SUBJECT
Title
RECEIVE UPDATE ON BEHAVIORAL HEALTH CAPITAL FACILITY PROJECTS RECOMMENDED FOR PROPOSITION 1 INFRASTRUCTURE BOND FUNDING AND AUTHORIZE GRANT SUBMISSIONS, AND AUTHORIZE A FORMAL PROCESS TO ISSUE LETTERS OF SUPPORT (DISTRICTS: ALL)
Body
OVERVIEW
In California, counties are responsible for administering specialty mental health and substance use services for residents eligible for Medi-Cal. In this capacity within San Diego County, the County of San Diego (County) Health and Human Services Agency, Behavioral Health Services (BHS) serves as the specialty mental health plan for Medi-Cal eligible residents with serious mental illness, and the service delivery system for Medi-Cal eligible residents with substance use disorder care needs. To ensure access to quality care that meets the needs of Medi-Cal beneficiaries in San Diego County, BHS is required to maintain a local network of behavioral health services and providers.
In March 2024, California voters passed Proposition 1 that includes the Behavioral Health Services Act (Senate Bill 326) and the Behavioral Health Infrastructure Bond Act of 2023 (Assembly Bill 531), which authorized $6.38 billion in a general obligation bond to expand behavioral health treatment, residential care settings, and housing to support people with mental health conditions and substance use disorders. Funds from the bond will be allocated to competitive grants for facilities that provide behavioral health treatment and residential settings, including for tribal entities; housing Veterans who are homeless or at risk of homelessness with behavioral health needs; and others who are homeless or at risk of homelessness with behavioral health needs.
To inform the priorities for the Proposition 1 Infrastructure Bond funding, on April 9, 2024 (4), the Board directed the creation of a process for seeking and investing funding, informed by data, community advocates, and stakeholders, and return to the Board within 120 days with a set of priorities to inform County planning efforts for these funds. The Proposition 1 grant funding will be administered by the State in multiple funding rounds through the Bond Behavioral Health Continuum Infrastructure Program (Bond BHCIP) and the State preliminary guidance indicates that awards will be prioritized to counties, cities, tribal entities, nonprofit, and for-profit entities demonstrating site control, emphasizing residential treatment, and commencing service delivery in an expedient manner. Following a review of capital projects within the BHS portfolio, BHS is recommending the prioritization of several behavioral health capital projects for Proposition 1 grant funding through Bond BHCIP. These capital projects are anticipated to be the strongest candidates for grant funding based on the State’s criteria and priorities, are high priorities locally, are furthest along in development, and will yield significant impact to clients in need of care in San Diego County.
Today’s action requests the Board receive an update on behavioral health capital facility projects prioritized for Proposition 1 Infrastructure Bond funding and authorize the submission of Bond BHCIP grant applications for essential infrastructure projects, including the Substance Use Residential and Treatment Services facility, the new Children’s Crisis Residential Care facility, and others including the Central Region Community-Based Care facility, should State and local criteria and priorities for funding align. In addition, today’s action requests the Board authorize a formal process to evaluate requests for letters of support submitted by local entities, as required for applications for Proposition 1 Infrastructure Bond funding, and issue letters of support for projects aligned with State and County priorities and criteria.
Today’s action 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 through further strengthening the continuum of behavioral health services in San Diego County.
RECOMMENDATION(S)
CHIEF ADMINISTRATIVE OFFICER
1. Receive an update on recommended behavioral health capital facility projects prioritized for Proposition 1 Infrastructure Bond grant funding, and authorize the Agency Director, Health and Human Services Agency, or designee, to submit grant fund proposals through the Bond Behavioral Health Continuum Infrastructure Program and Permanent Supportive Housing program for the behavioral health capital projects identified, and additional future applications for these projects or others identified as priority areas of investment, if opportunities arise.
2. Authorize the Behavioral Health Services Director to implement a formal process for the Behavioral Health Services department to evaluate requests for letters of support submitted by local entities, as required for applications for Proposition 1 Infrastructure Bond funding, and issue letters of support only for projects that meet State criteria, align with one or more State priorities, and align with County priorities.
