DATE: May 14, 2019
TO: Board of Supervisors
SUBMITTED BY: Dawan Utecht, Director, Department of Behavioral Health
SUBJECT: Retroactive State Application / Agreement for Substance Abuse and Mental Health Services Administration Community Mental Health Services Block 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 Substance Abuse and Mental Health Services Administration Community Mental Health Services Block Grant funds for dual diagnosis mental health services in licensed residential board and care facilities, effective July 1, 2018 through June 30, 2019 ($2,588,632).
2. Approve and authorize the Director of the Department of Behavioral Health, or designee, to execute associated grant agreement documents, expenditure forms and reports on behalf of the Board of Supervisors.
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 June 21, 2018 with a final revised submission date of April 15, 2019. 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 licensed residential board and care facilities for adults with serious mental illness (SMI).
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, with no increase in Net County Cost.
ALTERNATIVE ACTION(S):
If your Board chooses not to approve the recommended actions, DBH will not receive the grant funds for mental health and substance use disorder treatment to adult individuals in licensed residential care facilities for transitional residential board and care services. 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, 2018. DHCS released notice of the FY 2018-19 SAMHSA MHBG application via electronic mail to the County on June 21, 2018 with an original submission deadline of August 22, 2018. DHCS extended the deadline to April 15, 2019 after further direction from SAMHSA on allowable funding utilization and an increase to base allocation funding, which required additional program development and planning. 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 2018-19 SAMHSA MHBG non-competitive grant funds in the amount of $2,588,632. The total grant funding ($2,588,632) includes a base allocation of $2,169,733 and dual diagnosis set-aside funds of $418,899. The base allocation increased by $576,535 (or 36.1%) from the FY 2017-18 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 DBH Org 5630 FY 2018-19 Adopted Budget.
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 children and adolescents with serious emotional disturbance (SED). On December 12, 2018, DHCS confirmed direction from SAMHSA that MHBG funding to provide services to detained individuals did not meet the requirement for a community health setting.
Under guidance from DHCS, the recommended Application / Agreement will enable the County to receive funds to partially fund Transitional Residential Services Program (TRSP) and Specialized Transitional Residential Services Program (STRSP) services as operated by providers under existing County Agreement No. 17-377. These programs provide opportunity to transition SMI adults from locked and/or higher-level of care services to less restrictive facilities. The facilities include transitional board and care, specialized level of care services, and/or other certified/licensed facilities. The grant will also fund DBH’s staff time for administrative activities and periodic grant related expenditure reporting.
In FY 2017-18, 149 adults were placed in TRSP and STRSP facilities with an average length of stay of 256 days. From July 1, 2018 through April 8, 2019, 154 adults were placed with an average length of stay of 192 days.
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 April 15, 2019 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 was notified of the SAMHSA MHBG grant funding at the April 2019 meeting.
REFERENCE MATERIAL:
BAI #42, October 17, 2017, Agreement No. 17-531
BAI #38, July 11, 2017, Agreement No. 17-377
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Agreement with DHCS
CAO ANALYST:
Ron Alexander