DATE: September 10, 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, 2019 through June 30, 2020 ($2,524,182).
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 DBH 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). Approval of the first recommended action will allow DBH to resubmit the Application / Agreement replacing the placeholder. The grant allows the County to fund placement in licensed residential board and care facilities for adults with serious mental illness (SMI). The second recommended action will 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 the recommended actions are not approved, DBH will not receive grant funds to assist in placement of adults with mental health and substance use disorder treatment needs into transitional residential board and care facilities. Additionally, DBH will 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, 2019. DHCS released notice of the FY 2019-20 SAMHSA MHBG application via electronic mail to the County on June 21, 2019 with a submission deadline of August 5, 2019. 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 2019-20 SAMHSA MHBG grant funds in the amount of $2,524,182. The funding includes a base allocation of $2,105,283 and dual diagnosis set-aside funds of $418,899. The base allocation decreased by $64,450 (or 2.97%) from the FY 2018-19 allocation. The County is allowed up to 10% for administrative costs ($252,418). This funding does not require a County match and program expenses are 100% offset with these Federal funds and Mental Health Realignment. Sufficient appropriations and estimated revenues are included in the DBH Org 5630 FY 2019-20 Recommended Budget.
DISCUSSION:
The SAMHSA MHBG funds are allocated to county mental health departments to be used for community mental health services for adults with SMI and/or children and adolescents with serious emotional disturbance (SED). Since 1993, the County has received the funds to provide mental health services to dual diagnosed adults and juveniles in detention facilities. On December 12, 2018, DHCS confirmed direction from SAMHSA that funding services to detained individuals did not meet the requirement for a community health setting.
On May 14, 2019, your Board approved County Agreement No. 19-217 to receive MHBG 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. The recommended MHBG Application / Agreement will enable the County to continue supporting the transition of adults with SMI from locked and/or higher-level of care services to less restrictive facilities and more appropriate level of care. The facilities include transitional board and care, specialized level of care services, and/or other certified/licensed facilities. In FY 2018-19, 157 adults were placed in TRSP and STRSP facilities with an average length of stay of 240 days. The grant will also fund DBH’s staff time for administrative activities and periodic grant related expenditure reporting.
The DHCS approval process is contingent upon allocated Federal funding. The recommended MHBG Application / Agreement will act as the final agreement; the placeholder was submitted to meet the August 5, 2019 deadline. 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 Application/Agreement at the August 2019 meeting.
REFERENCE MATERIAL:
BAI #23, May 14, 2019, Agreement No. 19-217
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