REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
January 24, 2023
FROM
GEORGINA YOSHIOKA, Director, Department of Behavioral Health
SUBJECT
Title
Approve Grant Application for the Behavioral Health Continuum Infrastructure Program - Crisis and Behavioral Health Continuum
End
RECOMMENDATION(S)
Recommendation
1. Approve submission of the grant application to the California Department of Health Care Services, in the amount of $51,731,501, for the Behavioral Health Continuum Infrastructure Program - Crisis and Behavioral Health Continuum grant.
2. Authorize the Chief Executive Officer, the Assistant Executive Officer of Department Operations, or the Director of the Department of Behavioral Health, to submit any additional required application documents, including any subsequent non-substantive updates for the Behavioral Health Continuum Infrastructure Program - Crisis and Behavioral Health Continuum grant, on behalf of the County, to the California Department of Health Care Services, subject to review by County Counsel.
3. Direct the Director of the Department of Behavioral Health to submit all grant application documents, and non-substantive updates, in relation to the Behavioral Health Continuum Infrastructure Program - Crisis and Behavioral Health Continuum grant to the Clerk of the Board of Supervisors within 30 days of execution.
(Presenter: Georgina Yoshioka, Director, 388-0801)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Promote the Countywide Vision.
Create, Maintain and Grow Jobs and Economic Value in the County.
Ensure Development of a Well-Planned, Balanced, and Sustainable County.
Provide for the Safety, Health and Social Service Needs of County Residents.
Pursue County Goals and Objectives by Working with Other Agencies and Stakeholders.
FINANCIAL IMPACT
This item does not impact Discretionary General Funding (Net County Cost). The Behavioral Health Continuum Infrastructure Program - Crisis and Behavioral Health Continuum (BHCIP) grant application in the amount of $51,731,501 is funded by the California Department of Health Care Services (DHCS) and requires at least a 10% match. The Department of Behavioral Health (DBH) will provide a match of $12,460,446 using Mental Health Services Act funding.
BACKGROUND INFORMATION
The DHCS BHCIP grant will support DBH in continuing the treatment of the complex Substance Use Disorder (SUD) needs for residents in the County, as well as address the associated risk of homelessness for this population countywide.
The DHCS BHCIP grant provides capital infrastructure funds to acquire and rehabilitate real estate assets to expand the continuum of care. The County is included in the Southern California Region, which shares in prioritized competitive funding, specific to this grant opportunity, with five other counties: Imperial, Orange, Riverside, San Diego, and Ventura.
DHCS is issuing grant funds through a Request for Application for county behavioral health (BH) agencies to initiate and support the BH infrastructure efforts in their communities. The funding is intended to expand community capacity for serving the BH population with a commitment to serve the most vulnerable individuals, including those experiencing homelessness, and serving Medi-Cal beneficiaries through capital expansion projects, including acquisition, construction, and rehabilitation.
The Board of Supervisors (Board) is being presented with a companion item for the County’s acquisition of the St. John of God (SJOG) property. The County’s acquisition of the land and existing structure from SJOG, the property owner, and current contracted provider with DBH in the High Desert region, will all complement the opportunity, through the use of the grand funds, to enable the modernization and expansion of the existing infrastructure at the property, as well as establishing new structures on the surrounding land.
The County plans to purchase and utilize the SJOG property as a Comprehensive Treatment Campus that will serve both adults and youth (ages 12-17 years old) as follows:
• Twenty-four Withdrawal Management units and 36 Co-occurring Residential Treatment units for adults are projected to serve 350 adults annually.
• A 14-bed Psychiatric Residential Treatment Facility is projected to serve up to 475 youth annually.
• A 16-bed Co-occurring Adolescent Residential Treatment facility is projected to serve 192 youth annually.
• A Youth Wellness Center is projected to serve 667 youth annually.
• An Outpatient clinic serving both adults and youth is projected to serve 128 individuals annually.
DHCS has established Network Adequacy standards for counties in order to meet federal requirements. Network Adequacy requirements for all levels of SUD services includes the number of providers available to meet the local demand for these services and time and distance standards between providers to ensure services are available throughout the County. The services offered through the SJOG contract at this site assist DBH in meeting Network Adequacy time/distance standards for outpatient and residential treatment services.
SJOG is the only residential treatment provider for the High Desert, serving surrounding communities, in addition to the City of Victorville. A contracted SUD provider that offers similar multilevel care as SJOG within the High Desert Region is approximately 43 miles from the SJOG property. The projected utilization of residential treatment services countywide through the expansion detailed above, is three times higher than the current capacity (per Network Adequacy methodology).
Residential services for youth are currently unavailable within the County. Adolescent SUD residential treatment is only available from a provider outside the County, 60 miles from this proposed SJOG property, with a waitlist duration of approximately 35 days. No adolescent mental health residential treatment services equivalent to those proposed in this grant application currently exist in the State. A successful grant award would therefore integrate currently minimally available or unavailable adolescent behavioral health services into the County continuum of care.
The total amount requested is $51,731,501, divided into the following phases: Phase 1 - Planning and Pre-Development ($507,556), Phase 2 - Design Development ($3,847,884), Phase 3 - Shovel Ready ($3,543,730), and Final Phase - Construction ($43, 832,330). There is a required match of at least 10%. DBH will provide a matching amount of $12,460,446, in the form of cash, funded through Mental Health Services Act funding. The match amount includes funds for ongoing maintenance of the facilities and demonstrates the ongoing sustainability of the project.
This item is being presented at this time as this is the first date available following the virtual pre-application consultation required by DHCS as part of the application process to ensure application readiness and eligibility to apply, prior to DBH receiving access to the grant application portal. The virtual consultation with Advocates for Human Potential, the entity selected by DHCS to administer all BHCIP grants, occurred on December 7, 2022. Access to the grant application portal was granted the same day.
The notice of the release of the Request for Applications was received October 21, 2022, for BHCIP, with a due date for the grant application of January 17, 2023. On December 16, 2022, DHCS granted an extension of the due date to February 13, 2023. The site plans, required as part of the application, were received on December 5, 2022. The estimates for new construction related to the site plans were completed and forwarded to DBH on January 5, 2023. If the DHCS grant is awarded, DBH will return to the Board to accept the grant funds.
PROCUREMENT
N/A
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health Contracts (Natalie Kessee, Contracts Manager, 388-0869) on December 8, 2022; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on January 17, 2023; Finance (Christopher Lange, Administrative Analyst, 386-8393) on January 17 2023; and County Finance and Administration (Cheryl Adams, Deputy Executive Officer, 388-0238) on January 17, 2023.