EQUITY IMPACT STATEMENT
The County of San Diego Health and Human Services Agency, Behavioral Health Services (BHS) functions as the specialty mental health plan for Medi-Cal eligible residents with serious mental illness, and the service delivery system for Medi-Cal eligible residents with substance use disorder care needs within San Diego County. As a regional steward of public health, BHS must ensure services address social determinants of health by being accessible, capable of meeting the needs of a diverse population, and equitably distributed to those most in need. BHS utilizes a population health approach, evidence-based practices, robust data analysis, and input from consumers, community-based providers, healthcare organizations, and other stakeholders to identify community needs and design services that are impactful, equitable, and yield meaningful outcomes for clients. BHS conducts ongoing engagement activities, such as community outreach, focus groups, listening sessions, and key informant interviews, to ensure community input remains central to priorities and planning activities.
Establishing additional dedicated behavioral health infrastructure to support people with mental health and substance use needs who are Medi-Cal eligible is expected to yield positive outcomes for some of the most vulnerable residents in San Diego County. This will be accomplished through the development of the new Substance Use Residential and Treatment Services (SURTS), the new Children’s Crisis Residential, and the new Central Region Community-Based Care (CBC) facilities. These facilities will enhance access to behavioral health care across the region for adults in need of residential substance use services, children in need of behavioral health crisis services, and adults in need of access to housing and care within a licensed board and care facility. According to the 2021 National Survey on Drug Use and Health, 94% of people aged 12 and older with a substance use disorder do not receive any treatment. The SURTS facility will help meet the unmet and rising need for residential treatment options. In addition, development of the new Children’s Crisis Residential facility establishes a new resource for youth care not currently in place within the local behavioral health care continuum. The Central Region CBC will provide a new pathway for individuals in higher levels of care to step down into community-based care within the least restrictive setting.
SUSTAINABILITY IMPACT STATEMENT
Today’s proposed action supports the County of San Diego (County) Sustainability Goal #1, to engage the community in meaningful ways and continually seek stakeholder input, and Sustainability Goal #2, to ensure equitable access to County services. BHS has conducted extensive engagement activities to better understand local behavioral health needs and enhance collaboration with local partners. Through these efforts, BHS has solicited community feedback to inform department priorities, inclusive of services and infrastructure planning. Prioritizing the development of the recommended facilities will support increased capacity dedicated for children and adults with behavioral health conditions. These services will support equitable access to essential behavioral health care for Medi-Cal eligible children and adults, enabling them to be connected to the care they need.
FISCAL IMPACT
There is no fiscal impact associated with these recommendations. If awarded grant funding, the County of San Diego Behavioral Health Services department will return to the Board at a future date with additional recommendations. At this time, there will be no change in net County General Fund cost and no additional staff years.
BUSINESS IMPACT STATEMENT
N/A
Details
ADVISORY BOARD STATEMENT
On June 6, 2024, this item was presented to the Behavioral Health Advisory Board for discussion and comment.
BACKGROUND
In California, counties are responsible for administering specialty mental health and substance use services for residents eligible for Medi-Cal. In this capacity, the County of San Diego (County) Health and Human Services Agency, Behavioral Health Services (BHS) serves as the specialty mental health plan for Medi-Cal eligible residents with serious mental illness, and the service delivery system for Medi-Cal eligible residents with substance use disorder care needs within San Diego County. To ensure access to quality care that meets the needs of Medi-Cal beneficiaries in San Diego County, BHS is required to maintain a local network of behavioral health services and providers.
To optimize the local behavioral health system of care, the San Diego County Board of Supervisors (Board) has made key investments over the last several years to enhance community-based behavioral health services and develop critical behavioral health infrastructure that is regionally distributed in alignment with population health needs. Recent significant State initiatives have been implemented to accelerate the transformation of the behavioral health continuum of care, complementing the current efforts and offering new opportunities for the County to build on critical work already underway.
In March 2024, California voters passed Proposition 1, which includes the Behavioral Health Services Act (Senate Bill 326) and the Behavioral Health Infrastructure Bond Act of 2023 (Assembly Bill 531), which authorized $6.38 billion in a general obligation bond. Funds aim to expand behavioral health treatment, residential care settings, and housing to support people with mental health conditions and substance use disorders. Funding from the bond will be allocated as follows:
• $4.4 billion in competitive grants for facilities that provide behavioral health treatment and residential settings, which includes $30.0 million reserved for tribal entities,
• $1.065 billion for housing Veterans who are homeless or at risk of homelessness with behavioral health needs, and
• $922 million for others who are homeless or at risk of homeless with behavioral health needs.
