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Health and Human Services Agency (HHSA) and the Chief Administrative Office, Facilities Division, recommending the Board:
1) Adopt and authorize the Chair to sign Resolution 211-2024, authorizing HHSA to apply for the California Department of Health Care Services (DHCS) Bond Behavioral Health Continuum Infrastructure Program (BHCIP) Round 1 grant, in the estimated award amount of $24,000,000, which requires a 10% match which will be met with HHSA awarded grant funds, Mental Health Services Act budgeted project funds, and with in-kind equity match, for an estimated term of five years;
2) Approve and authorize the Chair to sign the attached Letter of Support (attachment B) expressing the Board’s support of HHSA Behavioral Health Division’s application for the County Medical Services Program Healthcare Infrastructure Development (HID) Matching Grant, that is required as part of the HID matching grant’s application process, which if awarded, will provide up to $1 million in funding to aid the County in meeting the local financial match requirements of the Bond BHCIP Round 1 Grant;
3) Make findings pursuant to Section 3.13.030 (C) of the El Dorado County Ordinance Chapter 13, Contracting Out, that specialty skills and qualifications not expressly identified in County classifications are involved in the performance of the work of Agreement for Services 9187 with Lionakis;
4) Authorize the Purchasing Agent to sign, competitively procured, Agreement for Services 9187 with Lionakis, in the amount of $168,839 with a two-year term to provide Architectural Design and Engineering Services for Tenant Improvement for the El Dorado County Psychiatric Health Facility and Behavioral Health Outpatient Services at 299 Fair Lane; and
5) Authorize the Purchasing Agent to execute any necessary amendments relating to Agreement for Services 9187, excluding term extensions and increases in compensation, contingent upon approval by County Counsel and Risk Management.
FUNDING: The State funded Bond BHCIP Round 1 grant requires a 10% match amount (estimated at $2.4 million if the County is awarded the full $24 million), which would be provided through HID Matching Grant funds (estimated at up to $1 million), up to $1 million of MHSA funding, and the remaining match funds will be met through in-kind equity in the property located at 299 Fair Lane in Placerville; Agreement for Services 9187 will be funded with American Rescue Plan Act (ARPA) funding allocated to the Health and Human Services Agency by the Board.
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DISCUSSION / BACKGROUND:
El Dorado County Health and Human Services Agency (HHSA) is currently planning to pursue an infrastructure expansion consisting of two components and is intended to provide improved management for complex mental health and substance abuse cases at a centralized, easily accessible location. This expansion is termed the Service, Outreach, Access, and Response (SOAR) Project.
The first component of this infrastructure expansion is comprised of the renovation of the upper floor of the property located at 299 Fair Lane, Placerville. These modifications and renovations will facilitate the relocation and expansion of HHSA’s current psychiatric health facility (PHF), currently located at 935B Spring Street, Placerville. A PHF is a locked, inpatient psychiatric treatment facility that provides treatment to individuals who are detained due to danger to self, others, or grave disability. This secure facility is supportive to treatment needs for the most acute mental health clients in El Dorado County and works in close coordination with hospitals and law enforcement staff across the community (including the El Dorado Sheriff’s Office and both Marshall and Barton Hospitals). This will serve to meet the State’s bond proposal to expand 6,800 residential beds across the state by ensuring that up to sixteen patients are able to receive treatment while granting them access to all department programs which may be beneficial upon their discharge to improve long-term outcomes. The current facility utilized for the PHF is past its end of life and patient capacity is often reduced, as the building requires escalating repairs to maintain a safe and habitable environment for the patients and staff.
The second component of the SOAR project is to renovate the lower floor of the above-mentioned property to house County staff from Outpatient Mental Health, Veterans’ Services, Self-Sufficiency, Substance Abuse, Public Guardian, and Protective Services. The co-location of these programs and the development of an integrated client intake team and process at a location that is on the county’s public transportation route will improve equitable access to HHSA’s programs by lowering access barriers that currently exist due to HHSA’s programs being housed at multiple locations across the West Slope area, some of which are inaccessible by public transit.
Passed in March 2024, Proposition 1 includes the Behavioral Health Services Act (Senate Bill 326) and the Behavioral Health Infrastructure Bond Act (BHIBA) of 2024. BHIBA is a $6.38 billion general obligation bond to develop behavioral health treatment facilities and supportive housing for individuals experiencing mental health and substance use disorders. Of the total amount, the Department of Health Care Services (DHCS) will award up to $4.4 billion in bond funding for Bond BHCIP Round 1 competitive grants to cities, counties, and tribal entities in the service of constructing, acquiring, and rehabilitating real estate assets to expand the continuum of behavioral health treatment and service resources for Californians. Bond BHCIP Round 1: Launch Ready funds are not intended to preserve existing service capacity. Grantees must commit to serving Medi-Cal beneficiaries. For purposes of Bond BHCIP Round 1: Launch Ready funding, a project is defined as “launch ready” when some essential predevelopment design, planning, site control, and budgeting details have been professionally formalized; the project meets the minimum threshold requirements (Project Readiness); and construction for the requested project is not currently underway.
