Author: Gregory Fearon

Behavioral Health Transformed

Proposition 1 is a two-part ballot initiative. It includes a bond to build treatment facilities and permanent supportive housing for people with mental health and addiction challenges. It also proposes changes to a longstanding tax on personal incomes over $1 million, known as the Mental Health Services Act, by requiring counties to spend 30% of that revenue on housing instead of other services.

Proposition One, passed by the voters of California last March, is changing the landscape of county behavioral health departments. For the first time, local behavioral health boards and commissions will be responsible for substance use disorder programs meeting local needs. To do so, and continue to meet the needs of those needing mental health services, counties are required to develop three-year Integrated Plans for all funding received from federal, state, and local sources.

Sonoma County’s Behavioral Health Board is implementing the new requirements, referred to as Behavioral Health Transformed, over the next six months. Initially, it is adding new members to its board and establishing a planning committee to establish a process for bringing the current plans for its funding into focus.

Here’s the actual instructions to Sonoma County from the California Department of Health Care Services, received on November 9, 2024: “The Behavioral Health Services Act (BHSA) requires counties1 to submit three-year Integrated Plans for Behavioral Health Services and Outcomes (Integrated Plans (IPs)). Whereas the Three-Year Program and Expenditure Plan required under the MHSA focused exclusively on MHSA dollars, the BHSA establishes the IP to serve as a three-year prospective global spending plan that describes how counties plan to use all available behavioral health funding, including BHSA, 1991 and 2011 Realignment, federal grant programs, federal financial participation from Medi-Cal, opioid settlement funds, local funding, and other funding to meet statewide and local outcome measures, reduce disparities, and address the unmet need in their community. In accordance with the BHSA, the IP provides a description of how counties will plan expenditures across a range of behavioral health funding sources and deliver high-quality, culturally responsive, and timely care along the Behavioral Health Care Continuum for the plan period.2 

IPs require counties to conduct a thorough data-informed local service planning process and provide transparency into county planning for expending BHSA funding and all other behavioral health funding sources overseen by counties. IPs will also facilitate local and statewide data collection by providing baseline data on services and planned expenditures and supporting analysis of county goals and outcomes.”

Redesigning California’s Behavioral Health System

BOS Authorizes Payments

Oct 15th, BOS Agenda Item 8A

The Department of Health Services contracts with a network of providers to deliver behavioral health, homelessness and housing support, and other public and behavioral health wrap-around services. These services include mental health treatment, substance use recovery programs, housing assistance, and other services.

At the start of each fiscal year, the Department renews and updates provider contracts to reflect changes in service needs, funding levels, and regulatory requirements. This process can take several months for completion. ​While the FY 2024-25 contracts are in the process of development, providers have been rendering services without disruption since July 1, 2024. However, without fully executed agreements, payments have not been processed. Consequently, many of our providers are at risk experiencing financial challenges as a result of these delayed payments.

Given completion of current fiscal year agreements is expected to take an additional several months, staff is requesting authority to execute payments for properly supported providers invoices thru December 31, 2024, in advance of an executed FY 2024/25 agreement, for those providers that had fully executed agreements for similar FY 2023/24 services. The Department will utilize the terms of the FY 2023/24 agreements to current year payments, and execute a reconciliation process once current year agreements or amendments are fully executed.  The Auditor-Controller-Treasurer-Tax Collector will use the Resolution adopted with this item as authority to release payments to service providers under the terms of the executed FY 2023/24 agreements listed in Attachment 2. 

Attachment 2 to the requested Resolution includes a list of the FY 2023/24 contracts which the Department is requesting authority to utilize, for execution of FY 2024/25 payments, for services received thru December 31, 2024. 

For transparency, this approach will not resolve all financial consideration for all current year partners.  For contractors which are new to the Department and did not provide services in FY 2023/24, and for which a corresponding FY 2023/24 contract does not exist, payments in FY 2024/25 without a current year agreement will not be feasible and these are not included in the requested Resolution and Attachment 2. Department staff will prioritize the execution of contracts to these vendors immediately, should this requested action be approved.

