To: Board of Supervisors
From: Dr. Ori Tzvieli, Interim Health Services Director
Report Title: Standard Agreement #78-078 with Department of State Hospitals
☒Recommendation of the County Administrator ☐ Recommendation of Board Committee
RECOMMENDATIONS:
APPROVE and AUTHORIZE the Interim Health Services Director, or designee, to execute on behalf of the County Standard Agreement #78-078 (State #24-79018-000) with the Department of State Hospitals (DSH) to pay County in an amount not to exceed $45,640,000 to participate in the Felony Incompetent to Stand Trial (IST) Mental Health Diversion program for the period March 1, 2025 through June 30, 2029.
FISCAL IMPACT:
Approval of this Agreement will result in an amount payable to County of $45,640,000 for the IST program from the DSH. (No County match)
BACKGROUND:
The California DSH manages the nation’s largest inpatient forensic mental health hospital system. DSH’s largest patient population includes individuals deemed by the courts to be IST and committed to DSH for competency restoration treatment. Individuals who are deemed IST can be restored to competency in inpatient treatment through a DSH facility, outpatient treatment through the Conditional Release Program (CONREP) or diverted into community mental health treatment through DSH’s Felony Mental Health Diversion Program. DSH’s Felony Mental Health Diversion program, allows felony IST defendants to participate in intensive community mental health treatment in lieu of inpatient DSH competency restoration treatment.
DSH has seen a persistent increase in the referral of IST individuals to DSH for competency restoration treatment. There has been a simultaneous increase in the number of unhoused and unsheltered individuals, many of whom experience symptoms of mental illness and co-occurring substance use disorders. DSH’s analysis of the factors driving the increase of individuals found IST on felony charges has been linked to an individual’s symptoms of serious mental illness or conditions of homelessness.
This Program was established to support the development and enhancement of community services to better address the factors that have been contributing to an increase in care in institutional settings. The goal of this Program is to support counties in connecting individuals to intensive and timely community treatment services, providing access to psychiatric and social stabilization services, and linking individuals to ongoing behavioral health and recovery services upon completion of the program with the result of continued engagement in wellness and recovery as well as increased independence in community settings. The intended outcome of the program is to provide felony IST defendants with ongoing community supports and mental health treatment to prevent the circumstances that led to arrest.
Approval of Standard Agreement #78-078 will allow County to receive funds for the IST program through June 30, 2029. This Agreement includes the County agreeing to indemnify the grantor for any claims arising out the performance of County under this Agreement.
CONSEQUENCE OF NEGATIVE ACTION:
If this Agreement is not approved, County will not receive funds to provide felony IST defendants with ongoing community supports and mental health treatment to prevent the circumstances that may lead to arrests.