Establishing a Behavioral Health Impact Fund

 

DATE: March 24, 2020

TO: Board of Supervisors

SUBJECT

ESTABLISH A BEHAVIORAL HEALTH IMPACT FUND (DISTRICTS: ALL)

OVERVIEW

Behavioral Health covers a broad spectrum of mental health, substance use, and alcohol services. In recent years, Behavioral Health has come into full focus as a priority for the Board of Supervisors. Our Board has moved with urgency on this issue to create a comprehensive system made up of regional hubs and person-centered care coordination to address the immediate crises, while also working with providers for other service lines such as long-term residential services.  Although service providers may be reimbursed for treatment services, they do not have the ability to use reimbursement dollars for capital needs. 

On February 19, 2020, Chairman Greg Cox announced at his State of the County Address, that he and his colleague, Supervisor Nathan Fletcher, would be working with Mayor Kevin Faulconer and the City of San Diego on developing a much-needed Behavioral Health Impact Fund (BHIF) that would help community-based organizations grow their capacity to serve more clients, for longer periods of time. These dollars would serve as a catalyst for these organizations to make capital investments that will allow them to expand their capacity for long-term treatment and strengthen our regional continuum of care.

Today’s recommendations will approve the Agreement for Behavioral Health Services By and Between the County of San Diego and the City of San Diego, and direct the Chief Administrative Officer to sign the Agreement and make the required budget actions. 

RECOMMENDATION(S)

CHAIRMAN GREG COX AND SUPERVISOR NATHAN FLETCHER

1) Approve the Agreement for Behavioral Health Services By and Between the County of San Diego and the City of San Diego (Agreement) and direct the Chief Administrative Officer to sign the Agreement.

2) Direct the Auditor & Controller to establish a new fund, Behavioral Health Impact Fund and establish $25,000,000 of appropriations in Countywide General Expenses Services and Supplies based on General Fund fund balance in order to fund the Behavioral Health Impact Trust Fund. (4 votes)

3) Establish appropriations of $25,000,000 in Countywide General Expenses Other Charges to record expenses to community based organizations based on revenues from the Behavioral Health Impact Fund. (4 votes)

FISCAL IMPACT

Funds for this request are not included in the Fiscal Year 2019-21 Operational Plan. If approved, this request will result in costs of $25,000,000 in Fiscal Year 2019-20. The funding source is available prior year General Fund fund balance. There will be one additional staff year to administer the program which will be funded by the Behavioral Health Impact Fund.

BUSINESS IMPACT STATEMENT

N/A

ADVISORY BOARD STATEMENT

N/A

BACKGROUND

Behavioral Health covers a broad spectrum of mental health, substance use, and alcohol services. In recent years, Behavioral Health has come into full focus as a priority for the Board of Supervisors. Our Board has moved with urgency on this issue to create a comprehensive system made up of regional hubs and person-centered care coordination to address the immediate crisis, while also working with providers for other service lines such as long-term residential services.  

This year, we have invested $711 million in resources to improve our Behavioral Health System, which represents more than 11 percent of our overall budget. In the year ahead, we will continue to forge new partnerships with local hospitals and other healthcare providers to create community hubs and develop a network of support services where those suffering with a behavioral health issue can receive the appropriate level of care and be transitioned to aftercare services. The County will be the beating heart of the hubs. Our community partners will be the arteries, delivering life-saving services to our neighborhoods.

Our investment in County behavioral health services will help build a network of care that meets individual’s needs. But for that network to succeed, we must also invest in our community partners. Although service providers have the ability to get reimbursed for treatment services, they do not have the ability to use reimbursement dollars for capital needs. 

On February 19, 2020, Chairman Greg Cox announced at his State of the County Address, that he and his colleague, Supervisor Nathan Fletcher, would be working with Mayor Kevin Faulconer and the City of San Diego on developing a much-needed Behavioral Health Impact Fund (BHIF) that would help community-based organizations grow their capacity to serve more behavioral health clients, for longer periods of time. These dollars would serve as a catalyst for these organizations to make capital investments that will allow them to expand their capacity for long-term treatment and strengthen our regional behavioral health continuum of care.

Today’s recommendations will approve the Agreement for Behavioral Health Services By and Between the County of San Diego and the City of San Diego, and direct the Chief Administrative Officer to sign the Agreement and make the required budget actions. 

LINKAGE TO THE COUNTY OF SAN DIEGO STRATEGIC PLAN

N/A

Respectfully submitted,

GREG COX

Chairman

NATHAN FLETCHER

Supervisor, Fourth District

ATTACHMENT(S)

Agreement for Behavioral Health Services By and Between the County of San Diego and the City of San Diego

AGENDA ITEM INFORMATION SHEET

REQUIRES FOUR VOTES: ☒ Yes ☐ No

WRITTEN DISCLOSURE PER COUNTY CHARTER SECTION 1000.1 REQUIRED

☐ Yes ☒ No

PREVIOUS RELEVANT BOARD ACTIONS: 

N/A

BOARD POLICIES APPLICABLE:

N/A

BOARD POLICY STATEMENTS:

N/A

MANDATORY COMPLIANCE:

N/A

ORACLE AWARD NUMBER(S) AND CONTRACT AND/OR REQUISITION NUMBER(S):

N/A

ORIGINATING DEPARTMENT: Districts 1 and 4

OTHER CONCURRENCE(S):    N/A

CONTACT PERSON(S):

Danny Melgoza

Stephanie Gioia-Beckman

619-531-5511

619-531-5544

danny.melgoza@sdcounty.ca.gov

stephanie.gioia@sdcounty.ca.gov