REPORT TO SHASTA COUNTY BOARD OF SUPERVISORS

BOARD MEETING DATE:  October  16, 2018
CATEGORY:  Consent - Health and Human Services-9.

SUBJECT:

CARE Center Extension Letter

Supervisorial District No. :  All

DEPARTMENT CONTACT:  Donnell Ewert, Director, Health and Human Services Agency, (530) 225-5899

STAFF REPORT APPROVED BY:  Donnell Ewert, Director, Health and Human Services Agency

RECOMMENDATION

Approve and authorize the Health and Human Services Agency Director to sign a letter to the Mental Health Services Oversight and Accountability Commission to request a one-year extension of the Mental Health Services Act Innovation Plan: CARE Center for Shasta County.

SUMMARY

The CARE Center, a one-stop mental health crisis center, was approved by the Mental Health Services Oversight and Accountability Commission (MHSOAC) on December 17, 2015 as a four-year pilot program. Because the CARE Center is meeting a critical community need and there is additional funding available, the Health and Human Services Agency would like to request that the MHSOAC extend the CARE Center project (Project) to a five-year program, allowing the CARE Center to operate under its existing funding structure through December 31, 2020.

DISCUSSION

In November 2004, California voters approved Proposition 63, the Mental Health Services Act (MHSA), which became effective January 1, 2005. The purpose of the initiative was to dedicate additional funds for the provision of enhanced mental health services. One of the five components of MHSA is Innovation. The goal Innovation is to increase mental health services for underserved groups, increase the quality of services, promote interagency collaboration and increase access to services. Innovation projects must be new to the community, contribute to learning, and are time-limited, up to a maximum of five years. Shasta County’s Innovative project is the CARE Center, and the original learning objectives of this Project were to determine:

1. The extent to which the after-hours Project improves access to services, particularly for individuals currently unserved or underserved by the existing mental health system.
2. Whether the Project reduces mental health crises, including trips to the emergency room, in both human and economic benefits.
3. The extent to which an after-hours “one-stop” resource center can help bridge service gaps, facilitate access to community-based resources, and better meet individual and family needs.
4. The impact of the Project on families, by partnering with other agencies and community-based organizations such as the National Alliance on Mental Illness (NAMI), including family-focused services as a priority, and increasing access to mental health services and supports for family members with competing daytime responsibilities.
5. The elements of the Project that are most associated with successful outcomes, with a particular focus on effective collaborative approaches.

The learning objectives have not changed, nor has the target population. The CARE Center is beginning to bridge a critical gap in Shasta County’s community mental health services, and is serving about three times more people than originally anticipated. Many clients report that they either would have gone to the emergency room or not sought services at all. The CARE Center has made hundreds of referrals to housing, substance abuse, ongoing mental health, and other resources since it opened in early 2017.

This additional year would fund the CARE Center through 2020, and add approximately $740,000 to the Project cost, which would draw down Shasta County’s Innovation funds from 2014-15 through 2016-17. These funds revert to the state if they are not spent within five years of receipt. The original, approved Innovation plan stated that the Shasta County Health and Human Services Agency and Hill Country Community Clinic would look at alternative funding sources to sustain the program after the pilot period if it was determined that it was worthwhile to continue operating the CARE Center, and that plan will not change with the requested extension; it will, however, give both entities additional time to solidify plans for funding it beyond the pilot phase. No other changes to the Project are being requested, and this request does not exceed the five-year limitation imposed upon Innovation projects.  If the one-year extension is approved an amendment to the agreement with Hill Country Community Clinic will be presented to the Board.

ALTERNATIVES

The Board could choose not to authorize the Health and Human Services Agency Director to request this extension. This would require Hill Country Community Clinic to take over financing this project in January 2020, and it could put the County’s Innovation dollars at risk for reversion to the state.

OTHER AGENCY INVOLVEMENT

Shasta County’s MHSA Stakeholder Workgroup endorsed extending the Care Center project by one year during its June 27, 2018, quarterly meeting. The Mental Health, Alcohol and Drug Advisory Board voted to support the extension on September 5, 2018. The contractor, Hill Country Community Clinic, supports the extension.  This recommendation has been reviewed by the County Administrative Office.

FINANCING

The $740,000 cost for the additional year would come from the MHSA’s Innovation component, and it would spend down Shasta County’s allocation of Innovation funds from Fiscal Years (FY’s) 2014-15 and 2015-16, as well as a portion of the FY 2017-18 allocation. This project is included in the department’s FY 2018-19 Adopted Budget. There is no additional General Fund impact associated with approval of the recommendation.