To inform the priorities for the Proposition 1 Infrastructure Bond funding, on April 9, 2024 (4), the Board directed a process be created for seeking and investing funding, informed by data, community advocates, and stakeholders, and return to the board within 120 days with a set of priorities to inform County planning efforts for these funds.
Behavioral Health Infrastructure Bond Funding
The bond funding will be available via competitive grants administered by the Department of Health Care Services (DHCS) in multiple funding rounds through the Bond Behavioral Health Continuum Infrastructure Program (Bond BHCIP), with the Permanent Supportive Housing (PSH) grant funds administered by the California Department of Housing and Community Development (HCD) in partnership with the California Department of Veterans Affairs.
The Bond BHCIP Round 1: Launch Ready grant funds will total up to $3.3 billion. The Request for Applications (RFA) for Bond BHCIP Round 1 is expected to be released in July 2024, with applications due in Fall 2024, and funding awarded in mid-2025, including:
• Up to $1.5 billion open only to counties, cities, and tribal entities through competitive awards, no regional funding cap, and a minimum of $30 million awarded to tribal entities; and
• Up to $1.8 billion open to counties, cities, tribal entities, nonprofit, and for-profit entities through competitive award and with a regional funding cap that allocates $263.7 million for Southern California Counties, along with 20% of funding set aside for use at the State discretion.
The Bond BHCIP Round 2: Unmet Needs grant funds will include total funding of up to $1.1 billion available to counties, cities, tribal entities, nonprofit, and for-profit entities through competitive award, and will be subject to a regional funding cap that allocates $161.1 million for Southern California counties, along with 20 percent set aside for use at the State discretion. The RFA is expected to be open to all applicants and released in May 2025.
Guidance for the PSH grant funds of up to $2.0 billion to build permanent supportive housing for Veterans and others with behavioral health conditions who are experiencing or at risk of homelessness will be made available through separate Notices of Funding Availability (NOFAs) in late 2024 from HCD.
State Criteria and Priorities for Bond BHCIP Funds
Infrastructure projects proposed for Bond BHCIP grant funds must expand community-based behavioral health facility capacity for Medi-Cal beneficiaries through regional models and collaborative partnerships that advance equity and increase services within areas that do not have adequate mental health and substance use treatment facilities. The facility types eligible for Bond BHCIP grant funds include a wide array of mental health and substance use facilities across the continuum of care, including but not limited to peer respite, crisis care, residential treatment, subacute care, inpatient care, and community-based care. Projects submitted for Bond BHCIP grant funds must be in one of the phases outlined below to be considered for a grant award. Those adding new residential capacity will be prioritized for funding per State criteria:
• Phase 1: Planning and Pre-development
• Phase 2: Design Development
• Phase 3: Shovel Ready
In addition, projects must align with State priorities to be eligible for funding. Projects must:
• Address urgent needs for people with mental health or substance use conditions, including unhoused people, Veterans, older adults, adults with disabilities, and children and youth;
• Invest in behavioral health care options that advance health equity;
• Increase options across the life span that serve as an alternative to incarceration, hospitalization, homelessness, and institutionalization;
• Meet the needs of vulnerable populations with the greatest barriers to access, including people experiencing unsheltered homelessness and justice involvement;
• Ensure care is provided in the least restrictive settings;
• Leverage County and Medi-Cal investments to support ongoing sustainability; and
• Leverage the historic State investments in housing and homelessness.
The State will prioritize Bond BHCIP grant awards for projects that demonstrate site control, project readiness, add new capacity, have a sustainable business plan, a conceptual schematic site plan, and stakeholder support. Entities applying for funds are required to identify match funding, which varies depending on the type of entity:
• 10% match for local government or non-profits;
• 25% match for-profit organizations; and
• 5% match for tribal entities.
The match requirement may be in the form of cash or in-kind contributions, such as land. If awarded funding, entities must execute contracts within 90 days of receipt of conditional award notice.
