Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Colleen Chawla, Chief, San Mateo County Health
Jei Africa, Director, Behavioral Health and Recovery Services
Subject: Agreement with the Mental Health Association of San Mateo County for Housing and Housing-Related Mental Health Services, Rehabilitation Services, and Flexible Fund Administration
RECOMMENDATION:
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Adopt a resolution authorizing an agreement with the Mental Health Association of San Mateo County for housing and housing-related mental health services, rehabilitation services, and Flexible Fund administration for the term of June 1, 2025 through June 30, 2027, in an amount not to exceed $7,550,810.
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BACKGROUND:
For many years, the Mental Health Association of San Mateo County (MHA) has contracted with Behavioral Health and Recovery Services (BHRS) to provide shelter, supported housing, and other mental health rehabilitation services to County clients. These services focus primarily on providing community-based alternatives for BHRS clients who are at risk of an acute, inpatient psychiatric admission; placed in a locked skilled nursing facility; or becoming homeless. In addition, MHA administers the Flexible Funds, which may be used to purchase unique services for BHRS clients, such as food, shelter, clothing, and other basic necessities. MHA’s Flexible Funds help clients maintain independent living in the community, remain engaged in mental health services, and avoid hospitalization.
DISCUSSION:
MHA will continue to provide rehabilitation services for seriously mentally ill (SMI) adults with co-occurring disorders and emergency short-term housing at the Spring Street Emergency Shelter for homeless clients. MHA will also provide Shelter Plus Care Project coordination, operate the Friendship Center, and administer Flexible Funds for BHRS’ Adult and Older Adult Services and its Pathways Program. MHA will provide on-site housing supportive services to nine SMI adults who are either chronically homeless or at risk of chronic homelessness housed in the No Place Like Home housing units in East Palo Alto. MHA will also provide on-site housing support services to seventeen SMI adults in two new Mental Health Services housing projects located in San Mateo and East Palo Alto. Additionally, funding will allow Transition Age Youth clients who had no ability to pay rent at the time of admission to enter the housing support program while working toward financial self-sufficiency.
Under the Administrative Memorandum B-1, the selection of providers delivering housing and related support services for mental health clients is exempt from the Request for Proposal requirement. In order to improve service capacity, BHRS may contract for housing and related support services with any willing, qualified provider.
The resolution contains the County’s standard provisions allowing amendment of the County’s fiscal obligations by a maximum of $25,000 (in aggregate).
The agreement and resolution have been reviewed and approved by the County Attorney as to form.
It is anticipated that 97% of clients in supportive housing will not be hospitalized.
PERFORMANCE MEASURE:
|
Measure |
FY 2024-25 Estimated |
FY 2025-26 Projected |
|
Percentage of clients in supportive housing that are not hospitalized |
97% 223 clients |
97% 223 clients |
COMMUNITY IMPACT:
This contract will positively impact a critically underserved community of behavioral health clients who have SMI and traditionally have been underserved due to being unhoused and lacking a fixed place of residence, extremely low-income, and often disabled by mental illness or mental health conditions and substance use disorders. Under this contract, clients will benefit from outpatient services that will support their stabilization and recovery. Providers such as MHA are a vital resource for such individuals, as they have expertise in supporting unhoused populations and helping clients continue to be housed. Having this contract with MHA is instrumental in connecting clients to the critical services clients need, as well as providing support and direct assistance to safely keep them from utilizing emergency room services when they are not needed. This provider is committed to serving this population and supporting them with achieving their recovery goals.
FISCAL IMPACT:
The term of the agreement is June 1, 2025 through June 30, 2027. The amount of the agreement is not to exceed $7,550,810 for the two-year term. Funds in the amount of $3,664,408 are included in the FY 2025-26 Recommended Budget. Of the FY 2025-26 total amount, it is anticipated that $1,097,756 will be funded by the Mental Health Services Act, $1,026,405 will be funded by Medi-Cal revenue, $674,405 will be funded by 2011 Realignment, and $865,842 will be funded by Net County Cost. Similar arrangements will be made for the future years.
BHRS is changing the methodology used to pay contracted providers that are currently paid on a 1/12th, monthly advance. Specifically, BHRS is changing the payment methodology for most contracts to fee-for-service and payments will be made in arrears. Additionally, in previous fiscal years, BHRS was granted an exception to pay providers during the accounting “blackout period” in July and August. This exception will no longer be available.
To facilitate these changes, BHRS has agreed to one three-month pre-pay for July-September of FY 2025-26 to qualifying providers. This payment will be reconciled in November. This payment must be made in June 2025. However, to make this payment, an ATR is needed. One ATR for all the impacted contracts will be submitted on the May 22, 2025 Board agenda. There will be no pre-pays in subsequent fiscal years.