Title
a. Approve and authorize the Director of Health Services or designee to accept a grant award in the amount of $678,839 from the California Department of Health Care Services, (“DHCS”) by way of The Center at Sierra Health Foundation to support implementation of the behavioral health provisions of Proposition 36 (“Prop 36”), specifically those related to “treatment-mandated felonies”; and
b. Approve and authorize the Director of Health Services or designee to execute a non-standard Agreement retroactive due to awaiting of the FINAL Agreement with The Center at Sierra Health Foundation in the amount of $678,839 for the full-term of March 1, 2026 through March 31, 2028; and
c. Approve and authorize the Director of Health Services or designee to execute up to three (3) future amendments that do not exceed 10% ($67,883) of the original Agreement amount, do not significantly alter the scope of services.
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
a. Approve and authorize the Director of Health Services or designee to accept a grant award in the amount of $678,839 from the California Department of Health Care Services, (“DHCS”) by way of The Center at Sierra Health Foundation to support implementation of the behavioral health provisions of Proposition 36 (“Prop 36”), specifically those related to “treatment-mandated felonies”; and
b. Approve and authorize the Director of Health Services or designee to execute a non-standard Agreement retroactive due to awaiting of the FINAL Agreement with The Center at Sierra Health Foundation in the amount of $678,839 for the full-term of March 1, 2026 through March 31, 2028; and
c. Approve and authorize the Director of Health Services or designee to execute up to three (3) future amendments that do not exceed 10% ($67,883) of the original Agreement amount, do not significantly alter the scope of services.
SUMMARY:
In November 2024, California voters approved Proposition 36, the “Homelessness, Drug Addiction, and Theft Reduction Act.” The measure includes two primary components:
• Theft Reduction: Increases penalties for repeat theft offenses.
• Drug Treatment: Creates a “Treatment-Mandated Felony” for possession of certain drugs (e.g., fentanyl, methamphetamine, heroin, cocaine) if the individual has two or more prior drug convictions.
This funding is designated to support counties in implementing the behavioral health provisions of Proposition 36, specifically those related to "treatment-mandated felonies."
DISCUSSION:
Proposition 36 establishes a treatment-focused court process in which eligible individuals are offered court-ordered substance use and mental health treatment in lieu of incarceration. Successful completion of treatment results in dismissal of charges, emphasizing a health-based approach to justice involvement. The statutory intent is to create a structured, treatment-focused court process that prioritizes rehabilitation and recovery while enhancing public safety.
To facilitate local implementation of these behavioral health requirements, the California Department of Health Care Services (DHCS) has allocated $678,839.92 in non-competitive funding to Monterey County for the period of March 1, 2026, through March 31, 2028. The Center at Sierra Health Foundation is contracted with DHCS and is the administrative entity who oversees and supports the implementation of Prop 36 Behavioral Health grant funds. The funding is intended to build the operational capacity necessary to carry out the treatment-mandated felony provisions.
Local implementation will require enhancements to staffing, service delivery capacity, and coordination systems within the Behavioral Health Bureau (BHB). Grant funds will support expanded clinical assessment services, increased access to Medication-Assisted Treatment (MAT), crisis intervention, and individual and group counseling, as well as dedicated personnel to coordinate with the courts, probation, and other justice partners. Resources will also be used to strengthen data tracking, reporting processes, and cross-system workflows to ensure effective program oversight and compliance.
Approval of this item will position Monterey County to fulfill statutory obligations while advancing a coordinated, health-centered response for justice-involved individuals. This Agreement is retroactive to March 1, 2026, as Behavioral Health was waiting on The Center at Sierra Health Foundation to provide a FINAL Agreement for grant funding.
This work supports the following County of Monterey Health Department 2025-2028 Strategic Plan Goal(s): 2). Provide Exceptional Person-Centered Care through Accessible, Community-Focused Health Services. It also supports one of the ten essential public health services, specifically: 7) Link people to the needed personal health services and assure the provision of health care when otherwise unavailable.
OTHER AGENCY INVOLVEMENT/COMMITTEE ACTIONS:
The Office of County Counsel and Auditor Controller have reviewed and approved as to legal form and fiscal provisions, respectively.
FINANCING:
The total grant award is $678,839.92 for the period of March 1, 2026, through March 31, 2028. Funding is provided by DHCS through The Center at Sierra Health Foundation and will support eligible Behavioral Health Bureau costs associated with implementation of the behavioral health provisions of Proposition 36. Sufficient appropriations and estimated revenues are included in the Health Department Behavioral Health Bureau’s (1310-400005) FY 2026-27 Adopted Budget, with funding for subsequent fiscal years to be incorporated into the respective requested budgets. There is no impact to the County General Fund associated with approval of the recommended actions.
BOARD OF SUPERVISORS STRATEGIC PLAN GOALS:
Proposition 36 advances community well-being and quality of life by shifting eligible individuals with substance use disorders from incarceration to treatment. By prioritizing rehabilitation over punishment, it creates both individual and system-level benefits.
Mark a check next to the related Board of Supervisors Strategic Plan Goals:
X Well-Being and Quality of Life
____ Sustainable Infrastructure for the Present and Future
____ Safe and Resilient Communities
____ Diverse and Thriving Economy
Prepared by: Rose Moreno, Management Analyst III, 755-4716
Approved by: Elsa Mendoza Jimenez, Director of Health Services, 755-4526
Attachments:
Board Report
Agreement with The Center at Sierra Health Foundation