The CMSP HID Matching Grant Program (HID Matching Grant) has been developed by the CMSP Governing Board to help CMSP counties and organizations contracted with CMSP counties develop expanded facility capacity to provide healthcare and behavioral health services to underserved populations, including CMSP beneficiaries (uninsured individuals between the ages of 21-64 who are not eligible for other publicly funded healthcare programs). The County of El Dorado is a participating CMSP county so is eligible for this program. The HID Matching Program Grant provides funding that aids counties and their contracted partners in meeting local financial match requirements of healthcare infrastructure funding opportunities provided by state, federal or other programs. Facilities that serve multiple counties are eligible for an award of the lesser of $1 million or 5% of total project costs to be used towards the matching requirements of the primary healthcare infrastructure grant throughout the duration of the program.
The Bond BCHIP Round 1 grant calls for a 10% match from the grantee, which is expected to be $2.4 million if the full amount of the Bond BHCIP Round 1 application is awarded. If HHSA’s Bond BCHIP Round 1 grant application is selected for award, HHSA intends to provide its expected $2.4 million local matching requirement through braided funding with up to $1 million through the HID Matching Grant, up to $1 million of budgeted MHSA funds as required to support match requirements based on awarded amount, with the remaining match requirement to be met through in-kind equity in the value of the County’s real property located at 299 Fair Lane, Placerville, which was last appraised at $1.14 million.
If HHSA is awarded, funds from the Bond BHCIP Round 1 grant and local matching funds will be applied towards the rehabilitation and renovation of the County facilities at 299 Fair Lane, Placerville, for the purposes of expanding the County’s existing Psychiatric Health Facility (PHF) capabilities and the establishment HHSA’s SOAR team and center. This integrated, multi-disciplinary team will consist of case workers and a coordinator, representing all of HHSA’s major divisions, granting clientele walk-in access to HHSA mental health programs at a single location. This co-location of services promises to lower access barriers and improve client retention and outcomes through integrated intake and case management. Implementation of this co-location will improve El Dorado County’s ability to meet emerging CalAIM care coordination requirements and new Behavioral Health regulations imposed by DHCS.
As such, HHSA recommends the Board approve this agenda item and sign the Resolution, which is a required component of HHSA’s Bond BHCIP Round 1 application packet and sign the attached Letter of Support, which is a required component for HHSA’s application for the CMSP HID Grant. Additionally, HHSA and Facilities recommends the Board approve Agreement for Services 9187 with Lionakis to provide the architectural and design services for the SOAR project. On August 22, 2023, as a result of RFQ #23-918-072, Lionakis was identified as a firm qualified for Architectural and Engineering Services.
ALTERNATIVES:
Should the Board decline to approve this recommendation, HHSA would continue to provide services at the existing PHF which will eventually need to be replaced through another avenue.
The Board could choose to not approve Agreement for Services 9187 or could choose another consultant. This alternative could result in an increase in project costs and delays with no guarantee of finding an alternative consultant.
PRIOR BOARD ACTION:
N/A
OTHER DEPARTMENT / AGENCY INVOLVEMENT:
County Counsel and Procurement and Contracts.
CAO RECOMMENDATION:
Approve as recommended.
FINANCIAL IMPACT:
There is no General Fund Cost associated with this agenda item. All matching funds associated with this project will be obtained through grants or budgeted Mental Health Services Act dollars. HHSA will return to the Board with a Budget Transfer Request to increase revenue if the grant funds are awarded. Funding for Agreement for Services 9187 been budgeted in the current Accumulative Capital Outlay Fiscal Year 2024-25 Workplan utilizing ARPA funding allocated to the Health and Human Services Agency by the Board.
CLERK OF THE BOARD FOLLOW UP ACTIONS
1) Clerk of the Board to obtain the Chair’s signature on one original of the Resolution;
2) Clerk of the Board to obtain the Chair’s signature on one original of the Letter of Support (attachment b); and
3) Clerk of the Board to return one certified Resolution and signed Letter of Support to HHSA, Contracts Unit via email at hhsa-contracts@edcgov.us.
STRATEGIC PLAN COMPONENT:
N/A
CONTACT
Olivia Byron-Cooper, MPH, Director, Health and Human Services Agency
Chuck Harrell, Facilities Division Manager