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DATE: |
December 10, 2024 |
09 |
SUBJECT
Title
AUTHORIZE ACCEPTANCE OF PROPOSITION 47 COHORT 4 GRANT PROGRAM FUNDS, AMEND AND EXTEND EXISTING CONTRACT, AND AMEND AND EXTEND EXISTING SINGLE SOURCE EVALUATION CONTRACT (DISTRICTS: ALL)
Body
OVERVIEW
On April 12, 2024, the California Board of State and Community Corrections (BSCC) released the Proposition 47 Grant Program: Safe Neighborhood and Schools Act, Cohort 4 Grant Program. This Grant Program provided $152.0 million in total funding to eligible California public agencies for the provision of mental health services, substance use disorder treatment, and diversion programs for people in the criminal justice system. In June 2024, County of San Diego (County) Health and Human Services Agency, Behavioral Health Services (BHS) applied for the maximum allowable grant funding award of $8.0 million. Subsequently, on October 3, 2024, the BSCC notified BHS of a final award in the full amount of $8.0 million.
Today’s item requests approval from the San Diego County Board of Supervisors (Board) to accept Proposition 47 Cohort 4 Grant Program funding that, if approved, will allow for implementation of the Forensic Assertive Community Treatment (FACT) treatment model, which currently does not exist in the BHS system of care. FACT serves individuals with serious mental illness who are involved with the criminal justice system by providing customized supports based on criminogenic needs and risks, while bridging the behavioral health and criminal justice systems. It is anticipated these enhanced services will reduce time spent in detention, avoid unnecessary psychiatric visits to emergency rooms, reduce unnecessary admissions to psychiatric hospitals, increase engagement into treatment, and increase public safety.
Today’s item also requests the Board to amend and extend an existing contract (#551670) with the Telecare Corporation to establish FACT services locally that will be funded through Proposition 47 Cohort 4 Grant Program. Additionally, Board approval is requested to amend and extend an existing single source contract (#568085) with the Criminal Justice Research Division (CJRD) of the San Diego Association of Governments to provide evaluation services for the Proposition 47 Cohort 4 Grant Program due to the organization’s unique qualifications, access to justice data needed for evaluation of services, and ability to meet the accelerated timeline for initial local evaluation plan.
This item supports the County vision of a just, sustainable, and resilient future for all, specifically those communities and populations in San Diego County that have been historically left behind, as well as our ongoing commitment to the regional Live Well San Diego vision of healthy, safe, and thriving communities. This will be accomplished by implementing new services that are designed to improve outcomes for persons with serious mental illness who are involved with the criminal justice system.
RECOMMENDATION(S)
CHIEF ADMINISTRATIVE OFFICER
1. Authorize the acceptance of $8,000,000 of one-time Proposition 47 Cohort 4 Grant Program funding from the California Board of State and Community Corrections for Fiscal Years (FY) 2024-25 through 2027-28 for the provision of mental health services, substance use disorder treatment, and/or diversion programs for people in the criminal justice involvement, and authorize the Deputy Chief Administrative Officer, Health and Human Services Agency, or designee, to execute all required documents, upon receipt, including any annual extensions, amendments and/or revisions that do not materially impact or alter the services of funding level.
2. In accordance with Board Policy A-87, Competitive Procurement, and Administrative Code Section 401, authorize the Director, Department of Purchasing and Contracting, subject to successful negotiations and determination of a fair and reasonable price, to amend the contract with Telecare Corporation (#551670), to include FACT services, and to extend the contract term for up to two years and six months, and up to an additional six months, if needed, subject to the availability of funds; and amend the contract as required in order to reflect changes to services and funding allocations, subject to the approval of the Deputy Chief Administrative Officer, Health and Human Services Agency.
3. In accordance with Board Policy A-87, Competitive Procurement, and Administrative Code Section 401, authorize the Director, Department of Purchasing and Contracting, subject to successful negotiations and determination of a fair and reasonable price, to amend the single source contract with the Criminal Justice Research Division (CJRD) of the San Diego Association of Governments (#568085), to include Proposition 47 Cohort 4 Grant Program evaluation services, and to extend the contract term for up to two years, and up to an additional six months, if needed, subject to the availability of funds; and amend the contract as required in order to reflect changes to services and funding allocations, subject to the approval of the Deputy Chief Administrative Officer, Health and Human Services Agency, and the Deputy Chief Administrative Officer, Public Safety Group.
EQUITY IMPACT STATEMENT
Individuals who are justice-involved experience barriers that impact their ability to successfully navigate systems of care and the justice system. The Proposition 47 Grant Program helps address barriers to services by supporting connections to behavioral health treatment, housing support, and other customized services for persons with high needs who are leaving custody and who may be at risk of returning to the justice system. Nationwide, systemic issues such as poverty, lack of education, inadequate access to healthcare, unsafe neighborhoods, and insufficient social support contribute to disproportionately high rates of crime, arrests, and incarceration among Black, Indigenous, and People of Color, as well as individuals who are poor, struggling with mental health or substance use challenges, or experiencing homelessness. It is anticipated that this grant will have a positive impact on these populations by providing mental health services, substance use disorder treatment, diversion programs, and other supportive services for individuals in the criminal justice system.
