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Health and Human Services Agency (HHSA) recommending the Board:
1) Make findings pursuant to Section 3.13.030 (B) of the El Dorado County Ordinance Chapter 3.13, Contracting Out, that the Mobile Crisis Team (MCT) services provided by Sierra Mental Wellness Group (SMWG) requires specialty skills and qualifications not expressly identified in County classifications are involved in the performance of the work;
2) Approve and authorize the Chair to sign Agreement for Services 10170 with SMWG, in the amount of $6,588,000 for the initial term of three years from July 1, 2026, through June 30, 2029, with the option to extend the Agreement for one additional year through June 30, 2030, for a maximum amount of $8,784,000 if extension is granted;
3) Authorize the Purchasing Agent to execute amendments relating to Agreement 10170, contingent upon approval by County Counsel and Risk Management, which do not increase the maximum dollar amount or term of the Agreement; and
4) Authorize the HHSA Director, or the Chief Assistant Director, to execute programmatic, administrative, and fiscal documents relating to Agreement 10170.
FUNDING: Federal and State Funding: 50% Behavioral Health Services Act and 50% Federal/State Medi-Cal.
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DISCUSSION / BACKGROUND:
In 2004, California voters approved Proposition 63, establishing the Mental Health Services Act (MHSA), which took effect on January 1, 2005. MHSA created a one-percent tax on personal incomes over $1,000,000, with the resulting funds distributed to counties to transform the state’s mental health system. The goal was to build a consumer- and family-driven, recovery-oriented, accessible, and culturally responsive system that provides services appropriate to the populations served. The BHSA replaces MHSA and modernizes the statewide behavioral health framework. It refocuses funding on individuals with the most significant mental health needs, incorporates treatment for substance use disorders (SUD), expands housing interventions, strengthens the behavioral health workforce, and increases oversight, transparency, and accountability at both state and local levels.
In alignment with BHSA requirements, HHSA has developed a BHSA Three-Year Integrated Plan for fiscal years (FY) 2026-29, which is expected to be adopted by the Board in June 2026. Mobile Crisis services are mandated under Full-Service Partnership and are included within Behavioral Health Services and Supports, the Children’s System of Care, and the Adult System of Care, ensuring compliance with the 24/7 service requirement. Pursuant to Behavioral Health Information Notice (BHIN) No. 23-025 published by the California Department of Health Care Services (DHCS), the County as the Mental Health Plan (MHP), is required to provide 24/7 Mobile Crisis Services, including on-site de-escalation and stabilization for behavioral health emergencies in the community. BHIN 23-025 permits MHPs to deliver these services directly or through contracted providers.
On December 10, 2024, competitively bid Agreement 9019 was executed and approved by the Board for SMWG to deliver Mobile Crisis Services in El Dorado County in accordance with BHIN 23-025 for MCT (Legistar 24-1608). SMWG operates the MCT during contracted hours in South Lake Tahoe and the Western Slope, coordinating with local law enforcement and partner agencies as needed and providing follow-up support to assist individuals in accessing services. Outside of SMWG’s contracted hours, Mobile Crisis services are provided by the Psychiatric Emergency Response Team (PERT) under County MOU 8008 with the El Dorado County Sheriff’s Office (EDSO) (Legistar 23-1677).
Under the proposed renewal Agreement, SMWG will continue to deploy an MCT composed of trained counselors and peer support specialists who respond to behavioral health emergencies, provide assessments, and connect individuals to needed support to improve engagement in ongoing care. HHSA recommends the Board approve this renewal agreement with SMWG to enable the County to meet its obligation as the MHP to provide continuous 24/7 Mobile Crisis services without interruption. Pursuant to Resolution 017-2026, this BHSA agreement is exempt from competitive bidding (Legistar 25-2044).
ALTERNATIVES:
Should the Board decline to approve this recommendation, HHSA would be unable to meet the mandated 24/7 Mobile Crisis services as outlined in BHIN 23-025 to eligible Medi-Cal beneficiaries experiencing a mental health and/or SUD crisis. HHSA would continue to provide services with EDSO through PERT, and with other law enforcement agencies as applicable, and will also independently provide services through its Behavioral Health Division but would be unable to meet the 24/7 requirements, resulting in state sanctioned fines and penalties. Additionally, counties are unable to draw down Medi-Cal Mobile Crisis funding in the absence of 24/7 services, leading to diminished funding for this project.
PRIOR BOARD ACTION:
1) 12/12/23, 23-1677, HHSA EDSO PERT MOU 8008
2) 12/10/24, 24-1608, HHSA Sierra Mental Wellness Group 9019
3) 01/27/26, 25-2044, HHSA Resolution Behavioral Health Services Act Services
OTHER DEPARTMENT / AGENCY INVOLVEMENT:
County Counsel, Human Resources, and Risk Management. The Auditor Controller was notified of this Agreement in accordance with Policy B-12.
CAO RECOMMENDATION:
Approve as recommended.
FINANCIAL IMPACT:
There is no Net County Cost associated with this agenda item. Sufficient appropriations were included in the Fiscal Year 2026-27 Budget request and will be included in future budgets for the term of the Agreement.
CLERK OF THE BOARD FOLLOW UP ACTIONS
Clerk of the Board to obtain signature of Chair on one original Agreement for Services 10170.
STRATEGIC PLAN COMPONENT:
N/A
CONTACT
Olivia Byron-Cooper, MPH, Director, Health and Human Services Agency