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 homelessnessservices. You heard about federal Medicaid cuts, dwindling local funds, and the critical role of Measure O. Officialsexpressed 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 healthcarefunding.
Announcements
A $10 million Notice of Funding Availability (NOFA), titled “Behavioral Health and Homelessness Pathways toSustainability,” 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 overseeMeasure 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 staffedand operational. A successful QPR (Question, Persuade, Refer) suicide prevention training was delivered to counselors at AnalyHigh 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 cutsto 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 healthneeds. 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, andcouncils 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.
Recommendations to the Behavioral Health Board – July 15th Meeting in Guerneville, 5-7pm, Russian River Resiliency Center, 16385 First Street.
Schedule Bi-Monthly Open Comment periods for the FY 26-29 Behavioral Health Integrated Plan, in September, November, January, March, and June.
Over the last month, the Behavioral Health Director and I have communicated concerning important Executive Committee recommendations about publishing recent behavioral health reports, guidelines, and the draft plan. The result is that, soon, the public will be able to find those reports and guidelines on the Department’s website. Their remaining decision, included in our recommendations, is to place the draft Integrated Plan, on the Department website in Open Comment Periods between now and the State submission deadline.
Motion: To advise the Department of Health Services and the Sonoma County Board of Supervisors to place the developing Implementation Plan documents on the County website, inviting Open Comment by all stakeholders online over the next eight months. Governmental planning has utilized this procedure regularly to broaden the opportunity for public input on important strategic plans and policy changes.
Partner with the Community Foundation of Sonoma County to achieve their Strategic Plan Goal #2.
I’m asking the Board to act on a recent invitation by the Community Foundation of Sonoma County when it revealed on July 10th. its new Strategic Plan, and expressed their desire to partner with us.
Motion: To advise the Department of Health Services and the Sonoma County Board of Supervisors to invite the Community Foundation of Sonoma County into a partnership in the development of our Integrated Plan.
Community Foundation Strategic Plan Goal # 2:
“We will partner with organizations that expand access to healthcare and mental health support, especially for communities historically excluded from care. By centering community voice, we will support systems change that leads to more just, responsive health outcomes.”
Our Board’s responsibility under Proposition One is to develop this fall an Integrated Plan for all funding available, and I believe that partnering with the Community Foundation of Sonoma County would expand the resources and options available and would be an exciting message to our community.
Gregory
California lawmakers reject hundreds of bills in rapid-fire hearings
Tax credits for the parents of young children. A state-funded scientific research institute. Exempting service workers’ tips from state income tax.
Those are among the hundreds of proposals California lawmakers swiftly rejected Friday under the banner of cost savings, as they cited the state’s $12 billion budget deficit — a worsening figure due to the threat of unprecedented federal funding cuts and California’s ballooning spending on health care for low-income residents.
“We are in (a) very difficult budget environment this year, so consequently many good bills are going to fall by the wayside today,” said Assembly Appropriations Committee Chair Buffy Wicks, an Oakland Democrat, before beginning that chamber’s hearing.
“We are not in a year where we can be expanding programs, developing new offices, new agencies, new departments, and expanding our footprints.”
The Friday procedure is known as the “suspense file” — the state Legislature’s most secretive and fast-paced biannual hearing, where the chairs of the Assembly and Senate Appropriations committees quickly shoot down pricey proposals with little explanation, often acting more aggressively during years of budget woes.
The suspense files are where the appropriations committees send bills that would cost the state at least $50,000 in the Senate and $150,000 in the Assembly. The process was originally a way for lawmakers to consider policy proposals that cost the state money together by balancing them against each other.
But the well-accepted open secret in Sacramento is that it’s also an opportunity for lawmakers to quietly kill controversial bills, appease powerful special interests or just winnow down the number of bills they’ll have to debate on the floor. Lawmakers decide ahead of time, in secret, whether to pass the bills to the full Senate or Assembly, or to withhold them. The public hearings are a rapid-fire announcement of the decisions.