Additionally, some providers are aware that the County does not historically pay invoices without an executed agreement. There may be providers which have not yet submitted invoices to the Department for audit review and payment processing as a result. The Department will actively communicate with all vendors listed on Attachment 2 to make them aware of the payment authority and encourage them to submit completed invoices for payment as soon as possible. Separately, item #2024-0935 on today’s agenda, is requesting the Board allow for 1/12th monthly advance payment for thirteen Medi-Cal partners to deliver Specialty Mental Health Services across the county. This model was reviewed and is endorsed by County Counsel, the Auditor-Controller-Treasurer-Tax Collector’s office, and the County Administrator’s Office.

Staff have been actively working to improve the contract development process to prevent such delays in future fiscal years. This includes implementing multi-year contract terms where appropriate and designing an internal system towards the goal of negotiating agreements which are ready for execution prior to the start of the next fiscal year. These improvements are intended to provide greater predictability for providers and ensure the uninterrupted delivery of essential services as well as payments to our community partners.

There is no new financial impact associated with this request. Payments for services will be made in accordance with the FY 2024-25 budget allocations for behavioral health, homelessness and housing support, and other public and behavioral health wrap-around services and the previous delegated authority provided by the Board for FY 2024/25 services and budget.

Sonoma County Secure Families Collaborative Funded

Executive Summary:

Consistent with California Code, Government Code – GOV § 26227 during the budget development process for fiscal year 2024-25, the Board approved Board Budget Request BOS-16, submitted jointly by Supervisors Coursey and Hopkins, which consists of a payment of $300,000 to the Secure Families Collaborative to support the Collaborative’s legal representation of undocumented people in Sonoma County.

CG 26227 allows for the county to appropriate and expend money from the general fund or to fund programs deemed by the Board of Supervisors to be necessary to meet the social needs of the population.

This item authorizes the County Administrator and/or designated staff to execute the agreement between the County and the Collaborative, and operationalizes the payment approved during budget. This action brings the total funding provided by the Board to the Collaborative since 2017-18 to approximately $1.2 million.  

Discussion:

In 2018, the Sonoma County Board of Supervisors established the Sonoma County Secure Families Collaborative (the Collaborative, website: https://sonomacountysecurefamilies.org/) to meet the needs of the community due to changes in federal immigration policy and the North Bay wildfires. The Collaborative has been a registered 501(c)(3) nonprofit organization since 2021. The Collaborative’s partners include nonprofit and community-based organizations such as the University of San Francisco Deportation Defense Clinic in Healdsburg, the Catholic Charities of the Diocese of Santa Rosa, the Immigration Institute of the Bay Area, Sonoma Immigrant Services, North Bay Organizing Project, Queer Asylum Accompaniment (QAA) Team, and Legal Aid of Sonoma County.

The Collaborative and its partners provide legal assistance with removal defense cases, with Deferred Action for Childhood Arrivals (DACA), conduct referrals to wraparound social services, and assist asylum seekers with essential needs such as housing, food, and other services. The Collaborative’s client base and legal work are distinct from County departments like the Public Defender’s Office (PDO) in that the Collaborative represents clients with cases involving the US Citizenship and Immigration Services (USCIS) and affirmative applications for immigration benefits with the Executive Office of Immigration Review (EOIR). The Collaborative does not represent clients with a criminal conviction. In contrast, the Public Defender’s Office represents justice-involved individuals charged with a criminal offense and handles defensive applications that seek to prevent deportation. 

The Board has provided financial support in varying amounts and from varying sources to the Collaborative over the past seven years. In 2017, the Board approved a $100,000 donation per year for 3 years to the Collaborative using Graton Tribal Mitigation Funds. In 2020-21, the Board provided a payment of $100,000 to the Collaborative using non-guaranteed Graton Tribal Mitigation Funds. Beginning in 2022-23 and again in 2023-24, the Board approved payments of $200,000 per year using one-time General Fund balance.

