TO: Board of Supervisors
FROM: Steve Lederer, Director of Public Works
REPORT BY: Daniel Basore, Engineering Supervisor
SUBJECT: Approval of Amendment 2 to Agreement No. 240326B with TLCD Architecture
RECOMMENDATION
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Approve and authorize Amendment No. 2 to Agreement No. 240326B with TLCD Architecture for $121,670 for a new maximum of $602,356 for additional architectural, engineering, and associated services in support of the “Crisis Stabilization Unit (CSU) - Children’s Services Expansion Project” PW 24-15. (Fiscal Impact: $121,670 Expense; Health and Human Services Fund; Budgeted; Discretionary)
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BACKGROUND
The Department of Health Care Services (DHCS) was authorized through Welfare and Institutions Code sections 5960-5960.45 to establish the Behavioral Health Continuum Infrastructure Program (BHCIP) with $2.2 billion to construct, acquire, and rehabilitate real estate assets or to invest in needed mobile crisis infrastructure to expand the community continuum of behavioral health treatment resources. DHCS is releasing BHCIP grant funds through six rounds that target various gaps in the state’s behavioral health facility infrastructure.
BHCIP aims to reduce homelessness, incarceration, unnecessary hospitalizations, and inpatient days and improve outcomes for people with behavioral health conditions by expanding access to community-based treatment. BHCIP proposes to invest in the expansion of beds, units, or rooms by building new behavioral health continuum infrastructure and expanding capacity. These resources would expand the continuum of services by increasing capacity for short-term crisis stabilization, acute and sub-acute care, crisis residential, community-based mental health residential treatment, substance use disorder residential treatment, peer respite, mobile crisis, community and outpatient behavioral health services, and other clinically enriched longer-term treatment and rehabilitation opportunities for individuals with behavioral health disorders, in the least restrictive and least costly setting.
AHP released “Round 5: Crisis and Behavioral Health Continuum” with a due date of applications by February 13, 2023. HHSA applied for the funds after extensive exploration and data collection on current community crisis needs, including children’s mental health needs related to the pandemic. The children’s expansion will provide crisis psychiatric assessment and crisis stabilization services for youth in Napa County. The services include medication assessment and administration, comprehensive care coordination, safety/discharge planning, and when necessary, facilitation of admission to psychiatric inpatient services. The service expansion will increase the current bed count from two in the current Crisis Stabilization Unit (CSU) to four in a separate area, created as a children’s specific treatment milieu focused on providing trauma informed, client-focused and culturally/linguistically appropriate services geared toward wellness and recovery.
By supporting an expansion of doubling the beds for children, we increase capacity not only within the crisis stabilization unit but also supporting the local emergency department. The two children’s beds in operation in the current CSU will be converted to adult beds. None of the BHCIP funding will be used in that transition to adult beds. The increase to four beds also supports the larger community mission to keep children in their communities and in home settings. Without local capacity, children are sent to out of county inpatient psychiatric hospital beds, which create costly barriers for family especially costs including childcare coverage for other children and transportation costs to out of county hospitals. The expansion of a children’s crisis CSU promotes the value in providing children and family specific services, creating a calm and safe therapeutic setting, and providing an opportunity for children to have more choice and voice in a separate clinical setting. On July 25, 2023, the Board adopted a resolution authorizing the Director of HHSA to execute all required documents to participate in the BHCIP program, including but not limited to the Program Funding Agreement (PFA), Declaration of Restrictions, and Performance Deed of Trust accepting $3,329,955 in deliverable based revenue from the California Department of Health Care Services (DHCS) through its contractor, Advocates for Human Potential (AHP).
On April 23, 2024, the Board approved and authorized the creation and funding of the CSU- Children’s Services Expansion project and Agreement No. 240326B with TLCD Architecture for a maximum of $466,286 for design and construction administration services needed to support the project. During the feasibility review phase, Napa County requested to explore the feasibility of shared staff “core” spaces between the adult and youth programs with the goal of eliminating redundant space and increasing efficiency.
On September 10, 2024, the Board approved and authorized Amendment No. 1 to further explore the shared staff “core” space concept. After exploring this concept further through the feasibility work, Napa County determined the shared staff “core” spaces concept was the most efficient, safe, and reasonable program layout moving forward. This Amendment No. 2 adds architectural and engineering services for design and construction administration services to support the additional square footage of the shared staff “core” spaces concept which modifies the overall project square footage from approximately 3,000 square feet to approximately 6,856 square feet.
Requested Action:
Approve and authorize Amendment No. 2 to Professional Services Agreement No. 240326B with TLCD Architecture for an additional $121,670 for a new maximum of $602,356 for further architectural, engineering, and associated services in support of the “Crisis Stabilization Unit (CSU) - Children’s Services Expansion Project” PW 24-15.
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? |
Funding came from HHSA Fund and is now budgeted in the Capital Improvement Projects Fund, Project 24027. |
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Is it Mandatory or Discretionary? |
Discretionary |
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Discretionary Justification: |
The amendment will allow TLCD and Napa County to design and construct shared staff ‘core’ spaces between the CSU Adult and Youth programs which will eliminate redundant spaces and increase efficiency of the overall program. |
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Is the general fund affected? |
No |
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Future fiscal impact: |
Staff will return to the Board later to request additional funds to fund construction. |
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Consequences if not approved: |
The project will not move forward and will jeopardize the grant funding received. |
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Additional Information |
The grant fund is a deliverable based program funding agreement and the State will reimburse the County up to but not to exceed an amount of $3,329,955. The County has deposited the required $277, 964 cash match that will not be reimbursed. |
ENVIRONMENTAL IMPACT
ENVIRONMENTAL DETERMINATION: The proposed action is not a project as defined by California
Code of Regulations title 14, section 15378 (State CEQA Guidelines) and therefore CEQA is not applicable.