On Friday, the Senate Appropriations Committee axed 29% of the 432 bills on its list, although it kept a handful of those alive to work on next year. That’s more aggressive trimming than the committee did last May.
“The state is facing a significant budget deficit and with that in mind, the committee had to make difficult choices on a number of bills to reduce costs,” said Senate Appropriations Chairperson Anna Caballero, a Merced Democrat, before the hearing. She opened the hearing with a defense of the arcane proceedings, explaining that the results would be posted online, but rushed out to catch a flight after the meeting without discussing her approach with reporters.
The Assembly Appropriations Committee killed 35% of the 666 measures on its suspense file, similar to last year. Lawmakers had been warned to keep the cost of their proposals down, Wicks said.
“We stressed heavily to members as they were putting together their legislative package this year to be very mindful of cost,” she told reporters.
The state’s fiscal future is anything but certain: As federal threats loom, Gov. Gavin Newsom earlier this month rolled out a $322 billion spending plan that included significant cuts to Medi-Cal, the state’s health care system for low-income Californians, and a 3% cut to public universities.
Health care expansions on the chopping block
On Friday, some Assembly measures that would have expanded health care services for Californians met their fate. That includes Wicks’ own proposal seeking federal approval to qualify some housing services as Medi-Cal benefits, a $40 million endeavor that Newsom previously vetoed. The committee also killed a proposal to allow more Medi-Cal enrollees to receive home-based care and another that would have allowed higher-earning immigrants in the country illegally to purchase insurance plans on Covered California, the state-run health care marketplace.
Assemblymembers meet during a suspense file hearing at the Capitol Annex Swing Space in Sacramento on May 23, 2025. Photo by Fred Greaves for CalMatters
The Senate Appropriations Committee also killed two Republican tough-on-crime proposals, showing the limits of Democrats’ recent shift slightly rightward on crime. Until Friday, it had been surprisingly smooth sailing this year for Senate Minority Leader Brian Jones’ bill to block sex offenders from being released from prison through the state’s elderly parole program, and Sen. Kelly Seyarto’s bill to increase penalties for selling or giving fentanyl to minors.
The law enforcement-backed bills were opposed by criminal justice reform advocates, who still hold sway with the majority party and often argue it would be too costly for the state to imprison more people.
In a statement, Jones, a San Diego Republican, called the suspense file process “anti-democratic” and accused Democrats of “silencing the voices of victims and the public.”
Some measures are now postponed until next year. That includes two Assembly measures seeking tighter regulations on ticket sales for sports and musical events, amid fierce opposition from ticketing platforms such as Stubhub and from local chambers of commerce. The measures would restrict when those platforms can resell tickets, strengthen the disclosure of ticket information and require venues to accept proof of purchase as tickets.
Assm. Isaac Bryan, a Culver City Democrat who authored one of the measures, said Wicks never articulated her concerns with his proposal, even though Wicks told reporters Friday her staff had been in touch with Bryan’s office. “There was never an attempt to discuss the bill,” which led him to believe her concerns had been alleviated, Bryan said in a statement.
Lawmakers also pushed off some issues to be debated further during budget negotiations between the Legislature and Newsom. That process will accelerate in the coming weeks before a mid-June deadline to pass a balanced budget.
Newsom’s film tax credit pushed to budget talk
They stripped out language in both Assembly and Senate bills to more than double the state’s film tax credit to $750 million. Newsom has pushed hard for the tax credit expansion to help the ailing Los Angeles industry and keep production in state, and he’s included the money in his budget proposals which lawmakers will debate separately.
Assemblymember Rick Zbur, a Los Angeles Democrat who authored the Assembly version of the measure, said the committee move was merely a technical one to separate budget allocations from policy changes.
“The increase in the size of the program will happen in the budget,” Zbur said. “I’m not that nervous about it.”
But to others, the move indicated that some lawmakers remain skeptical of spending so much on the program. Sen. Ben Allen, an El Segundo Democrat who sponsored the Senate bill to boost the tax credits, said he was “certainly disappointed.”
