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 Aspire House for Clubhouse Services
RECOMMENDATION:
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Adopt a resolution authorizing an agreement with Aspire House to provide clubhouse services, for the term of July 1, 2026 through June 30, 2027, in an amount not to exceed $455,064.
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BACKGROUND:
In 2004, California voters passed Proposition 63, known as the Mental Health Services Act (MHSA), which made additional state funds available to expand and transform behavioral health services. Since 2006, this Board has approved MHSA resources and expenditures as part of the larger County Health budget.
In 2023, California voters passed Proposition 1, Behavioral Health Services Act (BHSA), which reformed MHSA, prioritizing evidence-based practices in behavioral health treatment and recovery supports. Consequently, the Centers of Medicare and Medicaid Services approved BH-CONNECT through a new Section 1115 demonstration and a series of new State Plan Amendments expanding Medi-Cal coverage of key evidence-based practices, including Clubhouse Services.
From April 2025 through November 2025, County Health’s Behavioral Health and Recovery Services (BHRS) engaged in a comprehensive community planning process to prioritize strategies for the required BHSA Three-Year Integrated Plan for FY 2026-27; the plan includes the prioritization of evidence-based practices inclusive of Clubhouse Services.
DISCUSSION:
Aspire House (Clubhouse) has provided evidence-based practice clubhouse services to BHRS clients since 2015. In FY 2024-25, the program served 146 unduplicated transition-age youth and adults. Members spent a total of 16,313 hours inside the Clubhouse, averaging 112 hours per member. The high engagement level is crucial as increased time fosters stronger connections to vital resources and the community, reducing social isolation and preventing mental illness from escalating into more severely disabling conditions.
Through this agreement, the Clubhouse shall continue to provide a membership-based community where adults living with serious mental illness find a network of support and skills needed to achieve social, financial, educational, and vocational goals. Participants share responsibility for the success of the Clubhouse by helping each other become productive members of society through motivation and shared experience. The Clubhouse provides a restorative environment in which members are offered support, training, education, healthy social interaction, and positive reinforcement through collegial relationships. In addition, the Clubhouse collaborates with other San Mateo County programs. Specifically, the Clubhouse acts as a hub, linking Clubhouse members to other service providers to expand their opportunities for education, employment, housing, and medical and psychiatric treatment in both the private and public sectors.
The Clubhouse empowers its members to take accountability for their recovery and help shape the programs offered. Members are involved in key leadership roles, including positions on the Board of Directors. They create and implement solutions for the community. By focusing on empowerment, community, and accessible support, the Clubhouse provides a proven pathway to recovery for the most vulnerable communities. The recovery and peer support provided in the Clubhouse model differ from other peer recovery and wellness approaches. It is characterized by the “work order day,” with an emphasis on members learning and practicing skills that can be used in the workplace. Members are expected to work, contribute to the Clubhouse operation, and eventually move to employment of their own in the community.
Clubhouse is one of only three Clubhouse International-accredited Clubhouses in California and the only one on the Bay Area Peninsula; the other two are in Contra Costa County and Marin County. Under the B-1 Administrative Memorandum, agreements that provide “sole source” services are exempt from the Request for Proposal process.
A waiver request was reviewed by County Procurement, which recommended submission to this Board for approval.
The County Attorney has reviewed and approved the agreement and resolution as to form.
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 Clubhouse fills gaps in support services, a primary strategy for BHSA in San Mateo County. It is anticipated that 90% of the total clients served will receive peer-support services.
PERFORMANCE MEASURE:
|
Measure |
FY 2025-26 Estimated |
FY 2026-27 Projected |
|
Percentage of clients served that received peer support services |
90% 145 of 160 Clients |
90% 158 of 176 Clients |
COMMUNITY IMPACT:
The services provided by the Clubhouse have and will positively impact diverse individuals living with serious mental illness across San Mateo County, as the Clubhouse provides the supports and skills needed to achieve social, financial, educational, and vocational goals of members. The demographics and languages of individuals served represent various ethnicities in our County. In addition, the Clubhouse has welcomed persons of all ages, from transition-age youth (5%) to adults (74%) and older adults (19%).
FISCAL IMPACT:
The term of this agreement is July 1, 2026 through June 30, 2027. The amount of the agreement is not to exceed $455,064 for the one-year term, and funds in that amount are included in the BHRS FY 2025-26 Recommended Budget. Of that amount, $227,532 will be funded by BHSA and $227,532 will be funded by Medi-Cal Patient Care Revenue. There is no Net County Cost.