TO: Board of Supervisors
FROM: Jennifer Yasumoto, Director of Health and Human Services Agency
REPORT BY: Gaby Angeles, Staff Services Analyst II
SUBJECT: Revenue Agreement No. 240123B with Department of State Hospitals Forensic Conditional Release Program (CONREP)
RECOMMENDATION
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Director of Health and Human Services Agency (HHSA) requests approval of and authorization for the Chair to sign Revenue Agreement No. 240123B with Department of State Hospitals (DSH) for Fiscal Years 2024-2026 for a contract maximum of $1,528,825 for the continued Forensic Conditional Release Program (CONREP) in Napa County.
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EXECUTIVE SUMMARY
Approval of today’s action will allow Napa County to continue to provide specialty mental health services to participants of the State’s CONREP for another three-year term as the previous revenue agreement terminated June 30, 2023.
FISCAL & STRATEGIC PLAN IMPACT
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Is there a Fiscal Impact? |
Yes |
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Is it currently budgeted? |
Yes |
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Where is it budgeted? |
Health and Human Services Agency, Behavioral Health |
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Is it Mandatory or Discretionary? |
Discretionary |
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Discretionary Justification: |
Approval of the requested action is discretionary in that there is no mandate for the County to participate in the State's Conditional Release Program (CONREP). However, the State provides funding for the County to maintain CONREP participants in the community by providing the mental health services they need. |
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Is the general fund affected? |
No |
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Future fiscal impact: |
This agreement terminates on June 30, 2026. Appropriations have been included in the approved Fiscal Year 2023-2024 budget and future fiscal years will be budgeted accordingly. |
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Consequences if not approved: |
If the agreement is not approved, HHSA will not receive funding for CONREP-enrolled participants. |
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County Strategic Plan pillar addressed: |
Healthy, Safe, and Welcoming Place to Live, Work, and Visit |
ENVIRONMENTAL IMPACT
ENVIRONMENTAL DETERMINATION: The proposed action is not a project as defined by 14 California Code of Regulations 15378 (State CEQA Guidelines) and therefore CEQA is not applicable.
BACKGROUND AND DISCUSSION
Under the State-funded CONREP, DSH contracts with county behavioral health programs, or private contract providers, to provide direct outpatient treatment of State Hospital patients who are found Not Guilty by Reason of Insanity for felony crimes, and for prison inmates who meet statutory criteria as Mentally Disordered Offenders (MDO) and who are ordered into behavioral health treatment as a condition of parole. CONREP reintegrates these individuals back into the community by providing the appropriate level of supervision and behavioral health services for individuals placed on outpatient status. DSH requires that CONREP patients have direct access to a full range of behavioral health services during their period of outpatient treatment. These services include individual and group therapies, collateral contacts, home visits, substance abuse screenings, psychological assessments, and other needed supplemental behavioral health services. DSH has developed performance standards for these services that set minimum treatment and supervision levels for all CONREP patients to be provided by the County. DSH additionally specifies that specialized forensic behavioral health clinicians are essential to the effective management of CONREP patients in the community. Consequently, a Forensic Behavioral Health Counselor (FMHC) is responsible for managing Napa County's current CONREP caseload of up to ten individuals and ensuring that they receive an appropriate array of behavioral health services to maintain their placement in the outpatient program.
Approval of the requested action will enable the County to receive $1,528,825 in State funds for the continued operation of CONREP for July 1, 2023 through June 30, 2026. The funding being provided by the State is based on a contract budget prepared and submitted by the County and approved by DSH. The County's CONREP program includes the costs of clinical, supervisory, and administrative staffing, direct services (board and care, on-call coverage, and medication support), operating expenses (medications, communications, etc.) and administrative overhead costs associated with the program.
The previous revenue agreement for these services termed June 30, 2023. The new revenue amount is an increase of $755,883 from the previous agreement, which can be attributed to an increase in utilization and an increase in costs associated with the program. Additionally, the previous agreement was for a two-year term, this agreement is for three years. DSH bases the allocation of money on the number of clients that HHSA’s Behavioral Health division has in the system at the time of drafting the agreement. The increased revenue is due to a higher projected number of clients and the longer term of this agreement.
This agreement was received by HHSA mid-July 2023.