The Proposition 47 Cohort 4 Grant Program will prioritize equity by incorporating robust community engagement and evaluation components. From the initial development of the grant proposal through the design, implementation, and evaluation of the program, community involvement has and will continue to occur through a Local Advisory Committee comprised of diverse subject-matter experts and community members with lived experience. This approach ensures that the voices of those most affected by disparities are integral to informing and evaluating the program throughout its entire lifecycle. Participation and outcome data will be collected and reviewed by sub-populations to continually inform the design and implementation of the program.
SUSTAINABILITY IMPACT STATEMENT
Today’s actions support the County of San Diego (County) Sustainability Goal #2 to provide just and equitable access to County services by addressing barriers that disproportionately affect justice-involved individuals, particularly Black, Indigenous, and People of Color, and those experiencing homelessness, mental health, or substance use conditions. The Proposition 47 Grant Program addresses barriers to care by connecting individuals with behavioral health treatment, housing support, and diversion programs following incarceration.
Furthermore, these efforts align with Sustainability Goal #4 to protect the health and well-being of everyone in the region. By supporting connections to essential services for individuals re-entering the community after incarceration, the Proposition 47 Grant Program helps reduce the cycle of incarceration and homelessness, contributing to long-term improvements in health outcomes for San Diego County residents. Ongoing community engagement and program evaluation will ensure that services remain responsive to community needs, fostering sustainable improvements in both the justice and behavioral health systems over time.
FISCAL IMPACT
Funds for this request are included in the Fiscal Year (FY) 2024-26 Operational Plan in the Health and Human Services Agency (HHSA). If approved, this request will result in estimated costs and revenue of $0.4 million in FY 2024-25, $2.6 million in FY 2025-26, and $5.0 million in FYs 2026-27 through 2027-28, for a total cost and revenue of $8.0 million from FYs 2024-25 through 2027-28 to implement the Forensic Assertive Community Treatment (FACT) treatment model. Additionally, funding includes approximately $500,000 for required evaluation services through the term of the grant. The funding source is State General Funds from the Safe Neighborhoods and Schools Fund. Funds for FY 2024-25 will be covered by existing appropriations within HHSA and funds for subsequent years will be included in future operational plans. There will be no change in net General Fund cost and no additional staff years.
BUSINESS IMPACT STATEMENT
N/A
Details
ADVISORY BOARD STATEMENT
At its November 7, 2024 meeting, the Behavioral Health Advisory Board voted to approve the acceptance of the Proposition 47 Cohort 4 Grant Program funds on consent.
BACKGROUND
The San Diego County Board of Supervisors (Board) and County of San Diego (County) Health and Human Services Agency (HHSA) remain committed to supporting the well-being of those with behavioral health conditions and investing in services to meet the needs of individuals, including those who are involved with the justice system. In alignment with this commitment, County Behavioral Health Services (BHS) continues to pursue funding to enhance and expand access to critical mental health and substance use disorder prevention, engagement, housing, and treatment services. Recent grant programs from the State have created a unique opportunity to advance Board priorities and provide better connections to care for vulnerable populations with specialized needs.
In 2014, Proposition 47 was approved by California voters with the purpose of reducing certain felony drug and theft crimes to misdemeanor offenses and enacting the Safe Neighborhoods and Schools Act. This Act designates 65% of the State corrections savings by investing in alternatives for nonserious, nonviolent crime and for treatment and other services. These savings are deposited into a fund that is made available for various grant programs released through the California Board of State and Community Corrections (BSCC).
On April 12, 2024, BSCC released the Proposition 47 Grant Program: Safe Neighborhood and Schools Act, Cohort 4 Grant Program, which provided $152.0 million in total funding to eligible California public agencies for the provision of mental health services, substance use disorder treatment, and/or diversion programs for people in the criminal justice system. In addition to this service alignment, applicants were encouraged to submit proposals that also offer housing-related services and other community-based supports. BHS developed a proposal and on May 8, 2024, the proposed was shared with the County Local Advisory Committee (LAC) for input. The LAC was formed in 2016 for the sole purpose of planning, developing, and overseeing programs funded by Proposition 47 grants. Members consist of representatives with diverse expertise in the criminal justice system, including those with lived experience. On June 10, 2024, BHS applied for the maximum allowable grant funding award of $8.0 million, and on October 3, 2024, the BSCC notified BHS of a final award for the full amount.
The Proposition 47 Cohort 4 Grant Program funding will allow the expansion of the evidence-based Assertive Community Treatment (ACT) approach to include the implementation of the Forensic Assertive Community Treatment (FACT) treatment model, which currently does not exist in the BHS system of care. ACT services provide the most intense level of outpatient treatment to adults with serious mental illness (SMI) who are experiencing homelessness, using a “whatever it takes” approach to comprehensively address a person’s needs with a focus on resilience and recovery. ACT services are tailored to each person based on their unique needs and include, but not limited to housing, intensive case management, wraparound services, outpatient services, rehabilitation and recovery services, supported employment and education services, and peer support. FACT services build on the ACT model and provide care to people with SMI who are involved with the criminal justice system by providing customized supports based on criminogenic needs and risks, while bridging the behavioral health and criminal justice systems. Through the Proposition 47 grant, BHS will leverage approximately $6.4 million of existing Mental Health Services Act (MHSA) funding within current ACT programs to create the first local FACT program in the region.