For 2024-25, the Board authorized a payment of $300,000 to the Collaborative, again drawing on one-time General Fund balance. The $300,000 payment authorized for 24-25 will cover the cost of a .75 FTE Removal Defense Attorney with the University of San Francisco Deportation Defense Clinic, a .75 FTE Sonoma Immigrant Services Removal Defense Attorney, and a .75 FTE Secure Families Collaborative Executive Director (see attached funding breakdown documentation). Each removal defense attorney carries an open caseload of at least 30 cases per year. Removal defense cases are a complex area of law that can take up to 7 years to resolve, and the Collaborative has a waitlist of approximately 100 cases as of September 2024.

The Collaborative plans to return to the Board during the 25-26 budget process and in the out years with additional requests for continued support of these personnel.  In addition to Board support, for 2024-25, the Collaborative will receive approximately $125,000 in grant funds in partnership with the Economic Development Collaborative as part of the California Governor’s Office of Business and Economic Development Local Immigration Integration and Inclusion Grant. The Collaborative sources the remainder of its funding from a combination of state funds, grants and donors.

Advances Approved from County

October 15th board of Supervisors Agenda. Contracting Updates Related to Medi-Cal Payment Reform 2024-0935 A) Accept staff recommendation of a 1/12th monthly advance with monthly service review, quarterly performance evaluation and year-end reconciliation for Medi-Cal providers of Specialty Mental Health Services and Drug Medi-Cal Services included in CalAIM Payment Reform contracting with the Department of Health Services. B) Delegate authority to the Director of Health Services, or designee, to amend current contracts with the current thirteen (13) Behavioral Health Medi-Cal providers to implement advanced payment procedures beginning with the month of January 2025, subject to review and approval by County Counsel. There will be no change to the contract maximums or term of the agreements. Department or Agency Name(s): Health Services

Breaking Down Silos

Sonoma County Board of Supervisors

Chair Rabbitt, and other members of the Board,

I’m here today to seek clarification from you and County Counsel on a procedure I intend to utilize to facilitate more comprehensive communication on  advisory boards.   The Brown Act prohibits private conversations among members of local legislative bodies.   The result of which is that the only time any of us appointees ever get to share our advice with each other is in an open meeting on a topic placed on the agenda which is published prior to the meeting. Collective thinking and discussion on our boards on issues not ready for approval hardly ever happens.

But I think I’ve found a workaround.  I’ve read the rules governing emailed communications distributed with agendas.  Most indicate that emails received at least five days prior to the meeting will be distributed to all board members and the public.  Utilizing this procedure, my understanding is that such an email from me to the boards on which I sit will not violate the Brown Act’s prohibitions.

Additionally, at least one of your advisory boards has taken to place on their agenda an item they have called “Board Member Questions and Comments”, at which time the Board could discuss emailed comments provided with the agenda.

Thus, open discussion on any topic within the scope of responsibility of the Board, described in an email circulated with the agenda, and not currently ready for final action, can be addressed.

Unless I am told that such a procedure is a violation of the Brown Act, I am going to promote it’s use to generate collaborative planning, both within and across advisory boards.  It’s time we find ways to open up effective transparent productive, silo-breaking, conversations.Gregory Fearon

Public Safety Realignment Transitional Housing Agreement

On Oct 8th, the Sonoma County Board of Supervisors approved on the consent calendar:  

Public Safety Realignment Transitional Housing Agreement 

Authorize the Chief Probation Officer to execute a professional services agreement with Interfaith Shelter Network, Inc. for the initial term October 1, 2024, through September 30, 2027, in the amount of $1,247,892 to provide transitional housing beds and services for individuals on felony probation and to execute up to two one-year renewal options for a maximum five-year agreement value of $2,188,000.