“It’s something we are going to push back against as budget negotiations begin to heat up,” he said in a statement.
In the Senate Appropriations Committee, lawmakers passed the bill but Caballero said they would continue negotiating it to help the state meet its housing needs “without compromising environmental protections.”
The traditional government financing design is being turned upside down. No longer can we expect the federal or state governments to advance or reimburse local governments. And if the uses of federal and state funds are now to give tax breaks to the rich, and to end and reduce deficit spending, then federalism and state solvency are going to be severely tested.
Which brings us to the question addressed at Santa Rosa’s goal-setting workshop yesterday – What are the basic services which should consume the City’s budget? What do our residents want, and what should our elected representatives provide, from the City? The Council chose to recognize that its own workforce was exhausted and could not perform well on most of its assigned goals and duties. Their answers were fewer goals, clearly understood by the public, with longer acknowledged timeframes. Their very top priority was to “Achieve and Maintain Fiscal Sustainability”. Though you might have heard that before in tough economic times, I’ve never seen a more worried group of leaders and staff. The word “transformation” was used many times, and I don’t think many had clear visions of positive outcomes.
In the general questioning of the purposes of all government, this local examination is crucial. To many, it may be the only chance for citizen impact. Lately, Sonoma County voters have agreed to tax themselves to provide some vital resources under local control. A unified and cooperative group of leaders could work together to develop a better funding system. The County and its cities need to protect each other from simplistic departmental budget slashing, or none of us will be happy with how local governments will be transformed.
On Tuesday (tomorrow), the Board of Supervisors will be acting on two Consent Agenda items which have the ability to expand service and housing for residents served by the County:
(Item #9) Bond Behavioral Health Continuum Infrastructure Program Round-1 Grant Application Resolution Update. Adopt a Resolution to replace Resolution 24-0519 authorizing the Director of Health Services, or designee, to apply to the California Department of Health Care Services’ Behavioral Health Continuum Infrastructure Program Round 1 (BHCIP 2024) Launch Ready Program Request for Applications, increasing the application amount by $10,202,227.50 for a new not-to-exceed amount of $67,702,227.50 for the construction of four Mental Health Rehabilitation Centers and one Adult Residential Substance Use Disorder Treatment Facility.
(Item #11) New positions to support California Advancing and Innovating Medi-Cal (CalAIM). A) Adopt a Resolution amending the Sheriff’s Office Department Allocation List to add 1.0 Full Time Equivalent (FTE) Administrative Aide, effective February 4, 2025, to support the mandated California Advancing and Innovating Medi-Cal (CalAIM) Justice-Involved Initiative. B) Adopt a Resolution amending the Department of Health Services Department Allocation List to add 2.0 Full Time Equivalent (FTE) Senior Client Support Specialists, effective February 4, 2025, to support the mandated California Advancing and Innovating Medi-Cal (CalAIM) Justice-Involved Initiative.
In 2023, California became the first state in the nation approved to offer a targeted set of Medicaid services to youth and adults in state prisons, county jails, and youth correctional facilities for up to 90 days prior to release with the goal of addressing the unique and considerable health care needs of justice-involved individuals, improving health outcomes, delivering care more efficiently, and advancing health equity across the state.
Through a federal Medicaid 1115 demonstration waiver approved by the Centers for Medicare & Medicaid Services (CMS), the Department of Health Care Services (DHCS) has partnered with state agencies, counties, and community-based organizations to establish an expanded system for providing enhanced care. Implementation of the mandated expansion in services, called California Advancing and Innovating Medi-Cal, or CalAIM, involves establishing a reentry process that provides incarcerated adults with the physical and mental health services they need before release, and connecting them to appropriate service providers for care upon reentry to the community.
Eligible inmates will receive services up to 90 days before their release to stabilize their behavioral health conditions and establish a plan for their community-based care. The Sheriff’s Office intends to go-live with the provision of enhanced services in January 2026. The deadline to go live is September 30, 2026.
