To: Board of Supervisors
From: Anna Roth, Health Services Director
Report Title: Cancel Three (3) and Add Three (3) Positions to Behavioral Health Division in the Health Services Department
☒Recommendation of the County Administrator ☐ Recommendation of Board Committee
RECOMMENDATIONS:
ADOPT Position Adjustment Resolution No. 26369 to cancel one (1) vacant Pre Hospital Care Coordinator (VBSG) position (position #20324) at salary plan and grade ZZX 1001 ($12,483.69-$15,590.42), cancel one (1) vacant Medical Social Worker I (X4WB) position (position #20290) at salary plan and grade 255 1369 ($6,292.15-$7,648.15), cancel one (1) vacant MH Community Support Worker II (VQVB) position (position #20140) at salary plan and grade TC5 0968 ($4,090.32-$4,971.81), and add one (1) Clerk-Specialist Level (JWXD) at salary plan and grade 3RX 1156 ($5,258.45-$6,715.26), add one (1) Mental Health Program Manager (VQDC) at salary plan and grade ZA5 1844 ($9,737.47-$11,835.96) and add one (1) Planner & Evaluator- Level B (VCXD) at salary plan and grade ZB2 1323 ($6,587.89-$10,795.02) in the Health Services Department. (Represented) (50% Mental Health Realignment and 50% Federal Financial Participation)
FISCAL IMPACT:
Upon approval, this will result in an annual cost increase of $21,889.71 with an annual pension cost increase of $3,197.86. Funding will be split between Mental Health Realignment and Federal Financial Participation.
BACKGROUND:
CARE (Community, Assistance Recovery, and Empowerment) Court is aimed at assisting clients suffering from untreated mental health and substance use disorders leading to homelessness, incarceration or worse. CARE Court connects individuals struggling with untreated mental illness, and often also substance use challenges, with a court-ordered Care Plan for up to 24 months. Each plan is managed by a care team and can include clinically prescribed, individualized interventions with supportive services. CARE Court is a service the county must provide as mandated by the State.
The Clerk-Specialist Level will support the team by entering data into a data collection system. Data must be collected daily and reported to the State quarterly. This includes data from every CARE involved respondent. Data includes demographics of participants, housing placements, continuation of treatment information, and numerous data elements in the state Data Dictionary; a total of 93 elements. In addition, a timeline and calendar will need to be maintained starting at the point of a court order/petition being received to track all court dates, numerous types of report due dates, and client appointments for every client.
The Mental Health Program Manager will be responsible for overall supervision and training of the team, ensuring team members are assigned promptly for each new petition, coordination of team efforts to locate and make first contacts and provide timely service of hearing notice, act as point person for all communications to and from the court and petitioners, oversee coordination of care between all partnering agencies, maintain open communication with all justice partners, track timelines for reports due, maintain efficient system of data collection and reporting, and monitor timely and accurate time studies for billing non-Medical services.
Planner/Evaluator-Level B will ensure Behavioral Health meets the demands of CARE Court data reporting. The incumbent will be responsible for ongoing data collection from the various contributing data sources, management of the database, and administration of the submission of the required monthly reporting. Diligence in reporting for CARE Court is essential. Neglecting this critical area could likely result in sanctions. Regarding reimbursement for CARE Court, the State Department of Health Care Services (DHCS) Behavioral Health Information Notice 24-015 states that DHCS will reimburse for court hearing time, court reporting, outreach and engagement, drafting notices, and for data reporting. The data reporting includes, but is not limited to: demographics of participants, housing placements, continuation of treatment information, and other data. The data reporting requirements are intense in terms of content (91 separate dynamic variables) and frequency - monthly reporting of updated files. Most of the data for CARE Court is not native to existing data systems so tight data management will be critical to the integrity of the monthly submission.
CONSEQUENCE OF NEGATIVE ACTION:
If not approved, the program may risk not following state-mandated service and reporting requirements which could result in sanctions.