The Probation Department requests Board approval to execute a professional services agreement with Interfaith Shelter Network, Inc. (IFSN) to provide transitional housing services for homeless Public Safety Realignment individuals and others on felony probation being supervised in the community.  Under this Agreement, IFSN will operate drug- and alcohol-free residential facilities to provide these probationers with an out-of-custody structured housing environment, including wrap-around supportive services to assist with placement into permanent housing and transitioning back into the community.  The probationers participating in this program are those who would otherwise be living marginally in the community with little or no support and who would likely resort to criminal behavior without supportive housing and Probation oversight.  The program is intended to reduce recidivism and enhance public safety by providing a secure, sober living environment for participants.

The Sonoma County Community Corrections Partnership (CCP) allocates funding for this program and has approved the fiscal year 24-25 expenses.  Future funding will depend upon continued CCP approval.

Funding for the contract comes from state legislation (AB109, 2011) which transferred responsibility for managing select adult offenders from the state to California counties.  As of June 2024, Sonoma County Probation supervises 440 individuals.   The state provides funding to help manage this increased responsibility, which the CCP, in turn, allocates, pending Board approval.  Because many realigned offenders are homeless and lack the community connections and resources needed to secure stable housing, the CCP has allocated funding for transitional housing every year since 2011.

The Probation Department issued a Request for Proposals (RFP) announcement in June 2024, which was distributed to 487 known organizations that might have interest in operating transitional housing facilities for probationers as well as 2,200 notifications to subscribers on Purchasing’s RFP posting list. 

The RFP sought proposals from one or more organizations to provide at least 26 transitional housing beds for probationers, most of whom will be individuals on felony probation and some of whom will be sex offenders.  In addition to beds, the RFP requested an array of supportive services to help probationers stabilize their lives and become productive community members.  Finally, the RFP required that the successful organization(s) develop a quality assurance plan to ensure high service standards and report on outputs and outcomes to help stakeholders determine program performance.

IFSN was the only organization to submit a proposal.  A panel of representatives from the Probation Department and the Department of Health Services rated the proposal using clear criteria such as qualifications and experience, staffing, program services, and cost of service.  Based on its proposal review, the evaluation committee recommends awarding transitional housing services to IFSN.

While this program is intended primarily for realigned offenders, it will also be available for non-realigned individuals on felony probation as space permits.  During an intake process, Probation and IFSN will coordinate to determine which supportive services IFSN will provide to offenders.  Available services include case management; individual therapy; individual and group counseling; skill building; referrals for substance abuse, healthcare, food, and general assistance services; employment preparation; and permanent housing search and placement assistance.  IFSN will coordinate supportive services with offenders’ supervising Probation Officers to address individual needs without duplicating services from other sources.  All therapy and counseling services will be conducted by licensed therapists or interns under the supervision of a licensed clinical director. 

IFSN currently provides 26 beds.  Under the new contract, IFSN will provide 30 beds distributed among multiple houses in Santa Rosa and Rohnert Park.  The additional four beds will be for a female-only home in Santa Rosa.

Additionally, IFSN will develop and implement quality assurance and outcome reporting plans.  Quality assurance plans ensure, for example, that staff receives proper training, resources, and certifications, and that facilities are clean, safe, and up to code.  Outcome reporting can help the CCP and other stakeholders determine program performance.  Example data points include residents’ post-discharge living arrangements, success in completing programming, and behavioral changes such as improved cooperation, communication, and conflict resolution.

 Gregory Fearon

Sonoma County Opioid Settlement

The Sonoma County Board of Supervisors held a workshop on the expected $43 million which they have been told to expect from accepted prescription opioid litigation settlements to fund address the growing fentanyl and other serious drug abuse problems with “core abatement strategies” in the County. Many more lawsuits are pending, and the total which could be received by the County over the next few years may approach $100 million.

Currently, the County has $12 million in its fund balance, and is required to obligate or expend $2.5 million of it by next spring (one year after receipt). Here is a link to the video of the workshop.

Santa Rosa’s ARPA Funding

In response to a Public Record Request, the City of Santa Rosa has responded to questions on the use of its American Rescue Program Act federal allocation. HEAPA obtained from them last month their quarterly report to the U.S. Treasury, and raised questions about it. Our email, and the City response re below:

Greetings!