On Wednesday, there are three meetings that are central to the work of providing direction to County and community services for homeless, mentally-ill, and addicted residents in Sonoma County.
Behavioral Health Board Executive Committee, 10:30am, 2227 Challenger Way, Room 201. Planning meeting for the Full BHB meeting on Feb 18th.
MHSA Program Steering Committee, 1-3pm, 2227 Challenger Way, Galaxy Room (next to Room 201)
Measure O Oversight Committee, 4-5:30pm, 1450 Neotomas Ave, Suite 200. Quarterly meeting to review finances and progress on programs funded.
On January 28th, the Santa Rosa City Council considered, and then delayed approval of a an application to the State of California Department of Housing and Community Development’s HomeKey+ Grant Program for the City to be a co-applicant with Burbank Housing Development and Caritas Homes Phase II LLC in an amount not to exceed $13.95 million. The grant is for the development of permanent supportive housing for individuals or households with an individual who is homeless, chronically homeless, or at risk of homelessness and who are also living with a behavioral health challenge. Caritas Homes Phase II, the final stage of the Caritas Village project located in downtown Santa Rosa will add 30 new affordable apartments reserved for homeless individuals referred through the Sonoma County Coordinated Entry system, meets the eligibility criteria for HomeKey+ funding. The item was pulled from the City Council agenda, and will be rescheduled at a later date.
There is a Dec 10th Report to the Board of Supervisors from the Department of Health Services titled ” Measure O Update for Fiscal Year 2023-2024” which updates them on the progress of Measure O, our sales tax-funded Behavioral Health and Homeless Community Solutions Initiative.
Executive Summary: The Sonoma County Board of Supervisors requested an update on Measure O during the June 2024 Budget hearings. This update covers fiscal year 2023-2024 expenditures by category; estimated fund balance for fiscal year 2024-2025 and fiscal year 2025-2026; and provides a review of outcomes and numbers served from last fiscal year. Additionally, staff will highlight Measure O successes and discuss the approach for current and future Measure O funding.
Discussion: In November 2020 Sonoma County voters passed Measure O to provide essential funding for mental health and homeless services with 68.07% of the vote. Measure O, a one-quarter cent sales tax, was estimated to generate over $25 million each year for ten years to help protect essential mental health and homelessness services.
The Measure O Sales Tax Ordinance identified five categories of services to be funded with the revenue: 1) Behavioral Health Facilities, 2) Emergency Psychiatric and Crisis Services, 3) Mental Health and Substance Use Disorder Outpatient Services, 4) Homeless Behavioral Health and Care Coordination, and 5) Transitional and Permanent Supportive Housing. The Measure O Expenditure Plan designates a set percentage of funding for each category.
On December 7, 2021, the Board of Supervisors established a Citizen’s Oversight Committee to monitor the implementation of Measure O. The Citizen’s Oversight reviews expenditures for alignment with the intent of the Measure and does not make or recommend funding decisions.
On October 23, 2024, the committee voted to confirm that the Measure O expenditures for Fiscal Year 2023-2024 met the intent of the measure. This past fiscal year was the 3rd full year of Measure O funding. Tax revenues for the year again exceeded the initial projections made when voters considered Measure O. Tax receipts totaled $32 million as opposed to the initially projected $24 million (total revenues including interest and unrealized gains was $34.2 million) The surplus has provided capacity to pursue expanded opportunities within the established categories to support our community.
For Fiscal Year 2023-2024, below are the Measure O funds used/spent by category: · Behavioral Health Facilities: $7,055,539 · Emergency Psychiatric & Crisis Services: $12,425,458 · Mental Health & Substance Use Disorder Outpatient Services: $1,275,496 · Behavioral Health Homeless & Care Coordination: $7,842,652 · Transitional & Permanent Supportive Housing: $3,345,616 The total projected Measure O revenue for FY 2024-2025 is $32,865,501.
