition from Homelessness (PATH) Grant
RECOMMENDED ACTION(S):
TITLE
1. Approve and authorize the Chairman to execute a retroactive Application / Agreement with the California Department of Health Care Services for the Federal Stewart B. McKinney Homeless Block Grant, through the McKinney Projects for Assistance in Transition from Homelessness Grant, effective July 1, 2017 through June 30, 2018 ($420,239).
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, reports or modifications that do not exceed 10% of the maximum compensation.
REPORT
As in prior years, the Department of Behavioral Health submitted a placeholder application, signed by the Department Director, contingent upon your Board’s approval, due to the short turnaround period for the Projects for Assistance in Transition from Homelessness (PATH) grant application / agreement process. The FY 2017-18 application / agreement was released by the California Department of Health Care Services (DHCS) on May 15, 2017 and was due on June 9, 2017. Approval of the first recommended action will allow the Department to resubmit the application / agreement to DHCS in place of the initial application / agreement submitted as a placeholder. Approval of the second recommended action will allow the Department Director, or designee, to sign on behalf of your Board, all necessary reports and forms due to DHCS for administration of the grant. The grant allows for services to adults with mental health conditions who are homeless or at risk of homelessness and requires a County match, which is funded with Mental Health Services Act - Community Services Support (MHSA - CSS) funds, with no increase in Net County Cost.
ALTERNATIVE ACTION(S):
There is no viable alternative action for the first recommended action, if not approved, the grant funds would be forfeited and services to adults with mental health conditions who are homeless or at risk of homelessness will be impacted or may result in a higher cost to the County. If the second recommended action is not approved, the Department will have to approach the Board to seek signature for all necessary reports and forms due to DHCS.
RETROACTIVE AGREEMENT:
The period to prepare and review the recommended agreement / application, which will be retroactive to July 1, 2017, did not allow presentation to your Board on an earlier date. The Department received notice from DHCS on May 15, 2017, and the turnaround period was too short to bring before your Board prior to the submittal deadline date of June 9, 2017. Historically, the application / agreement has been submitted to the Board retroactively due to DHCS processing timelines.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The PATH grant allocation for FY 2017-18 is $315,179 and requires a County match of $105,060 or 33%, which is funded with MHSA - CSS funds, for a total amount of $420,239; 0.42% ($1,793) decrease from the final total amount in FY 2016-17. PATH funds are utilized as follows: $9,462 (or 2%) for county administrative costs and the remainder ($410,777) for the County’s PATH program contracted and operated by Kings View Corporation. Total PATH administration cost is 10% (2% County, 8% provider). The entire program is funded with the PATH grant, MHSA - CSS funds, Medi-Cal revenues and client rents. Sufficient appropriations and estimated revenues are included in the Department Org 5630 FY 2017-18 Recommended Budget.
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 the grant funding annually to address the needs of individuals with serious mental illness (SMI) and/or co-occurring SMI and substance use disorder, who are homeless or at risk of homelessness.
If approved by your Board, the FY 2017-18 PATH application / agreement will partially fund the County’s program, effective July 1, 2017 through June 30, 2018. On June 16, 2015, your Board approved Agreement No. 15-257 with Kings View Corporation to operate the PATH program and provide services to homeless adults with mental health conditions.
In FY 2015-16, the program outreached to 408 homeless clients and enrolled 238 eligible clients, experiencing SMI or co-occurring disorder, for outreach, linkage, and related services. Of the enrolled clients, 34 received ongoing, intensive mental health treatment and case management and supportive housing services; these clients experienced 97% reduction in incidents of homelessness, incarceration, and hospitalization.
The PATH program provides for:
• mental health treatment;
• outreach;
• case management;
• crisis intervention;
• referral/linkage;
• supportive housing (less than 20% of total funding);
• education for clients and family or other caregivers as appropriate;
• client supports; and,
• integrated physical and mental health services in collaboration with primary care physicians.
The program utilizes the Wellness Recovery Action Plan, an evidence-based practice, which empowers clients to achieve their respective goals. The PATH program is a vital resource to the community as it seeks to reduce and end chronic homelessness, and serves as an avenue for clients to involve themselves in mainstream mental health, primary health care, and substance use disorder services.
The DHCS approval process is contingent upon allocated Federal funding. The recommended application / agreement will act as the final agreement; the placeholder application was submitted to meet the June 9, 2017 deadline. Your Board’s approval will allow the Department to submit an updated application / agreement to replace the placeholder application. The recommended application / agreement contains language which allows the Department Director, or designee, to modify services and budget line item changes within 10% of the grant budget, in order to address program funding needs that may fluctuate over the term of the application / agreement.
OTHER REVIEWING AGENCIES:
The Behavioral Health Board was notified of this application / agreement at the June 2017 meeting.
REFERENCE MATERIAL:
BAI# 26, March 28, 2017, Amendment to Agreement No. 16-362 with Ca. DHCS
BAI# 31, June 21, 2016, Agreement No. 16-362 with DHCS
BAI#45, June 16, 2015, Agreement No. 15-257 with Kings View Corporation
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Agreement with DHCS
CAO ANALYST:
Sonia De La Rosa