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Regular-Health & Human Services # 38.
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| Board of Supervisors |
Adult & Aging |
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| Subject |
Receive presentation on the proposed plan for provision of 24-hour mental health crisis services to Yolo County residents; and authorize staff to amend Agreement No. 17-219 with Yolo Community Care Continuum to remove $85,291 from fiscal year 2018-19 for the provision of telephone access on evenings, weekends and holidays. (No general fund impact) (Larsen)
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| Recommended Action |
- Receive presentation on the proposed plan for provision of 24-hour mental health crisis services to Yolo County residents; and
- Authorize staff to amend Agreement No. 17-219 with Yolo Community Care Continuum to remove $85,291 from fiscal year 2018-19 for the provision of telephone access on evenings, weekends and holidays.
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| Strategic Plan Goal(s) |
Thriving Residents
Safe Communities |
| Reason for Recommended Action/Background |
During the past three years, the Yolo County Health and Human Services Agency (HHSA) has utilized two contracted providers to offer 24-hour emergency mental health response to Yolo County residents. HHSA has utilized grant funding from Senate Bill (SB) 82 to fund a local mobile crisis program known as the Community Intervention Program (CIP), which was contracted to Turning Point Community Programs. The program embedded Clinicians in local law enforcement agencies during Monday through Friday, daytime and evening hours to provide clinical support to law enforcement interactions that involved a person experiencing a mental health emergency. Additional funds from the Mental Health Services Act (MHSA) were contracted to Yolo Community Care Continuum for the provision of telephone crisis services during evenings, weekends and holidays.
The combined services offered by these two programs supported the work of local law enforcement agencies when they intervened in behavioral health episodes in the community. These programs also provided support to families who have a family member in crisis and allowed for the client to be seen at home or in various community-based settings. Often, these interventions were able to reduce the need for hospitalization or other residential care for Yolo County residents experiencing a crisis.
The funding HHSA received from Senate Bill 82 was primarily used to fund the Community Intervention Program over a two-year period from fiscal year 15/16 to 16/17. During that time, HHSA paid approximately $1.3 million dollars and the program engaged in a total of 1,188 crisis response contacts (approximately 594 contacts per year). This resulted in an average cost of approximately $1,123 per contact.
HHSA’s grant for Senate Bill 82 funding ended in fiscal year 17/18. The California Mental Health Services Act Oversight and Accountability Commission, who oversees Senate Bill 82 moneys has altered their funding priorities for the upcoming funding round, and HHSA is not able to seek continued funding for the Community Intervention Program from SB 82. Without this key funding source, the current design of mobile crisis as currently delivered in Yolo County is no longer financially sustainable.
To address this issue, HHSA hosted two focus groups (one with local hospital leadership and one with local law enforcement agencies) to discuss how mental health emergency services should be offered in Yolo County on an ongoing basis. Based on the feedback received from stakeholders, HHSA plans to move forward with development of a new mental health crisis services program.
The new program will provide 24-hour crisis response, including clinical staff available to respond to law enforcement or hospital requests and after-hours telephone access to crisis services. HHSA has hired two (2) full-time clinicians who will be available from 8am until 5pm, Monday through Friday, to respond to law enforcement incidents and hospitals for incidents involving a mental health crisis. When not responding to an emergency, these site-based Clinicians will also be available to provide other community based interventions and will be able to provide clinical consultation and support to local law enforcement agencies.
HHSA plans to release a Request for Proposals (RFP) in December that will seek a qualified provider to offer similar services during the evenings, weekends and holidays. In order to ensure cohesion of services, HHSA plans to use a single contracted provider to operate the after-hours telephone crisis services and also employ clinical staff to respond to law enforcement and local hospitals. In order to do this, HHSA will need to modify the existing contract 17-219 with Yolo Community Care Continuum to remove the scope of work and funding ($85,291) for the provision of telephone access on evenings, weekends and holidays in fiscal year 18-19.
The efforts described above, in conjunction with the opening of the first responders Urgent Care in West Sacramento, will provide walk in coverage from 8am until 9pm Monday through Friday, and likely 12pm until 9pm Saturday and Sunday. This comprehensive plan will ensure crisis support at all times to the people of Yolo County. |
| Collaborations (including Board advisory groups and external partner agencies) |
Davis Police Department; Sutter Davis Hospital; West Sacramento Police Department; Woodland Memorial Hospital; Woodland Police Department; Winters Police Department; Yolo County Sheriff’s Office, American Medical Response.
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| Fiscal Impact |
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| Source of Funds for this Expenditure |
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Explanation (Expenditure and/or Revenue) |
| Further explanation as needed: |
HHSA plans to use three funding sources to support the proposed plan for 24-hour mental health crisis services as described in this staff report. Funding sources include:
- Intergovernmental Transfer: $380,000 per year for 2 years
- Mental Health Services Act: $300,000 per year for 3 years
- Mental Health Budget: $100,000
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