In FY 24/25 a total of $66.2M of Measure O resources are available for programming, financed with $33.3 in fund balance and $32.9M of total revenues. The approved FY24-25 budget includes $37.5 million in expenditures for Measure O. The Department will be seeking $10.2 in additional appropriation in FY 2024-2025 Q4. Given the total planned expenditures of $47,739,541 for FY 2024-25 budget, the ending fund balance in June is projected to be $18,478,541.
Details of the various expenses by categories with additional information can be found in Attachment A Presentation.
The Mobile Support Team and Crisis Assessment Prevention and Education described below highlight recent updates from the Measure O-funded Mobile Support Team (MST) and Crisis Assessment Prevention & Education (CAPE).
· In December 2022, California Department of Health Care Services (DHCS) established a new Medi-Cal benefit providing 24/7/365 community-based mobile crisis intervention services to those experiencing a behavioral health crisis. On April 16, 2024, county staff launched Sonoma County’s 24/7 call center and a revamped Mobile Support Team (MST) to meet this need. The MST is partnering with SAFE (which serves Petaluma, Rohnert Park, Cotati and Sonoma State University) and inRESPONSE (which serves Santa Rosa)) to provide countywide coverage. The Sonoma County 24/7 call center and revamped MST is available to all Sonoma County residents regardless of insurance status. An additional $5M in Measure O funds are being held for contingencies from potential MST expansion based on future county and Regional Model City needs. The actual draw on the fund balance will be recalculated based on Federal Financial Participation action receipts from the Medi-Cal program.
· Crisis Assessment Prevention & Education (CAPE). CAPE provides school-based behavioral health support and interventions to schools in Sonoma County. Four mental health teams are strategically located across the county. CAPE is reinstituting in-person response to students experiencing behavioral health crisis and linking students to substance use disorder treatment services for to youth and young adults.. The program is active and expanding, providing services such as: direct linkage to County Behavioral Health services and navigating other health insurance to connect to treatment; substance use and suicide prevention and early intervention – educational presentations and campaigns, linkage, and referral; and peer support and groups. In the 2024-2025 school year , CAPE will be partnering with these schools: Analy High School and Laguna High School in West County; and Sonoma Valley High School, Creekside High School, Adele Harrison Middle School, Alta Mira Middle School, and Hanna Boys Center in the Sonoma Valley.
Successful Outcomes from Measure O
The Psychiatric Health Facility (PHF) has continued to operate at its full capacity of 16 beds, serving over 150 individuals annually due to Measure O funding.
The Crisis Stabilization Unit (CSU) served nearly 1,000 individuals and was also able to continue operations at full capacity due to Measure O until the current temporary closure due to facility issues. The Mobile Support Team has expanded into a Regional Collaboration that utilizes exciting new approaches to crisis response.
Measure O has also laid the groundwork for new programs launching this year, including CAPE, additional support for the Valley of the Moon Short Term Residential Treatment facility, and the expansion of Medi-Cal drug service.
This year also saw the finalization of incorporating Homelessness Services into DHS with Measure O providing 100% of funding for the Homeless Encampment Assistance and Resource Team (HEART) and Solving Obstacles for Unsheltered Lives (SOUL) programs, and a significant amount of funding ($4.2M) for George’s Hideaway. The George’s Hideaway project is a Permanent Supportive Housing (PSH) Project Homekey site near Guerneville. Measure O funds were used to support site renovation (including planning, water/sewer, and demolition work) under oversight of the Community Development Commission (CDC). This site will provide supportive care including therapy, substance use disorder care, benefit navigation, job training and life skills.
