Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise F. Rogers, Chief, San Mateo County Health
Jei Africa, Director, Behavioral Health and Recovery Services
Subject: Recommendation to Apply for Prop 1 Bond Funds for the Non-Ambulatory Access Improvement Project at Serenity House
RECOMMENDATION:
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Adopt a resolution authorizing Behavioral Health & Recovery Services (BHRS) to apply for Proposition 1 Bond Revenues through the Behavioral Health Continuum Infrastructure Program (BHCIP) for the Non-Ambulatory Access Improvement Project at Serenity House.
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BACKGROUND:
The passage of Proposition 1 on the March 2024 ballot authorized the Behavioral Health Infrastructure Bond Act of 2024 (BHIBA), which is a $6.38 billion general obligation bond to develop an array of behavioral health treatment, residential care settings, and supportive housing to help provide appropriate care facilities for Californians experiencing mental health conditions and substance use disorders. The California Department of Health Care Services (DHCS) was authorized to award up to $4.4 billion in BHIBA funds for BHCIP competitive grants.
There are two BHCIP application rounds: Round 1 - Shovel Ready ($3.3 billion) and Round 2 - Unmet Needs ($1.1 billion). The application deadlines for Round 1 and Round 2 are December 13, 2024, and December 12, 2025, respectively. The application requires an authorizing resolution of the Board of Supervisors that permits submission of an application, participating in the BHCIP Round 1 Request for Applications, and naming the authorized signatory for the application and supporting documents.
DISCUSSION:
BHRS has developed two shovel ready proposals that it seeks to submit to the BHCIP Round 1 Request for Applications, one of which is the Non-Ambulatory Access Improvement Project at Serenity House. (We are bringing forward the other proposal separately, as each project requires its own application.) In 2021, BHRS was awarded a planning grant that was used to create a public engagement process to identify behavioral health infrastructure needs. This process included surveys, community meetings, focus groups with staff and contractors, key stakeholder interviews, and engagement with the Behavioral Health Commission. Providing access at Serenity House to the older adult non-ambulatory population, which currently cannot be accommodated, was identified as an important need.
Serenity House is a County-owned building located at the corner of 37th Avenue and Hacienda Street on the San Mateo Medical Center (SMMC) campus. It is a 13-bed short-term crisis residential treatment program for adults with a mental health diagnosis, including co-occurring substance use disorders, operated by Telecare Corp. It provides respite services that allow residents to find relief from distress, maintain stability, and emphasize choice-making skills and harm-reduction techniques. Serenity House helps divert people from entering SMMC Psychiatric Emergency Services (PES) and can serve as a stepdown from SMMC PES for individuals not ready to return home.
Serenity House has served the adult population successfully for a number of years now, but the Behavioral Health Commission raised as a barrier the fact that one of the admission prerequisites is that individuals must be ambulatory, and that this requirement limits access to a high-need portion of the adult population that would otherwise benefit from the program.
The improvement in non-ambulatory client access at Serenity House is a small project that will create big impact by expanding the eligible populations served by the facility and will add an endorsement to the facility licensure to allowing non-ambulatory patients. Currently, non-ambulatory residents cannot utilize the services at Serenity House because it is not equipped to meet the needs of this population. The installation of ADA compliant hardware and fixtures as well as ramps will allow the program to expand and accept individuals that are non-ambulatory. Expansion to include this population as eligible for Serenity House services will further divert persons from SMMC PES, expand step down options from SMMC PES, and address the unmet needs of this population.
Equity Impact:
Expanding to meet the respite needs of the non-ambulatory population provides this population with choices that allow these individuals to avoid hospital or inpatient care or PES and have their behavioral health needs addressed through a less intensive level, through a community-based service that was previously unavailable to them. This improves service options for a population that is 25% Latin, 25% Asian/Pacific Islander, 5% Black and 3% mixed race.
FISCAL IMPACT:
The Serenity House project is approximately $500,000 with a $50,000 local match that is 100% Mental Health Services Act funded and $450,000 that is 100% funded by the Prop 1 revenue bond. There is no Net County Cost associated with this plan.