Title
Receive a presentation on the County of Monterey Proposition 47 (Prop 47) Grant Program, a voter-approved initiative on the November 2014 ballot that reduced from felonies to misdemeanors specified low-level drug and property crimes.
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
Receive a presentation on the County of Monterey Proposition 47 (Prop 47) Grant Program, a voter-approved initiative on the November 2014 ballot that reduced from felonies to misdemeanors specified low-level drug and property crimes.
SUMMARY/DISCUSSION:
At the recommendation of the Health, Housing and Human Services Committee of the Board of Supervisors, the County of Monterey Health Department, Behavioral Health Bureau (BHB) will provide a PowerPoint presentation regarding recent activities, program updates and outcome data on the Prop 47 Grant Program.
Proposition 47 was a voter-approved initiative on the November 2014 ballot that reduced from felonies to misdemeanors specified low-level drug and property crimes. Each year, the state savings generated by the implementation of Proposition 47 are deposited into the Safe Neighborhoods and Schools Fund. Sixty-five percent of these savings are set aside annually for the Board of State and Community Corrections (BSCC) to administer a competitive grant program.
Proposition 47 requires that these funds be awarded to public agencies to provide mental health services, substance use disorder treatment and/or diversion programs for those in the criminal justice system. Additional legislation (AB 1056, Chap. 438, Stats. of 2015) requires that the grants be awarded competitively and specifies that funds may serve both adults and juveniles and allows funds to be used for housing-related assistance and other community-based supportive services, including job skills training, case management or civil legal services. The BSCC further requires that at least 50 percent of the award made to grantees is passed through to community-based service providers.
The BHB Prop 47 Grant Services Program was launched in 2017 following the initial award of $6,000,000. Subsequently, BHB has received two additional awards of $6,000,000. These awards totaling $18,000,000 were utilized to support three “Cohorts” of program service periods.
Prop 47 services in Monterey County were designed to address the historic unmet need for substance use disorder (SUD) treatment, specialty mental health services, and supportive services in rural South Monterey County (South County) to decrease nonviolent offenders’ risk for subsequent incarceration and treat behavioral health disorders among people with co-occurring conditions. The program also supports community members from all regions of Monterey County with Post-Conviction relief support from the Office of the Public Defender and through the operation of the Sobering Center.
Services include, or have included, inpatient and outpatient Substance Abuse Disorder (SUD) services, Sober Living Homes, Community Outreach, Employment Support, Legal Aid, operation of the Sobering Center, facilitation of culturally relevant groups, Post-Conviction relief, Behavioral Health linkage and treatment, and Housing linkage and support.
Services have been established through collaborative partnership between BHB and partner agencies. Since the establishment of the grant program, there has been a concerted effort to have BHB and the partner agencies develop a collaborative model that appears smooth and seamless to the individuals receiving services. This has been accomplished through frequent Stakeholder Meetings facilitated by the BHB Project Director. Additionally, frequent communication is emphasized and encouraged between BHB and partner agency staff. In 2022, the Prop 47 Coordination Team was established, consisting of the BHB Prop 47 Clinical Coordinator and the Sun Street Centers Prop 47 Outreach Coordinator. The coordination team serves as an inward focused and community focused coordination hub, which allows for Prop 47 staff, enrolled participants, and community members to have a point of contact that can be accessed to assist with program enrollment, resolve system navigation issues, provide community information, and work with partner agencies on enhancing and improving provision of services.
The three (3) Prop 47 Grant Cohorts thus far are: Cohort I- No Zip Code Left Behind Addressing Inequalities Through Collaborative Partnerships (July 2017 - July, 2021), Cohort II - Advancing Transformative Healing and Interpersonal Growth Through Collaborative Partnerships (August 2019 - May, 2023), and Cohort III - Continuing the Path to Healing and Transformation Through Collaborative Partnerships (February 2023 - May, 2026).
Cohort I- No Zip Code Left Behind Addressing Inequalities Through Collaborative Partnerships (July 2017 - July 2021). Upon receiving the initial award, funding was utilized to establish a service provider network, and to begin building the infrastructure to support program services that has allowed the South County community to feel the presence of services, which resulted in an increasing demand for services, and led to other providers offering services in the South County region.
Cohort II - Advancing Transformative Healing and Interpersonal Growth Through Collaborative Partnerships (August 2019 - May 2023). Cohort II focused on the continuation of building the infrastructure and on building a network of collaboration and interconnectedness across program providers. The public awareness campaign, with radio spots, community billboards and postings were also started. Services were expanded to include housing resources and support. The Prop 47 Coordination Team was created, which expanded support to clients, community access to services, and to supporting the service provider partners. Due to the strategic nature of program service design, there was minimal impact to services because of the pandemic.