The Proposition 47 Cohort 4 Grant Program funding will be amended into an existing ACT program serving justice-involved populations transitioning from custody to community-based treatment and supervision, including participants in and graduates of the Behavioral Health Collaborative Court treatment program. The current ACT program provides clinical case management, mental health services, substance-induced psychiatric disorder rehabilitation treatment, and recovery services to adults with SMI. The program also assists participants in managing their symptoms and co-occurring conditions by focusing on criminogenic risk and needs to prevent future justice involvement, reducing recidivism, and minimizing costs associated with repeated involvement in the criminal justice system for low-level, non-violent offenses. Grant funding will be utilized to enhance the program through new housing interventions and ancillary housing supports, embedded criminal justice staff, substance use treatment support and coordination, and flexible funding for customized supports.
Today’s actions request the Board authorize an extension of a contract (#551670) with the Telecare Corporation for two years and six months to align with the time-limited term of the Proposition 47 Cohort 4 Grant Program. Extending the contract will establish FACT services locally and support continuity of care for participants receiving FACT services through the term of the grant. The County will also be able to leverage expertise of the provider who operates FACT programs in San Bernardino, Alameda, Los Angeles, and San Joaquin Counties to support a more seamless transition to FACT services. FACT services are anticipated to begin in early 2025.
The FACT program is anticipated to improve outcomes for persons with SMI who are involved with the criminal justice system. Overall goals of FACT services include:
• Reduced homelessness and increase housing retention outcomes.
• Reduced recidivism through an integrated multi-disciplinary team approach.
• Reduced time spent in detention.
• Reduced psychiatric visits to emergency rooms and admissions to psychiatric hospitals.
• Increased client engagement in treatment.
Today’s actions request the Board authorize an extension of the existing contract with Telecare Corporation to align with the Proposition 47 Cohort 4 Grant Program funded services and supports through FY 2027-28. Additionally, the Proposition 47 Cohort 4 Grant Program requires a portion of the grant award to be set aside for data collection and evaluation efforts to measure the impact of these grant-funded services. This will include data collection of participant experience records, treatment information, justice system information, pre- and post- analysis of need and risk assessments, equity measures, and may include surveys and focus groups with participants, staff, and community stakeholders.
On September 27, 2022 (2), the Board approved a single source contract with the Criminal Justice Research Division (CJRD) of the San Diego Association of Governments (SANDAG) for the Proposition 47 Cohort 3 Grant Program funded services due to the organization’s unique qualifications and access to data needed for the required evaluation of services. This program qualifies for a single source contract based on the following section of Board Policy A-87 Competitive Procurement, Section 1D-3: The procurement is for services from a provider with unique knowledge, skill, or ability not available from other sources. The CJRD has significant expertise and knowledge of regional criminal justice data systems based on previous evaluation efforts across the region. The entity is approved by the SANDAG Police Chiefs’ and Sheriff’s Committee to provide regional criminal justice clearinghouse information and is the only research organization approved by regional criminal justice agencies and by HHSA to access both the Automated Regional Justice Information System (ARJIS) and the MultiAgency Interface System for law enforcement data.
As the only outside entity with access to the MultiAgency Interface System, CJRD is uniquely equipped to access both criminal justice and behavioral health data needed to perform evaluation of the grant program. In addition, the CJRD has established agreements with the County and other regional partner organizations and has developed methods to compile and analyze data in the MultiAgency Interface System. Therefore, the CJRD is the only known entity that can support the evaluation requirements required by the BSCC. CJRD also has immediate capacity to perform the data collection and evaluation planning work required for the BSCC’s accelerated evaluation timeline. The initial local evaluation plan is due no later than March 31, 2025, and the final evaluation report is due June 30, 2028.
Today’s actions request the Board authorize the acceptance of one-time Proposition 47 Cohort 4 Grant Program funding of $8.0 million, an amendment and extension of the ACT service contract (#551670) with Telecare Corporation to establish FACT services, and an amendment and extension of the evaluation contract (#568085) with the SANDAG CJRD for evaluation services to measure the effectiveness of Proposition 47 Cohort 4 Grant Program funded services and supports.
LINKAGE TO THE COUNTY OF SAN DIEGO STRATEGIC PLAN
Today’s proposed actions support the County of San Diego 2024-2029 Strategic Plan initiatives of Equity (Health), Community (Quality of Life), and Justice (Restorative) as well as the regional Live Well San Diego vision, by reducing disparities and disproportionality of individuals by implementing new services that are designed to improve outcomes for persons with serious mental illness who are involved with the criminal justice system.
Respectfully submitted,
ebony n. shelton
Chief Administrative Officer
ATTACHMENT(S)
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