Thank you very much for your prompt response to my public records request for the City’s quarterly report to the Treasury Department on the use of American Rescue Program Act funds.  I have incorporated the information in it into the original spreadsheet you provided me when the City allocated ARPA and PG&E funding (attached).  By doing so, I can better understand the progress of the programs begun by it, and the changes you have made to the City’s original decisions.

What is clear from the report is that the City has declared obligations to spend $22,629,794, and has expended $16,660,661 against those obligations.  That leaves a balance of expenditures of a little under $6 million.  Maxing out the expenditures on remaining obligations, you should be able to spend about $3.5 million of those remaining funds within your program design.  That will leave $2.5 million in funds to be re-obligated before December 31, 2024.  How and when will the Council make those additional obligations?

The only other question I have is “What happened to the original obligation of $10 million for the Roseland Community Center?”  The quarterly report seems to indicate that it has been shifted into the category of “Revenue Replacement”.  Your report states “Funding under the revenue loss provision will be allocated towards Roseland Community Center. Construction of Roseland Community Center would provide a publicly owned Community Center in Roseland which would ensure a culturally safe space and sense of belonging, would reflect the voices of the community in the design process, represent an equitable investment in the City infrastructure for the newly annexed Roseland, and provide more opportunities for the City’s youth and elders.”    May I assume that the shift to Revenue Replacement accounts for the drop in overall obligations from $34,937,000 originally to the current figure of $22,629,794?  The City is still going to apply the ARPA funding to the Roseland Community Center, correct?

Again, thanks for the report. 

Gregory Fearon

Hi Gregory,

I’ll try to answer your questions below, but I’m also available if you want talk this through – just let me know and I’ll set something up.  Also, staff will be presenting an update to Council on the use of all ARPA funds scheduled for November 12.

To date, Santa Rosa has spent or encumbered approximately $24.8 million.  All funds must be spent or under contract by December 31, 2024, or the funds not under contract would be returned to US Treasury.  

There have been no changes to the initial allocation of $10 million for the “Roseland Community Center,” which is now known as the Hearn Community Hub project.  The designation of Revenue Replacement reflects the type of expenditure category allowed in the ARPA legislation and US Treasury guidance.  Treasury allows jurisdictions to claim a lump sum of $10 million to cover revenue losses, and those funds could be used for general government services, which provided more flexibility to use the funds on that capital project.  In the initial ruling from Treasury, the use of funds on capital projects were restrictive, so the change in guidance benefited the City. 

Treasury recently provided guidance on the use of ARPA funds for certain transportation projects.  This allowed us to move $2 million from the Samuel Jones Hall Capital Projects allocation to the Hearn Community Hub project for site development.  This was another benefit to the City as the SJH projects likely wouldn’t have met the obligation deadline, and would have been challenging to justify with Treasury.  I’ve attached the staff report from the December 12, 2023, that discussed this move, along with an update on the other projects.

I hope this helps.  Again, I’m available to meet to discuss in more detail if you’d like. 

Alan

Alan Alton | Chief Financial Officer 
Finance Department 
90 Santa Rosa Avenue | Santa Rosa, CA 95404 
Tel. (707) 543-3093 | Cell (707) 312-4413 |aalton@srcity.org 

Santa Rosa City Council ARPA Decisions in December of 2023

June 30th Treasury Report from Santa Rosa

California Interagency Council on Homelessness

Today’s meeting adopted the Draft Three-Year Action Plan (2025-2027). In a few days, it should be up on the CAL-ICH website, and a link to it will appear here. The Department Updates are a good summary of what’s happening at the State and Federal Level concerning homelessness programs. Here is a link to the Meeting Presentation, which contains valuable perspectives on California’s unhoused. In another announcement today, the Governor appointed Kim Johnson, Director of the Department of Social Services to become Director of the Department of Health Services, replacing Mark Ghaly, who stepped down and five years with the Department.

CAL ICH September 5th Meeting Recording