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Health and Human Services Agency (HHSA) recommending the Board adopt and authorize the Chair to sign Resolution 138-2023, authorizing the addition of one full-time equivalent Deputy Public Guardian I/II allocation in HHSA .
FUNDING: 100% State-funded Mental Health Services Act for the Lanterman-Petris-Short Project.
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DISCUSSION / BACKGROUND:
The LPS Act, enacted in 1967, authorizes the involuntary commitment and treatment of persons with specified mental health disorders for the protection of the persons so committed. The LPS Act of 1967 defines actions and services when an individual, as a result of a mental health disorder, is considered gravely disabled, a danger to others, or to themselves, and is taken into custody on a temporary hold or a series of progressive holds leading to a determination of conservatorship. The individual will receive an assessment and crisis intervention as necessary and may be placed in a locked Psychiatric Health Facility (PHF). LPS conservatorships are established to arrange mental health treatment and placement for people who are gravely disabled and unable to provide for their food, clothing, shelter, and treatment needs as a result of a mental disorder.
Pursuant to California WIC Section 5604, the governing board in each county or counties acting jointly under the provisions of Article 1 (commencing with Section 6500) of Chapter 5 of Division 7 of Title 1 of the Government Code, shall designate the agency or agencies to provide LPS conservatorship investigation. On February 1, 1983, the County of El Dorado Board of Supervisors (Board), designated the HHSA Behavioral Health Division (previously titled the Mental Health Division) as the entity to conduct LPS conservatorship investigations (Resolution 25-83).
County residents who have been assessed by a psychiatrist to meet the criteria for a severe mental illness are referred to the El Dorado County HHSA Behavioral Health Division (BHD), prompting a team, including the County Mental Health Medical Director and Mental Health Clinicians, to perform LPS conservatorship investigations.
On September 30, 2022, Assembly Bill (AB) 2242 amended the LPS Act, clarifying that counties may pay for LPS services using funds from the MHSA budget when included in county plans. On June 20, 2023, the Board approved the HHSA Fiscal Year 2023-24 through 2025-26 MHSA Three Year Program and Expenditure Plan (MHSA Plan) (File ID: 23-0933). Within this adopted MHSA Plan, the LPS Project was budgeted for an annual MHSA allocation of $500,000, to expend on support services defined within the LPS Act allowable by AB 2242.
These LPS services may include the initial assessment administered by HHSA, through the final determination if an individual should be conserved or not, including any treatment services administered throughout the assessment and investigation period. MHSA may also fund care coordination, also defined by AB 2242, which supports planning for the individual’s needs after the determination of conservatorship is made.
On July 25, 2023, due to the limited number of Mental Health Clinicians performing LPS investigations in HHSA BHD, the Board adopted Resolution 114-2023, authorizing that LPS investigations may be performed by the County Public Guardian Office, in addition to HHSA BHD (File ID 23-1147).
Working directly with the Human Resources Department, HHSA has developed the attached Personnel Allocation Resolution which was approved by County Counsel. HHSA is recommending the Board adopt and authorize the Chair to sign said Resolution, thereby adding one FTE Deputy Public Guardian I/II allocation to HHSA, to enable HHSA Public Guardian to have a dedicated staff member for performing the LPS conservatorship investigations.
The classification of Deputy Public Guardian I/II is a flexibly staffed entry/journey level classification in the Deputy Public Guardian class series, responsible for the performance of routine conservatorship duties including assessing individuals for eligibility into the program and learning the rules and regulations with respect to the different types of conservatorships.
ALTERNATIVES:
The Board could decline to adopt and authorize the Chair to sign the attached Personnel Allocation resolution, thereby not adding a position to HHSA, in which Public Guardian may be unable to perform LPS investigations. Should the Board decline to approve this recommendation, HHSA will continue to provide services by the HHSA BHD Mental Health Clinicians assigned to LPS investigations.
PRIOR BOARD ACTION:
7/25/23, 23-1147, HHSA Lanterman-Petris-Short (LPS) Conservatorship Investigation Designation and Resolution
OTHER DEPARTMENT / AGENCY INVOLVEMENT:
Approved by County Counsel, Human Resources.
CAO RECOMMENDATION:
Approve as recommended.
FINANCIAL IMPACT:
There is no General Fund cost associated with this item. The addition of one FTE Deputy Public Guardian I/II allocation has an estimated annual cost increase to the HHSA Behavioral Health budget of $119,000, which was included in the Board’s adopted Three-Year MHSA Plan for Fiscal Years 23/24-25/26 for the LPS Project. For the remainder of the current fiscal year, the cost increase is estimated at a total of $60,000, which was also included in the MHSA Plan for this project. There are sufficient appropriations in the Fiscal Year 2023-24 Budget to cover the addition of this position.
CLERK OF THE BOARD FOLLOW UP ACTIONS
Clerk of the Board to obtain signature of Chair on one (1) original Resolution.
STRATEGIC PLAN COMPONENT:
Healthy Families
CONTACT
Olivia Byron-Cooper, MPH, Interim Director, Health and Human Services Agency