Also, in September of this fiscal year, the funds allowed for the release of the Measure O: Behavioral Health & Homelessness Community Solutions Notice of Funding Availability (NOFA) in the amount of $5.6 million, including $4.2 of Measure O funding and $1.4 million in Homeless Housing, Assistance and Prevention (HHAP) funding. The NOFA is open to applications from interested parties, community partners and any other local government agencies. The NOFA covers multiple program areas within each Measure O category with a specific focus on areas of identified need including on service navigation, staffing shortages, education/training and upstream approaches, peer support, individual and family counseling, and cultural competence. Additionally, the HHAP portion of the NOFA prioritizes permanent supportive housing, rapid rehousing, emergency shelter (congregate and non-congregate), street outreach, capital expenses for permanent supportive housing or enhancing existing emergency shelter projects for privacy, and lastly, operating subsidies for permanent supportive housing and rapid rehousing.
To determine priorities and opportunities for strategic application of Measure O funding in the future, department leadership plans to conduct a detailed budget and program analysis and identify areas where Measure O funding could be used and where other funding sources could be leveraged. The goal is to separate annual, recurring commitments from the projects where funding could be shifted as they mature and/or become self-sustaining.
The remaining Measure O funding would be a mix of unallocated fund balance and expected revenues. Staff plans to release a recurring Notice of Funding Availability (NOFA) for which Community Based Organizations and local government partners could apply. Through an open application process, a Community Advisory Panel will be selected to help review NOFA proposals and make recommendations to the Board for final approval. Staff will present the outlines of this proposal to the Board for further guidance and direction at the Board meeting.
A) Authorize the Chief Probation Officer to execute a professional services agreement with Interfaith Shelter Network, Inc. (IFSN) for the initial term December 1, 2024, through November 30, 2027, in the amount of $2,105,870, and to execute up to two one-year renewal options for a maximum five-year agreement value of $3,691,122 in addition to amendments that do not exceed $50,000 per year or otherwise substantively change agreement.
B) Authorize the Chief Probation officer to retroactively amend the current agreement expiring 11/30/24 with Interfaith Shelter Network by $135,000 for a maximum five-year value of $2,235,000.
Executive Summary:
The Probation Department requests Board approval to execute a professional services agreement with IFSN to provide services for individuals on pretrial release who are homeless and have mental illness or co-occurring mental illness and substance abuse disorder. Such individuals pose difficult challenges to the courts because while the crimes for which individuals are charged might not warrant incarceration while awaiting trial, their mental health and living conditions increase their likelihood of committing new crimes, failing to appear in court, causing harm to themselves, or being victimized in the community. To reduce these risks, courts may require such individuals to remain incarcerated until adjudication. The continuing services proposed under this agreement provide the courts a viable alternative to incarceration whereby individuals on pretrial release can remain safely in the community and receive supportive housing and intensive case management. Overall program goals are to reduce unnecessary incarceration and associated costs, provide treatment and services to improve outcomes of justice system-involved individuals, and increase public safety.
Additionally, the Probation Department requests a retroactive increase of $135,000, bringing the 5-year maximum agreement value to $2,235,000. When the contract was originally prepared in 2019, inflation was estimated to be 3 percent per year. However, the CA Consumer Price Index for All Urban Consumers has averaged 4 percent per year for the past 5 years. In addition, rent, utility, insurance, and living wage increases have contributed to the increase. These updated costs have been programmed into the agreements and contracts within the Community Corrections Partnership’s FY 24-25 budget.
The Sonoma County Community Corrections Partnership (CCP) and Measure O allocate funding for this program and have approved the FY 24-25 expenses. Future funding will depend upon continued CCP approval and Measure O funding.
Discussion:
Background
In 2016, the U.S. Department of Justice released a competitive grant for the Justice and Mental Health Collaboration Program (JMHCP). Sonoma County was awarded $250,000 for a three-year project to improve public safety and serve individuals with co-occurring mental illness and substance abuse disorder who encounter the justice system. This grant continued through September 30, 2020 and was expanded upon in 2018 with an additional $750,000 award.
In FY 21-22, upon exhaustion of JMHCP funds, Probation requested partial year funding from the CCP to continue housing and case management for mentally ill individuals on pretrial release. In FY 22-23, CCP funding was expanded to cover the full year and combined with Health Services allocation of Measure O funds for case management. The CCP and Measure O have continued to fund pretrial housing and case management, and the CCP has allocated funding for this program as part of FY 24-25 expenses. Future funding will depend upon continued CCP and Measure O approval.
