Title
a. Approve the implementation of Project 1701, Behavioral Health Alisal (East Salinas) Integrated Clinic (“Project”); and
b. Support the development of a Memorandum of Agreement (MOA) between the Health Department and the Department of Public Works, Facilities, and Parks (PWFP) to clearly stipulate the roles and responsibilities of the respective departments consistent with Monterey County Code Section 2.27.010.B.; and
c. Approve the allocation of $16,250,000 from the Building Improvement and Replacement Sub-Fund (478-BIR-1050-8539-CAO047) for financing of the Project (4/5ths vote required); and
d. Authorize and direct the Auditor-Controller to transfer $16,250,000 from the Building Improvement and Replacement Fund 478, Sub-fund BIR (478-BIR-1050-8539-CAO047) and $4,500,000 from the Behavioral Health Fund (023-4000-8410-HEA012-MHSACAP) to the Facility Master Plan Implementation Fund, (404-3200-8564-PFP057) (4/5ths vote required).
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
a. Approve the implementation of Project 1701, Behavioral Health Alisal (East Salinas) Integrated Clinic (“Project”); and
b. Support the development of a Memorandum of Agreement (MOA) between the Health Department and the Department of Public Works, Facilities, and Parks (PWFP) to clearly stipulate the roles and responsibilities of the respective departments consistent with Monterey County Code Section 2.27.010.B.; and
c. Approve the allocation of $16,250,000 from the Building Improvement and Replacement Sub-Fund (478-BIR-1050-8539-CAO047) for financing of the Project (4/5ths vote required); and
d. Authorize and direct the Auditor-Controller to transfer $16,250,000 from the Building Improvement and Replacement Fund 478, Sub-fund BIR (478-BIR-1050-8539-CAO047) and $4,500,000 from the Behavioral Health Fund (023-4000-8410-HEA012-MHSACAP) to the Facility Master Plan Implementation Fund, (404-3200-8564-PFP057) (4/5ths vote required).
SUMMARY/DISCUSSION:
Project 1701, Behavioral Health Alisal Integrated Clinic in East Salinas (hereafter, “Project” or “clinic”) has been in development since 2016 when the Board of Supervisors approved a property swap with the City of Salinas; the swap exchanged 312 East Alisal Street for 331 North Sanborn Road. The Health Department (Department) in its efforts to advance health equity has long sought opportunities to embed amid the communities it aims to serve, and this project provides such an opportunity. The Project’s main goal is to address the unmet needs for an integrated behavioral health/primary care clinic for the Alisal community. The Project’s location will remove or ease transportation as a barrier to services and allow the Department and its bureaus to engage the public, particularly Spanish speaking Latinx residents by meeting them where they are and thereby strengthen its relationship with the community. More importantly, the Project will allow the Department to deliver much needed comprehensive services that will help improve health outcomes for the Alisal community.
This Project has been in development and progressing slowly due to funding constraints. During this period, the Department has worked in conjunction with staff from the Department of Public Works, Facilities, and Parks (PWFP) to complete the design of the Project, a new 19,300 square foot two-story clinic. The clinic will provide 42 offices/workstations and seven (7) treatment rooms for use by the Behavioral Health Bureau (BHB), five (5) exam rooms and eight (8) workstations for use by the Clinics Services Bureau (CSB), a joint lobby/waiting area and a multipurpose room with direct access from the outside for use by other community agencies. The BHB will house Access and Children System of Care programs at this location. These programs will provide a full array of behavioral health services to the target client populations comprised of children, and individuals with short-term behavioral health issues. The CSB will offer comprehensive primary care and preventive services to children and adults.
If Project funding is approved, the Health Department and PWFP will develop a Memorandum of Agreement (MOA) to establish and clearly define the roles and responsibilities of the respective Departments consistent with Monterey County Code (MCC) Section 2.27.010.B.4 and MCC Section 2.27.010.B.5. which provide as follows:
MCC Section 2.27.010.B.
…(The) Public Works and Facilities Division…shall provide the following services in connection with its programs and activities:
B. 4. Delivery of infrastructure and services that provide for the public health and safety in transportation, public works, and utility services consistent with available funding;
B. 5. Engineering and capital planning services in support of County owned and leased facilities. (Emphasis Added).
The first detailed discussion about the Project and the respective roles and responsibilities of the Health Department and PWFP has occurred. PWFP will prepare the initial draft of the MOA consistent with MCC Section 2.27.010.B which will be circulated for further input by all parties. To maintain critical Project milestones, the Health Department is requesting that the Board approve the commitment of funds for the Project and provide direction to proceed with the Project. This will help the Health Department and PWFP move toward meeting the deliverables and timelines in the Project Funding Agreements.
In partnership with the County Administrative Office Budget & Analysis Division, the Department identified a viable financing structure which will allow construction of this Project entirely with local funds. The financing structure includes a combination of grant and Health Department funds, and funds from the Building Improvement and Replacement Sub-fund, which would be repaid over time. The Department requests Board approval to implement the Project with the identified financing structure, and for the allocation and transfer of funds from the Building Improvement and Replacement Fund to the Facility Master Plan Implementation Fund.
This Project received the support of the Capital Improvement Committee on March 8, 2021, and of the Budget Committee on March 31, 2021.
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 3. Ensure access to culturally and linguistically appropriate, customer-friendly, quality health services. It also supports one of the ten essential public health services, specifically: 1. Monitor health status to identify and solve community health problems; 2. Diagnose and investigate health problems and health hazards in the community; 3. Inform, educate, and empower people about health issues.
OTHER AGENCY INVOLVEMENT:
The Office of the County Counsel-Risk Manager has reviewed the staff report. The Health Department has worked with PWFP in the development of the Project design and with the County Administrative Office Budget & Analysis Division to identify additional local funds for the Project.
FINANCING:
The estimated Project total is $23.7 million, of which $848,000 has been incurred to date. The Department has secured $7.45 million for the construction of the new clinic as follows: $2.5 million are capital grant funds awarded by the Central California Alliance for Health (CCAH), $4.5 million of BHB one-time Mental Health Service Act (MHSA) funds reserved for capital needs, $150,000 from a development grant awarded by CCAH, and $300,000 BHB funds. The estimated remaining balance of $16.25 million will be financed with funds from the Building Improvement and Replacement sub-fund (478-BIR-1050-8539-CAO047) and will be transferred to the Facility Master Plan Implementation Fund (404-3200-8564-PFP-057) as the construction schedule dictates. The funds from the BIR will be repaid through the building depreciation expense allocated to the BHB in the annual Countywide Cost Allocation Plan (COWCAP). MHSA funds will be transferred from the Behavioral Health Fund (023-4000-8410-HEA012-MHSACAP) to the Facility Master Plan Implementation Fund (404-3200-8564-PFP-057) upon implementation of the Project in Fiscal Year (FY) 2021-22.
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: Miriam Y. Mendoza-Hernández, Finance Manager, 755-4622
Approved by:
______________________________Date:__________
Elsa Mendoza Jimenez, Director of Health, 755-4526
Approved by:
______________________________Date:___________
Randell Ishii, MS, PE, TE, PTOE, Director of PWFP, 784-5647