County Priorities for Bond BHCIP Grant Funds
In anticipation of the release of the RFA for the Bond BHCIP grant funds, BHS has been reviewing the array of County capital projects in various stages of the planning and development process. In addition to the criteria put forth by the State, BHS developed additional criteria to identify capital projects to prioritize for Bond BHCIP grant funds. Based on these criteria, projects must:
• Support regional distribution, including density of need and Medi-Cal enrollment density, to ensure access to care;
• Align with recommendations outlined in the Optimal Care Pathways (OCP) Model or other critical service priorities within the department;
• Leverage other grants, including but not limited to Behavioral Health Bridge Housing funds, Incompetent to Stand Trial Infrastructure funds;
• Establish an innovative partnership with another entity such as a developer or operator, healthcare organization;
• Support revenue optimization through cost savings and/or cost avoidance;
• Have ongoing services that are sustainable through State/federal revenue; and
• Support health equity to improve access to care across diverse communities within San Diego County.
Projects Recommended for Bond BHCIP Grant Funds
To ensure BHS grant proposals are best situated to receive Bond BHCIP grant funds, BHS utilized an approach to prioritize and uplift capital projects that most align with the State priorities and criteria as well as those of the County. BHS reviewed capital projects within its capital portfolio and is recommending the prioritization of several behavioral health capital projects for Bond BHCIP funds. These projects are anticipated to be the strongest candidates for funding based on the State criteria and priorities, are highest priorities locally, are furthest along in development, and will yield the highest impact across our continuum of care. Additionally, prioritized projects have funding identified or are situated on County-owned land to meet the State 10% local match requirement for local government or non-profits. Based on all of these criteria and priorities, BHS recommends moving forward with Bond BHCIP applications for the Substance Use Residential and Treatment Services (SURTS) facility and the Children’s Crisis Residential Care (CCRC) facility, and potentially with an application for the Central Region Community Based Care (CBC) facility if State criteria is expanded to include licensed board and care facilities as an eligibility type.
Substance Use Residential & Treatment Services
The SURTS facility will establish new substance use residential and treatment services in the South Region to enhance access to care locally for people with substance use conditions who are Medi-Cal eligible. Located on a County-owned parcel, the SURTS facility will require renovations, including mechanical, electrical, and plumbing systems, modernization of residential rooms and office spaces, and the building-out of the Annex, which will include a kitchen and laundry facility. Extensive planning has already occurred and the total estimated cost for this renovation is $26.8 million. It is anticipated that the SURTS facility will establish between 72 and 96 new substance use residential treatment and recuperative care beds, depending on the most optimal model determined. This project is in Phase 1: Planning and Pre-development, with architectural plans at 50%. The County awarded a contract for architectural and engineering services in February 2023, and the design phase, including construction planning, is nearing completion.
The SURTS facility is strongly positioned to receive Bond BHCIP grant funds, meeting State criteria, aligning with State priorities, and aligning with County priorities, including enhancing residential substance use capacity. Expanding substance use residential treatment care beds is crucial to ensuring people in need of substance use treatment have access to care. Senate Bill 43 highlights the urgent need for increased residential treatment options to combat rising rates of substance use locally and ensure comprehensive care. According to the 2021 National Survey on Drug Use and Health, 94% of people with a substance use disorder do not receive any treatment. Expanding capacity through the SURTS facility provides the opportunity to build a space that anticipates future need and encourages people to seek treatment while enhancing our ability to provide timely access to residential level care and significantly improve patient outcomes.
The substance use services provided within this facility will be sustainable through Medi-Cal funding. Additionally, BHS has submitted an application for Behavioral Health Bridge Housing Round 3 grant funding to support the development and operations of the recuperative care beds within the SURTS facility, which is pending notice of award from the State. Bond BHCIP grant funds would be requested specifically for the new substance use residential treatment beds within this facility.
Children’s Crisis Residential Care Facility
Crisis residential care, often an alternative to hospitalization, is an essential level of care for the treatment of children and youth with serious emotional disturbance in mental health crisis. Currently, crisis treatment is unavailable to many children and youth in regions throughout California. To address this challenge, in 2021, Assembly Bill (AB) 153 was passed establishing the Children’s Crisis Continuum Pilot Program (CCCPP), a five-year program to be jointly implemented by California Department of Social Services (CDSS) and DHCS.
CCCPP will integrate the system of care for foster youth, enabling a seamless transition between service settings and to provide stabilization and treatment to foster youth with high acuity needs in the least restrictive setting possible. On July 18, 2023 (13) the Board authorized the acceptance of $8.5 million of CCCPP funds from CDSS and DHCS for children’s crisis residential services for the anticipated funding period of Fiscal Year (FY) 2023-24 through FY 2027-28.
