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Affirm the submission of a California Department of Health Care Services grant application for the Providing Access and Transforming Health (PATH) Justice-Involved Reentry Initiative Round 3 program for planning and implementation of justice-involved pre-release services for individuals with mental health and substance use disorders; Accept the provisional PATH Justice-Involved Round 3 grant award of $1,191,233 for the period September 8, 2023 through December 31, 2026; and Delegate authority to the County Administrator to accept and execute all necessary documents associated with the grant application and grant agreement
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Published Notice Required? Yes ____ No _X _
Public Hearing Required? Yes ____ No _X _
DEPARTMENTAL RECOMMENDATION:
The Department of Health and Social Services (H&SS) recommends that the Board of Supervisors affirm the submission of a California Department of Health Care Services grant application for the Providing Access and Transforming Health (PATH) Justice-Involved Reentry Initiative Round 3 program for planning and implementation of justice-involved pre-release services for individuals with mental health and substance use disorders; Accept the provisional PATH Justice-Involved Round 3 grant award of $1,191,233 for the period September 8, 2023 through December 31, 2026; and Delegate authority to the County Administrator to accept and execute all necessary documents associated with the grant application and grant agreement.
SUMMARY:
The purpose of the PATH Justice-Involved Round 3 grant, known as Justice-Involved Reentry Initiative Capacity Building Program, is to assist participating entities in the delivery and the provision of the California Advancing and Innovating Medi-Cal (CalAIM) Justice Reentry Demonstration Initiative. The Department of Health Care Services (DHCS) envisions 90-day pre-release services as part of the initiative, which is mandatory per federal and state law and allows Medi-Cal enrollment assistance and pre-release coverage for certain services. This includes behavioral health services to promote continuity of care and to facilitate successful care transitions upon re-entry to communities. The demonstration initiative aims to address the needs of incarcerated beneficiaries as they near the end of their incarceration and re-enter the community, building a bridge to community-based care for justice-involved Medi-Cal members, offering them services to stabilize their condition(s) and establishing a re-entry plan for their community-based care to improve care transitions.
The Department of Health and Social Services’ Behavioral Health Division received a provisional award of $1,191,233 from the Department of Health Care Services (DHCS) under the Providing Access and Transforming Health (PATH) Justice-Involved Capacity Building Round 3 grant program to support collaborative planning and service linkages for persons with mental health and substance use disorder challenges being released from the jails. As a result of federal approval under CalAIM, this grant supports capacity building and services for pre-release and re-entry services in the 90 days prior to an individual’s release into the community. This funding will support Solano County Behavioral Health in implementing behavioral health linkages as mandated in California statute (AB 133 Chapter 143, Statutes of 2021).
FINANCIAL IMPACT:
PATH Round 3 funding distribution will be received as a percentage of total awarded funds based on milestones. Health and Social Services’ Behavioral Health Division has received 10% of the maximum award amount or $119,123 after the submitted grant application was reviewed and approved by DHCS. Upon DHCS’ review and approval of an implementation plan, 60% of the funding will be distributed, and the remaining 15% will be distributed upon review and approval of an interim progress report.
As a requirement of the PATH Justice-Involved Round 3 grant, Solano County Behavioral Health will develop an Implementation Plan that is due to DHCS by March 3, 2024. Appropriations and revenue associated with this grant are not included in the Department’s FY2023/24 Working Budget. After the Implementation Plan is developed/submitted and final notification of the award is received from DHCS, H&SS will assess if additional appropriations are needed in this fiscal year and may return to the Board at a later date to request approval of an Appropriations Transfer Request (ATR).
There is no impact to the County General Fund as 100% of the expenditures during the first two years will be covered with the PATH Justice-Involved Round 3 grant. Thereafter, expenditures will be funded through Realignment and Mental Health Services Act (MHSA) funds, and Medi-Cal reimbursement.
The costs associated with preparing the agenda item are nominal and absorbed by the Department’s FY2023/24 Working Budget. There is no additional impact to the County General Fund.
DISCUSSION:
On January 26, 2023, DHCS received federal approval under its California Advancing and Innovating Medi-Cal (CalAIM) 1115 Demonstration for Providing Access and Transforming Health (PATH) capacity building funds to support the Justice-Involved Reentry Initiative. This approval makes California the first state in the nation to get federal approval to waive the inmate exclusion and, as mandated in California statute (AB 133 Chapter 143, Statutes of 2021), to provide pre-release services in order to improve care transitions to the community for youth and adults in state prison, county jails, and youth correctional facilities. The approved CalAIM 1115 waiver authorized DHCS to disseminate up to $410 million in capacity building funds to support the collaborative planning and implementation of pre-release and re-entry services to incarcerated individuals in the 90 days prior to their release into the community.
