Title
Consider a preliminary analysis report in response to Board Referral No. 2024.16 seeking to establish on-site mental health services for children and families served at the SHARE Center and to modify the Memorandum of Understanding with the City of Salinas to require advance notice, input and agreement by the Board of Supervisors when there is a proposed change to the operator of the SHARE Center.
Report
RECOMMENDATION:
It is recommended that the County of Monterey Board of Supervisors:
a. Receive a preliminary analysis report in response to Board Referral No. 2024.16;
b. Provide direction on a preferred referral processing option:
i. Proceed with completion of referral as outlined in preliminary report;
ii. Proceed with completion of referral based on modifications by Board;
iii. Return to Board with a more comprehensive analysis of referral and anticipated effort for completion; or
iv. Rescind referral.
c. Provide further direction, as appropriate.
PRELIMINARY ANALYSIS:
Background:
Board Referral No. 2024.16 was assigned on December 3, 2024, to the Health Department, County Counsel, and County Administrative Office, to explore the need and opportunity to provide on site mental health services to families and individuals being served at the SHARE Center. Additionally, the referral requests modifications to the MOU between the County of Monterey and the City of Salinas for the operation of the SHARE Center, to ensure the Board of Supervisors is consulted prior to making any changes to the operation of the Center, and to require annual reporting of SHARE Center activities to the Board of Supervisors.
Project Description:
The SHARE Center is operated by the County of Monterey through its Department of Social Services in partnership with the City of Salinas. After a recent Request for Proposals, Community Human Services (CHS) was awarded the contract to serve as the operator of the SHARE Center.
Health Department staff reached out to CHS to better understand the status of mental health and substance use disorder needs and services being provided to the individuals and families being served at the SHARE Center. Currently, CHS staff assess all individuals being accepted for services at the SHARE Center. Individuals determined to need mental health and/or substance use disorder services are referred to behavioral health service providers’ clinic sites in the area with transportation being provided if needed. CHS is conducting a more thorough assessment of their data and will be sharing findings with Health Department staff to further discuss opportunities to better meet the individuals’ needs for behavioral health services. The data may indicate that CHS should continue the current approach of assessing individuals and making referrals to community service providers with transportation being provided if needed. The data may show a need to provide some services onsite via telehealth or other means. Or the data may suggest a need for substantial increased services onsite which would necessitate a modification to the existing Agreement between CHS and the Health Department for specialty mental health services.
As the overseer of the SHARE Center operations in collaboration with the City of Salinas, the Department of Social Services staff will ensure that the Board of Supervisors is kept apprised of any anticipated or planned changes to the operations and/or operator of the SHARE Center, and formal modifications to the MOU between the City of Salinas and the County of Monterey may not be required. Per the current operational agreement between DSS and CHS, CHS is required to provide an annual report to the County Board of Supervisors to include program outcomes, services delivered, challenges, and achievements. Specific indicators to be reported on include summary of client exits, reason and destination; number and percentage of unsheltered individuals who entered permanent housing; referral origin for person placed at SHARE Center; summary of guest satisfaction surveys; number and percentage of individuals connected to or maintaining enrollment in benefits by benefit type; amongst other data. DSS staff will ensure CHS is scheduled to present to the Board of Supervisors on an annual basis.
Estimated Project Cost:
Staff from the Health Department continue to have discussions with CHS, the current operator of the SHARE Center, to better understand the needs for mental health services of its guests. Once additional data is gathered and analyzed, the Health Department will be able to determine an estimated cost for provision of additional services. The Health Department anticipates having an estimated cost by early March 2025.
DSS does not anticipate any additional costs regarding keeping the Board of Supervisors timely apprised of any anticipated changes to the operations of the SHARE Center or to ensure annual reporting is completed by its operator.
Staffing Level Estimate:
Additional information needs to be gathered to better understand if additional staffing is needed. The Health Department anticipates having an estimate of additional staffing needs by early March 2025.
DSS does not anticipate having additional staffing needs to fulfill their obligations under this referral.
Departmental Challenges:
Health Department staff anticipate there may be some challenges in timely meeting the SHARE Centers’ individuals’ needs for onsite mental health services and/or continuing warm hand offs to community service providers due to behavioral health workforce challenges providers are experiencing. Staff also anticipate there may be a challenge in ensuring services can be sustained which is dependent on individuals’ health insurance/payor source(s).
DSS does not anticipate any challenges in fulfilling their obligations under this referral.
Proposed Response Date:
County staff will provide an updated response to this referral on March 11, 2025.
BOARD OF SUPERVISORS STRATEGIC INITIATIVES:
This recommendation advances the Board of Supervisors Health and Human Services Strategic Initiative and supports these key objectives: Reduce regional, socio-economic inequities in health outcomes; and improve health outcomes through health and wellness promotion and access to top quality healthcare.
Mark a check next to the related Board of Supervisors Strategic Initiatives
__Economic Development
__Administration
X Health & Human Services
__Infrastructure
__Public Safety
Prepared by: Elsa Mendoza Jimenez, MPH, Director of Health Services, 755-4526
Approved by: Debbie Paolinelli, Assistant County Administrative Officer, 755-5309
Attachments:
Preliminary Analysis Report
Board Referral No. # 2024.16