Request for Proposals
The Probation Department issued a Request for Proposals (RFP) announcement in August 2024, which was distributed to 714 suppliers as well as 2,200 notifications to subscribers on Purchasing’s RFP posting list. The RFP sought proposals from organizations that could provide eight or more supportive housing beds along with case management services to individuals with mental illness on pretrial release. Additionally, the RFP requested an array of supportive services to help individuals on pretrial release stabilize their lives, such as permanent housing assistance, enrollment in health care, and job search assistance. Finally, the RFP required that the successful organization develop a quality assurance and outcome reporting plan to ensure high service standards and to help stakeholders determine program performance.
Sonoma County received proposals from IFSN and Committee on the Shelterless (COTS). A panel of representatives from the Probation Department and the Department of Health Services rated the proposals using clear criteria such as qualifications and experience, staffing, program services, and cost of service.
While both IFSN and COTS presented viable programs, the panel rated IFSN more highly based on the alignment of program services offered with the County’s needs, the ability to provide uninterrupted services, and the cost to provide services. Additionally, the COTS proposal included community-based case management only, while IFSN offers transitional housing, case management for house occupants, as well as community-based case management.
Based on its proposal review, the panel recommends awarding supportive housing and case management services to IFSN.
Program and Scope Overview
Housing: The program will provide an eight-bed housing facility, which has averaged 91 percent occupancy for the last 12 months, and support individuals with mental illness or co-occurring mental illness and substance abuse disorder maintain stability on pretrial release and achieve better outcomes. Desired outcomes include participants not committing new offenses, making their court appearances, and complying with court orders, and, post-adjudication, being better prepared to live successfully in the community. The broader goals are to enhance public safety, rehabilitate individuals in the criminal justice system, and reduce unnecessary incarceration.
Case Management: A case manager working outside the jail will support participants during the pretrial process, including accompanying them to court. This case manager will work closely with a case manager in the jail to ensure that information regarding participant needs is included in the planning process, and that those selected for the program benefit from a warm handoff and avoid service gaps. Additionally, a case manager will work on site at the supportive house to help participants connect with stabilization services, obtain medication, address health issues, and other related activities.
Quality Assurance: IFSN will collaborate with the Probation Department to develop and implement quality assurance and data collection plans to ensure high-quality program implementation and allow the Probation Department to evaluate program performance.
Conclusion
This program intends to promote public safety, improve outcomes, and reduce costs for justice-system-involved individuals with mental illness. Commonly, this population ineffectively-and expensively-accesses multiple community services, including police and fire first responders, hospital emergency departments, mental health crisis services, and jails. Most treatment is short-term and non-rehabilitative, resulting in repeated cycles through these services. By providing stable housing, intensive case management, and 24-hour monitoring, this program intends to break the cycle.
On Tuesday, March 26, 2024 The Pepperdine School of Public Policy hosted “Homeless America: Creative and Compassionate Responses to a Cross-Sector Challenge” conference in downtown Los Angeles. Before COVID struck the United States in early 2020, California governor, Gavin Newsom, gave his annual “State of the State Address”, which was focused on addressing the burgeoning homelessness crisis in the state. As the impact of the virus has receded, the issue of homelessness has returned to center stage. A recent survey of Californians by the Public Policy Institute of California found that a full 89% of those questioned view homelessness as either a “Big Problem” or “Somewhat of a Problem”. The issue of homelessness draws so many policy domains from housing to mental health services and public safety. It’s also a true “cross sector” challenge, requiring engagement by the government, nonprofit, and business sectors. Through an afternoon of panels and keynotes, we explored how the public sector and nonprofit leaders are taking a variety of approaches to respond to this crisis. Keynote Address:
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.
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.
Homeless Emergency Assistance Program Association 