Health and Social Services’ Behavioral Health Division applied for PATH Justice-Involved Reentry Initiative Capacity Building Program Round 3 grant funds and submitted an application to DHCS in July 2023.
On September 8, 2023, Solano County Behavioral Health received notification of a provisional award of $1,191,233 for the period of September 8, 2023 through December 31, 2026 to support the planning and implementation of targeted pre-release Medi-Cal services to incarcerated individuals who meet the eligibility criteria as outlined in the CalAIM Section 1115 Demonstration approval. This funding will support Solano County Behavioral Health in the implementation of a collaborative system that will offer behavioral health linkages to individuals to stabilize their condition(s) and establish a re-entry plan for their community-based care prior to release. PATH Justice-Involved Round 3 funds are intended to support personnel capacity, and to implement processes, protocols, and information technology system modifications that are necessary to implement or modify processes to support the provision of pre-release services.
Solano County Behavioral Health is currently working with consultants, and county and community partners in developing an implementation plan to submit to DHCS by March 3, 2024 that will address the unique and considerable behavioral health care needs of justice-involved individuals, improve outcomes, and deliver care more efficiently. DHCS contracted with Public Consulting Group (PCG) as the Third-Party Administrator (TPA) to support the administration and management of the Justice-Involved Reentry Initiative.
Solano County applied for a PATH Round 1 planning grant in July 2022 to support collaborative planning between county correctional agencies, H&SS, and other enrollment implementation partners. An allocation of $125,000 was awarded to the Sheriff’s Office on August 12, 2022.
A joint PATH Round 2 implementation grant application by H&SS, Sheriff’s Office, and Probation Department was submitted on March 29, 2023. The Board accepted a total of $1,623,083 in Round 2 implementation grant funds on June 27, 2023, with DHCS allocating $449,908 to H&SS and $1,173,175 to the Sheriff’s Office. This implementation grant allows H&SS, Sheriff’s Office, and the Probation Department to implement processes, protocols, and information technology system modifications necessary to comply with pre-release Medi-Cal enrollment and suspension mandates in accordance with AB 133, including establishing data sharing automation between the Sheriff’s Office and H&SS’ Employment and Eligibility Division computer systems, create sound business process design and process management to become fully compliant.
On October 24, 2023, the Board affirmed the Sheriff’s Office submission of their application for PATH Justice-Involved Reentry Initiative Round 3 grant funds. The Sheriff’s Office recently received a provisional award of $3.5 million from DHCS.
The PATH Justice-Involved Reentry Initiative Round 3 grant will provide funding to continue the planning and implementation targeting pre-release Medi-Cal services to individuals in county jails and youth correctional facilities who meet the eligibility criteria as outlined in CalAIM section 1115 demonstration (providing person centered care to integrate care coordination) and supports county behavioral health agencies in implementing behavioral health linkages. The provision of behavioral health-related pre-release services and linkages will be done in partnership with the Sheriff’s Office and Probation Department, and will support various focus areas, including clinical coordination, release planning, capacity, and/or data-sharing systems needed for collaborative planning and implementation to effectuate pre-release services.
This grant complements Solano Behavioral Health’s existing efforts supporting the behavioral health justice-involve population. Furthermore, the PATH Justice-Involved grant brings County partners together which include the Sheriff’s Office, Probation Department, H&SS’ Employment and Eligibility Division, as well as law enforcement, partners involved in the crisis continuum, and others to reduce unnecessary incarceration for those with mental health and substance use issues and early intervention services.
ALTERNATIVES:
The Board may choose not to accept the Department of Health Care Services’ PATH Round 3 provisional award of $1,191,233. This is not recommended as the provisional award will enable H&SS to comply with the CalAIM Justice-Involved Initiative which enhances services for justice-involved individuals.
OTHER AGENCY INVOLVEMENT:
The Department of Health and Social Services is working closely with the Sheriff's Office and Probation Department in the planning and development of this project and will continue to do so during implementation, along with additional system and community partners.
CAO RECOMMENDATION:
APPROVE DEPARTMENTAL RECOMMENDATION