Complementing the grant funds for crisis residential services, dedicated infrastructure for the CCRC facility will be established within an existing County-owned facility, repurposing an area previously utilized as administrative space. The facility is sited on a County-owned parcel in the North Central Region of San Diego County. Renovations required for the new CCRC facility include reconfiguring the existing internal layout to establish a new layout, overhauling the HVAC system, adding a new fire suppression system, extensive plumbing, and other improvement activities. The total estimated cost for this renovation is $6.0 to $10.0 million, depending on the final design, and will establish 16 new children’s crisis residential beds, which do not currently exist within the local behavioral health continuum of care. Based on the State criteria, this project is in Phase 1: Planning and Pre-development.
This CCRC facility is strongly situated to submit for Bond BHCIP grant funds, meeting the State criteria, and aligning with State and County priorities, including adding new capacity to support vulnerable children and youth experiencing a mental health crisis. There are currently no children's crisis residential facilities for children and youth in acute behavioral health distress in San Diego County. The lack of availability of this level of cares results in youth accessing care in available settings such as crisis stabilization units, emergency departments, or psychiatric hospitals. Utilization at this level can incur additional costs and is often not most appropriate for the child's needs. With the national recognition that children and youth are requiring behavioral health supports, it is imperative that access to timely screening and quality care is readily available. Establishing these services will address this unmet need for children’s crisis services locally. The services provided within this facility would leverage Medi-Cal funding.
Central Region Community-Based Care
Although the Central Region CBC facility currently does not meet the existing criteria for priority services outlined by the State, the project would be strongly situated to submit for Bond BHCIP grant funds if the State guidance were to shift to include licensed board and cares. The Central Region CBC project is of high priority and aligns with County priorities. The County will pursue advocacy with the State around establishing licensed board and care services as an eligible service for Bond BHCIP grant funds.
The CBC facility will be sited on a County-owned parcel in the Central Region and will establish new board and care slots dedicated for people with behavioral health conditions who are Medi-Cal eligible. Locally, we have prioritized the need to establish new board and care capacity, as outlined in the OCP model, as approved by the Board of Supervisors on September 27, 2022 (23) and April 9, 2024 (20). Specifically, the OCP model outlines the need for approximately 400 new licensed board and care beds across our region to support people with behavioral health needs. Upon completion of construction, the Central Region CBC is anticipated to establish up to approximately 148 new beds, making progress toward the 400 new board and care slots needed.
To date, extensive collaborative planning has occurred between BHS the County Department of General Services (DGS) on the Central Region CBC project. This includes program planning, facility design, and engagement of experts. A Request for Information (RFI) was released to gather feedback from local experts, including board and care operators and developers, to inform the most optimal path to developing, constructing, and operating the Central Region CBC. Based on this feedback, the County will pursue a developer/County partnership model for this facility and recently onboarded a consultant with subject matter expertise to guide efforts in establishing an innovative developer/operator model. The Central Region CBC facility will address unmet needs for adults experiencing serious mental illness and requiring housing within a licensed board and care facility. The total estimated cost for the development and construction of this facility is anticipated to range from $55.0 to $65.0 million. This project is included in the County Capital Improvement Needs Assessment and the County is in Phase 2: Design Development for this project. The services provided within this facility are anticipated to be sustainable through Behavioral Health Services Act funds and patient care revenue received through behavioral health payment reform.
Other BHS capital infrastructure projects were also evaluated for Bond BHCIP grant funds; however, they were all determined not to meet one of more of the State mandatory criteria, although all did align with the County priorities for areas of investment. If projects are not awarded Bond BHCIP Round 1: Launch Ready grant funds, BHS would resubmit grant applications for Round 2: Unmet Need grant funds, based on alignment with the State grant requirements. Additionally, in alignment with the recommendations from the OCP model and other County priorities, BHS may pursue Bond BHCIP grant funds for other facilities, if opportunities arise that meet the State mandatory criteria and the County priorities for areas of investment. BHS will provide an update to the Board in the future if this occurs.