Cohort III - Continuing the Path to Healing and Transformation Through Collaborative Partnerships (February 2023 - May, 2026). We are currently in the early stages of this cohort and the focus is on continuing integration of services, enhancing collaboration and community connectedness. Attention is also being given to program evaluation and how to support the sustainability of Prop 47 services beyond the life of the current grant funding.
Working in partnership and collaborating with a variety of partners has been critical throughout all cohorts of the Prop 47 grant program and continues to be essential for the ongoing success of this project. Currently Cohort III services are being provided by Monterey County Behavioral Health Bureau, Sun Street Centers, Motivating Individual Leadership for Public Advancement (MILPA), Office of the Public Defender, and Housing Resource Center. Additionally, we have continued to contract with the Institute of Community Collaborative Studies (ICCS) at California State University Monterey Bay (CSUMB) for data collection and data reporting to the BSCC.
Behavioral Health services are provided by existing BHB treatment teams throughout all regions of the county. The Prop 47 clinician provides assessment and linkage to individuals meeting the eligibility criteria and manages a small caseload of clients. From August 2017 to February 2023, 450 Prop 47 clients have been served by BHB.
Sun Street Centers operates the Sobering Center and provides the Outpatient and Residential Treatment services for Prop 47. The Sobering Center opened in December 2017 for adults 18 years old and over referred by law enforcement. The program is designed to serve individuals as a diversion from jail for First Offender DUI and Public Intoxication. The maximum length of stay is 23 hours, and the program is staffed by an Alcohol and Other Drug (AOD) Counselor and Medical Assistant. From December 2017 - March 2023, over 1,500 individuals have been served at the Sobering Center. Sun Street Centers Outpatient SUD treatment utilizes evidence-based treatment and trauma informed interventions such as Motivational Interviewing and the Matrix Model. Drug Medi-Cal funds are utilized to leverage payment for these services. From July 2018 to March 2023, 404 individuals have been served. Sun Street Centers Residential SUD Treatment Services include a 22-bed residential treatment program, clinically trained staff and SUD counselors, and a Sober Living Environment (SLE).
Motivating Individual Leadership for Public Advancement (MILPA) conducts extensive outreach into the community to identify individuals that qualify for Post-Conviction Relief and links the individuals to the Office of the Public Defender. They provide La Cultura Cura groups (Talking Circles), which is a trauma informed treatment for transformational health and healing. These groups address trauma in a culturally informed manner, as not all justice-involved individuals are comfortable working with traditional mental health providers, substance use treatment modalities, or governmental agencies.
Office of the Public Defender conducts extensive outreach into the community to identify individuals that qualify for Post-Conviction Relief. Post-Conviction Relief Petitions include Prop 47 Reclassifications, Dismissal Of Charges (PC 1203.4), Adult Sealing of Records (PC 851.91), and Reduction of Charges Felony to Misdemeanor (PC 17B Motions). The total number of petitions filed as of March 2023 is 1,545 and are as follows: Prop 47 Reclassifications (430), PC 1203.4 Dismissals (1,037), Adult Sealings of Records (71), and PC 17B Reduction of Charges Felony to Misdemeanor (7).
Housing Resource Center (HRC) is an independent non-profit housing resource agency that uses evidenced based models recommended by the Federal Department of Housing and Urban Development (HUD). HRC provides reclassified and post recovery individuals with rental assistance, rapid rehousing, and supportive case management to maintain housing. They also provide help for at risk, post recovery individuals and families to maintain their recovery and reduce recidivism. HRC has successfully placed Prop 47 clients into permanent housing. A total of 28 have been housed since FY 20-21 out of the 38 total that have been served. Clients with a successful outcome: 28 clients have reached their housing goals, 14 out of 38 clients reached their employment goals. Clients who utilized the hotel stays while working on securing housing: 78 hotel weeks used in total for 21 clients.
The Institute of Community Collaborative Studies (ICCS) at California State University Monterey Bay (CSUMB) conducts evaluative review of the Prop 47 grant programs and services culminating in comprehensive evaluation reports which are submitted to the BSCC. The most recent ICCS evaluation report was received following completion of Cohort II and reported the following outcomes.
Direct impacts:
Had a significant impact on reducing recidivism for clients that received case management.
• There was a 57% reduction in arrests for participants who were enrolled in case management services.
• Only 7.7% of clients were convicted of a new crime after enrolling in services.
