The County of Santa Clara
California

Fiscal/Budget Item
95291

Approve Request for Appropriation Modification No. 13 - $308,902 increasing revenue and expenditures in the Behavioral Health Services Department and Office of Supportive Housing budgets, relating to adding one full-time Psychiatric Social Worker II/I or Marriage and Family Therapist II/I position, one Community Worker position, and contract services to support outpatient expansion and housing support in collaboration with the Superior Court. (4/5 Roll Call Vote)

Information

Department:Mental Health Services (Santa Clara Valley Health and Hospital System)Sponsors:
Category:Appropriation Modification (4/5 Roll Call Vote)

Body

FISCAL IMPLICATIONS

Approval of the recommended action would have no net impact to the County General Fund.  To support the Collaborative Court Enhancement Project in partnership with the Superior Court, the Behavioral Health Services Department (BHSD) requests to add 1.0 Full-Time Equivalent (FTE) Psychiatric Social Worker (PSW) II/I or Marriage and Family Therapist (MFT) II/I position and increase contract appropriation supporting co-occurring treatment by an additional thirteen slotsThe Office of Supportive Housing (OSH) requests to add 1.0 FTE Community Worker (CW) position.

Memorandums of Understanding (MOUs) with the Superior Court to support these positions, as funded through the Substance Abuse and Mental Health Services Administration (SAMHSA) grant awarded to the Superior Court on August 17, 2018, were approved by the Board of Supervisors on June 18, 2019 (ID# 97182)The BHSD is now returning to the Board of Supervisors to request the appropriation modification related to the approved MOUs.

For BHSD, the cost of the position is approximately $116,070 in Fiscal Year (FY) 2020 and $150,790 ongoingContracts appropriation is also being increased by $101,448 in FY 2020 and $104,889 ongoing.  The remaining expenses that are not covered under the SAMHSA award would be offset by reducing appropriation from services and supplies. 

For OSH, the cost of the position is approximately $91,394 in FY 2020 and $95,964 ongoing.

The total award amount is $1,550,000, where the BHSD would receive $1,090,797, and OSH would receive $459,203.  See below for the breakdown by year.

County Period

OSH Award

BHSD Award

Total Award

07/01/19 - 06/30/20

$91,394

$217,508

$308,902

07/01/20 - 06/30/21

$95,964

$224,079

$320,043

07/01/21 - 06/30/22

$100,762

$230,979

$331,741

07/01/22 - 06/30/23

$105,801

$238,225

$344,026

07/01/23 - 06/30/23

$65,282

$180,006

$245,288

Total

$459,203

$1,090,797

$1,550,000

 

REASONS FOR RECOMMENDATION

The recommended actions would add one PSW II/I or MFT II/I position to the BHSD and one CW position to the Office of Supportive Housing. The recommended actions would also approve MOUs with the Superior Court and OSH respectively to outline the roles and responsibilities of each department in this collaborative and support the sustainability of these positions.

The BHSD has expanded its outpatient program to add thirteen treatment slots allocated for immediate access. These slots would be utilized to provide treatment services to clients. As such, the PSW II/I or MFT II/I position is required to update the BHSD on client treatment status, engage in effective communication with the court case managers and the program director, and manage holistic service coordination for each client. The PSW II/I or MFT II/I position would also utilize the Adult Level of Care (ALOC) assessment tool to screen and refer up to 70 behavioral health clients to appropriate levels of treatment, including dedicated outpatient treatment slots. This position is critical to ensure clients receive appropriate referrals and linkages to behavioral health treatment services.  Mental health and substance use outcomes for each client would be monitored and shared with the program’s staff and evaluator to track client needs and successes.

It is also recommended to add one CW position to the Office of Supportive Housing (OSH) to work with Seriously Mentally Ill (SMI), Seriously Emotionally Disturbed (SED), or Co-Occurring Disorder (COD) clients. This position would be located at the Justice Partners Office located in the Superior Court of California. The CW position would serve up to 70 clients by conducting Vulnerability Index-Service Prioritization Decision Assistance Tool (VI-SPDAT) assessments to assist clients with receiving long-term housing support, enrolling in the Emergency Assistance Program (EAP) for immediate and short-term housing support, and assisting the PSW II/I or MFT II/I and case managers in providing and coordinating services that meet individual client needs. Other services also include assisting clients and providers in service delivery and developing treatment plans. The OSH would monitor referral outcomes and housing support provisions for clients and share this information with the project team and evaluator to track needs and successes.

Both positions are critical to ensuring that clients are placed into appropriate treatment services and have a stable housing environment to facilitate reintegration into the community. Services provided by staff would also help in the reduction of recidivism and ensure that the BHSD is in compliance with SAMSHA grant legislation and program regulations.

The recommended action supports the County of Santa Clara Health System’s Strategic Road Map goals by ensuring adequate staffing to reduce the burden of illness and improve client access to behavioral health services.

CHILD IMPACT

The recommended action will have no/neutral impact on children.

SENIOR IMPACT

The recommended action would have a positive impact on seniors by increasing staff to provide adequate program coverage to provide linkages and referrals to behavioral health services.

SUSTAINABILITY IMPLICATIONS

The recommended action balances public policy and program interests by enhancing the Board of Supervisors’ sustainability goals of social equity and safety by ensuring appropriate oversight and staffing to behavioral health monitoring and linkages in Santa Clara County.

BACKGROUND

As a result of the SAMHSA grant awarded to the Superior Court on August 17, 2018, the Superior Court has partnered with the BHSD and OSH to hire and manage the requested positions. In 2017, the Adult Treatment Court, Family Law Treatment Court, and the Dependency Wellness Court served a combined 2,208 clients who suffered from mental health and/or substance use disorders.  Currently, there are nearly 1,500 active clients in the Adult Treatment Court in need of screening and assessment services.  These clients are unemployed, at risk of homelessness, and/or underserved. Many have complex needs stemming from behavioral health disorders, criminal justice involvement, dependency issues, and ongoing family law cases. On average, 70 clients per day are waiting in custody for services due to the lack of treatment placements available or the need to rescreen clients for higher levels of care.

The requested PSW II/I or MFT II/I and CW positions would facilitate these much-needed referrals, assessments, screenings, and re-screeningsIn addition, the positions would support a strong partnership between the Adult Treatment Court, Family Law Treatment Court, Dependency Wellness Court, BHSD, OSH, and other community-based providers.  This partnership would ensure a comprehensive care coordination for clients through the enhancement of services, communication, and collaboration.

The Employee Services Agency supports the recommended action.

CONSEQUENCES OF NEGATIVE ACTION

Failure to approve the recommended action would negatively impact BHSD’s ability to obtain sufficient staffing necessary to ensure adequate monitoring of behavioral health referrals and service delivery to Santa Clara County residents.

STEPS FOLLOWING APPROVAL

The Clerk of the Board of Supervisors is requested to send e-mail notification to Evonne Lai at Evonne.Lai@hhs.sccgov.org.

Meeting History

Aug 13, 2019 9:30 AM Video Board of Supervisors Regular Meeting
RESULT:APPROVED [UNANIMOUS]
MOVER:Cindy Chavez, Vice President
SECONDER:Susan Ellenberg, Supervisor
AYES:Mike Wasserman, Cindy Chavez, Dave Cortese, Susan Ellenberg, S. Joseph Simitian