Measure O Meeting on August 20th

Short Summary of a meeting of the Measure O Oversight Committee on August 20th

County officials discussed severe funding cuts impacting behavioral health and homelessness services,highlighting critical financial challenges.

Long Summary

The conversation delved into the precarious financial state of Sonoma County’s behavioral health and homelessness services. You heard about federal Medicaid cuts, dwindling local funds, and the critical role of Measure O. Officials expressed nervousness about future reductions, the difficulty in predicting impacts, and the need for tough decisions, strategic partnerships, and community advocacy to maintain vital services amidst a “seismic shift” in healthcare funding.

Announcements

A $10 million Notice of Funding Availability (NOFA), titled “Behavioral Health and Homelessness Pathways to Sustainability,” has been released to support existing programs facing funding loss.  The deadline for proposals is September 17th, with a pre-bid conference scheduled for the following day.  Marc, the former board chair of NAMI, is recommended to fill the vacant “lived experience” seat.  His appointment will go to the Board of Supervisors for official approval on September 3rd. A new ad hoc committee, including Supervisor Gore and Supervisor Coursey, has been established to oversee Measure O funding and enhance collaboration with partners.  The county’s homeless services unit is undergoing a leadership transition, with a plan to reorganize the team under the behavioral health department.

Key Achievements

The Crisis Stabilization Unit (CSU) has successfully addressed staffing shortages and is now almost fully staffed and operational.  A successful QPR (Question, Persuade, Refer) suicide prevention training was delivered to counselors at Analy High School, increasing their confidence in addressing suicidal ideation.  The Crestwood Healing Center, a 16-bed psychiatric health facility, is running effectively and has become a significant asset, reducing reliance on private hospitals. Measure O currently funds 58.33 employees who are delivering essential mental health and crisis services across the county.

Challenges and Adjustments Needed

Financial Uncertainty: The most significant challenge is the looming fiscal crisis due to anticipated federal cuts to Medicaid/Medi-Cal, described as a “seismic shift” in healthcare funding.  The county’s Realignment fund balance is dwindling, and the projected Measure O ending balance of $7.1 million is causing significant concern among leadership.

Project and Funding Gaps:

The planned mental health unit at the county jail is stalled because the allocated $39 million is insufficient for current construction costs, and the state has not allowed for plan lterations. Many homeless and housing providers are in urgent need of financial support to sustain their operations.

Strategic Adjustments:

A reorganization is planned to move the homelessness team into the behavioral health department to leverage Medi-Cal billing and improve service integration.  A strategic pivot is underway for homeless services to focus on residents with higher behavioral health needs.  An allocation adjustment for the $10 million NOFA may be requested to direct more funds toward struggling homeless and housing providers.

Action Items and Accountability for the Week Ahead

The team will continue developing a data-driven proposal for a second psychiatric health facility to further reduce costs associated with private hospital placements.  The leadership will continue its monthly meetings with the new ad hoc committee to provide updates on. Measure O and align on strategic priorities, including the preference for transparent NOFA processes. A plan is being formulated to “take the show on the road” to proactively inform community groups, mayors, and councils about Measure O’s impact and the upcoming financial challenges.  The search for an interim and permanent leader for the homeless services team is actively underway.