Diverted individuals with behavioral health/SUD needs from the criminal justice system.
• 676 clients received services at the Sobering Center instead of being booked at county jail.
• At least 1,000 jail nights were avoided (combining sobering center and reduction in arrests)
Provided support for social reintegration.
• 403 clients received post-conviction services of re-classification and petitions for dismissal. More than 90% were successful.
• 50 clients received Housing support. By the time of the evaluation analysis the number of individuals in independent living more than doubled and the number of homeless individuals was reduced from 19% to 6%.
• 70 Clients received employment support.
Reduced regional inequity by assuring access to behavioral health/SUD treatment.
• About 79% of clients that received case management service self-identified as Hispanic or Latino.
• Prior to the project, provision of services in South County was severely limited.
Indirect impacts:
Created a collaborative network of services with providers that traditionally worked in silos.
• Providers that would operate independently now share risks and benefits of collaboration to serve clients. The project’s coordination team ensures that referrals are seamless. Thus, after a period of 6 years in the project these previously independent agencies have streamlined their referrals and work as one.
Created an innovative intervention by combining social work and public health approaches to address a public safety issue.
• The project is an innovative approach to address a public safety issue. It combines services at the individual (client) level using traditional social work/behavioral health treatments, while maintaining a public health focus on a regional system of care and prevention. This approach is truly innovative and the BSCC has taken notice.
Bolstered service capacity by transforming physical infrastructure and facilitating service provision in the community. This will contribute to the project’s sustainability.
• The infrastructure developed by and for this project in partnership with providers and other grants has transformed the physical landscape in King City and has allowed the community to feel the presence of services which not only has increased demand for services but has facilitated other providers to offer services in south county.
• In addition to the physical infrastructure impacts, the soft infrastructure created by inter-agency collaborations has impacted providers’ way of serving clients in all the county. For example, MILPA’s partnership with the Public Defender’s office now extends to other services beyond those of the Prop 47 grant.
• Furthermore, other partnerships between service providers and other non-direct provider agencies like the California Highway Patrol with Sun Street Centers (through the Sobering Center), or CSUMB’s ICCS linkages with providers (through the grant’s evaluation) represent linkages that have the potential to strengthen the entire regional system of care and could translate into more innovative programing in the future.
ICCS future evaluative efforts will focus on assessing the project’s causal impact. We know that Prop 47 participants have positive outcomes. What would have happened with participants in the absence of the project? By identifying a counterfactual (comparison group) of clients with similar characteristics to those in the program that did not qualify for the program services, the difference in outcomes between participants and the comparison group can be assessed and that is the Prop 47 treatment effect.
This work supports the Monterey County Health Department 2018-2022 strategic plan initiatives: 1) Empower the community to improve health through programs, policies, and activities; and 2) Enhance community health and safety by emphasizing prevention. It also supports one of the ten essential public health services, specifically: 9) Evaluate effectiveness, accessibility, and quality of personal and population-based health services.
OTHER AGENCY INVOLVEMENT:
Monterey County Health Department, Behavioral Health Bureau, Monterey County Office of the Public Defender, Sun Street Centers, Housing Resource Center, and MILPA.
FINANCING:
Receiving this report will have no impact on the Health Department Behavioral Health Bureau’s FY 2023-2024 Adopted Budget nor to the General Fund.
BOARD OF SUPERVISORS STRATEGIC INITIATIVES:
Check the related Board of Supervisors Strategic Initiatives:
☐ Economic Development:
• Through collaboration, strengthen economic development to ensure a diversified and healthy economy.
☐ Administration:
• Promote an organization that practices efficient and effective resource management and is recognized for responsiveness, strong customer orientation, accountability and transparency.
☒ Health & Human Services:
• Improve health and quality of life through County supported policies, programs, and services; promoting access to equitable opportunities for healthy choices and healthy environments in collaboration with communities.
☒ Infrastructure:
• Plan and develop a sustainable, physical infrastructure that improves the quality of life for County residents and supports economic development results.
☒ Public Safety:
• Create a safe environment for people to achieve their potential, leading businesses and communities to thrive and grow by reducing violent crimes as well as crimes in general.
Prepared by:
Phil Sherwood, Behavioral Health Services Manager II, 647-7714
Melanie Rhodes, Deputy Director Behavioral Health, 796-1742
Katy Eckert, Behavioral Health Bureau Chief, 755-4580
Approved by:
________________________________Date_________________
Elsa Mendoza Jimenez, Director of Health Services, 755-4526
Attachments:
Board Report
Presentation