Other Entities Seeking Letters of Support for Grant Funds
Letters of support will be required to be submitted with Bond BHCIP grant applications from local entities. Local entities may request a letter of support by submitting general information to BHS about the capital project for which Bond BHCIP grant funds are being requested. Pending release of the Bond BHCIP RFA from the State, which is anticipated for release in July 2024, BHS will develop and establish a formal process using State criteria and priorities as outlined within the State guidance and the RFA, and local priorities for the continuum of care (outlined in today’s item on pages 5 and 6). This process will yield standard parameters against which potential behavioral health infrastructure projects will be assessed for alignment, enabling the Director of BHS to review and issue letters of support requested by local entities applying for Bond BHCIP grant funds. Information about the letter of support request process, criteria, and priorities will be made available on the BHS website and shared through public meetings and community engagement activities, as well as through the County BuyNet.
Projects Recommended for PSH Grant Funds
Guidelines outlining the priorities, criteria, and timelines for the Proposition 1 PSH grant funds have not yet been released; however, NOFAs are anticipated to be released in late 2024 from HCD, in partnership with the California Department of Veterans Affairs. PSH grant funds are intended to build PSH for Veterans and others with behavioral health conditions who are experiencing homelessness. Housing remains difficult to obtain across San Diego County, and it is even more difficult for people experiencing mental health or substance use conditions. Housing helps create a stable living environment which supports people to stay connected to care. Locally, a need has been identified for additional capacity across an array of different types of housing within the behavioral health continuum of care, including bridge housing, recovery residence housing, independent living homes, board and cares, PSH, and others.
The County Housing and Community Development Services (HCDS) is leading local efforts to establish affordable housing and permanent supportive housing through various funding opportunities. This includes collaborations with DGS to repurpose County-owned excess property for the development of affordable and permanent supportive housing. Despite these efforts, the need for additional housing capacity continues to grow. These grant funds will provide an opportunity to build additional new permanent supportive housing on existing County-owned excess property for Veterans and others with behavioral health conditions who are at risk of or experiencing homelessness.
Although detailed grant funds requirements have not yet been released, the following have been identified as potential opportunities for PSH funding under Proposition 1 within the existing portfolio of County-owned surplus property:
• 73rd Street in San Diego
• Mission Gorge Road in San Diego
• Market Street in San Diego
• East Valley Parkway in Escondido
• 12th Street in Ramona
• Other opportunities as identified
HCDS will commence planning discussions with DGS and property developers partnering with the County to develop these properties to determine the viability and potential eligibility for PSH grant funds. Additionally, BHS in partnership with HCDS, may also pursue PSH grant funds for other projects that meet the State mandatory criteria and the County priorities for areas of investment, and convene future planning and engagement sessions with community stakeholders to identify additional housing infrastructure development opportunities eligible for PSH grant funds. HCD is expected to release the NOFA later in 2024, to include guidance on eligibility.
Over the last several years, BHS has conducted presentations and community engagement activities to educate members across various community sectors on behavioral health topics and resources and solicit their feedback to help inform department priorities for the continuum of care, including its services and infrastructure. Engagement activities have included community outreach, focus groups, listening sessions, key informant interviews, online input forms, and panel/Q&A-style workshops. Through these efforts, BHS is increasing its understanding of local behavioral health needs, has identified opportunities to collaborate with local partners, and is implementing tailored health promotion programming to augment broader initiatives and behavioral health public messaging. Should any projects be awarded funding, additional community outreach will take place prior to construct.
Today’s action requests the Board receive an update on behavioral health capital facility projects prioritized for Proposition 1 Infrastructure Bond funding, including the SURTS facility, Children’s Crisis Residential Care facility, and the Central Region CBC facility, should it become eligible for Bond BHCIP grant funds, and authorize grant submissions. If awarded, staff will return to the Board at a future date to seek authority to accept grant funds. Today’s action also requests the Board authorize a formal process for evaluation of requests for letters of support submitted by local entities, as required for applications for Proposition 1 Infrastructure Bond funding, and issue letters of support only for projects aligned with State and County priorities and criteria.
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) and Community (Quality of Life) as well as the regional Live Well San Diego vision. This is accomplished by reducing disparities and disproportionality of individuals with mental illness and substance use disorders and ensuring access to a comprehensive continuum of behavioral health services administered through accessible behavioral health programs.
Respectfully submitted,
EBONY N. SHELTON
Chief Administrative Officer
ATTACHMENT(S)
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