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What Happened To The Crisis Residential Grant?

It’s always interesting how the Board of Supervisors glosses over major blunders by staff rather than asking staff why such blunders occur. The latest to come to light was yet another failure of the Health and Human Services Department’s Mental Health staff (presumably the former Director Tom Pinizzotto whose blunders and favoritism toward his old boss Ortner Management Group continue to echo in the Supervisors chambers.

On Tuesday, the Supes had an item on their consent calendar to process a $500,000 crisis residential mental health grant that could have gone a long ways toward keeping Mendo’s mentally ill from being shipped out of county, away from family and support, at huge expense. Ortner’s facility in Yuba City got a lot of County business. Supervisor McCowen asked Ortner several times about their development of a residential crisis center which Ortner shined on time and again, but it indicates a high priority — and still the mental health staff failed to act.)

Apparently Pinizzotto — now gone from county employ — dropped the ball (or intentionally missed it, we don’t know because nobody ever asks). So now the County has to scramble to find a way to spend the $500k or lose it in just a few months.

PS. No mention was made of the Sheriff’s sales tax initiative which is now slated for the November ballot. (See below.) The Sheriff's plan would provide much the same kinds of mental health service, albeit on a larger scale. (Nobody ever connects any dots in Ukiah when it comes to the many sub-components of Mental Health. The Courts have a piece, the DA and public defender have pieces, the jail has big a piece, patrol deputies have a piece, the mental health department employees have a piece, various contractors have various pieces, the County Counsel’s office has a piece… Probation (?). But nobody ever asks: How does it all fit together? Apparently no one cares.)

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Board of Supervisors Agenda Item 4f. March 15, 2016

Adoption of Resolution Authorizing Health and Human Services Agency (HHSA) Behavioral Health & Recovery Services (BHRS) Director to Accept the Senate Bill (SB) 82, Investment in Mental Health Wellness Grant Program Final Allocation Third Round Funding (Crisis Residential Treatment (CRT)) Grant Award of $500,000 from the California Health Facilities Financing Authority (CHFFA)

Summary Of Request: Senate Bill (SB) 82, the Investment in Mental Health Wellness Act of 2013, established a competitive grant program to disburse funds to California counties or to their nonprofit or public agency designates for the purpose of developing mental health crisis support programs. Specifically, funds wll “increase capacity for client assistance and services in crisis intervention, crisis stabilization, crisis residential treatment, rehabilitative mental health services, and mobile crisis support teams.” The grants from the California Health Facilities Financing Authority (CHFFA) support capital improvement, expansion, and limited start-up costs. Behavioral Health and Recovery Services (BHRS) applied for, and was awarded, the allotted amount of $500,000 to develop a Crisis Residential Treatment Program. We plan to establish ten (10) beds for voluntary crisis service placements by adding a Crisis Residential Treatment (CRT) facility. The CRT will provide additional movement throughout the Crisis Continuum of Care, providing law enforcement increased opportunity for a warm hand-off to trained personnel for persons in mental health crisis. Ongoing funding sources for sustainability will include appropriate Federal Medi-Cal reimbursement and increased billing potential with the implementation of the Affordable Care/Medi-Cal Expansion Act.

Recommended Action/Motion: Adopt Resolution authorizing Health and Human Services Agency (HHSA) Behavioral Health & Recovery Services (BHRS) Director to accept the Senate Bill (SB) 82, investment in Mental Health Wellness Grant program final allocation third round funding (Crisis Residential Treatment (CRT)) grant award of $500,000 from the California Health Facilities Financing Authority (CHFFA); authorize the BHRS Director to enter into and sign the grant agreement, including all documents, subsequent amendments or renewals that do not affect the total amount payable under the terms of the agreement; and further, authorize Chair to sign same.

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Supervisor John McCowen: “We are adopting a resolution accepting the grant for crisis residential treatment. This is a grant that was applied for and we were awarded about a year ago or more. So I just wanted to clarify that this is not a new grant, this is simply completing the paperwork for the one that has already previously been awarded. But apparently there was an oversight in adopting a resolution — or for not adopting it.”

Mental Health Director Jenine Miller: “We are in the process. Like Supervisor McCowen said it is something we were granted and we do need to spend the money by July 1. We are looking at — we are working with a couple of current contractors about what the options are to do a crisis residential for Mendocino County. We're working with — we've spoken to other crisis residential programs to see what it looks like, how they did it, how they fund it, how are they funding it. Many of them use HHSA and Medi-Cal dollars to fund it. So we are in the process of really researching it to get it up and running by July so we can use the money by July 1. We have had a couple of interested parties interested in putting a proposal in to look at doing crisis residential for Mendocino County.”

(Ed note: A proposal to “look at” doing crisis residential?)

Supervisor Dan Hamburg: “The concern that was raised about this grant and the reason there was even some hesitation about accepting it was certainly not about the start-up money, it was about sustainability. I would just like to know what the latest thinking of the department is. If we — we have a fairly tight timeline to expend the money and get a facility up and running, Do you anticipate, does the department anticipate that there will be sufficient reimbursement dollars to sustain it?”

Miller: “Based on what I have been told from other programs that are operating in Marin and Sonoma, they are able to sustain it with — and do it with HHSA and Medi-Cal funds. If their models work for us then yes we will be able to.”

Hamburg: “Have any locations being considered at this point since we are only about four months out?”

Miller: “I know that one agency does have a location that they are looking at and they are putting a proposal together for that agency for us. So they are putting something together and they do have a building in mind.”

McCowen: “Part of Supervisor Hamburg's concern if I understand correctly is we want to make sure and do this right rather than do it quick. My belief in a previous discussion that I had with Director Cryer was there was some thought we could apply for an extension just to make sure that we do have time to effectively use these funds and with so many other changes going on, that might actually be a wise move since we are in the middle — or rather at the beginning of a very extensive transition process.” (I.e., getting rid of Ortner and cleaning up the mess.)

Miller: “That is correct. They said we can apply for it but they cannot guarantee that they will give it to us. We are planning in March to do a report to them and that will be part of the report which is requesting the extension, but they have let us know there is no guarantee that we will get that extension, so we are operating on, If we get the extension great. We're going to ask for it. But if we don't — we don't want to lose the dollars for bringing a crisis residential to Mendocino County. So we are operating to do the best we can, you know, get it together, and if we get the extension that will give us more time.”

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